Environmental surface sampling of SARS-CoV-2 in selected hospitals in Malaysia.

COVID-19 has spread rapidly worldwide. The role of fomites in facilitating onward transmission is plausible. This study aimed to determine the presence of viable virus and its persistence on the surfaces of fomites in wards treating COVID-19 patients in Malaysia. This study was conducted in two stages. First, environmental sampling was performed on random days in the intensive care unit (ICU) and general wards. Then, in the second stage, samples were collected serially on alternate days for 7 days in two selected general wards. In Stage 1, a total of 104 samples were collected from the surfaces of highly touched and used areas by patients and healthcare workers. Only three samples were tested positive for SARS-COV-2. In Stage 2, three surface samples were detected positive, but no persistence of the virus was observed. However, none of the SARS-CoV-2 RNA was viable through tissue culture. Overall, the environmental contamination of SARS-CoV-2 was low in this hospital setting. Hospitals' strict infection control and the compliance of patients with wearing masks may have played a role in these findings, suggesting adherence to those measures to reduce occupational exposure of COVID-19 in hospital settings.

Environmental surface sampling of SARS-CoV-2 in selected hospitals in Malaysia

@#COVID-19 has spread rapidly worldwide. The role of fomites in facilitating onward transmission is plausible. This study aimed to determine the presence of viable virus and its persistence on the surfaces of fomites in wards treating COVID-19 patients in Malaysia. This study was conducted in two stages. First, environmental sampling was performed on random days in the intensive care unit (ICU) and general wards. Then, in the second stage, samples were collected serially on alternate days for 7 days in two selected general wards. In Stage 1, a total of 104 samples were collected from the surfaces of highly touched and used areas by patients and healthcare workers. Only three samples were tested positive for SARS-COV-2. In Stage 2, three surface samples were detected positive, but no persistence of the virus was observed. However, none of the SARS-CoV-2 RNA was viable through tissue culture. Overall, the environmental contamination of SARS-CoV-2 was low in this hospital setting. Hospitals’ strict infection control and the compliance of patients with wearing masks may have played a role in these findings, suggesting adherence to those measures to reduce occupational exposure of COVID-19 in hospital settings.

SPECT/CT lymphoscintigraphy of heterotopic cardiac grafts reveals novel sites of lymphatic drainage and T cell priming.

The normal function of lymphatic vessels is to facilitate the trafficking of antigen presenting cells to draining lymph nodes where they evoke an immune response. Donor lymphatic vessels are not connected to that of recipients' during organ transplantation. The pathophysiology of this disruption has received little attention. Murine heterotopic cardiac transplantation has been used extensively in transplantation research. Following vascularized organ transplantation, the main site of allosensitization is thought to be in the spleen of the recipient as a result of migration of donor passenger leukocytes via blood. Here, using Single Photon Emission Computed Tomography/Computerized Tomography (SPECT/CT) lymphoscintigraphy, we studied the pattern of lymphatic flow from mouse heterotopic abdominal cardiac grafts and identified mediastinal lymph nodes as the draining nodes for the donor graft. Staining with HY tetramer after transplantation of HY mismatched heart grafts and ELISPOT following allogeneic grafts to detect donor specific T cells revealed them as important sites for allosensitization. Our data indicates that mediastinal lymph nodes play a crucial role in the alloimmune response in this model, and should be used for ex vivo and adoptive transfer studies after transplantation in addition to the spleen.

An antibody combination that targets activated T cells extends graft survival in sensitized recipients.

Memory T cells are the very essence of adaptive immunity with their rapid and efficient response to antigen rechallenge and long-term persistence. However, it is becoming increasingly evident that when primed with self or transplanted tissue, these cells play a key role in causing and perpetuating tissue damage. Furthermore, current treatments, which efficiently control the naive response, have limited effects on primed T cells. We have used a treatment based on a combination of antibodies specific for molecules expressed by activated T lymphocytes to selectively remove these cells. This approach, which we termed multi-hit therapy, leads to cumulative binding of antibodies to the target T cells and a striking prolongation of skin graft survival in presensitized recipients in a stringent skin transplant model. The findings are consistent with the depletion of graft-specific CD4+ and CD8+ T cells, although other modes of action, such as T-cell regulation and altered migration could play a role. In conclusion, our therapeutic strategy controls primed T cells which are a major driving force in the pathology of many autoimmune diseases and in transplant rejection.

Mother-child HIV transmission: prevention options for women in developing countries.

PIP: Although over 90% of cases of maternal-child human immunodeficiency virus (HIV) transmission are in the Third World, these countries have lacked the resources to implement effective preventive strategies. The costs of testing women of reproductive age for HIV and counseling women who are HIV-positive about the risks of pregnancy are prohibitive. Even when these resources are available, financial dependence on men and traditional gender roles may impede women's ability to make sound decisions about childbearing and health. The antiretroviral drug zidovudine has been shown to reduce perinatal HIV transmission by two-thirds if given to women before, during, and after delivery, but its high cost prohibits widespread use in developing countries. Researchers are planning clinical trials to assess the efficacy of less costly short-term regimens during different stages of pregnancy, delivery, and breast feeding. Also under investigation is whether vitamin A supplementation reduces mother-child HIV transmission.^ieng

Tanzanian women's organizations respond to HIV / AIDS. Women's forum.

PIP: The cumulative number of AIDS cases reported to the National AIDS Control Program from Arusha rose from 579 in 1990 to 1599 in 1994. The Women's AIDS Control Society of Arusha (CHAWAKUA) is a 3-year-old, 100-member organization which educates the public about HIV/AIDS prevention, counsels people who are HIV-seropositive, distributes condoms, and provides child care, including orphan support. CHAWAKUA's goal is to empower women to cope with HIV infection and its effects by providing a forum in which infected women can openly share their experiences and console each other. CHAWAKUA is supported by members' entry and annual fees as well as in-kind contributions of food, clothing, and medicine. A similar organization in Kilimanjaro region, KIWAKKUKI, educates female adolescents about human relations, sexuality, and the consequences of teenage sexual relations. KIWAKKUKI also works with churches, schools, and youth groups; develops educational materials; and airs radio programs about HIV/AIDS.^ieng

Doppler-guided cannulation of the internal jugular vein: a prospective, randomized trial.

OBJECTIVES: The internal jugular vein (IJ) is commonly used as an access to the central venous system. Despite the high success rate for cannulation of the IJ, the incidence of complications (1% to 16%) has remained essentially the same, with most complications resulting from unintentional punctures of surrounding structures. In an attempt to reduce the complication rate of this technique, we evaluated the use of a Doppler-guided needle device to cannulate the IJ. METHODS: The study was performed on 41 patients scheduled for cardiothoracic or major vascular surgery requiring central vein cannulation as part of their anesthetic management. RESULTS: The number of needle advances in the Doppler group was 1.35 (SD 0.88) compared with 2.8 (SD 2.78) in the control group (p = 0.037). A significantly greater percentage of cannulations were successful on the first attempt in the Doppler group (85%), compared with the control group (55%) (95% CI for proportion = 0.3 to 0.57). CONCLUSION: The Doppler-guided cannulation technique can reduce the number of attempts required for successful IJ cannulation.