Angiogenesis in human coronary atherosclerotic plaques.

Neovascularization in the walls of coronary arteries is associated with the presence of atherosclerotic plaque. The mechanisms responsible for the formation of these intraplaque microvessels are not understood. The purpose of this study is to examine the prevalence of endothelial cell replication in plaque microvessels. Two hundred and one primary and restenotic coronary atherectomy specimens were analyzed for the presence of microvessels and proliferation as reflected by positive immunolabeling for Ulex agglutinin and the proliferating cell nuclear antigen, respectively. In primary but not restenotic specimens, proliferation of any cell type was associated with the detection of microvessels on the same slide. However, intraplaque microvessels were more commonly found in restenotic compared to primary specimens (P = 0.004). Twelve highly vascularized specimens with evidence of replication were subjected to detailed histomorphological and quantitative image analyses. At 200 x, the most vascular optical field of each slide was identified and consistently included plaque macrophages. Total slide endothelial cell replication indices for these specimens varied, but in some instances were remarkably elevated (eg, 43.5%). The role of intraplaque angiogenesis may be analogous to that of tumor or wound angiogenesis and be important in development and progression of coronary artery lesions and restenosis.     

Penetration of teniposide (VM-26) into human intracerebral tumors

Thirty-four consenting patients received VM-26 50–100 mg/m² I.V. before surgical resection of intracerebral tumor, and drug was measured using a high pressure liquid chromatographic technique. Sufficient tumor for analysis was obtained from 29 patients. Brain metastases (13 patients) had higher concentrations of V M-26 than did gliomas (13 patients). Concentrations were comparable in brain metastases and meningiomas (3 patients). Prolonged (24 h) infusion of V M-26 did not appear to result in higher tumor drug concentrations in 5 patients than did rapid (1 h) infusion in 24 patients. Pretreatment with Amphotericin-B 10 mg/m² 12 h and 1 h before VM-26 did not appear to have any effect on VM-26 uptake into 4 intracerebral tumors, although data were limited, and VM-26 concentrations were very high in 1 metastasis. Pretreatment with oral glycerol 500 mg/kg 18 h, 12 h, 6 h, and immediately before I.V. VM-26 may have resulted in increased penetration of VM-26 into 9 tumors, although confirmation is required. Amphotericin-B, glycerol, and operative conditions did not appear to alter VM-26 plasma pharmacokinetics.VM-26 4-demethylepipodophyllotoxin 9-(4-6-O-thenylidene-B-D-glucopyranoside) - VP-16 4-demethylepipodophyllotoxin 9-(4-6-O-ethylidene-B-D-glucopyranoside) Presented in Part at the 74th Annual Meeting of the American Association for Cancer Research, San Diego, California, May 25–28, 183(1).     

Insecure Birth: A Qualitative Study of Everyday Violence During Pregnancy in Port au Prince,Haiti

Maternal and Child Health Journal - While the city offers economic opportunities for women in many countries, their safety and security remain vulnerable to urban violence, especially in poor...     

Food Program Participation Influences Nutrition Practices in Early Care and Education Settings

ObjectiveTo determine differences by Child and Adult Care Food Program (CACFP) participation on nutrition requirements and best practices and barriers to implementing both in early care and education programs (ECEs) stratified by context (centers vs home-based ECEs).DesignCross-sectional survey.SettingThree-thousand and fourteen licensed Nebraska ECEs in 2017.ParticipantsOne-thousand three hundred forty-five ECEs.Main Outcome Measure(s)Director-reported nutrition practices in classrooms serving children aged 2-5 years (8 requirements for foods served, 5 best practices for foods served, and 14 best practices for mealtime behaviors).AnalysisChi-square analysis adjusted for multiple comparisons.ResultsOf the sample, 86.8% participated in CACFP, 21.7% were center-based, and 78.3% were home-based. Overall, CACFP participation was related to the higher implementation of CACFP requirements for foods served (P < 0.004 for all) and receiving professional development on nutrition (P < 0.012). In home-based ECEs only, CACFP participation was related to a higher prevalence of serving meals family-style (P = 0.002); however, these practices had low implementation overall.Conclusion and ImplicationsFindings suggest strengthening of requirements to include staff mealtime behaviors beyond service of healthful foods. Improving CACFP enrollment and including CACFP standards in state licensing requirements may be key strategies for improving nutrition practices in ECEs.     

High dose parenteral ciprofloxacin in pleuro-pulmonary disease: a comparative pharmacolinetics of 400 and 200 mg intravenous

In this study we determined the pharmacokinetics of higher IV doses of ciprofloxacin (Cipro) in patients with pleuro-pulmonary diseases undergoing treatment for various bacterial infections. Cipro IV was infused over 30-45 min in 11 patients (seven on 400 mg bid, four on 200 mg bid). Blood samples were taken at intervals of up to 4 h and assayed for Cipro using the HPLC method. The 'mean' peak concentration (C(max)) was 6.9 +/- 2.2 (S.D.) and 11.8 +/- 5.2 (S.D.) for the 200 and 400 mg groups, respectively. The mean concentrations at 1.5 h were 1.2 and 2.6 mg/l and the area under the curve in 0-4 h was 4.6 +/- 0.9 (S.D.) and 7.5 +/- 2.4 (S.D.), respectively for the 200 and 400 mg groups. Steady state serum concentrations of 400 mg were approximately double those for the 200 mg group. IV 200 mg did not reach the required levels to cover the minimum inhibitory concentrations (MICs), whereas, 400 mg IV dose clearly will provide an improved coverage for the commonly encountered organisms with MICs in the 1-4 mg/l range.     

Physical exercise and health promotion in childhood and youth]

The "new health consciousness" that emerged in the developing countries in the 70s and 80s, has contributed to consider exercise as an element of health promotion. But it can establish simplistic relationships between exercise and health, particularly critical for professionals who develop promotion programmes. In this paper, five problematic aspects linked, to exercise and health relationships both in children and youngsters, are discussed and should be taken into account when promoting health programmes. We refer to: 1) the problematic role of exercise in health promotion and in physical education curriculum as an area of privileged action in children and youngsters; 2) the automatic relationship between fitness and health, when the former addresses to high levels of performance and the later is linked to moderate, regular and frequent exercise; 3) problems of fitness tests as a measure of health-related physical activity; 4) the assumption that any kind of physical activity is health-related; and 5) the quantity of exercise necessary for health as a practical problem. From the discussion different proposals are offered in order to develop health-related exercise promotion programmes such as to consider the risks of doing physical activity as a criteria to select exercises; to emphasize the qualitative instead of quantitative aspects of practice; to reconceptualize fitness and sport towards a health focus; to include a broad range of activities which offer the opportunity to every child and youngster to participate; to reduce the importance of testing in evaluation programmes; and other educational considerations which can help to maintain exercise practice beyond the schooling period.     

Complicated appendicitis: is there a minimum intravenous antibiotic requirement? A prospective randomized trial

The proper duration of postoperative intravenous (IV) antibiotics in patients suffering complicated (perforated or gangrenous) appendicitis is debatable. Some advocate a set minimum number of IV antibiotic days whereas others discontinue IV antibiotics depending on the patient's clinical course regardless of the length of therapy. Our objective was to determine whether there are differences in morbidity and resource utilization between the two treatment methodologies. Ninety-four patients with intraoperative findings of complicated appendicitis were included. In all patients IV antibiotics were discontinued on the basis of clinical factors. However, Group 1 patients were given a minimum 5-day IV antibiotic course whereas Group 2 patients had no minimum IV antibiotic requirement. Group 1 patients received more IV antibiotics than Group 2 patients did (5.9 vs 4.3 days; P = 0.014). Infectious complications were not statistically different between the two groups (13.0% in Group 1 and 12.5% in Group 2). Average hospital stay was also not statistically different between the two groups. The data suggest that a protocol with no minimum IV antibiotic requirement in patients with complicated appendicitis does not increase morbidity. Furthermore, the protocol arm with no minimum IV antibiotic requirement led to less IV antibiotic use but did not significantly decrease hospital stay.