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The role of pharmacy has changed dramatically during the last decades, which has led to new demands on pharmacy personnel. Objective: This study aims at exploring the attitudes of Swedish pharmacy personnel on their role as public health promoters and to look at the opportunities and obstacles they identify in the efforts to widen the pharmacy remit to include a wider health approach. Method Eight focus group discussions were conducted with a strategic sample of pharmacy personnel working in two counties in Sweden. The discussions were transcribed verbatim and analysed by qualitative inductive analysis. Results Five themes were identified, “Pharmacy activities impact on public health”, “The employer, Apoteket AB”, “The new role welcomed”, “Obstacles in the new role”, and “Need of change and support”. Conclusion The concept of pharmacy personnel as public health promoters was not initially in the mindset of the participants. In the process of discussion, the impact of traditional pharmacy practice as well as new pharmacy based initiatives on public health gradually became more obvious to them. The findings show a pharmacy staff involved in a process of change. The participants have not yet landed in their new role as public health promoters and the study shows that practical as well as conceptual support is needed in order for pharmacy personnel to play a more important role in public health.

An analysis of the inter-annual frequency of the main summer rainfall producing synoptic system [tropical temperate troughs (TTTs)] over Mozambique and the Southwest Indian Ocean and their relationships with regional sea surface temperatures and circulation patterns is presented for the January-March season. Correlations and composite anomalies based on annual frequency of occurrence of TTTs over Mozambique suggest that TTT occurrence is related to La Niña and Southern Hemisphere planetary waves (wavenumber-3 or -4) that modulate the subtropical high pressure cells in the three oceanic basins. These modulations lead to enhanced easterly winds over the South Indian Ocean and onshore moisture fluxes towards southeastern Africa. A stronger than average Angola low, particularly linked to La Niña, also plays an important role in the frequency and intensity of the TTT, by enhancing the wind and moisture convergence over southeastern Africa. Moisture fluxes over the warm Agulhas current and tropical southeast Atlantic also affect the rainfall variability over southern Africa to some extent during summers with a high frequency of TTT. Positive sea surface temperature (SST) anomalies over the tropical and subtropical South Indian Ocean that are linked to El Niño-Southern Oscillation appear to play a significant role in causing dry conditions over Mozambique. These positive SST anomalies help promote convective activity offshore, and also weaken the northern half of the South Indian Ocean high pressure cell. As a result, the easterly winds are weakened leading to less onshore moisture fluxes than in the wet seasons. Copyright © 2009 Royal Meteorological Society [ABSTRACT FROM AUTHOR]

Background and Objective The basis of blood group A1 and A2 phenotypes has been debated for many decades, and still the chemical basis is unresolved. The literature generally identifies the glycolipid chemical differences between blood group A1 and A2 phenotypes as being poor or no expression of A type 3 and A type 4 structures on A2 red cells, although this assertion is not unanimous. Materials and Methods Using purified glycolipids and specific monoclonal antibodies, we revisited the glycolipid basis of the A1 and A2 phenotypes. Purified glycolipids were extracted from four individual A1 and four individual A2 blood units. One blood unit from an A weak subgroup was also included. Monoclonal anti-A reagents including those originally used to define the basis of A1 and A2 phenotypes were used in a thin layer chromatography – enzyme immunoassay to identify the presence of specific glycolipids. Results A type 3 glycolipid structures were found to be present in large amounts in all phenotypes. In contrast, the A type 4 glycolipid structure was virtually undetectable in the A2 phenotype, but was present in the A1 and A subgroup samples. Conclusion The major glycolipid difference between the A1 and A2 phenotypes is the dominance of A type 4 glycolipids in the A1 phenotype. [ABSTRACT FROM AUTHOR]

We analysed HLA haplotypes in pairs of 78 sporadic multiple sclerosis (MS) patients and 78 healthy siblings. The presence of 2 oligoclonal IgG bands, detected by immunoblotting of the cerebrospinal fluid in healthy siblings, has previously been defined as MS immunopathic trait (MSIT), based on a cut-off derived from healthy unrelated volunteers. The frequency of MSIT was 17.9% (n=14/78 siblings). The HLA-DR(15)2 allelle was present in 21.4% (n=3/14) of the siblings with MSIT, in 40.6% (n=26/64) of the siblings without MSIT, and in 59% (n=46/78) of the patients with clinically-definite (CD) MS. The distribution of zero, one or two HLA-DR(2)15 alleles was significantly skewed towards a lower allelle count in the siblings with MSIT compared with the group of unrelated siblings with MS (P=0.002), and also lower than their related siblings with MS (P=0.1). These results suggest that the MS susceptibility gene, HLA-DR(2)15 type, does not induce MSIT, and conceivably these are two separate risk factors in the development of MS. The effect of HLADR( 2)15 and MSIT in sporadic MS appears to be synergistic. [ABSTRACT FROM AUTHOR]

We studied two extended families in which not only multiple sclerosis (MS) segregates, but also approximately 18% of the cerebrospinal fluid (CSF) investigated blood relatives have 'MS immunopathic trait', an oligoclonal CSF immunopathy similar to that seen in MS, but with no neurological symptoms. Both families fit a genetic model for autosomal dominant inheritance for MS immunopathic trait, although with reduced penetrance in family A. In order to identify genetic factors of importance for the development of MS immunopathic trait, we performed a genome scan using the CHLC/Weber Screening Set (ver 6A), with 285 successful markers, to test the hypothesis that a single gene is causing the MS immunopathic trait in these families. Using a parametric method, we identified regions with suggestive linkage at chromosome 6q12 with a LOD-score of 2.4, putative linkage with LOD-score 1.5 at chromosome 6p21 (HLA region), putative linkage at chromosome 12q24 with a LOD-score of 1.7 and suggestive linkage at chromosome 19q13.2 with a LOD-score of 1.8. The LOD-score at chromosome 19q13.2 increased to 2.2 when only family A was analysed. In family A, all MS patients and two of five individuals with MS immunopathic trait had HLA DRB1*(15) and in family B, all blood relatives had the rare HLA type DRB1*0103, which is associated with other autoimmune diseases. We suggest that DRB1*0103 is a necessary but not sufficient condition for the susceptibility for MS immunopathic trait in this family. [ABSTRACT FROM AUTHOR]

A 57-year-old female, blood group B, with polycystic kidney disease, received an ABO-identical, HLA-A,B,DR 5-mismatched renal allograft in 1986. Due to graft artery thrombosis and vascular rejection, she lost the kidney 6 months after transplantation and developed HLA antibodies with a panel reactivity of 99%. Despite 5 years on a European waiting list for highly immunized patients, she was not offered a second kidney. An attempt to remove her HLA antibodies by plasmapheresis combined with cyclophosphamide therapy did not succeed. Her 53-year-old HLA-identical, but ABO-incompatible sister (blood group A) was then accepted as a donor. After immunoadsorption on Biosynsorb-A columns, transplantation was performed. The post-transplant course was uneventful without any signs of rejection. Studies on the anti-A antibody binding characteristics before and after immunoadsorption and after transplantation, showed that IgM and IgG antibodies recognizing the A trisaccharide epitope based on the type 1,2, and 4 core saccharide chains, were effectively removed by Biosynsorb-A adsorption, but the column failed to remove anti-A antibodies recognizing the A type 3 antigen. These antibodies probably requires part of the core saccharide chain for binding. The presence of these antibodies did not seem to influence the outcome of the ABO-incompatible transplantation. [ABSTRACT FROM PUBLISHER]

The cell-mediated immune response was studied, using mixed lymphocyte reactivity (MLR) and cell-mediated lympholysis (CML) tests, in patients with well-functioning kidney grafts from living donors at 6 and 12 months and at 2-5 years after transplantation. The patients were allocated to treatment with cyclosporin A (CyA) and prednisolone (group A) or with CyA, prednisolone and azathioprine (group B). The MLR towards a third party were in the range of that of untreated controls while the anti-donor activities were reduced after 6 months in both groups. The CML activities in group A towards a third party were in the range of that of untreated controls at all times, while the anti-donor activities were decreased. By contrast, the CML activities in group B towards a third party were decreased during the first year and were in the range of that of normal controls at 2-5 years. The anti-donor CML activities were low at all times in group B. In summary, the two CyA protocols allowed the induction of donor-specific unresponsiveness within the first post-transplant year. The anti-third party activities were low during the first post-transplant year in recipients with triple therapy but not in those without azathioprine. [ABSTRACT FROM AUTHOR]

The distributions of ABO, rhesus, and Lewis blood group antigens were studied in patients with alcoholic cirrhosis, alcoholic pancreatitis, chronic active hepatitis, and primary biliary cirrhosis. There were no differences in frequencies of ABO and rhesus blood group antigens between the groups or in comparison with a control group of blood donors. Lewis phenotype Le (a- b-), however, was more common on erythrocytes than in saliva in patients with alcoholic cirrhosis, alcoholic pancreatitis, and severe renal disease but equally common in saliva and on red blood cells in patients with non-alcoholic liver disease. It is suggested that Lewis typing should be performed on saliva because blood typing may give misleading results in some patients. [ABSTRACT FROM PUBLISHER]