ABSTRACT
Merozoite surface proteins (MSPs) are critical for parasite invasion; they represent attractive targets for antibody-based protection against clinical malaria. To identify protection-associated target MSPs, the present study analysed antibody responses to whole merozoite extract (ME) and to defined MSP recombinant antigens in hospitalized patients from a low endemic urban area as a function of disease severity (mild versus cerebral malaria). Sera from 110 patients with confirmed severe cerebral malaria (CM) and 91 patients with mild malaria (MM) were analysed (mean age = 29 years) for total and subclass immunoglobulin (Ig)G to ME and total IgG to MSP1p19, MSP2, MSP3, MSP4 and MSP5 by enzyme-linked immunosorbent assay (ELISA). Functional antibody responses were evaluated using the antibody-dependent respiratory burst (ADRB) assay in a subset of sera. There was a trend towards higher IgG1 and IgG4 levels to ME in CM compared to MM; only ME IgM responses differed significantly between fatal and surviving CM patients. Increased prevalence of IgG to individual MSPs was found in the CM compared to the MM group, including significantly higher levels of IgG to MSP4 and MSP5 in the former. Sera from fatal (24·5%) versus surviving cases showed significantly lower IgG to MSP1p19 and MSP3 (P < 0·05). ADRB assay readouts correlated with high levels of anti-MSP IgG, and trended higher in sera from patients with surviving compared to fatal CM outcome (P = 0·07). These results document strong differential antibody responses to MSP antigens as targets of protective immunity against CM and in particular MSP1p19 and MSP3 as prognostic indicators.
Subject(s)
Antigens, Protozoan/immunology , Cell Extracts/immunology , Malaria, Cerebral/immunology , Malaria, Falciparum/immunology , Merozoites/immunology , Plasmodium falciparum/immunology , Urban Population , Adolescent , Adult , Aged , Antibodies, Protozoan/blood , Child , Child, Preschool , Disease Progression , Female , Hospitalization , Humans , Immunoglobulin M/blood , Infant , Malaria, Cerebral/mortality , Malaria, Falciparum/mortality , Male , Merozoite Surface Protein 1/immunology , Middle Aged , Recombinant Proteins/immunology , Survival Analysis , Treatment Outcome , Young AdultABSTRACT
Disaster situations involving mass burn casualties can occur at any time after a fire, a terrorist attack, an industrial explosion or a transport accident. The various burn societies in the world published recommendations on disaster burn-care planning. French burn society (Société Française d'Étude et de Traitement des Brûlures-SFETB) proposes triage of burned victims according to Total Burn Surface Area (TBSA), inhalation injury and associated traumatic injuries. This plan seeks to classify victims and to refer each burned patient to a bed suited to its needs (burn centre, surgical or medical ICU, Emergency room, surgical ward and triage). Emergency Medical Services play a pivotal role in this organisation: first care, advanced medical post, medical coordination, triage and transportation, additional equipment supply in proximal hospital. Burn disaster plan should be adapted to local medical resources.
ABSTRACT
Introduction: L'asthme aigu grave constitue une urgence medicale pouvant mettre en jeu le pronostic vital. L'objectif de ce travail est d'evaluer les aspects epidemiologiques; cliniques; paracliniques et therapeutiques de l'asthme aigu grave en reanimation .Patients et methode: Il s'agissait d'une etude retrospective ayant collige tous les patients de plus de 15 ans admis dans le service de reanimation de l'hopital Principal de Dakar entre octobre 2000 et octobre 2002 pour une crise d'asthme avec presence de criteres de gravite. Nous avions analyse les elements epidemiologiques; les aspects cliniques et paracliniques ainsi que les differentes modalites de prise en charge medicamenteuse et la ventilation artificielle.Resultats: Trente trois patients avaient ete inclus dans cette etude. L'age moyen etait de 44 ans avec un sex-ratio de 1;65. A l'admission 26des patients ventiles presentaient un silence auscultatoire; un etat de choc ou un coma avec score de Glasgow inferieur a 12. Au niveau de la gazometrie; on notait la presence d'une acidose de type respiratoire; metabolique ou mixte chez respectivement 48; 9et 12des patients. La ventilation assistee etait indiquee chez 45des patients. L'evolution etait le plus souvent favorable avec un taux de mortalite de 6.Conclusion: Le pronostic des patients admis dans un service de reanimation pour asthme aigu grave est favorable
Subject(s)
Asthma , Asthma/diagnosis , Asthma/epidemiologyABSTRACT
In an attempt to find a method of gastric mucosal damage assessment that yields consistent results, the experiments presented here employed the measurement of the movement of inulin out of the gastric contents into the stomach wall and vascular compartment as an estimate of mucosal damage. Anesthetized male Sprague-Dawley rats were functionally nephrectomized and were administered a control or test solution containing 3H-inulin. The test solutions contained one of three doses of aspirin. Blood samples were taken at 15-min intervals over a 90-min exposure period. The stomach was removed from the animal and full-thickness tissue samples taken for measurement of 3H-inulin content. When the gastric mucosa was exposed to the test agents, there was a significantly greater accumulation of inulin in the body and antrum as well as in the plasma when compared to controls. We conclude that intragastric inulin can be employed to estimate gastric mucosal damage.
