A qualitative investigation into knowledge, beliefs, and practices surrounding mastitis in sub-Saharan Africa: what implications for vertical transmission of HIV?

BACKGROUND: Mastitis constitutes an important risk factor in HIV vertical transmission. Very little, however, is known on how women in sub-Saharan Africa conceptualise health problems related to breastfeeding, such as mastitis, and how they act when sick. We aimed at filling this gap in knowledge, by documenting the indigenous nosography of mastitis, health seeking behaviour, and remedies for prophylaxis and treatment in rural sub-Saharan Africa. METHODS: The study was conducted in the Nouna Health District, rural Burkina Faso. We employed a combination of in-depth individual interviews and focus group discussions reaching both women and guérisseuers. All material was transcribed, translated, and analysed inductively, applying data and analyst triangulation. RESULTS: Respondents perceived breast problems related to lactation to be highly prevalent and described a sequence of symptoms which resembles the biomedical understanding of pathologies related to breastfeeding, ranging from breast engorgement (stasis) to inflammation (mastitis) and infection (breast abscess). The aetiology of disease, however, differed from biomedical notions as both women and guerisseurs distinguished between "natural" and "unnatural" causes of health problems related to breastfeeding. To prevent and treat such pathologies, women used a combination of traditional and biomedical therapies, depending on the perceived cause of illness. In general, however, a marked preference for traditional systems of care was observed. CONCLUSION: Health problems related to breastfeeding are perceived to be very common in rural Burkina Faso. Further epidemiological research to assess the actual prevalence of such pathologies is urgently needed to inform the design of adequate control measures, especially given the impact of mastitis on HIV vertical transmission. Our investigation into local illness concepts and health care seeking behaviour is useful to ensure that such measures be culturally sensitive. Further research into the efficacy of local customs and traditional healing methods and their effect on viral load in breast milk is also urgently needed

Individual Shrink Wrapping of Zucchini Fruit Improves Postharvest Chilling Tolerance Associated with a Reduction in Ethylene Production and Oxidative Stress Metabolites

We have studied the effect of individual shrink wrapping (ISW) on the postharvest performance of refrigerated fruit from two zucchini cultivars that differ in their sensitivity to cold storage: Sinatra (more sensitive) and Natura (more tolerant). The fruit was individually shrink wrapped before storing at 4°C for 0, 7 and 14 days. Quality parameters, ethylene and CO2 productions, ethylene gene expression, and oxidative stress metabolites were assessed in shrink wrapped and non-wrapped fruit after conditioning the fruit for 6 hours at 20°C. ISW decreased significantly the postharvest deterioration of chilled zucchini in both cultivars. Weight loss was reduced to less than 1%, pitting symptoms were completely absent in ISW fruit at 7 days, and were less than 25% those of control fruits at 14 days of cold storage, and firmness loss was significantly reduced in the cultivar Sinatra. These enhancements in quality of ISW fruit were associated with a significant reduction in cold-induced ethylene production, in the respiration rate, and in the level of oxidative stress metabolites such as hydrogen peroxide and malonyldialdehyde (MDA). A detailed expression analysis of ethylene biosynthesis, perception and signaling genes demonstrated a downregulation of CpACS1 and CpACO1 genes in response to ISW, two genes that are upregulated by cold storage. However, the expression patterns of six other ethylene biosynthesis genes (CpACS2 to CpACS7) and five ethylene signal transduction pathway genes (CpCTR1, CpETR1, CpERS1, CpEIN3.1 and CpEN3.2), suggest that they do not play a major role in response to cold storage and ISW packaging. In conclusion, ISW zucchini packaging resulted in improved tolerance to chilling concomitantly with a reduction in oxidative stress, respiration rate and ethylene production, as well as in the expression of ethylene biosynthesis genes, but not of those involved in ethylene perception and sensitivity.This work was supported by grants AGL2011-30568-C02/ALI from the Spanish Ministry of Science and Innovation, and AGR1423 from the Consejería de Economía, Innovación y Ciencia, Junta de Andalucía, Spain. Z.M. acknowledges FPU program scholarships from MEC, Spain. S.M. is funded by grant PTA2011-479-I from the Spanish Ministry of Science and Innovation

Community cardiovascular disease risk from cross-sectional general practice clinical data: a spatial analysis

Contains fulltext : 154830.pdf (publisher's version ) (Open Access)INTRODUCTION: Cardiovascular disease (CVD) continues to be a leading cause of illness and death among adults worldwide. The objective of this study was to calculate a CVD risk score from general practice (GP) clinical records and assess spatial variations of CVD risk in communities. METHODS: We used GP clinical data for 4,740 men and women aged 30 to 74 years with no history of CVD. A 10-year absolute CVD risk score was calculated based on the Framingham risk equation. The individual risk scores were aggregated within each Statistical Area Level One (SA1) to predict the level of CVD risk in that area. Finally, the pattern of CVD risk was visualized to highlight communities with high and low risk of CVD. RESULTS: The overall 10-year risk of CVD in our sample population was 14.6% (95% confidence interval [CI], 14.3%-14.9%). Of the 4,740 patients in our study, 26.7% were at high risk, 29.8% were at moderate risk, and 43.5% were at low risk for CVD over 10 years. The proportion of patients at high risk for CVD was significantly higher in the communities of low socioeconomic status. CONCLUSION: This study illustrates methods to further explore prevalence, location, and correlates of CVD to identify communities of high levels of unmet need for cardiovascular care and to enable geographic targeting of effective interventions for enhancing early and timely detection and management of CVD in those communities

Extracorporeal photopheresis as a new supportive therapy for bronchiolitis obliterans syndrome after allogeneic stem cell transplantation

letter to the edito

Stem cells: sources and therapies.

stem cell biology today perspective

Cord blood derived endothelial progenitor cells: a superior buiding company in angiogenesis market.

Objective: Endothelial progenitor cells (EPCs) are a promising tool in regenerative medicine. We designed a comparative study of peripheral (adult, PB) versus umbilical cord blood (CB) derived EPCs in order to investigate the angiogenic properties of these two sources. Methods: Mononuclear cells (MNCs) were isolated from PB (n=4) and CB (<24 hours, n=4) and cultured on fibronectin-coated cell culture plates in endothelial cell culture medium until the formation of cobblestone-shaped colonies. Colony-derived cells were expanded for further investigation and their endothelial phenotype was confi rmed evaluating the uptake of Di-Iacetylated-low-density lipoprotein (Ac-LDL) and expression of endothelial cell-surface antigens (CD34, CD31, CD146, vWF, KDR) and CD45. Proliferation rates of CB and PB derived EPCs were determined using the MTT assay. The angiogenic properties of colony-derived EPCs were assessed by in vitro capillary-like network formation assay: early-passage cells were seeded (20,000 cells per well) onto 96-wells plates coated with Matrigel. Capillary-like network formation and maintenance were evaluated with an inverted microscope after 4-18-24-48-72 hours of incubation; images were taken from 3 random fields of Matrigel wells to assess the number of branch points per field to quantify the degree of tubulogenesis. Each experiment was performed in triplicate. Results: The median frequency of colonies obtained was higher in CB than PB (0.49/107MNCs vs 0.05/107MNCs) and CB-derived EPCs had higher proliferative potential than PB-derived EPCs. Both CB and PB colony-derived cells incorporated Ac-LDL, expressed the endothelial cell-surface antigens and were CD45-. Both CB and PB derived EPCs formed capillary-like structures in Matrigel, but CB-derived tubes formed earlier and more complex networks than PB-derived EPCs. Moreover, the number of branch points in CB-derived capillary-like networks was higher than PB-derived networks (16.3±4.3 vs 7.1±-2.6). Finally, CB-derived capillary-like networks were maintained for at least 72 hours, while PB-derived networks started to disassembly in 48 hours. Conclusion: Our study confirms the different clonogenic and proliferative potential of EPCs derived from PB and CB and demonstrates a superior angiogenic potential of CB-derived cells. Our preliminary data indicate that CB-derived EPCs have a better angiogenic potential than PB-derived EPCs and CB is a promising source of EPCs for regenerative medicine purpose

Cord blood derived endothelial progenitor cells: time dependent in vitro generation capacity.

OBJECTIVES. To test in vitro endothelial progenitor cells (EPCs) generation from fresh cord blood (CBs) cultured at different time after collection. MATERIALS AND METHODS. Mononuclear cells (MNCs) were isolated by density gradient centrifugation using Lympholyte Cell Separation Media (Cedarlane) from CBs collected for banking and discharged either for low TNC count or volume. 20 * 106 MNCs from CBs aged from 6 to 12 hours (group 1) and from 13 to 36 hours (group 2) were cultured in endothelial cell culture medium (EGM-2 Bulletkit, Lonza) on fibronectin-coated cell culture plates (Becton Dickinson) for maximum 20 days monitoring the appearance of EPC cobblestone-shaped colonies. The colony-derived cells (CDCs) were enumerated and studied by immunofluorescence and flow cytometry for typical endothelial markers as well as for capillary-like structures formation using the Matrigel assay (Becton Dickinson). RESULTS. MNCs from group 1 CBs gave rise to EPC colonies with a mean generation rate (ratio of CDCs / CD34+ seeded cells) of 29.3% (range, 12.1 – 38.9), while MNCs from group 2 CBs showed a 0% generation rate. Consistently with an EPC phenotype, CDCs were able to form vascular networks on extracellular matrix (Matrigel), showed Ac-LDL uptake and were positive for CD34, CD31, CD146, vWF, KDR and negative for CD45 markers. A positive correlation between EPCs generation rate and MNCs CD34+ cell content was observed; while the other parameters (including MNCs viability) seemed not to influence EPCs generation. CONCLUSIONS. Even if our data need to be confirmed in a larger study, our preliminary experience indicates that CBs may be an attractive source of EPCs and shows that EPCs generation is highly influenced by CB age. These biological features should be considered in planning regenerative medicine protocols

γ-Irradiated cord blood MNCs: Different paracrine effects on mature and progenitor endothelial cells

Cell-based therapies have been employed to promote neovascularization mainly through the release of paracrine factors inhibiting apoptosis and supporting migration and proliferation of resident differentiated cells. We tested in vitro pro-angiogenic effects of apoptotic cord blood-derived mononuclear cells (CB-MNCs) and their conditioned medium (CM) on mature endothelial cells (HUVECs) and peripheral blood-derived endothelial progenitor cells (ECFCs).CB-MNCs were γ-irradiated to induce apoptosis and cultured for 72. h to obtain the release of CM. MNCs viability, evaluated by flow cytometry, decreased progressively after γ-irradiation reaching 41% at 72. h. γ-Irradiated MNCs (γMNCs) released increasing amounts of EGF, PDGF-AB and VEGF in their CM over time, as assessed by ELISA. γ-MNCs and their CM enhanced capillary-like network formation (in a dose-dependent and time-persistent manner), proliferation and migration of HUVECs in vitro, while they primed capillary-like network formation (dose-independent and not time-persistent) and induced migration but did not support proliferation of ECFCs. Our data support the hypothesis of paracrine mechanism as prevalent in regenerative medicine and demonstrate the efficacy of MNCs secretome in inducing neovascularization. To our knowledge, this is the first paper highlighting differential pro-angiogenic effects of CM on mature and progenitor endothelial cells, adding a tile in the understanding of mechanisms involved in neovascularization. © 2014 Elsevier Inc