Lancet
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The final quarter of the 20th century saw a profound change in international health cooperation. The World Bank emerged and consolidated its position as the leading external financier of health-sector activities in countries of low and middle income. ⋯ The scope of the Bank's involvement, and the nature of its policy thrusts and investment strategy in the sector, are outlined in this paper and illustrated with specific reference to Bangladesh. This backdrop serves to raise four issues and enables us to explore their relevance to global health cooperation in the first quarter of the 21st century.
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Fetal cells can be found in the maternal circulation in most pregnancies. Fetal progenitor cells have been found to persist in the circulation of women many years after childbirth. We tested the hypothesis that microchimerism is involved in the pathogenesis of scleroderma. Scleroderma is of interest because of a strong female predilection, an increased incidence in the years after childbearing, and clinical similarities between scleroderma and chronic graft-versus-host disease after allogeneic bone-marrow transplantation. We also investigated whether HLA-compatibility of a child was associated with later development of scleroderma in the mother. ⋯ Low concentrations of male DNA can be detected in healthy women decades after the birth of a son. Microchimerism in scleroderma patients could be secondary to the underlying disease. However, the finding that HLA class II compatibility of a child was more common for scleroderma patients than for controls, supports the possibility that microchimerism may be involved in the pathogenesis of scleroderma.