Differences in utilization of asthma drugs between two neighbouring Swedish provinces: relation to treatment in individuals with airway disease

Abstract. Objective . To assess the extent to which drugs were used by individuals found to have asthma in a population survey. To assess the relative influence of the proportion of patients treated and doses reported on the sales of drugs. To study if observed differences in sales of asthma drugs between the county of Jämtland (with high sales) and Gävleborg (with lower sales) correlated to a difference in the control of the disease. Design . A cross-sectional population study with a postal questionnaire followed by an interview and examination of symptomatic individuals. Asthma was diagnosed in subjects reporting a typical history of asthma or repeated episodes of dyspnoea and wheezing, or dry cough combined with reversibility in FEV₁. PEF-variability or PC₂₀ ≤ 4 mg ml^-1. Setting . The county of Jämtland, and Gästrikland, a southern part of the county of Gävleborg in central Sweden. Subjects . All 16 year olds, and 13% (randomly selected) of 30–39 and of 60–69 year olds (totalling 12732 individuals). Subjects reporting airway symptoms in the questionnaire (n = 2100) and 450 asymptomatic controls were further investigated. Main outcome measures . Drug use and symptoms reported by individuals found to have asthma or chronic obstructive pulmonary disease (COPD). Results . Inhaled β₂ agonists and inhaled steroids were used more often by individuals with asthma and COPD in Jämtland. However, regular use was more common in Gävleborg. Most of the asthmatics did not use any medication in spite of the fact that symptoms were commonly reported. The drug combinations most often used were inhaled β₂ agonists alone or in combination with inhaled steroids. There were only minor differences in the prevalence of symptoms reported by individuals with asthma treated in different ways. Conclusion . Differences in the way anti-asthma drugs were used contributed to the observed difference in the sales of drugs. However, this difference was mainly caused by differences in the prevalence of asthma. The goals of asthma management plans were fulfilled only in a minority of patients despite the sales of asthma drugs being high.     

SUBCLINICAL PROTEIN-ENERGY MALNUTRITION IN UNDER-PRIVILEGED ETHIOPIAN MOTHERS AND THEIR NEWBORN INFANTS

ABSTRACT. An increased glycine/valine ratio in the maternal and cord vein plasma was observed in under-privileged women and their newborn babies in Ethiopia. There was a delay in the decrease of branch-chained amino acids during the immediate neonatal period. These findings indicate malnutrition in utero and are identical with those of a previous study in an under-privileged group in Pakistan. A reduced cord/maternal ratio of tyrosine and methionine was found in the Ethiopian material, indicating placental dysfunction of unknown origin.     

Light microscopic study of experimental cell-mediated immunity in rat oral mucosa

A model for hapten-induced cell-mediated immunity (CMI) in the oral mucosa of the Spraque-Dawley rat is presented. Sensitization was performed with 0.1 ml of a hapten (DNCB 2%, in acetone solution) administered five times on shaved dorsal skin. Ten days after completed sensitization, eliciting doses of 0.1–0.02% of the hapten were applied in the buccal mucosa one or several times giving rise to an inflammation dominated by lymphocytes. The development of the reaction was studied in a time sequence study. Also sensitization through the buccal mucosa was attempted, with three or more of the eliciting doses applied directly in the buccal mucosa. Light microscopically, the reaction was identical to the one seen in previously sensitized rats. The effects of DNCB and DNFB on sensitized animals with eliciting doses of 25 μl 2% or 0.02% in acetone/olive oil were compared. No differences were seen in the low concentration range, but in the high concentration range, DNFB showed a more potent effect giving rise to ulcers, not observed with DNCB.     

The turnover of acetylcholine in ligated sciatic nerves of the rat

The accumulation of acetylcholine (ACh) and choline acetyltransferase (ChAT) and acetylcholinesterase (AChE) activities proximal to a crush on rat sciatic nerves was investigated after superfusion of the nerves in situ with or without inhibitors of ACh synthesis and/or AChE. 9 h after crushing of nerves, the ACh-content of the 5 mm segment of nerve immediately proximal to the crush was increased from 37±5 to 80±4 pmol (mean ± SE), while ChAT-activity was increased to 112±10% and AChE-activity to 198±19% over that in non-ligated nerves. Superfusion of the nerves for 8 h with Krebs' bicarbonate medium had no effect on enzyme accumulations, but reduced the ACh content to 59±4 pmol. The presence of hemicholinium 3 (HC-3) (2×10^-5 M) in the superfusion medium reduced the ACh content markedly (to 17±2 pmol), but had no effect on enzyme accumulations at the crush. Adding eserine (10^-5 M) or soman (10^-6 M) to the superfusion medium increased ACh content to 133±8 pmol and 101±8 pmol, respectively, and markedly reduced AChE-activity; ChAT activity was not effected. Superfusion with a combination of HC-3 and eserine caused a marked reduction in ACh content compared with eserine alone; the effect was less with soman. The results are consistent with the view that the ACh which accumulates proximal to crush exists in a protective organelle, but that there is a continuous turnover of ACh due to leakage of ACh from the organelle, both during axonal transport and after accumulation.     

In Vitro Target Cell Lysis Mediated by Normal Human Lymphocytes

Lysis of DNP-coated chicken erythrocytes by human blood lymphocytes (K cells) was induced by means of rabbit anti-DNP antibodies. Antisera were prepared by injecting the animals with DNP-conjugated proteins emulsified in Freund's complete adjuvant An ammonium sulphate precipitation technique was used for assay of antibody concentration and affinity. Sephadex G-200 chromatography indicated that 90% of the DNP antibodies were 7S in the bleedings on days 10–16. whereas 99. 8% were 7S in later bleedings. 7S antibodies induced K-cell lysis at high dilutions, whereas 19S antibodies were essentially negative Antibody fractions obtained by DF.AE- or CM-cellulose chromatography were used to establish possible heterogeneities in the capacity of 7S antibodies to induce either K-cell- or complement-mediated target cell lysis. No such heterogeneities were found Fifteen IgG preparations containing antibodies of different affinities were compared with regard to their capacity to induce K-cell-mediated lysis. A statistically significant correlation was found between antibody affinity and efficiency in K-cell-mediated lysis. In a similar study of complement mediated lysis the correlation was not significant at the 5% level but was significant at the 10% level.     

SIMS study of element concentration profiles in enamel and dentin

abstract – The ion probe technique has been employed for the determination of the concentrations of P, F, Cl, C, Na, K, Mg, Sr, Al, and Si at different depths in human tooth. The applicability of the method depends selectively on the element's position in the periodic table, but may be regarded as good for a wide range of microelements of dental interest.