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Biomedical subjects

B Bain

Publications and source records attributed to B Bain.

At least 19 recordsLinked to original sources

Human immunodeficiency virus type-1 (HIV-1) subtypes in Jamaica.

The subtypes of 141 isolates of human immunodeficiency virus type-1 (HIV-1) from Jamaica were determined by a combination of env and gag heteroduplex mobility analysis (HMA) genotyping. The majority of HIV-1 isolates were subtype B (131/141, 93.0%); one (0.8%) isolate each of subtypes C, D and E was found and 7 (4.9%) were indeterminate. These results and the failure of the sets of primers used to amplify some of the HIV-1 isolates provide strong evidence of genetic diversity of the HIV/AIDS epidemic in Jamaica. Surveillance of the circulating HIV-1 genetic subtypes is a pre-requisite for developing regional vaccine strategies and understanding the transmission patterns of the virus. This is the first study of its kind in Jamaica and the findings complement data from other Caribbean countries. This work supports the view of colleagues from the French and Spanish-speaking Caribbean that an epidemiological network supported by regional laboratories will help track this epidemic accurately with positive outcomes for the public.

DNA, Viral↗

Socio-demographic and clinical characteristics of Jamaican adolescents with HIV/AIDS.

BACKGROUND: Clinical symptomatology and socio-demographic factors have not been characterized in Jamaican adolescents with HIV/AIDS. METHODS: We studied these factors in 25 HIV-positive Jamaican adolescents, 10-19 years of age, who were seen at the Centre for HIV/AIDS Research, Education, and Services (CHARES) between the years 1996 and 2002. Data were collected between June 2003 and August 2003 from CHARES social work files and The University Hospital of the West Indies (UHWI) medical records. Microsoft Excel was used to compile descriptive statistics for the data. RESULTS: The mean age of HIV diagnosis was 15.6 (+/-3.09) years, and the mean age of enrollment at CHARES was 16.3 (+/- 2.9) years. Consensual sexual intercourse was the most prominent mode of transmission (56%), followed by vertical transmission (16%), unknown (16%), forced sexual intercourse (8%), and blood transfusion (4%). The predominant clinical presentations among these adolescent patients were generalized dermatitis (77.2%) and lymphadenopathy (50%). Of the patients for whom clinical status could be determined, 70% were "Severely Symptomatic ". Of these patients only 14% were recommended for antiretroviral treatment. CONCLUSIONS: These findings reinforce the need to globally incorporate the goal of the 2002 Joint United Nations Programme on HIV/AIDS (UNAIDS) "to provide reproductive health services, including low-cost or free condoms, voluntary counselling and testing, diagnosis and treatment of sexually transmitted diseases and infections for adolescents in order to effectively prevent HIV infection " (1).

Acquired Immunodeficiency Syndrome↗

A serosurvey of hepatitis B virus, hepatitis C virus, human T lymphotropic virus type-1 and syphilis in HIV-1-infected patients in Jamaica.

The seroprevalences of hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotropic virus type-1 (HTLV-1) and syphyilis were determined in 129 HIV-1-infected patients using commercially prepared reagents. The seroprevalences were HCV, 0% (0/129); HBV, 37% (48/129); HTLV-1, 5% (6/129) and syphilis, 20% (26/129). Fifteen per cent (19/129) of the patients had active/chronic HBV infection. The seroprevalence of HBV was statistically significantly higher in HIV-1 infected men (24/49, 50% versus 17/80, 21%; p = 0.005), while the seroprevalence of syphilis was statistically significantly increased in HIV-1 infected patients in the over-40 age group (10/31, 32% versus 6/53, 11%; p = 0.05). These findings throw the spotlight on HBV infection and syphilis and suggest that these two sexually transmitted infections should be carefully surveyed in patients with HIV/AIDS in Jamaica. It is essential for management protocols in Jamaica to include screening for evidence of these co-infections.

Adult↗

Acute erythremic myelosis (true erythroleukaemia): a variant of AML FAB-M6.

AIMS: Classic erythroleukaemia (acute myeloid leukaemia M6, or M6 AML) is defined as an excess of myeloblasts in an erythroid predominant background. Leukaemia variants in which the primitive blast cells are demonstrably erythroid are extremely rare and poorly characterised. Variably referred to as "true erythroleukaemia" or "acute erythremic myelosis", they are often included within the M6 AML category even though they do not meet strict criteria for this type of AML. METHODS: Two cases of acute erythroid neoplasia are presented with clinical, morphological, immunophenotypic, and cytogenetic analysis. RESULTS: Both patients presented with profound anaemia, one in a setting of long standing myelodysplasia. Bone marrow examination revealed a predominant population of highly dysplastic erythroid cells in both cases. In one case, the liver was infiltrated by neoplastic erythroid cells. Both patients died within four months of diagnosis. CONCLUSIONS: This report illustrates that cases of acute leukaemia occur in which the dominant neoplastic cell is a primitive erythroid cell without an accompanying increase in myeloblasts. This does not preclude the neoplastic clone originating in a multipotent haemopoietic stem cell, as suggested by cases arising in patients with myelodysplasia. Acute erythremic myelosis should be recognised as a distinct variant of M6 AML.

Adult↗

Haemophagocytic syndrome and histiocytic necrotising lymphadenitis (Kikuchi's disease).

A young boy presented with a rash, fever, and cervical lymphadenopathy, originally thought to be caused by tuberculosis. A lymph node biopsy showed the features of Kikuchi's disease, with necrosis and histiocytic infiltration without neutrophils. No evidence of tuberculosis was found on staining, culture, or the polymerase chain reaction. Bone marrow biopsy revealed prominent haemophagocytosis, and a diagnosis of haemophagocytic syndrome was reached. The aetiology of haemophagocytic syndrome, and its association with Kikuchi's lymphadenitis, is discussed.

Bone Marrow↗

Judgments of grammaticality of sentences with a differing number of arguments: a comparison of English and Japanese speakers.

This study explored native speakers' linguistic intuition as revealed in judging the grammaticality of sentences. Speakers of English (n = 36) and Japanese (n = 57) judged the relative grammaticality of sentences involving a verb which occurred together with one, two or three arguments. Findings showed that English speakers were more affected by the number of arguments in sentences. They judged sentences having three arguments as grammatical most often and ones having one or two arguments as grammatical less often. However, Japanese speakers gave rather similar and more grammatical judgments regardless of the number of arguments in sentences. The findings indicate a difference in tightness of argument structure in the two languages even when the sentences judged are simple sentences and they are given without any sentential context.

Adolescent↗

Identification of the t(15;17) in AML FAB types other than M3: evaluation of the role of molecular screening for the PML/RARalpha rearrangement in newly diagnosed AML. The Medical Research Council (MRC) Adult Leukaemia Working Party.

Acute promyelocytic leukaemia (APL) is characterized by the t(15;17) leading to the formation of PML-RARalpha and RARalpha-PML fusion genes; this rearrangement has been considered both diagnostic for, and restricted to, this subtype of acute myeloid leukaemia (AML FAB M3). We describe two cases of AML with the t(15;17) associated with a PML/RARalpha rearrangement which lacked typical APL morphology, classified as FAB M1 and M2 respectively. In both cases morphological review revealed small populations of cells which exhibited some features associated with APL. In the case classified as M1, PML immunofluorescence studies revealed the classic microparticulate nuclear staining pattern as observed in typical cases of APL with the t(15;17). Similarly, blasts from this case were found to be sensitive to ATRA in vitro as determined by NBT reduction test and by normalization of the PML nuclear body staining pattern. To determine the frequency of PML/RARalpha rearrangements in FAB subtypes other than M3, 530 patients from the MRC AML trials were screened using nested RT-PCR. Only one individual, initially classified as M5 with a normal karyotype, was found to have a PML/RARalpha rearrangement. The diagnosis was revised to M3 variant on subsequent morphological review. In conclusion, this study demonstrates that, in rare cases, the t(15;17) is not restricted to patients with M3 morphology as defined by current FAB criteria. Therefore, although we consider cytogenetic analysis of newly diagnosed cases of AML to be mandatory, our data suggests that routine molecular screening for PML/RARalpha rearrangements is not justified and should be reserved for those cases displaying features which may be suspicious of APL even if such cells comprise only a minority of the total population.

Adolescent↗

Experiences and socialization of Jamaican men with multiple sex partners.

One of the goals of the Acquired Immunodeficiency Syndrome (AIDS) control programme in Jamaica is to encourage persons to have a single sex partner. Before this can be achieved in men, it is important to identify the demographic characteristics as well as the sexual attitudes and socialization of men who have multiple sex partners. A national survey was conducted on sexual decision-making in Jamaica in which a random sample of 3,001 persons was selected for study and of 2,580 (86%) interviewed 979 were men. The following analyses included the 769 men who were sexually active. Thirty-four per cent (34%), 95% CI, 30.6-37.4%) of these men said that they were currently having sex with more than one woman. Although condom use was higher in men with multiple sex partners, 33% of them said that they never used condoms. Independent predictors of having multiple sex partners were: not being in a stable union; being raised by fathers only; and having a secondary school education. There was no significant association with church attendance or with occupation. Compared with other males, men who had multiple sex partners started having sex at an earlier age and were more likely to engage in high-risk sex behaviours such as having sex with prostitutes and abusing drugs prior to coitus. They were also more likely to believe in the use of sex as a means to control their partners and were less likely to think that being married or involved in a long-term relationship was important. These data must be taken into consideration by the AIDS control programme in Jamaica when formulating policies to promote monogamy. There may also be a need to implement parenting support or education programmes for single men who raise their sons.

Adolescent↗

Respiratory muscle fatigue during simulated air combat maneuvering (SACM).

HYPOTHESIS: This study tested the hypothesis that respiratory muscle fatigue occurs during a simulated air combat maneuver (SACM) centrifuge profile. METHODS: Six subjects (four males, two females) were exposed to a SACM consisting of alternating +4 Gz to +7 Gz plateaus until volitional fatigue. Electrical activities of the diaphragm, scalene, intercostal and external oblique muscles were monitored along with esophageal pressure and ventilation. RESULTS: SACM times averaged 358 +/- 115 s. The mean frequency of the electromyographic signal of the diaphragm and scalenes during inspiration, and the intercostals during the static expiratory portion of the anti-G straining maneuver (AGSM), decreased significantly (p < 0.05) over the course of the SACM by about 9%, 10% and 4%, respectively, indicating muscle fatigue. Esophageal pressure (PES) during the straining portion of the AGSM decreased significantly from 72 +/- 20 to 66 +/- 21 mmHg (mean +/- SD). Ventilation increased significantly both at +4 Gz and +7 Gz (32 +/- 16 L.min-1 to 56 +/- 19 L.min-1 at +4 Gz and 27 +/- 5 to 35 +/- 9 L.min-1 at +7 Gz) over time. PES during a maximal AGSM at +1.4 Gz (baseline) was decreased post- vs. pre-SACM (p = 0.0575). PES exerted during a maximal static inspiratory maneuver at residual lung volume was not changed after the SACM. Inspiratory work increased significantly during the SACM. The elastance of the respiratory system did not change during the SACM, but it was significantly increased when tested after the SACM. CONCLUSION: Increased inspiratory work, decreased pressure generation during a maximal AGSM and EMG frequency shifts suggest respiratory muscle fatigue coincides with the termination of SACM.

Acceleration↗

Working women's sexual risk taking in Jamaica.

Although the rates of HIV are increasing among female populations in developing countries, there is little information available about factors influencing sexual risk taking among working class women. This paper describes some of the issues discussed by two groups of 58 women working in Jamaica: Informal Commercial Importers and women working in the Freezone. These women discuss their economic vulnerability, expectations about the role of men as providers, multiple partners, perceptions of children as resources and concern about physical abuse as factors that could influence decisions about condom use. The implications of these findings are discussed for their impact on intervention programs targeting working class women in Jamaica.

Adult↗