Dichloroacetate: Effects on exercise endurance in untrained rats

The effect of dichloroacetate (DCA), an activator of pyruvate dehydrogenase, on the performance of fed, untrained rats was evaluated while swimming for different durations. DCA-treated rats were able to swim almost 40% longer than controls (354 ± 18 versus 255 ± 18 sec, p < .001). This was associated with lower levels of blood and muscle lactate at rest and after 210 and 240 sec of swimming. At exhaustion, blood lactate was the same in the two groups even though the DCA rats had worked for an additional 99 sec (16.9 ± 1.2 versus 15.8 ± 1.2 mM/L NS). Pretreatment with DCA did not alter the usual exercise-induced decreases in muscle ATP and creatine phosphate or liver glycogen. After 210 sec of exercise, plasma FFA and blood glucose and acetoacetate were also the same in the two groups; however, β-hydroxybutyrate was somewhat higher, and there was a small but significant sparing of muscle glycogen in the DCA group. The data indicate that DCA enhances the ability of rats to exercise at near maximal work loads. They are consistent with the notion that improved endurance is a consequence of a decreased rate of lactate accumulation; however, the possibility that it is secondary to some other action of DCA cannot be excluded.     

Atherosclerotic ulcerative disease and associated aneurysms of the coronary arteries.

Abnormal cardiac muscle function has been reported in experimental diabetes mellitus from this laboratory. To examine left ventricular performance in diabetic patients without clinical evidence of myocardial ischemia or other cardiovascular disease, a noninvasive measurement of the systolic time intervals was carried out. Simultaneous recordings of the electrocardiogram, heart sounds, and carotid pulse were made in 25 diabetic subjects, 20 to 56 years of age, and compared with 37 normal subjects. The diabetic subjects had a shorter left ventricular ejection time, longer pre-ejection period, and a higher ratio of pre-ejection period/left ventricular ejection time (P < 0.001). The isovolumic time was prolonged (P < 0.001), while heart rate and arterial pressure were within normal limits. Abnormal function was independent of apparent duration and treatment by diet alone, insulin, or hypoglycemic agents. On the basis of available morphologic data in human and canine diabetes, an alteration of the myocardial interstitium may be the basis for this preclinical abnormality in diabetic patients.     

T cell subsets and cellular immunity in end-stage renal disease

The T lymphocyte population was studied by immunofluorescent staining with monoclonal antibodies and laser flow cytometry in the blood of 50 patients with end-stage renal disease undergoing long-term maintenance intermittent hemodialysis. The absolute number of T cells was lower in patients receiving dialysis for more than one year (p less than 0.001), as was the absolute count of helper T cells (p less than 0.005). In patients under 30 years of age, the absolute number of helper T cells was markedly reduced, whereas the number of suppressor/cytotoxic T lymphocytes was not changed. In patients between the ages of 30 and 60 years, both helper and suppressor cells were significantly reduced. In patients over 60 years of age, only the number of helper T cells was reduced. The in vitro response of patients' lymphocytes was reduced both in the mixed lymphocyte reaction (p less than 0.01) and after phytohemagglutinin stimulation (p less than 0.001). Natural killer cytotoxicity of patients' peripheral blood mononuclear cells, however, was unaffected.     

Clinical importance of "breakthrough" bacteremia

Fifty-one episodes of bacteremia and a single episode of fungemia occurred during treatment with seemingly adequate doses of appropriate antibiotics. Clinical findings in these "breakthrough" bacteremias and fungemia were compared with those in 448 non-breakthrough episodes. Breakthrough was more likely to be caused by facultative or aerobic gram-negative rods (e.g., Enterobacteriaceae and Pseudomonas species) than by anaerobes. Of the underlying conditions examined, immunosuppressive doses of glucocorticosteroids, diabetes mellitus, and moderate renal failure were significantly more frequent in patients with breakthrough. A significant association was also observed between an intra-abdominal primary focus of infection (abscesses, biliary tract or bowel infections) and the occurrence of breakthrough. Mortality in breakthrough bacteremia was 61 percent compared with 40 percent in non-breakthrough episodes. The phenomenon of breakthrough bacteremia shows the potential limitations of antibiotic therapy alone.     

Synovial fluid leukocytosis. A study of extremes.

Three hundred and eighty-eight synovial fluids from 310 patients with definite diagnoses were reviewed. Seventy per cent of the patients with culture-proved infections in the joint space had leukocyte counts above 50,000/mm³ whereas 12.5 per cent of the patients with gout, 10 per cent of those with pseudogout and 4 per cent of those with rheumatoid arthritis had leukocyte counts in this high range.White cell counts ranged from 6,000 to 46,000/mm³ in 30 per cent of the patients with infectious arthritis. However, their fluids contained 90 per cent neutrophils and poor mucin clots, and within 12 to 48 hours repeat aspirations of the same joint showed large increases in the leukocyte count. These patients were divided into two groups, one with mild infections due to Neisseria gonorrhea and Diplococcus pneumoniae, and another consisting of patients with complicated underlying diseases whose infections, usually due to more virulent organisms, were poorly controlled and whose mortality rate was 25 per cent within days of synovial fluid analysis.In one fourth of the fluids with sodium urate crystals and one third of the fluids with calcium pyrophosphate crystals, leukocyte counts were below 2,500/mm³. Compared to patients with gouty arthritis, a larger number of patients with pseudogout had normal mucin precipitates despite higher numbers of leukocytes. These data document the magnitude of overlap at extremes of synovial fluid leukocytosis in common forms of arthritis and suggest a need for a careful search for crystals in fluids with high as well as low leukocyte counts.     

Differences in male–female ratios of Aedes albopictus (Diptera: Culicidae) following ultra-low volume adulticide applications

Suppression of Aedes albopictus populations is a substantial challenge for mosquito control programs globally because juveniles of this species are found in numerous kinds of domestic artificial containers that are difficult to detect, access, and eliminate. We conducted a multi-year assessment of the effect of different interventions to control Ae. albopictus near the northernmost geographic boundary of the species in temperate North America and deployed an array of BG-Sentinel traps for adult surveillance. Here we present the results of a comparative examination of adult sex ratios in urban and suburban areas, shifts in sex ratios after control interventions, and a discussion of the critical drivers of population dynamics of Ae. albopictus in our area. We collected significantly more male mosquitoes in urban as compared to suburban areas in June through September, but not in May (p < 0.001). The higher number of male mosquitoes in urban areas could be attributed to a higher number of larval habitats within a closer proximity of the surveillance traps and the lower flight dispersal of males. Following application of adulticides in urban areas, Ae. albopictus male populations were reduced by 88% on average, which was higher than the 69% reduction in female populations. The higher reduction of male mosquitoes could be attributed to the smaller body mass of the males and their higher susceptibility to adulticides. The results of this study are directly relevant to the development of suitable control strategies that depend on manipulation of males, such as the sterile insect technique. The results could also be used to refine mosquito abatement by providing more accurate methods to determine the need and timing of vector control.     

Screening for cardiovascular risk factors in a dental setting

BACKGROUND: The authors assessed the utilization of oral health care professionals (OHCPs) as a resource for identifying patients who were unaware of their increased risk of developing cardiovascular disease (CVD). METHODS: OHCPs administered a CVD risk-screening questionnaire, measured blood pressure and tested cholesterol levels, high-density lipoprotein levels and hemoglobin A1c (HgA1c) levels using "finger-stick" blood testing in 100 patients treated in a dental school clinic who were unaware of their CVD risk status. The authors determined the prevalence of specific risk factors (that is, smoking and abnormal levels of systolic blood pressure, lipids, body mass index and HgA1c) and calculated Framingham 10-year coronary heart disease (CHD) risk scores. RESULTS: Seventeen percent of the 100 patients (35 percent of men, 5 percent of women) had an increased global risk of experiencing a CHD event within 10 years (Framingham risk score>10 percent). Seventy-three percent of participants had one or more risk factors and 31 percent had two or more risk factors present. More men than women had low levels of high-density lipoprotein (45 percent [18/40] of men versus 3.3 percent [2/60] of women; P<.0001). The mean Framingham CHD risk score increased with increasing risk factor burden. CONCLUSIONS: OHCPs identified patients with an increased CHD risk who could benefit from primary prevention activities. A substantial proportion of study patients who were unaware of their risk status were at an increased risk of experiencing a CHD event within 10 years. OHCPs could contribute to public health CHD control efforts.