Examining the Efficacy of a Family Peer Advocate Model for Black and Hispanic Caregivers of Children with Autism Spectrum Disorder.

Autism spectrum disorder (ASD) affects individuals across all racial and ethnic groups, yet rates of diagnosis are disproportionately higher for Black and Hispanic children. Caregivers of children with ASD experience significant stressors, which have been associated with parental strain, inadequate utilization of mental health services and lower quality of life. The family peer advocate (FPA) model has been utilized across service delivery systems to provide family-to-family support, facilitate engagement, and increase access to care. This study used a randomized controlled design to examine the efficacy of FPAs in a racially and ethnically diverse sample. Results demonstrate significantly increased knowledge of ASD and reduced levels of stress for caregivers who received the FPA intervention as compared to treatment as usual.

Asbestos exposure and mesothelioma in South Africa.

OBJECTIVES: To describe the exposure experiences of South African mesothelioma cases, with emphasis on the contribution made to the caseload by different fibre types, the proportion of subjects with no recall of asbestos exposure and only environmental contact, and the importance of putative causes other than asbestos. DESIGN: A multi-centred case-control study. SUBJECTS AND SETTING: 123 patients with mesothelioma interviewed by trained interviewers in study centres established in Johannesburg, Kimberley, Pretoria, Bloemfontein, Cape Town and Port Elizabeth. RESULTS: A convincing history of asbestos exposure was obtained in the overwhelming majority of cases (only 5 cases had unlikely asbestos exposure). Twenty-three subjects had worked on Cape crocidolite mines, 3 at Penge (an amosite mine), 3 on mines producing amosite and Transvaal crocidolite and 1 on a Transvaal crocidolite mine. Exclusively environmental exposure accounted for at least 18% of cases; 91% of these cases (20/22 subjects) had had contact with Cape crocidolite. There was a relative paucity of cases linked to amosite and no convincing chrysotile case. Non-asbestos causes occur rarely, if at all, in South Africa. CONCLUSION: The preponderance of crocidolite cases, followed by amosite and then chrysotile cases, is consistent with the view that there is a fibre gradient of mesotheliomagenic potential for South African asbestos (crocidolite > amosite > chrysotile).

Case-control study of mesothelioma in South Africa.

BACKGROUND: South Africa has, uniquely, mined, transported, and used crocidolite, amosite, and chrysotile. A multicenter case-control study was done in South Africa to examine the details of asbestos exposure in cases and controls, and to calculate relative risks for level of certainty of asbestos exposure, nature of exposure (e.g., environmental, occupational) and fiber type. METHODS: Cases and controls (one cancer and one medical per case) were collected by six study centers from referral hospitals, and exposure information was collected by interviewing cases and controls in life. RESULTS: One hundred and twenty-three cases were accepted into the study. None had purely chrysotile exposure. Twenty-three cases had mined Cape crocidolite; three had mined amosite; and three Transvaal crocidolite plus amosite. A minimum of 22 of the cases had exclusively environmental exposure, 20 were from the NW Cape crocidolite mining area. The relative risks associated with environmental exposure in the NW Cape (crocidolite) were larger than for environmental exposure in the NE Transvaal (amosite and crocidolite): 21.9 vs. 7.1 and 50.9 vs. 12.0 for the cancer control and medical control datasets, respectively. CONCLUSIONS: The results confirm the importance of environmental exposure in the Cape crocidolite mining area, the relative paucity of cases linked to amosite, the rarity of chrysotile cases and are consistent with a fiber gradient in mesotheliomagenic potential for South African asbestos with crocidolite > amosite > chrysotile.

A randomized, comparative study of the efficacy and tolerance of roxithromycin and doxycycline in the treatment of women with positive endocervical cultures for Chlamydia trachomatis and Mycoplasma spp. in an in vitro fertilization program.

A total of 45 patients wishing to enter an in vitro fertilization program had positive endocervical cultures for Chlamydia trachomatis, 86 had positive cultures for Ureaplasma urealyticum, and 11 had positive cultures for Mycoplasma hominis. These patients and their consorts were randomly allocated to treatment with either roxithromycin or doxycycline. Both antibiotics were completely effective against C. trachomatis. In patients with U. urealyticum infection, roxithromycin was successful in 73% and doxycycline in 87% of cases. Mycoplasma hominis was eradicated in 100% of cases by doxycycline and in 85% of cases by roxithromycin. Doxycycline caused significantly more side effects than did roxithromycin.

A distinctive skin eruption following small-bowel by-pass surgery.

Crops of distinctive skin lesions appeared after jejuno-ileal by-pass surgery for morbid obesity in three patients. They consisted mainly of large numbers of macules on the extremities, of vague outline and with a tendency to central pustulation and necrosis. Severe arthralgia and myalgia preceded the skin lesions, which histologically showed a dense neutrophil leukocytic infiltrate, nuclear debris, and fibrin deposition around blood vessels in the dermis.

Rheumatoid arthritic syndrome after chikungunya fever.

An outbreak of chikungunya fever which occurred during April 1977 among a group of high-school children from Pretoria after a visit to the northern Transvaal bushveld is reported. Some of the adults who accompanied the pupils also contracted the disease. The adults suffered more severely from the chronic arthritic form of the disease than did the children. In some cases the episodic polyarthritis was still present 18 months after the onset of the disease. Rheumatoid factors in low titre could be demonstrated in the circulation of patients with longstanding symptoms.

A comparison of the antibacterial activity of sulphonamide-trimethoprim combinations.

Sensitivity patterns of 326 clinical isolates toward sulphonamide/trimethoprim combinations were tested in vitro. The relative merits of the different combinations are discussed in their pharmacological and bacteriological contexts. It is concluded that organisms sensitive to cotrimoxazole as judged by in vitro sensitivity tests performed at 37 degrees C are also sensitive to sulphamoxole/trimethoprim.

Erythema elevatum diutinum, cryoglobulinaemia, and fixed urticaria on cooling.

A mixed cryoglobulin (IgG/IgM) was detected in a patient with erythema elevatum diutinum. Cold exposure activated the complement system and provoked a fixed urticarial reaction with the histology of a leukocytoclastic vasculitis.

Pernicious anaemia with hypogamma-globulinaemia. A case report.

Auto-immune mechanisms are important in the evolution of pernicious anaemia, but cannot be demonstrated in all cases. Cell-mediated immunity is involved in the pathogenesis, and explains the occurrence of pernicious anaemia in patients with hypogammaglobulinaemia. The pernicious anaemia seen in these patients differs in some respects from the classical form of the disease. The case history of a patient with pernicious anaemia and hypogammaglobulinaemia is presented, and the possible pathological mechanisms are discussed.