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.

Sarcoidosis in native Saudis.

Sarcoidosis is believed to be rare in Saudi Arabia. We report twenty cases of sarcoidosis among native Saudis followed-up at our tertiary care centre. The majority (55%) of these patients were referred as either tuberculosis or lymphoma. Twelve out of twenty patients had been or were being treated for pulmonary tuberculosis at the time of presentation. The clinical presentation of these patients was similar to the western pattern of disease with some differences such as severe constitutional symptoms (52%), relative frequent eye involvement (35%) and common occurrence of stage II changes on chest film (70%). Mantoux skin test was negative in nineteen patients (95%). Histological evidence of non-caseating granulomata was obtained in 19 patients. A positive correlation (p < 0.034) between constitutional symptoms and Angiotensin Converting Enzyme (ACE) levels was noted. Thirteen patients (65%) were treated with oral steroids while topical ophthalmic steroids were used in seven patients (35%). Functional and radiographic deterioration was observed in four patients (20%). Three patients went into respiratory failure including a patient who developed Hodgkin's lymphoma six years after the diagnosis of sarcoidosis. The epidemiology of sarcoidosis among native Saudis requires further studies.

Malignant mesothelioma: King Faisal Specialist Hospital and Research Centre experience.

Ten cases of malignant mesothelioma were diagnosed and treated at the King Faisal Specialist Hospital and Research Centre over a ten year period from 1977 to 1987. Seven of these cases were referred from the Southern Province and were clustered in the Al-Baha and Najran districts. In only one case (a plumber from Taif) was there the likelihood of occupation exposure. None of the patients had interstitial changes or pleura plaques on chest x-ray. Epidemiological studies are warranted to establish the etiology of mesothelioma in the Southern region of Saudi Arabia.

Physostigmine inhibition of 3',5'-cyclic AMP phosphodiesterase from cat sciatic nerve.

This study was designed to determine whether cholinergic drug interaction with cyclic (c) AMP phosphodiesterase (PDE) might account for part of the effects of this class of drugs at the neuromuscular junction. The activity levels of both high- and low-affinity forms of cAMP PDE from cat sciatic nerve were examined for drug inhibition or activation. Of the cholinergic drugs tested, only physostigmine and Tacrine produced significant cAMP PDE inhibition. Physostigmine was 10 times more potent than theophylline and half as potent as SQ 20,009 (known PDE inhibitors) in inhibiting motor nerve cAMP PDE. Tacrine inhibited this enzyme at concentrations comparable with theophylline. None of the other drugs tested (diisopropylfluorophosphate, edrophonium, neostigmine, ecothiophate, carbachol or d-tubocurarine) produced significant changes in cAMP PDE activity. The inhibitory effects of physostigmine were shown to be pH independent over a range of 7.0 to 8.5. Kinetic studies indicated a mixed form of inhibition for physostigmine and Tacrine comparable with that seen for theophylline. These data indicate that the anticholinesterase activity of physostigmine and Tacrine do not adequately describe the facilitatory actions of these drugs at the motor nerve ending.

Induction of colon tumors by a single oral dose of 1,2-dimethylhydrazine.

Male Fischer rats were treated at 7 weeks of age with a single oral dose of 1,2-dimethylhydrazine (35 mg/kg). After 1.5 years, the 14 control and 28 treated animals were killed for general autopsy. The incidence of tumor formation in the treated animals was 78.6% as compared to 0% for the control animals. All tumors (1--3/rat) were located in the colon, with the exception of one in the Zymbal's gland of the ear and one in the small intestine. The dosage of 1,2-dimethylhydrazine used in this study is the lowest single oral dose of this carcinogen reported to induce colon tumors.