Southern Africa ports as spaces of HIV vulnerability: case studies from South Africa and Namibia.

There is increasing recognition that in order to respond to the HIV epidemic migrants and mobile populations must be included in national and regional responses. While migration in and of itself does not necessarily contribute to increased risk of HIV infection, some migrants and mobile populations do face increased HIV risk. With its immense coastline and extensive transport industry, Southern Africa provides an excellent case study to examine the HIV risks and vulnerabilities of mobile workers and local communities through port settings. IOM's research in Southern African ports illustrates why HIV/AIDS policies and programmes must focus on spaces where migrants and mobile populations interact with sedentary populations (including sex workers and other sexual partners) in environments conducive to multiple concurrent partnerships, in order to reduce HIV risk and increase access to treatment, care, and support for all.

Reduction and redistribution of gap and adherens junction proteins after ischemia and reperfusion.

BACKGROUND: Previous studies have demonstrated that alterations in myocardial structure, consistent with tissue and sarcomere disruption as well as myofibril dissociation, occur after myocardial ischemia and reperfusion. In this study we determine the onset of these structural changes and their contribution to electrical conduction. METHODS: Langendorff perfused rabbit hearts (n = 47) were subjected to 0, 5, 10, 15, 20, 25, and 30 minutes global ischemia, followed by 120 minutes reperfusion. Hemodynamics were recorded and tissue samples were collected for histochemical and immunohistochemical studies. Orthogonal epicardial conduction velocities were measured, with temperature controlled, in a separate group of 10 hearts subjected to 0 or 30 minutes of global ischemia, followed by 120 minutes of reperfusion. RESULTS: Histochemical and quantitative light microscopy spatial analysis showed significantly increased longitudinal and transverse interfibrillar separation after 15 minutes or more of ischemia (p < 0.05 versus control). Confocal immunohistochemistry and Western blot analysis demonstrated significant reductions (p < .05 versus control) of the intercellular adherens junction protein, N-cadherin, and the active phosphorylated isoform of the principal gap junction protein, connexin 43 at more than 15 minutes of ischemia. Cellular redistribution of connexin 43 was also evidenced on immunohistochemistry. No change in integrin-beta1, an extracellular matrix attachment protein, or in epicardial conduction velocity anisotropy was observed. CONCLUSIONS: These data indicate that there are significant alterations in the structural integrity of the myocardium as well as gap and adherens junction protein expression with increasing global ischemia time. The changes occur coincident with previously observed significant decreases in postischemic functional recovery, but are not associated with altered expression of matrix binding proteins or electrical anisotropic conduction.