Shannon Famenini

Perspectives of people in Mali toward genetically-modified mosquitoes for malaria control

BackgroundGenetically-modified (GM) mosquitoes have been proposed as part of an integrated vector control strategy for malaria control. Public acceptance is essential prior to field trials, particularly since mosquitoes are a vector of human disease and genetically modified organisms (GMOs) face strong scepticism in developed and developing nations. Despite this, in sub-Saharan Africa, where the GM mosquito effort is primarily directed, very little data is available on perspectives to GMOs. Here, results are presented of a qualitative survey of public attitudes to GM mosquitoes for malaria control in rural and urban areas of Mali, West Africa between the months of October 2008 and June 2009.MethodsThe sample consisted of 80 individuals - 30 living in rural communities, 30 living in urban suburbs of Bamako, and 20 Western-trained and traditional health professionals working in Bamako and Bandiagara. Questions were asked about the cause of malaria, heredity and selective breeding. This led to questions about genetic alterations, and acceptable conditions for a release of pest-resistant GM corn and malaria-refractory GM mosquitoes. Finally, participants were asked about the decision-making process in their community. Interviews were transcribed and responses were categorized according to general themes.ResultsMost participants cited mosquitoes as one of several causes of malaria. The concept of the gene was not widely understood; however selective breeding was understood, allowing limited communication of the concept of genetic modification. Participants were open to a release of pest-resistant GM corn, often wanting to conduct a trial themselves. The concept of a trial was reapplied to GM mosquitoes, although less frequently. Participants wanted to see evidence that GM mosquitoes can reduce malaria prevalence without negative consequences for human health and the environment. For several participants, a mosquito control programme was preferred; however a transgenic release that satisfied certain requirements was usually acceptable.ConclusionsAlthough there were some dissenters, the majority of participants were pragmatic towards a release of GM mosquitoes. An array of social and cultural issues associated with malaria, mosquitoes and genetic engineering became apparent. If these can be successfully addressed, then social acceptance among the populations surveyed seems promising.

Effect of Treating Psoriasis on Cardiovascular Co-Morbidities: Focus on TNF Inhibitors

Psoriasis patients are at increased risk for cardiovascular disease. Literature on rheumatoid arthritis has shown the association of treatment with tumor necrosis factor (TNF) inhibitors and improvement of cardiovascular disease. Recent literature has also shown similar findings in psoriasis patients. We present a review of the literature on the effect of TNF inhibitors for psoriasis treatment on cardiovascular disease, cardiovascular biomarkers, and insulin resistance. We conclude that TNF inhibitors may be especially beneficial in preventing myocardial infarction, to a degree greater than methotrexate, especially in the Caucasian population. The effects of TNF inhibitors in altering insulin sensitivity or preventing new onset diabetes have been contradictory. Case reports of both hyperglycemia and hypoglycemia developing in patients under TNF inhibitor treatment teach us to warn patients about these side effects. More robust clinical studies are needed to evaluate the true effect of TNF inhibitors in diabetic psoriasis patients. More studies are also needed to assess the effect of TNF inhibitors on hypertension, dyslipidemia, and stroke.

Bariatric surgery and psoriasis

Obesity is associated with psoriasis and poses a significant obstacle to psoriasis management. Bariatric surgery is an effective procedure for weight loss, and some reports suggest that it may improve psoriasis. However, more evidence is needed before definitive conclusions can be drawn. Bariatric surgery procedures, in particular the Roux-en-Y gastric bypass, may one day be a viable option for obese patients with refractory psoriasis.

Aspirin use and melanoma risk: A review of the literature

In view of the increasing incidence of melanoma, it is critical to find effective preventive approaches. Contradictory evidence has been reported with regard to the possible association of aspirin use and the risk of melanoma. We review these studies and seek to elucidate the mechanism by which aspirin may produce a chemoprotective effect against melanoma.

Aspirin use and melanoma: A UCLA pilot study

Study limitations included small convenience samples recruited from a single university that had allowed students to use university debit cards at local tanning salons. Although this practice has since been disallowed, the competitive local business environment for IT salons may have resulted in unusually high rates of DCM. The extent to which findings can be extrapolated to other populations and settings remains to be determined.