The public health response to the re-emergence of syphilis in Wales, UK.

During the 1990s, cases of infectious syphilis were uncommon in Wales. In 2002, an outbreak occurred in a sexual network of men who have sex with men (MSM) attending a sauna. A multidisciplinary outbreak control team was convened to raise awareness of the outbreak among MSM and health professionals, assess the extent of outbreak, and initiate surveillance measures. It is likely that early intensive control efforts dampened the epidemic curve. However, since 2006 the number of cases has increased steadily to a peak of four cases per 100,000 population in 2008. The majority of cases continue to occur in MSM (81% in 2009) and in those attending genitourinary (GU) medicine clinics in south east Wales (76%). Traditional sexual networks such as saunas, bars/clubs and cruising grounds remain frequently reported, but Internet-based networks are assuming increasing importance. Public health interventions have been sustained, using traditional partner notification, health promotion initiatives, and more innovative Internet network tracing methods.

Haemodynamic effects of clonidine injected epidurally in halothane-anaesthetized dogs.

The haemodynamic effects of clonidine administered in the epidural space were studied in 16 halothane-anaesthetized dogs. The animals were randomly assigned to two groups: Group I received three doses of 3 ml of normal saline, Group II received three doses of 3 micrograms X kg-1 of clonidine, through an epidural catheter, whose tip was located between L2-T11. Control haemodynamic measurements were taken one hour after completion of the surgical preparation (period P1); they were repeated every 45 minutes after each incremental dose (periods P2, P3, P4) and 105 minutes after a total cumulative dose of 9 micrograms X kg-1 of clonidine or 9 ml of saline were given (period P5). No significant changes over time were observed in Group I. In Group II clonidine produced statistically significant reductions of systemic blood pressure (BP), mean left ventricular pressure (LV), heart rate (HR), cardiac output (CO) and peak LV dP/dt only after a total clonidine dose of 9 micrograms X kg-1 and these changes were sustained. BP fell 15 per cent, CO 21 per cent, HR 25 per cent, LV 20 per cent and peak LV dP/dt 30 per cent when P5 measurements were compared to control values within Group II (p less than 0.05). These haemodynamic effects of clonidine are likely due to minimal systemic absorption and/or cephalad spread of the drug towards its site of action in the brain stem. The reductions of HR, CO, BP, and isovolemic indices of contractility are likely explained by a reduction of sympathetic outflow at the spinal cord and medulla oblongata levels as well as increased parasympathetic tone.(ABSTRACT TRUNCATED AT 250 WORDS)

Bovine RPE heterotransplants simulate proliferative vitreoretinopathy (PVR) in rabbits.

A model of proliferative vitreoretinopathy (PVR) is described. This is the first reported model based on the transplantation of heterologous retinal pigment epithelium cells into the vitreous cavity of rabbits. Freshly isolated cells or short-term primary cultures of bovine pigment epithelium are employed. Strands develop in the vitreous cavity and, with a frequency now approaching 100%, traction retinal detachments develop by 3-4 weeks. Light and electron microscopic features of this model parallel those found for transplanted autologous RPE cells; there are no overt signs of rejection. Examination of the strands should prove useful in identifying strategies of therapeutic value. This model permits such studies, since retinal detachments in adequate numbers are readily produced. The model resembles human PVR.