Substance abuse and maxillofacial injuries

Some of the major causes of maxillofacial injuries are assault/ inter-personal violence (IPV), motor vehicle accidents (MVAs), work-related injuries, sporting accidents and falls. However, the epidemiological data for the different types of injury vary significantly and are influenced by geographic location, socioeconomic status, the time of year when patients are assessed and the type of facility where the study is conducted. The 2012 Statistics South Africa's release document on 'mortality and causes of death in South Africa' indicated that 9.8% of all deaths in South Africa were reported as nonnatural. Transport accidents were the third most common (11.2%) reported cause of non-natural deaths followed by assaults at 10.2%. According to a number of international studies, the face is the most common site affected by assault- related trauma. Substance abuse is a major public health concern in South Africa and has also been rated as the leading health problem in the United States. Intoxication is also the most common denominator associated with violence and injury. In a Swiss study, Eggensperger found that almost a quarter of assault-related facial fractures were caused by people intoxicated with alcohol, illicit drugs or a combination thereof. This article explores epidemiologic data and relevant information related to maxillofacial trauma, specifically associated with alcohol and substance abuse.DHE

Oral medicine case book 67: Oral manifestations of Evans syndrome: a presenting feature of HIV infection?

A 19 year old female presented with spontaneous intra - oral bleeding of two days duration. The patient reported that she was, until recently, in good general health and also that she had an uncomplicated parturition three years ago. She recently started noticing blood in her stools and felt increasingly lethargic. There was no history of trauma or intra-oral intervention that may have initiated the bleeding. The clinical examination revealed marked pallor of the facial skin and multiple small petechiae were seen on both of her forearms. The intra-oral examination identified marked halitosis and multiple haemorrhagic lesions with a variable appearance, being plaque-like on the lip, nodular on the tongue and fungating and exophytic on the palate and in the retromolar regions. Even delicate manipulation of the tissues produced profuse bleeding.DHE

The antigenicity and cholesteroid nature of mycolic acids determined by recombinant chicken antibodies

<div><p>Mycolic acids (MA) are major, species-specific lipid components of Mycobacteria and related genera. In <i>Mycobacterium tuberculosis</i>, it is made up of alpha-, methoxy- and keto-MA, each with specific biological functions and conformational characteristics. Antibodies in tuberculosis (TB) patient sera respond differently towards the three MA classes and were reported to cross-react with cholesterol. To understand the antigenicity and cholesterol cross-reactivity of MA, we generated three different chicken -derived phage-displayed single-chain variable fragments (scFv) that reacted similarly towards the natural mixture of MA, but the first recognized all three classes of chemically synthetic MAs, the second only the two oxygenated types of MAs and the third only methoxy MA. The cholesterol cross-reactivity was investigated after grafting each of the three scFv types onto two configurations of constant chain domains–CH1-4 and CH2-4. Weak but significant cross-reactivity with cholesterol was found only with CH2-4 versions, notably those two that were also able to recognize the <i>trans</i>-keto MA. The cholesteroid nature of mycobacterial mycolic acids therefore seems to be determined by the <i>trans</i>-keto MA subclass. The significantly weaker binding to cholesterol in comparison to MA confirms the potential TB diagnostic application of these antibodies.</p></div

The burden of diabetes mellitus during pregnancy in low- and middle-income countries : a systematic review

Peer reviewedPublisher PD

The antigenicity and cholesteroid nature of mycolic acids determined by recombinant chicken antibodies

Mycolic acids (MA) are major, species-specific lipid components of Mycobacteria and related genera. In Mycobacterium tuberculosis, it is made up of alpha-, methoxy- and keto- MA, each with specific biological functions and conformational characteristics. Antibodies in tuberculosis (TB) patient sera respond differently towards the three MA classes and were reported to cross-react with cholesterol. To understand the antigenicity and cholesterol cross-reactivity of MA, we generated three different chicken -derived phage-displayed single- chain variable fragments (scFv) that reacted similarly towards the natural mixture of MA, but the first recognized all three classes of chemically synthetic MAs, the second only the two oxygenated types of MAs and the third only methoxy MA. The cholesterol cross-reactivity was investigated after grafting each of the three scFv types onto two configurations of constant chain domains±CH1-4 and CH2-4. Weak but significant cross-reactivity with cholesterol was found only with CH2-4 versions, notably those two that were also able to recognize the trans-keto MA. The cholesteroid nature of mycobacterial mycolic acids therefore seems to be determined by the trans-keto MA subclass. The significantly weaker binding to cholesterol in comparison to MA confirms the potential TB diagnostic application of these antibodies.S1 Fig. Sequences of gallibody clones produced by antibody engineering. 12) Anti-MA 12, 16) Anti-MA 16, 18) Anti-MA 18, CH1-4 = full length constant region, CH2-4 = truncated constant region, VH = variable heavy chain, VL = variable light chain.S2 Fig. SDS-PAGE analysis illustrating gallibody purification using Ni-NTA affinity columns. A) 12CH1-4, B) 16CH1-4, C) 18CH1-4, D) 12CH2-4, E) 16CH2-4, F) 18CH2-4. Gel lanes 1) Marker, 2) Culture supernatant, 3) Flow through 1, 4) Flow through 2, 5) Washes, 6) Elution 1, 7) Elution 2, 8) Elution 3, 9) Elution 4. Successful purification is demonstrated by the comparable thickness of the 67 kDa band obtained with the culture supernatant (2) and the elutions (6±9).S1 Dataset. Experimental data used for producing Figs 3 and 4.S2 Dataset. Experimental data used for producing Fig 5.S3 Dataset. Experimental data used for producing Fig 6.The Council for Scientific and Industrial Research (CSIR) parliamentary grants (YL) and the National Research Foundation of South Africa for the grants, unique grant numbers: 99386 (HR), 88622, 80577 (YL) and TTK1206281756 (LN).http://www.plosone.orgam2018Biochemistr

Dementia in Africa: Current evidence, knowledge gaps, and future directions

\ua9 2021 the Alzheimer\u27s Association. In tandem with the ever-increasing aging population in low and middle-income countries, the burden of dementia is rising on the African continent. Dementia prevalence varies from 2.3% to 20.0% and incidence rates are 13.3 per 1000 person-years with increasing mortality in parts of rapidly transforming Africa. Differences in nutrition, cardiovascular factors, comorbidities, infections, mortality, and detection likely contribute to lower incidence. Alzheimer\u27s disease, vascular dementia, and human immunodeficiency virus/acquired immunodeficiency syndrome–associated neurocognitive disorders are the most common dementia subtypes. Comprehensive longitudinal studies with robust methodology and regional coverage would provide more reliable information. The apolipoprotein E (APOE) ε4 allele is most studied but has shown differential effects within African ancestry compared to Caucasian. More candidate gene and genome-wide association studies are needed to relate to dementia phenotypes. Validated culture-sensitive cognitive tools not influenced by education and language differences are critically needed for implementation across multidisciplinary groupings such as the proposed African Dementia Consortium

Diffuse duodenal nodular lymphoid hyperplasia: a large cohort of patients etiologically related to Helicobacter pylori infection

Abstract Background Nodular lymphoid hyperplasia of gastrointestinal tract is a rare disorder, often associated with immunodeficiency syndromes. There are no published reports of its association with Helicobacter pylori infection. Methods From March 2005 till February 2010, we prospectively followed all patients with diffuse duodenal nodular lymphoid hyperplasia (DDNLH). Patients underwent esophagogastroduodenoscopy with targeted biopsies, colonoscopy, and small bowel video capsule endoscopy. Duodenal nodular lesions were graded from 0 to 4 based on their size and density. Patients were screened for celiac sprue (IgA endomysial antibody), immunoglobulin abnormalities (immunoglobulin levels & serum protein electrophoresis), small intestine bacterial overgrowth (lactulose hydrogen breath test), and Helicobacter pylori infection (rapid urease test, and histological examination of gastric biopsies). Patients infected with Helicobacter pylori received sequential antibiotic therapy and eradication of infection was evaluated by 14C urea breath test. Follow up duodenoscopies with biopsies were performed to ascertain resolution of nodular lesions. Results Forty patients (Males 23, females 17; mean age ± 1SD 35.6 ± 14.6 years) with DDNLH were studied. Patients presented with epigastric pain, vomiting, and weight loss. Esophagogastroduodenoscopy showed diffuse nodular lesions (size varying from 2 to 5 mm or more) of varying grades (mean score ± 1SD 2.70 ± 0.84) involving postbulbar duodenum. Video capsule endoscopies revealed nodular disease exclusively limited to duodenum. None of the patients had immunoglobulin deficiency or small intestine bacterial overgrowth or positive IgA endomysial antibodies. All patients were infected with Helicobacter pylori infection. Sequential antibiotic therapy eradicated Helicobacter pylori infection in 26 patients. Follow up duodenoscopies in these patients showed significant reduction of duodenal nodular lesions score (2.69 ± 0.79 to 1.50 ± 1.10; p Helicobacter pylori infection showed no significant reduction of nodular lesions score (2.71 ± 0.96 to 2.64 ± 1.15; p = 0.58). Nodules partially regressed in score in 2 patients, showed no interval change in 10 patients and progressed in 2 patients. Conclusions We report on a large cohort of patients with DDNLH, etiologically related to Helicobacter pylori infection.</p

MIGHTEE-HI : discovery of an H I-rich galaxy group at z = 0.044 with MeerKAT

We present the serendipitous discovery of a galaxy group in the XMM-LSS field with MIGHTEE Early Science observations. 20 galaxies are detected in H I in this z ∼ 0.044 group, with a 3σ column density sensitivity of NH I = 1.6 × 1020 cm−2. This group has not been previously identified, despite residing in a well-studied extragalactic legacy field. We present spatially resolved H I total intensity and velocity maps for each of the objects which reveal environmental influence through disturbed morphologies. The group has a dynamical mass of log10(Mdyn/M) = 12.32, and is unusually gas-rich, with an H I-to-stellar mass ratio of log10(f ∗ H I ) = −0.2, which is 0.7 dex greater than expected. The group’s high H I content, spatial, velocity, and identified galaxy type distributions strongly suggest that it is in the early stages of its assembly. The discovery of this galaxy group is an example of the importance of mapping spatially resolved H I in a wide range of environments, including galaxy groups. This scientific goal has been dramatically enhanced by the high sensitivity, large field-of-view, and wide instantaneous bandwidth of the MeerKAT telescope.http://mnras.oxfordjournals.orgpm2021Physic

Stem cell transplant in immune-deficiency-associated vaccine-derived poliovirus

Patients with severe primary immunodeficiency are at risk for complications from live-attenuated vaccines. Here, we report a case of a vaccine-associated paralytic polio and Bacille Calmette-Guérin disease in a 6-month-old girl with severe combined immunodeficiency resulting from homozygous recombinant activating gene 1 deficiency. The patient was successfully treated with intravenous immunoglobulins and oral pocapavir for poliovirus, and antimycobacterial therapy for regional Bacille Calmette-Guérin disease, allowing stem cell transplant. Following transplantation, poliovirus type 3 with 13 mutations was detected from cerebrospinal fluid but not from stool, indicating ongoing viral evolution in the central nervous system despite pocapavir treatment. Clinical improvement and immune reconstitution allowed the patient to be successfully discharged with no further detection of poliovirus.https://academic.oup.com/ofidhj2024Medical VirologyPaediatrics and Child HealthSDG-03:Good heatlh and well-bein

Enrolling adolescents in HIV vaccine trials: reflections on legal complexities from South Africa

<p>Abstract</p> <p>Background</p> <p>South Africa is likely to be the first country in the world to host an adolescent HIV vaccine trial. Adolescents may be enrolled in late 2007. In the development and review of adolescent HIV vaccine trial protocols there are many complexities to consider, and much work to be done if these important trials are to become a reality.</p> <p>Discussion</p> <p>This article sets out essential requirements for the lawful conduct of adolescent research in South Africa including compliance with consent requirements, child protection laws, and processes for the ethical and regulatory approval of research.</p> <p>Summary</p> <p>This article outlines likely complexities for researchers and research ethics committees, including determining that trial interventions meet current risk standards for child research. Explicit recommendations are made for role-players in other jurisdictions who may also be planning such trials. This article concludes with concrete steps for implementing these important trials in South Africa and other jurisdictions, including planning for consent processes; delineating privacy rights; compiling information necessary for ethics committees to assess risks to child participants; training trial site staff to recognize when disclosures trig mandatory reporting response; networking among relevant ethics commitees; and lobbying the National Regulatory Authority for guidance.</p