Telepathology in emerging countries pilot project between Italy and Egypt

Pathological examination includes gross & microscopic examinations at different magnification. Through the steps of examination, we obtain many images that can be used for telepathology. Telepathology is the practice of pathology at a distance, viewing images on a monitor rather than directly through a light microscope. It can be used for primary diagnosis, second opinion, quality assurance and distance learning. Telepathology is classified into Static, Dynamic, Hybrid and Whole Slide Imaging (WSI). We have a successful experience in Egypt in applying the static & dynamic techniques in a pilot project between the Italian Hospital in Cairo (NPO) and the Civico Hospital in Palermo. This project began in 2003 and continued till now. From the second year 2004, Ospedale S. Giovanni e Paolo Hospital in Venice, Charing Cross Hospital in London and the University of Pittsburgh Medical Center Health System (UPMC) in the USA participated actively in our project. During the past five years we consulted on many problematic pathological cases with these different specialized pathological centers in Italy, UK & USA. In addition to the highly specialized scientific value of consulting on the cases and exchanging knowledge, we saved a lot of time and money and succeeded in providing our patients with a better medical service.We are now in the process of establishing a Digital Telepathology Center (DTC) in the pathology department, Cairo University, using the latest technique of telepathology which is Whole Slide Imaging (WSI). We believe that it will help us to improve and extend diagnosis for our difficult pathological cases and will facilitate increased E-learning opportunities for staff and students both in Egypt and in the longer term in the wider Eastern Mediterranean.     

Paramecium genome survey: a pilot project

A consortium of laboratories undertook a pilot sequencing project to gain insight into the genome of Paramecium. Plasmid-end sequencing of DNA fragments from the somatic nucleus together with similarity searches identified 722 potential protein-coding genes. High gene density and uniform small intron size make random sequencing of somatic chromosomes a cost-effective strategy for gene discovery in this organism.     

Outcomes of a pilot fish telemetry workshop for developing countries

Fisheries management is a crucial issue worldwide, but it is proportionally more crucial in developing countries that rely heavily on inland fisheries. Management requires proper knowledge of fish behaviour and habitat use, as can be achieved through telemetry techniques, although these are most rarely used in tropical regions. Here we report briefly on the outcomes of a pilot workshop and training course aiming at improving technology transfer and capacity building, laying the stress on strengths and weaknesses of this approach, as evaluated by trainees.     

HIV-associated neurocognitive disorders in sub-Saharan Africa: a pilot study in Cameroon

Background

The disease burden of human immunodeficiency virus (HIV) - acquired immunodeficiency syndrome (AIDS) is highest in sub-Saharan Africa but there are few studies on the associated neurocognitive disorders in this region. The objectives of this study were to determine whether Western neuropsychological (NP) methods are appropriate for use in Cameroon, and to evaluate cognitive function in a sample of HIV-infected adults.

Methods

We used a battery of 19 NP measures in a cross-sectional study with 44 HIV+ adults and 44 demographically matched HIV- controls, to explore the validity of these NP measures in Cameroon, and evaluate the effect of viral infection on seven cognitive ability domains.

Results

In this pilot study, the global mean z-score on the NP battery showed worse overall cognition in the HIV+ individuals. Significantly lower performance was seen in the HIV+ sample on tests of executive function, speed of information processing, working memory, and psychomotor speed. HIV+ participants with AIDS performed worse than those with less advanced HIV disease.

Conclusions

Similar to findings in Western cohorts, our results in Cameroon suggest that HIV infection, particularly in advanced stages, is associated with worse performance on standardized, Western neurocognitive tests. The tests used here appear to be promising for studying NeuroAIDS in sub-Saharan Africa.     

Infertility in developing countries: funding the project

³ Correspondence address. E-mail: hnsallam{at}link.net Assisting developing countries in establishing infertility servicesis not a uniform exercise and depends on the stage of developmentof each country. Three levels of assistance are suggested: providingbasic (level 1), advanced (level 2) or tertiary referral infertilityservices (level 3). At each of these levels, four activitiesare needed: equipping the clinics, training the staff, educatingthe public and running the services. Basic (level 1) clinicscan be equipped by international donors, whereas level 2 and3 clinics can be funded through a partnership between an internationalscientific body (WHO, ESHRE, etc.) and an international bank(World Bank, African Development Bank, etc.). Training of themedical and paramedical staff should be the responsibility ofthe non-profit organizations (NPOs) preferably in regional trainingcenters. An awareness campaign is necessary to educate the publicand inform them of the range of treatment available in theircommunity and can also be funded by NPOs. Finally, the runningcost of the services including the staff salaries, the costof the investigations and medication should be the responsibilityof the local government, although in many countries, this hasto come from out of pocket payments.     

Psychoeducational groups for youth attention-deficit hyperactivity disorder: a family medicine pilot project

Attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed behavioural disorder of youth and is estimated to affect ～4% of school-age children. Although medication is the most common and efficacious treatment for ADHD, some experts believe that multimodal treatment strategies help children improve symptoms more than medicine alone. Psychoeducational strategies focus on educating youth and families about a given disorder. This study compared youth who participated with their parents in a five-session, one-hour psychoeducational group at a family medicine clinic and those who received customary treatment and were on a waiting list for the intervention. Findings of youth behaviour from parent and teacher perspectives were compared at the outset of the group and one month after group completion using the Vanderbilt scales. Results revealed that youth in both conditions improved over the two months of the study from the parent perspective in terms of all ADHD symptoms (e.g. inattention, hyperactivity/impulsivity) and in terms of school functioning. However, no gains were made in youth functioning or ADHD behaviour from the teacher perspective. Youth in the treatment group made modest gains in school performance from the parent perspective when compared with youth in the control condition. The results suggest that parents of ADHD youth should be involved in the treatment process to maximise the likelihood of improvement. Psychoeducational groups can be of modest benefit to help educate parents and youth regarding the challenges of ADHD management.     

Maternal serum alpha-fetoprotein screening: report of a Canadian pilot project.

A pilot project of maternal serum alpha-fetoprotein (MSAFP) screening was carried out in Ontario from 1982 to 1985 to examine the feasibility and acceptability of screening a prenatal population for open fetal neural tube defects. A total of 8140 patients at low genetic risk were screened. Patient acceptance was excellent. Blood samples were taken at 16 to 18 weeks'' gestation. If the MSAFP level was elevated, the assay was repeated and an ultrasound examination performed. Amniocentesis was offered to 67 women with unexplained persistently elevated levels. The outcome of pregnancy was known in 7473 patients (91.8%). Seven of nine known open fetal neural tube defects were detected. All were confirmed, and no unaffected fetuses were aborted on the basis of the screening results. The rates of perinatal death (6.7%), intrauterine growth retardation (11.7%) and prematurity (23.3%) were significantly higher among the patients with unexplained elevated MSAFP levels than among those with normal levels (p less than 0.001). Of 20 patients with unexplained low levels, 10 subsequently had spontaneous abortions and 10 gave birth to term appropriate-for-gestational-age infants. Seven of nine patients who gave birth to infants with autosomal trisomy had MSAFP values below the median. The findings indicate that MSAFP screening is feasible, accurate and acceptable in a low-risk area.     

Meso-scale ecology of anthrax in southern Africa: a pilot study of diversity and clustering

It has only recently been possible to detect sufficient genetic diversity among anthrax isolates to allow genotype grouping (Keim et al. 1997). Early results of such grouping suggest that the southern African subcontinent may be the geographical origin of Bacillus anthracis. This report describes a pilot investigation of the genetic diversity of a study group of isolates from the Kruger National Park, South Africa, and efforts to detect spatio-temporal clustering within the study group. This study has also served as further validation for the newly developed Multi-Locus VNTR Analysis (MLVA), designed to simplify genotyping of B. anthracis isolates. The results reveal a diverse range of genotypes within the park allied with three genotype reference groups, and show that the MLVA procedure is robust for rapid analysis of B. anthracis genotypes. We also observed multiple genotype groups within epidemics and between geographically and temporally close epidemic episodes. This is in contrast to earlier characterizations of anthrax epidemics. The result of a Mantel test for time-space clustering indicates clustering of the anthrax isolates selected for the study.     

Towards the development of a macroinvertebrate sampling technique for palustrine wetlands in South Africa: a pilot investigation in the KwaZuluNatal midlands

A study was undertaken in November 2003 to derive a suitable sampling technique for collecting a representative sample of aquatic macroinvertebrates from a selected emergent vegetation biotope in a palustrine wetland, Melmoth Vlei, KwaZulu-Natal, South Africa. The aim was to undertake a preliminary investigation on the development and testing of a macroinvertebrate sampling technique for use in emergent sedge-dominated palustrine wetlands (sensu Cowardin et al. 1979), which could contribute to the development of a South African wetland health biomonitoring programme. Sweep nets and activity traps were evaluated for their effectiveness in terms of macroinvertebrate collection. Sweep net sampling was tested over a range of sweep intensities to determine the minimum number of sweeps required to collect a representative sample. Sampling efficiency of activity traps placed at four depths was tested, and taxon diversity and composition of sweep net and activity trap samples were compared to determine whether activity traps are required to supplement sweep net data. A total of 32 taxa (identified mainly to family level) were identified in the samples collected. Taxon diversity and composition did not differ in the activity traps placed at the four depth locations. Taxon diversity did not differ significantly between different sweep intensities. This may be a result of high variability of macroinvertebrate distribution within a wetland. There is evidence, however, to suggest that this result is due to an inadequate sample size. There was a significant difference in taxon composition between the different sweep intensities (P < 0.05) and between activity trap and sweep net samples (P < 0.05). Sixty-eight percent of taxa appeared more frequently in sweep net sampling than in activity trap sampling. Two taxa were found exclusively in activity traps, although the numbers of these taxa collected were not significant, and they do not represent any unique trophic group. Based on these findings, it was concluded that activity traps are not required to supplement sweep net data, and a technique using a sweep net with a sweep intensity of five would be suitable for collecting a representative sample of macroinvertebrates from a palustrine wetland.     

Sex differences in obesity rates in poor countries: Evidence from South Africa

Globally, men and women face markedly different risks of obesity. In all but of handful of (primarily Western European) countries, obesity is much more prevalent among women than men. We examine several potential explanations for this phenomenon. We analyze differences between men and women in reports and effects of potential underlying causes of obesity—childhood and adult poverty, depression, and attitudes about obesity. We evaluate the evidence for each explanation using data collected in an urban African township in the Cape Town metropolitan area. Three factors explain the greater obesity rates we find among women. Women who were nutritionally deprived as children are significantly more likely to be obese as adults, while men who were deprived as children face no greater risk. In addition, women of higher adult socioeconomic status are significantly more likely to be obese, which is not true for men. These two factors - childhood circumstances and adult SES - can fully explain the difference in obesity rates between men and women that we find in our sample. More speculatively, in South Africa, women's perceptions of an ‘ideal’ female body are larger than men's perceptions of the ‘ideal’ male body, and individuals with larger ‘ideal’ body images are significantly more likely to be obese.