Nuclear particles of non-A, non-B type in healthy volunteers and patients with hepatitis B

In an electron microscopic study, nuclear aggregates of virus-like spherical and tubular particles measuring 20 to 29 nm in diameter were found in 5 of 7 clinically healthy volunteers with normal liver histology, 6 of 10 patients with hepatitis B and 17 of 18 patients with hepatitis non-A, non-B. The incidence of hepatocytes containing nuclear particles was approximately 0.5 to 2% in all three groups. We conclude that these nuclear particles are not specific ultrastructural markers of hepatitis non-A, non-B in man as originally claimed for experimental hepatitis non-A, non-B in chimpanzees.     

Presensitization and kidney transplant failures

Over 1000 kidney transplant patients were tested for cytotoxic antibodies before transplantation.     

WIN 55,212-2 decreases the spatial spread of neocortical excitation in vitro

The 'intrinsic optical signal' was used to monitor neuronal network excitability. The cannabinoid receptor type 1 agonist WIN 55,212-2 reduced the intensity and the spatial spread of the intrinsic optical signal and prolonged its kinetics in the rat neocortex in vitro. These effects were antagonized by the cannabinoid receptor antagonist SR141716A. Thus, our results suggest that neocortical network activity is modulated via the activation of cannabinoid receptors. The decrease of neocortical network excitability in the present study is probably due to a decreased excitability of glutamatergic neurons.     

Preventing HIV transmission to children: quality of counselling of mothers in South Africa

AIM: To assess the quality of counselling provided to mothers through the programme to prevent mother-to-child transmission (PMTCT) of HIV in South Africa. METHODS: Structured observations of consultations and exit interviews with 60 mothers attending clinics at three purposively selected PMTCT sites across South Africa were conducted. RESULTS: Twenty-two counsellors were observed. The general quality of communication skills was very good, and 73% of HIV-negative mothers were informed of the advantages of exclusive breastfeeding (EBF). However, only one of 34 HIV-positive mothers was informed about the possible side effects of nevirapine, and none was told what to do when it occurred. Only two HIV-positive mothers were asked about essential conditions for safe formula feeding before a decision about an infant feeding option was made. None of the 12 mothers choosing to breastfeed was shown how to position the baby correctly on the breast or asked whether they thought EBF was feasible. Fewer than a quarter of mothers expressed confidence in performing the actions required, and 85% could not define the term EBF. CONCLUSION: The poor quality of counselling in the PMTCT programme will reduce the effectiveness of these programmes. As they are being scaled up, there needs to be far more attention paid towards the counselling of mothers, especially with regards to optimal infant feeding.     

Regulation of microglial behavior by ion channel activity

Microglia play an important role in the central nervous system, where these cells, it is believed, have both neuroprotective and neurotoxic effects. In response to acute brain injury or during neurodegenerative and neuroinflammatory diseases, activated microglial cells undergo shape changes, migrate to the affected sites of neuronal damage, proliferate, and release a variety of substances, such as cytokines and reactive oxygen species (ROS). This review summarizes the physiological mechanisms underlying microglial activation and deactivation processes, with particular focus on the involvement of microglial ion channels. Microglial ion channels have been shown to be capable, by regulating membrane potential, cell volume, and intracellular ion concentrations, of modulating or facilitating proliferation, migration, cytokine secretion, shape changes, and the respiratory burst of microglial cells.     

Do older adults use the Internet for information on heart attacks? Results from a survey of seniors in King County, Washington

BACKGROUND: Early treatment can reduce mortality from heart attacks. However, patient delay, especially among the elderly, has slowed progress in this area. One of the reasons for delay may be because of a lack of knowledge about symptoms of acute myocardial infarction (AMI) and treatment benefits. The Internet is a new and promising source of heart health information, but we know little about how elderly people use this medium. METHODS: This study investigates the demographic and psychosocial variables that are related to Internet access, health information seeking, and information seeking about heart attacks from the Internet among seniors. We interviewed seniors (N = 323) aged more than 65 years and asked them questions about Internet access, health information seeking, and information seeking on heart attacks, as well as demographic information, risk perceptions for AMI, and personal experience with AMI. RESULTS: The results showed that several demographic variables were related to access to the Internet. Only 7% of the seniors who reported access to the Internet had sought information on heart attacks from the Internet. Age, history of AMI, and family history of AMI were significant predictors of information seeking on heart attacks. This suggests that to date only a very small, high-risk group of seniors actually seeks information on heart attack emergencies from the Internet.     

Impaction allografting for femoral component revision: clinical update

The technique of cancellous impaction allografting with cement aims to reconstitute a bone-deficient proximal femur while also gaining stable fixation of the femoral prosthesis. Some reports of this technique imply it is a system, requiring not just an exacting surgical method, but also a particular implant design, the polished, double-tapered stem. Other series consider it a surgical technique, and have varied the femoral component design, the method of graft delivery, and other elements of the procedure. Our review evaluates the current literature, with the goal of beginning to ascertain whether published results suggest impaction grafting must be considered a system, requiring a particular stem design, or simply another means to achieve femoral reconstruction in the revision setting. The conclusive answer will require randomized, controlled clinical trials to evaluate particular elements of the procedure, and these studies have yet to be done. However, investigators have shown similarly good short-term to intermediate-term results with various femoral stems at numerous centers. Currently, femoral impaction allografting, whether as a system using particular implant designs or as a surgical technique, is an accepted alternative for revision of a failed femoral component, particularly when bone-stock deficiency is present.     

Communication of randomization in childhood leukemia trials

Context  Most children diagnosed as having leukemia become research subjects in randomized clinical trials (RCTs), but little is known about how randomization is explained to or understood by parents. Objective  To investigate physicians' explanation and parental understanding of randomization in childhood leukemia RCTs. Design and Setting  A multisite study of the informed consent communication process for RCTs of childhood leukemia. Consecutive cases were recruited from pediatric oncology inpatient wards at 6 US children's hospitals associated with major academic medical centers from July 1, 1999, until December 31, 2001. The informed consent conferences were observed and audiotaped, and the information obtained was coded and analyzed. Parents were interviewed shortly after the conference to ascertain their understanding. Participants  Parents and members of the health care team who participated in 137 informed consent conferences for children with newly diagnosed acute leukemia. Main Outcome Measures  Observed explanations of randomization and parental understanding of randomization after the consent conference. Results  Randomization was explained by physicians in 83% of cases and a consent document was presented during the conference in 95% of cases. Interviews after the conference demonstrated that 68 (50%) of 137 parents did not understand randomization. Parents of racial minority and lower socioeconomic status were less likely to understand randomization (P<.001 for each). Discussion of specific clinical trial details and the presence of a nurse during the conference were associated with understanding. Eighty-four percent of children were enrolled in a leukemia trial. Conclusions  Despite oral and written explanation, half of the parents in this study did not understand randomization for childhood leukemia trials. To make informed consent more effective, future research must seek to improve communication during this critical interchange.