Genetic heterogeneity of hepatitis E virus in Darfur, Sudan, and neighboring Chad.

The within-outbreak diversity of hepatitis E virus (HEV) was studied during the outbreak of hepatitis E that occurred in Sudan in 2004. Specimens were collected from internally displaced persons living in a Sudanese refugee camp and two camps implanted in Chad. A comparison of the sequences in the ORF2 region of 23 Sudanese isolates and five HEV samples from the two Chadian camps displayed a high similarity (>99.7%) to strains belonging to Genotype 1. But four isolates collected in one of the Chadian camps were close to Genotype 2. Circulation of divergent strains argues for possible multiple sources of infection

An Extracellular Domain of the Insulin Receptor β-Subunit with Regulatory Function on Protein-Tyrosine Kinase

Abstract Anti-insulin receptor monoclonal antibody MA-10 inhibits insulin receptor autophosphorylation of purified rat liver insulin receptors without affecting insulin binding (Cordera, R., Andraghetti, G., Gherzi, R., Adezati, L., Montemurro, A., Lauro, R., Goldfine, I. D., and De Pirro, R. (1987) Endocrinology 121, 2007-2010). The effect of MA-10 on insulin receptor autophosphorylation and on two insulin actions (thymidine incorporation into DNA and receptor down-regulation) was investigated in rat hepatoma Fao cells. MA-10 inhibits insulin-stimulated receptor autophosphorylation, thymidine incorporation into DNA, and insulin-induced receptor down-regulation without affecting insulin receptor binding. We show that MA-10 binds to a site of rat insulin receptors different from the insulin binding site in intact Fao cells. Insulin does not inhibit MA-10 binding, and MA-10 does not inhibit insulin binding to rat Fao cells. Moreover, MA-10 binding to down-regulated cells is reduced to the same extent as insulin binding. In rat insulin receptors the MA-10 binding site has been tentatively localized in the extracellular part of the insulin receptor beta-subunit based on the following evidence: (i) MA-10 binds to insulin receptor in intact rat cells; (ii) MA-10 immunoprecipitates isolated insulin receptor beta-subunits labeled with both [35S]methionine and 32P; (iii) MA-10 reacts with rat insulin receptor beta-subunits by the method of immunoblotting, similar to an antipeptide antibody directed against the carboxyl terminus of the insulin receptor beta-subunit. Moreover, MA-10 inhibits autophosphorylation and protein-tyrosine kinase activity of reduced and purified insulin receptor beta-subunits. The finding that MA-10 inhibits insulin-stimulated receptor autophosphorylation and reduces insulin-stimulated thymidine incorporation into DNA and receptor down-regulation suggests that the extracellular part of the insulin receptor beta-subunit plays a role in the regulation of insulin receptor protein-tyrosine kinase activity

Euthanasia: from the perspective of HIV infected persons in Europe.

BACKGROUND: In the debate about legalization of euthanasia very little attention has so far been given to the opinion of the patient. OBJECTIVE: To assess the opinion of persons with HIV infection in Europe. METHODS: A cross-sectional survey of persons with HIV infection attending HIV/AIDS treatment centres or HIV support organizations in 11 European Union Member States was performed. A total of 2751 anonymous patient self-administered questionnaires were distributed between August 1996 and September 1997. The questionnaire contained 108 questions concerning a variety of topics about HIV care, including five questions on euthanasia. RESULTS: One thousand three hundred and seventy-one people with HIV infection completed the questionnaire, of whom 1341 (98%) responded to the questions concerning euthanasia. Seventy-eight percent of respondents agreed with the legalization of euthanasia in case of severe physical suffering, 47% if there was severe psychological suffering and 24% simply at the patient's request. For physical suffering and at a clear patient's request, accepted practices were: alleviation of pain with double effect (81%), medical euthanasia (62%) and physician assisted suicide (45%). Fifty percent would consider euthanasia for themselves if all treatment options were exhausted. Social indicators such as educational level and employment seemed to play a more significant role in determining attitudes towards legalization, and personal interest in, euthanasia than indicators related to disease status. CONCLUSION: In this study a majority of HIV infected persons in Europe favoured the legalization of euthanasia

Effect of two fasting periods of different duration on ghrelin response to a mixed meal.

The inhibitory effect of food on ghrelin secretion is reduced in several eating disorders such as restricting type anorexia nervosa, bulimia and obesity. These conditions are frequently characterised by irregular distribution of meals during the day. It is unknown whether two short fasting periods different duration affect ghrelin response to a mixed meal. Aim of the present study was to examine, in healthy volunteers, the effects of two fasting periods of different duration on pre- and post-prandial ghrelin concentrations after a standard mixed meal. Methods and results: Nine healthy men (mean ageGS.E.M., 25.1G0.2 years; mean body mass indexGS.E.M., 22.6G0.3 kg/m2) were studied in 2 days after 12 h of fasting (12F) and 17 h of fasting (17F) with a within-subject repeated measure design. On both days they ate a standardized mixed meal. Before each meal hunger rating was evaluated with a visual analogue score. Blood samples for ghrelin, insulin, and glucose were collected at 0, 45, 60, 90, 120, 150 and 180 min after meal. Comparing fasting values of 17F with 12F there was a significant increase in plasma ghrelin (160G20 vs. 146G18 fmol/mL, PZ0.015) and hunger rating (evaluated with a visual analogue scores) (7.0G0.3 vs. 5.1G0.4, P!0.003). A positive correlation between fasting ghrelin and hunger rating (rZ0.52, P!0.01) was found. Circulating ghrelin decreased after both meals without any significant difference in relation with the previous length of fasting. Also postmeal ghrelin AUC as well as fasting and postmeal concentrations of insulin and glucose were similar after 12F and 17F. Conclusions: In healthy subjects a longer fasting period increases ghrelin concentration but did not affect post-prandial ghrelin response to a mixed meal

WHO Regional Office for Europe guidance for influenza surveillance in humans.

Recent international mandates, and the emergent circulation of pandemic (H1N1) 2009 virus in human populations, call for strengthening influenza surveillance to better target seasonal influenza control programmes and support pandemic preparedness. This document provides technical guidance to establish sentinel site surveillance to assess the virologic and epidemiologic characteristics of respiratory disease leading to outpatient consultation or hospitalization that may be caused by influenza (seasonal or pandemic) or another respiratory virus. A simple, broad case definition for severe acute respiratory infection (SARI) is provided as a standard to enumerate severe influenza infections leading to hospitalization. Case definitions of influenza-like-illness (ILI) and acute respiratory infection (ARI) are proposed for the surveillance of outpatient illness related to mild influenza and other respiratory pathogens. This guidance document also contains practical suggestions for implementing hospital and outpatient-based site surveillance, including: criteria for selecting sentinel sites; forms for epidemiological data collection; procedures for collecting, testing, storing and transporting laboratory specimens; report templates for weekly and annual data summaries; and pandemic preparedness support functions. This document complements, not replaces Human infection with pandemic (H1N1) 2009 virus: updated interim WHO guidance on global surveillance. (aut.ref.