Scientific understanding of East African climate change from the HyCRISTAL project

Integrating Hydro-Climate Science into Policy Decisions for Climate-Resilient Infrastructure and Livelihoods in East Africa (HyCRISTAL) is a Future Climate for Africa (FCFA) project funded to deliver new understanding of East African climate change and its impacts, and to demonstrate use of climate change information in long-term decision-making in the region. Here, we briefly summarise key findings from HyCRISTAL so far on climate change, as well as key findings from the pan-African FCFA project “IMPALA” relevant to East Africa, both in the context of previous literature on the topic

Nosocomial outbreak of novel arenavirus infection, Southern Africa

A nosocomial outbreak of disease involving 5 patients, 4 of whom died, occurred in South Africa during September—October 2008. The first patient had been transferred from Zambia to South Africa for medical management. Three cases involved secondary spread of infection from the first patient, and 1 was a tertiary infection. A novel arenavirus was identified. The source of the first patient's infection remains undetermined

Scientific understanding of East African climate change from the HyCRISTAL project

Integrating Hydro-Climate Science into Policy Decisions for Climate-Resilient Infrastructure and Livelihoods in East Africa (HyCRISTAL) is a Future Climate for Africa (FCFA) project funded to deliver new understanding of East African climate change and its impacts, and to demonstrate use of climate change information in long-term decision-making in the region. Here, we briefly summarise key findings from HyCRISTAL so far on climate change, as well as key findings from the pan-African FCFA project “IMPALA” relevant to East Africa, both in the context of previous literature on the topic

Hyponatremic hypertensive syndrome (HHS) in an 18-month old-child presenting as malignant hypertension: a case report

BACKGROUND: The combination of hyponatremia and renovascular hypertension is called hyponatremic hypertensive syndrome (HHS). Malignant hypertension as a presentation has been reported in adults with HHS but is rare in children. CASE PRESENTATION: An eighteen month-old male presented with drowsiness, sudden onset status epilepticus and blood pressure of 210/160. The electrolytes on admission revealed sodium of 120 mEq/L and potassium of 2.1 mEq/L. The peripheral renin activity (PRA) was 172 ng/ml/min (normal 3–11 ng/ml/min) and serum aldosterone level was 91 ng/dl (normal 4 to 16 ng/dl). Patient underwent angioplasty with no success, followed by surgical correction. Two years since the diagnosis, the blood pressure is controlled with labetolol and amlodipine (at less than sixth of the pre-operative dosages). The PRA is 2.4 ng/ml/min and aldosterone 15.5 ng/dl. The child not only had three renal arteries on left but all of them were stenosed which to best of our knowledge has not been described. CONCLUSION: As uncommon as HHS with malignant hypertension may be in adults it is under-reported in children and purpose of the case report is to raise its awareness

Simulated response of the climate of eastern Africa to stratospheric aerosol intervention

Eastern Africa is vulnerable to extreme climate events, including droughts and floods, which are expected to become more frequent and intense in the future. This paper evaluates the potential of solar radiation management (SRM) with stratospheric aerosol injection (SAI) to influence the projected climate, including extreme events, over the region. The study utilized climate simulation outputs from the Community Earth System Model version 2 with the Whole Atmosphere Community Climate Model (CESM2-WACCM6) to assess future climate changes under two scenarios: one without Solar Aerosol Injection (SAI) following the SSP2-4.5 emissions pathway, and another with SAI, based on the first set of simulations from the Assessing Responses and Impacts of Solar Climate Intervention on the Earth System with Stratospheric Aerosol Injection (ARISE-SAI) project. The analysis of model performance was conducted for the 1981–2010 period, while future changes were assessed over two climatological periods: the near-term (2035–2054) and the mid-term (2050–2069). Changes in extreme temperatures and rainfall events were evaluated using four extreme indices: two for temperature (WSDI and DTR) and two for rainfall (CDD and CWD). Additionally, the Standardized Precipitation-Evapotranspiration Index (SPEI) was used to assess changes in the frequency of extreme wet and dry events. In the historical period, there is good agreement between the observed and simulated data in representing the spatial distribution of temperature and rainfall over the region, despite the slight overestimation and underestimation by the model in some areas. The model effectively captures the seasonal cycles of rainfall and temperature over the cities of interest. Analysis of future projections indicates that temperatures are projected to rise consistently in the future under the SSP2-4.5 scenario. However, SAI produces a steady trend in the four cities, suggesting SAI’s potential to counteract warming in Eastern Africa. Rainfall is projected to increase in the equatorial region compared to the reference period, while other areas remain stable. ARISE-SAI shows higher increases in rainfall during the MAM season but lower increases during the JJAS and OND seasons compared to SSP2-4.5. Overall, the study’s findings suggest that SAI technology could have a clear effect in reducing temperatures in Eastern Africa, both in the near- and mid-term futures. However, its impact on rainfall varies by region and season, indicating that further simulations with a wider range of scenarios and analyses are required to assess the robustness of these results. The results of this study should be interpreted cautiously since they are specific to the approach of SAI applied, the modelling experiments employed, and the scenarios considered

Il contributo degli esuli italiani alla riflessione sui caratteri dei totalitarismi: alcuni casi di studio

Il saggio esami la riflessione sviluppata da alcuni grandi esuli italiani sui caratteri dei totalitarism

Mixed cryoglobulinemia

Mixed cryoglobulinemia (MC), type II and type III, refers to the presence of circulating cryoprecipitable immune complexes in the serum and manifests clinically by a classical triad of purpura, weakness and arthralgias. It is considered to be a rare disorder, but its true prevalence remains unknown. The disease is more common in Southern Europe than in Northern Europe or Northern America. The prevalence of 'essential' MC is reported as approximately 1:100,000 (with a female-to-male ratio 3:1), but this term is now used to refer to a minority of MC patients only. MC is characterized by variable organ involvement including skin lesions (orthostatic purpura, ulcers), chronic hepatitis, membranoproliferative glomerulonephritis, peripheral neuropathy, diffuse vasculitis, and, less frequently, interstitial lung involvement and endocrine disorders. Some patients may develop lymphatic and hepatic malignancies, usually as a late complication. MC may be associated with numerous infectious or immunological diseases. When isolated, MC may represent a distinct disease, the so-called 'essential' MC. The etiopathogenesis of MC is not completely understood. Hepatitis C virus (HCV) infection is suggested to play a causative role, with the contribution of genetic and/or environmental factors. Moreover, MC may be associated with other infectious agents or immunological disorders, such as human immunodeficiency virus (HIV) infection or primary Sjögren's syndrome. Diagnosis is based on clinical and laboratory findings. Circulating mixed cryoglobulins, low C4 levels and orthostatic skin purpura are the hallmarks of the disease. Leukocytoclastic vasculitis involving medium- and, more often, small-sized blood vessels is the typical pathological finding, easily detectable by means of skin biopsy of recent vasculitic lesions. Differential diagnoses include a wide range of systemic, infectious and neoplastic disorders, mainly autoimmune hepatitis, Sjögren's syndrome, polyarthritis, and B-cell lymphomas. The first-line treatment of MC should focus on eradication of HCV by combined interferon-ribavirin treatment. Pathogenetic treatments (immunosuppressors, corticosteroids, and/or plasmapheresis) should be tailored to each patient according to the progression and severity of the clinical manifestations. Long-term monitoring is recommended in all MC patients to assure timely diagnosis and treatment of the life-threatening complications. The overall prognosis is poorer in patients with renal disease, liver failure, lymphoproliferative disease and malignancies

Immune signatures in human PBMCs of idiotypic vaccine for HCV-related lymphoproliferative disorders

Hepatitis C virus (HCV) is one of the major risk factors for chronic hepatitis, which may progress to cirrhosis and hepatocellular carcinoma, as well as for type II mixed cryoglobulinemia (MC), which may further evolve into an overt B-cell non-Hodgkin's lymphoma (NHL)

Successfully controlling malaria in South Africa

Following major successes in malaria control over the past 75 years, South Africa is now embarking on a malaria elimination campaign with the goal of zero local transmission by the year 2018. The key control elements have been intensive vector control, primarily through indoor residual spraying, case management based on parasitological diagnosis using evidence-based drug policies with artemisinin-based combination therapy since 2001, active health promotion in partnership with communities living in the malaria transmission areas, and cross-border collaborations. Political commitment and long-term funding for the malaria control programme have been a critical component of the programme’s success. Breaking the cycle of transmission through strengthening of active surveillance using sensitive molecular tests and field treatment of asymptomatic persons, monitoring for antimalarial drug resistance and insecticide resistance, strengthening cross-border initiatives, and ongoing programme advocacy in the face of a significant decrease in disease burden are key priorities for achieving the elimination goal.http://www.samj.org.zaam201