Does antigenic overload exist? The role of multiple immunizations in infants

There is no evidence that currently recommended vaccines overload or weaken the infant immune system. Infants have an enormous capacity to respond safely and effectively to multiple vaccines. The schedule for the administration of childhood vaccines is tailored to the unique developmental pattern of the infant immune system. Childhood vaccines provide immediate protection from common childhood illness and establish the foundation for lifelong immunity that develops with subsequent vaccination or infection. Widespread vaccination of infants and children represents a public health triumph of the 20th century. This fact must be reinforced continually by health care workers and parent education to help maintain progress in the 21st century.     

Proximate, Mineral and Procyanidin Content of Certain Foods and Beverages Consumed by the Kuna Amerinds of Panama

The Kuna Amerinds reside chiefly in the San Blas islands (Kuna Yala) on the Caribbean coast of Panama. The diet of this population has not previously been described in detail and composition data for certain foods consumed by this population does not exist or is lacking for certain important nutrients. The protein, fat, moisture, fiber, sugar, mineral and procyanidin content was determined in foods selected because of the frequency with which they are consumed by this population. For that reason, emphasis was given to Tule Masi, a typical Kuna stew-like dish, and cocoa-containing beverages. The foods analyzed were generally low in fat and protein. Potassium and magnesium are present in Tule Masi, common beverages and certain fruits and vegetables at significant levels when considering the preliminary reports on the daily intake of these foods. In addition, preliminary reports indicate that salt use is common, an observation that is supported by the sodium content of the Tule Masi. The cocoa and cocoa beans used in the preparation of beverages are rich in several minerals and procyanidins, as expected. This analysis will allow for the estimation of nutrient intake and subsequent investigations into the relationship between diet and health in this population.     

Monitoring cardiovascular health in men with prostate cancer treated with androgen deprivation therapy

Earlier diagnosis and improved treatments have resulted in men with prostate cancer living for many years following diagnosis. Long‐term effects of treatments are therefore important. Androgen deprivation therapy (ADT) is now commonly used to treat prostate cancer. We have estimated that, in Australia, 6500 men used ADT in 1999/2000 with a steady increase to about 21 800 men in 2009/2010 (over 300% increase), a trend similar to those in the USA and UK. ADT has a range of side‐effects that can impact on quality of life such that risks and benefits should be carefully considered before making treatment decisions. Cross‐sectional and longitudinal studies show that ADT can have cardio‐metabolic effects including increases in fat mass and reduced lean mass, possible adverse effects on lipid levels, increased insulin resistance and increased risk of type 2 diabetes. ADT may also increase the risk of incident cardiovascular events and possibly cardiovascular mortality, although the evidence is not conclusive. In the absence of high‐quality evidence to guide management, it is prudent to consider men using androgen deprivation are at higher risk of diabetes and cardiovascular disease. Maintenance of normal body weight through diet and exercise, smoking cessation, and control of blood pressure, lipid levels and blood glucose are recommended, based on guidelines for the general population. Men at significant cardiovascular risk should consider aspirin therapy. All health professionals involved in the care of men undergoing prostate cancer treatment need to be aware of the risks of ADT and ensure appropriate monitoring and management.     

EC145: a novel targeted agent for adenocarcinoma of the lung

INTRODUCTION: EC145 is a folate receptor (FR)-targeted vinca alkaloid conjugate currently under development as an anticancer agent. The FR is overexpressed on a number of major malignancies including adenocarcinoma of the lung and ovarian cancer. A companion diagnostic radiopharmaceutical, EC20, allows for non-invasive determination of the presence of functionally active FR. AREAS COVERED: This review will discuss the rationale for the FR as a target for anticancer agents, the pharmacology of EC145 and the preclinical and clinical results for EC145 and related compounds. In addition, it will discuss the utility of a companion imaging diagnostic, EC20, for the selection of patients who might benefit from EC145. EXPERT OPINION: EC145 is a first in class, novel agent with a unique target. The companion diagnostic, EC20 may allow for enrichment of the patient population, and therefore accelerate development of the drug. The drug has demonstrated benefit in preliminary reports of trials in ovarian cancer. If similar benefit is demonstrated in lung cancer, the drug is likely to have significant use in lung cancer and other malignancies with overexpression of FRs.     

The Proportions of Streptomyces californicus and Stachybotrys chartarum in Simultaneous Exposure Affect Inflammatory Responses in Mouse RAW264.7 Macrophages

Abstract

Adverse health outcomes associated with moisture-damaged buildings originate from an exposure consisting of complex interactions between various microbial species and other indoor pollutants. The concentrations and proportions of microbial components in such environments can vary greatly with the growth conditions. In this study, we aimed to evaluate the effects of simultaneous exposure with modified proportions of actinobacteria Streptomyces californicus and fungi Stachybotrys chartarum on inflammatory responses (cytokines macrophage inflammatory protein 2 [MIP2], interleukin 6 [IL-6] and tumor necrosis factor α [TNFα]; nitric oxide) and cytotoxicity (MTT-test and DNA content analysis) in mouse RAW264.7 macrophage cell line. Five different proportions of microbial spores were studied (Str. californicus: S. chartarum 10:1; 5:1; 1:1; 1:5; 1:10). RAW264.7 cells were coexposed to the total dose of 3 × 10⁵ spores/ml for 24 h and also both of these microbial spores on their own at the respective doses. At least the 1.5-fold synergistic increase in cytokine production of RAW264.7 macrophages was detected when coexposure contained an equal amount or more fungal spores (S. chartarum) than bacterial spores (Str. californicus) compared to the sum response caused by these microbial spores separately. On the contrary, NO production after coexposure was nearly 40% less than the sum response induced by the microbial spores separately, when coexposure contains 5 times more bacterial than fungal spores. In addition, coexposure slightly changed the cytotoxic potency of the spores. The present results revealed that mutual proportions of fungal and bacterial spores in simultaneous exposure affect the nature of their interactions leading to increased or suppressed production of inflammatory mediators in RAW264.7 macrophages.     

Drug prevention as co-ordination: the vicious circle of devolving responsibility in primary prevention

Due to ongoing managerial and decentralizing trends in public policy, responsibility for drug prevention is continuously being devolved from one level to another, from the European Union all the way down to the civil society. In this paper, a drug prevention program in Helsinki represents a realization of the EU drugs strategy due to similar rhetoric and goals: co-ordinating multi-agency co-operation. An analysis of contradictions inherent in this setting is based on interviews of the program workers as well as representatives of governmental and national drug-prevention agencies. The analysis results show that ‘almost anything goes’ because no single body has the legitimacy to prioritize any particular approach over any other. The situation easily results in either ineffective indecision or overdoing preventive enthusiasm that simplifies the drugs issue. This vicious circle is difficult to break. In order to provide more realistic prevention, a systematic increase in the knowledge base of the practitioners in the drug field is needed. Simultaneously, the issue becomes political, requiring authority and agreement on concrete guidelines at a national level—issues that prevailing public policy tries to evade.