Can Diabetic Neuropathy Be Modeled In Vitro?

Diabetic neuropathy is a common secondary complication of diabetes that impacts on patient's health and well-being. Distal axon degeneration is a key feature of diabetic neuropathy, but the pathological changes which underlie axonal die-back are incompletely understood; despite decades of research a treatment has not yet been identified. Basic research must focus on understanding the complex mechanisms underlying changes that occur in the nervous system during diabetes. To this end, tissue culture techniques are invaluable as they enable researchers to examine the intricate mechanistic responses of cells to high glucose or other factors in order to better understand the pathogenesis of nerve dysfunction. This chapter describes the use of in vitro models to study a wide range of specific cellular effects pertaining to diabetic neuropathy including apoptosis, neurite outgrowth, neurodegeneration, activity, and bioenergetics. We consider problems associated with in vitro modeling and future refinement such as use of induced pluripotent stem cells and microfluidic technology.

Effect of a contact monitoring system with immediate visual feedback on hand hygiene compliance.

BACKGROUND: Hand hygiene compliance is traditionally monitored by visual methods that are open to bias and strictly limited in time and place. Automatic monitoring may be more effective for infection control as well as performance management. AIM: To establish accuracy and acceptability of an automatic contact monitoring system for hand hygiene. METHODS: Monitoring equipment was installed across 55 beds in three wards, and included modified identity badges, bedside furniture, sinks and alcohol gel dispensers. Badges were in near-skin contact (through uniform) and could detect alcohol vapour. All devices were linked by wi-fi. A traffic light system on the badge provided immediate feedback to staff and patients on the hand hygiene status of a member of staff on approach to a patient. Compliance was logged automatically. Following a period of immediate feedback, no visual feedback was given for two weeks. Subsequently, feedback was given using red/green lights for 10 days, followed by retrospective feedback to the ward. Hand hygiene was verified independently by an observer. FINDINGS: Hand hygiene compliance increased from 21% of 97 opportunities to 66% of 197 opportunities during active immediate feedback. Compliance decreased when feedback was provided to wards retrospectively. Six staff (26%) avoided wearing a badge, saying that it was too heavy or they were not on the ward all day. Only three of 30 patients stated that they would challenge staff who had not performed hand hygiene. CONCLUSIONS: Automatic contact monitoring with immediate feedback was effective in increasing hand hygiene compliance, but feedback given retrospectively did not prevent a decrease in compliance.

The prevalence of hepatitis Be antigen and anti-HBE in adults in Benin City.

Two hundred and seventy four adults in Benin City were screened for HBeAg in their sera using the ELISA method. The overall HBe-Antigenemia prevalence was 7.3%. 12.7% of adult males and 5.4% of 203 adult females were positive for HBeAg. Of the 91 samples available for screening for anti-HBe, an overall positivity rate of 8.8% was obtained. 10.3% of 68 adult males and 4.4% of 23 adult females were positive for anti-HBe. Reports of high carrier rate for Hepatitis B virus (HBV) markers in Nigeria is further confirmed. The high HBeAg positivity rate could further explain the high transmission rate of HBeAg from chronic carriers in this country. Compared to the Far East countries, Prevalence of HBe-antigenemia is relatively lower and may further confirm that the vertical, that is neonatal maternal infant hepatitis B virus transmission might play a less important role than the later horizontal transmission in this country. Therefore in considering immunization programme, the use of hepatitis B vaccine alone, without the additional, much more expensive hepatitis B Immunoglobulin (HBIG) might be an adequate prophylactic measure. The high HBe-antigenemia as well as the already well documented endemicity of hepatitis B virus in this country however calls for urgent steps to ensure introduction of this vaccine into neonatal practice in this country.

Amoebic liver abscess: the effect of aspiration on the resolution or healing time.

Recent sonographic monitoring of patients treated for amoebic liver abscess has shown the healing or resolution time varying between 10 and 300 days. The effect of percutaneous needle aspiration under or resolution time was studied in 36 patients. Nineteen patients had drugs and needle aspiration under ultrasound guide whilst the 17 patients had drugs--metronidazole, diloxanide, and chloroquine--alone. Both groups were monitored clinically and sonographically. Results showed that the abscess cavities of 18 out of 19 patients (94.7%) of the aspirated group and 10 of 17 patients (58.8%) of the non-aspirated group had resolved at the end of three weeks. The difference in response to treatment was significant (P less than 0.02) more so for lesion size more than 6 cm (P less than 0.01). There was also a more rapid clinical response in the aspirated group than in the non-aspirated group, particularly for patients whose lesion size was more than 6 cm (P less than 0.01). In conclusion, percutaneous needle aspiration is safe, enhances clinical recovery, and accelerates resolution particularly in patients with large abscess cavities.

Abdominal tuberculosis in pregnancy.

Two patients are described who presented with abdominal tuberculous ascites and hepatomegaly, one in the 2nd trimester of pregnancy who aborted and the other in the post partum period following a normal delivery. Both patients responded to anti-tuberculosis chemotherapy.