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Review: Peyer's patches.
The function of Peyer's patches as antigenic sampling sites involves the complex interplay of a variety of mechanisms that aim to recognize luminal antigens, induce an immunological response and decrease the incidence of antigen translocation across the mucosal epithelium. This is achieved by M cells, which facilitate the uptake of luminal antigens, a vascular architecture that promotes the retention of absorbed antigens within the patch interstitium (allowing for maximal antigenic activation of lymphocytes) and the presence of lymphoid follicles that contain antigen-presenting cells and lymphocytes. Lymphocytes encountering antigen in the Peyer's patches proliferate, differentiate into fully mature antigen-specific effector cells and migrate to the mesenteric lymph nodes where they undergo final maturation. The mature lymphocytes then enter the systemic circulation and migrate throughout the other mucosa-associated lymphoid tissues of the body and "home' into the gut via high endothelial venules and gut-associated lymphoid tissue-specific adhesion molecules, providing antigen-specific lymphocytes at sites likely to re-encounter the antigen.
Changing water-use patterns in a water-poor area: lessons for a trachoma intervention project.
An epidemiological survey carried out in the Dodoma region of Tanzania found that high rates of trachoma infection in pre-school children were associated with unwashed faces. Prior to a planned trachoma intervention project, a pilot study was done on household decisions about water use and perceptions about face washing and eye disease. The study found that mothers overestimated the amount of water necessary to wash a child's face. In addition, mothers would not change their water-use priorities without the consent of their husbands and the support of the community. Therefore a health education program was designed to address the perception that face washing required a great deal of water. The program also sought to involve and re-educate the whole community rather than focus only on the mothers who were most likely to wash the children's faces.
SARS update: Winter, 2003 to 2004.
Transmission of severe acute respiratory syndrome (SARS) related coronavirus (CoV) appears to be heterogeneous. Most transmission occurs through large droplets, but there is some evidence of spread through aerosol transmission. Proper use of personal protective equipment (PPE) and scrupulous attention to hand hygiene are critical to reducing transmission of SARS, especially in health care facilities. Surgical masks have been shown to be highly effective in reducing transmission when N-95 respirators are unavailable. Health care workers bore a large burden of illness during the 2002 to 2003 SARS epidemic. Occupational health nurses working in health care agencies will play a key role in preparing for a re-emergence of the disease. Occupational health nurses should "bookmark" the Centers for Disease Control and Prevention website for Public Health Guidance for Community-Level Preparedness and Response to SARS: www.cdc.gov/ncidod/sars/clinicalguidance.htm for easy retrieval and reference.