Evidence of a thyrotropin-releasing activity of ovine corticotropin-releasing factor in the domestic fowl (Gallus domesticus)

New tools to prevent malaria morbidity and mortality are needed to improve child survival in sub-Saharan Africa. Insecticide treated bednets (ITBN) have been shown, in one setting (The Gambia, West Africa), to reduce childhood mortality. To assess the impact of ITBN on child survival under different epidemiological and cultural conditions we conducted a community randomized, controlled trial of permethrin treated bednets (0.5 g/m2) among a rural population on the Kenyan Coast. Between 1991 and 1993 continuous community-based demographic surveillance linked to hospital-based in-patient surveillance identified all mortality and severe malaria morbidity events during a 2-year period among a population of over 11000 children under 5 years of age. In July 1993, 28 randomly selected communities were issued ITBN, instructed in their use and the nets re-impregnated every 6 months. The remaining 28 communities served as contemporaneous controls for the following 2 years, during which continuous demographic and hospital surveillance was maintained until the end of July 1995. The introduction of ITBN led to significant reductions in childhood mortality (PE 33%, CI 7-51%) and severe, life-threatening malaria among children aged 1-59 months (PE 44%, CI 19-62). These findings confirm the value of ITBN in improving child survival and provide the first evidence of their specific role in reducing severe morbidity from malaria.     

Examination and anatomy of the hand

In preparation for forthcoming chapters, the reader is offered a clear and thorough discussion of the anatomy of the hand, with important tips for examination and diagnosis.     

Mutational analysis of the A-kinase anchoring protein (AKAP)-binding site on RII. Classification Of side chain determinants for anchoring and isoform selective association with AKAPs

Compartmentalization of the type II cAMP-dependent protein kinase is conferred by interaction of the regulatory subunit (RII) with A-Kinase Anchoring Proteins (AKAPs). The AKAP-binding site involves amino-terminal residues on each RII protomer and is formed through dimerization. A site-directed mutagenesis strategy was utilized to assess the contribution of individual residues in either RII isoform, RIIalpha or RIIbeta, for interaction with various anchoring proteins. Substitution of long-chain or bulky hydrophobic groups (leucines or phenylalanines) for isoleucines at positions 3 and 5 in RIIalpha decreased AKAP-binding up to 24 +/- 3 (n = 8)-fold, whereas introduction of valines had minimal effects. Replacement with hydrophilic residues (serine or asparigine) at both positions abolished AKAP binding. Mutation of proline 6 in RIIalpha reduced binding for four AKAPs (Ht31, MAP2, AKAP79, and AKAP95) from 2.3 to 20-fold (n = 4) whereas introduction of an additional proline at position 6 in RIIbeta increased or conferred binding toward these anchoring proteins. Therefore, we conclude that beta-branched side chains at positions 3 and 5 are favored determinants for AKAP-binding and prolines at positions 6 and 7 increase or stabilize RIIalpha interaction with selected anchoring proteins.     

The treatment of peptic ulcer patients during exacerbation at the day hospital of an industrial enterprise polyclinic

Results are submitted of treatment of 659 patients with exacerbated peptic ulcer at an in-plant day in-patient facility. The basic therapy was hyperbaric oxygenation and ultraviolet irradiation of blood. The relapse rate over the year was 16%. A surgical operation was performed in 1.5% of those cases having completed the course treatment at the day in-patient facility, with 33.3% of patients having been operated on urgently, and 11.28% at a twenty-four-hour department; of these, in 85.62% cases operations were performed in situations of emergency needing prompt action. Duration of temporary disability in patients cared for at the day hospital was 21.3 days, while in those treated at a twenty-four-hour facility-27.8 days. Indications for hospitalization were of social character. Comparison of results of treatment, relapse rates and complications of ulcer disease in hospitalized patients versus those having been treated at a day-care facility gave arguments in favour of reorientation of treatment of major part of those patients experiencing exacerbation of ulcer disease at well equipped day-care in-patient facilities.