Serum magnesium levels in asthmatic patients during acute exacerbations of asthma.

The purpose of this study was to determine whether serum magnesium levels in asthmatic patients during acute exacerbations differ from those of a control population. Twenty-three known asthmatics presenting to the emergency department in acute exacerbation (cases) and 15 nonasthmatic patients (controls) matched for age, sex, race, and socioeconomic status had serum magnesium assays drawn. Admission criteria were: age 18 to 50 years with no history of alcoholism, heart disease, renal disease, or diuretic use. Patients giving a history of pregnancy were excluded. Serum magnesium levels were not significantly different in the two study populations, nor did they correlate with the severity of asthma (mean values: cases, 2.04 +/- 0.159 versus controls, 2.03 +/- 0.134 mg/dL; SD of the difference of the means = .048). An analysis for beta-error demonstrated the true difference of the means to be less than .1 (95% confidence) or less than .13 (99% confidence). In conclusion, serum magnesium levels in asthmatics are not significantly different from those of a control nonasthmatic population. They are not clinically useful for predicting the severity of disease.     

Risk Behavior and Perception Among Youths Residing in Urban Public Housing Developments

The scientific literature and popular media suggest that variations in housing structure and neighborhood influence risk behaviors among youths living in low-income urban communities. To explore the importance of these factors on early sexual intercourse, substance use, drug trafficking, and school truancy, data from a community-based survey, conducted in six public housing developments in a major eastern metropolis, were analyzed. The survey group consisted of 300 youths aged 9 through 15 years. There were minimal differences in three potential mediators of risk behaviors (e.g., perceived social support, parenting style, and perceived risk exposure) and in self-reported adolescent risk behaviors among youths residing in different housing developments and between youths residing in high-rise and in low-rise structures. These findings do not support the hypothesis that within a risk-dense low-income environment, variations in building structure or in neighborhood are associated with differences in adolescent risk behaviors.     

Effects of camber on wheeling efficiency in the experienced and inexperienced wheelchair user

The objective of this study was to determine whether energy costs differed between 0 degrees , 3 degrees , and 6 degrees of camber during steady state overground wheeling. Three subject groups were examined: experienced wheelchair users with disabilities (thoracic lesion level 6 and below), nondisabled individuals with manual wheeling experience, and nondisabled individuals with no manual wheeling experience. Heart rate, rating of perceived exertion, visual analog scale for comfort, and a user preference questionnaire were collected for all subjects. Expired gas analysis data were collected for the group with disabilities. No statistically significant differences emerged in respiratory measures for camber angle or group. A camber of 6 degrees was most preferred in terms of stability on a side slope, hand comfort on the pushrims, maneuverability, and overall preference. Rear-wheel camber angle did not affect the energy expenditure of manual wheelchair propulsion, as measured by cardiopulmonary means. The individual manual wheelchair user's perceived level of comfort should be the determining factor in rear-wheel camber selection.     

Detection of human bocavirus in Canadian children in a 1-year study

Human bocavirus was detected by PCR in 65 (5.1%) of 1,265 respiratory specimens collected in 2002 and 2003 from the Stollery Children's Hospital from children <17 years of age. The spectrum of illness included upper respiratory infection, croup, bronchiolitis, and pneumonia with a prominence of cough and fever.     

Adults' perceived prevalence of enteric fever predicts laboratory-validated incidence of typhoid fever in children

This study was undertaken to develop a model to predict the incidence of typhoid in children based on adults' perception of prevalence of enteric fever in the wider community. Typhoid cases among children, aged 5-15 years, from epidemic regions in five Asian countries were confirmed with a positive Salmonella Typhi culture of the blood sample. Estimates of the prevalence of enteric fever were obtained from random samples of adults in the same study sites. Regression models were used for establishing the prediction equation. The percentages of enteric fever reported by adults and cases of typhoid incidence per 100,000, detected through blood culture were 4.7 and 24.18 for Viet Nam, 3.8 and 29.20 for China, 26.3 and 180.33 for Indonesia, 66.0 and 454.15 for India, and 52.7 and 407.18 for Pakistan respectively. An established prediction equation was: incidence of typhoid (1/100,000= -2.6946 + 7.2296 x reported prevalence of enteric fever (%) (F=31.7, p<0.01; R2=0.992). Using adults' perception of prevalence of disease as the basis for estimating its incidence in children provides a cost-effective behavioural epidemiologic method to facilitate prevention and control of the disease.     

Cell culture (Vero) derived whole virus (H5N1) vaccine based on wild-type virus strain induces cross-protective immune responses

The rapid spread and the transmission to humans of avian influenza virus (H5N1) have induced world-wide fears of a new pandemic and raised concerns over the ability of standard influenza vaccine production methods to rapidly supply sufficient amounts of an effective vaccine. We report here on a robust and flexible strategy which uses wild-type virus grown in a continuous cell culture (Vero) system to produce an inactivated whole virus vaccine. Candidate vaccines based on clade 1 and clade 2 influenza H5N1 strains were developed and demonstrated to be highly immunogenic in animal models. The vaccines induce cross-neutralising antibodies, highly cross-reactive T-cell responses and are protective in a mouse challenge model not only against the homologous virus but also against other H5N1 strains, including those from another clade. These data indicate that cell culture-grown whole virus vaccines, based on the wild-type virus, allow the rapid high yield production of a candidate pandemic vaccine.     

Global health status: two steps forward, one step back

Impressive improvements have occurred in global health status in the past century. Unfortunately, these improvements have not been shared equally and health in equalities within and among countries are entrenched. The fragility of health gains has been seen in response to economic, political, and social changes changes, and civil disruption. The limitations of health-status measure hinder our ability to map health trends except in the simplest way. There is an urgent need for better regional and national health surveillance systems to underpin efforts to address the complex mixture of old and new health concerns.     

Tissue-Specific Cytokine Production During Experimental Acute Pancreatitis (A Probable Mechanism for Distant Organ Dysfunction)

Our purpose was to determine if cytokines are produced systemically during acute pancreatitis. Proinflammatory cytokines are elevated during acute pancreatitis and have been implicated in the progression of pancreatitis-associated multiple organ dysfunction. Whether these mediators are produced within all tissues or very few specific organs is not known. Edematous pancreatitis was induced in adult male mice by IP injection of cerulein. Necrotizing pancreatitis was induced in young female mice by feeding a choline-deficient, ethionine supplemented diet.Animals were sacrificed as pancreatitis worsened, with multiple organs prepared for tissue mRNA and protein analysis by RT-PCR and immunoblotting.Pancreatitis severity was established by histologic grading and serum amylase and lipase. There was no cytokine mRNA or protein detectable prior to the induction of pancreatitis. Tumor necrosis factor- (TNF-) and interleukin-1- (IL-1) mRNA and protein were detected within the pancreas early in the course of pancreatitis in both models,coinciding with the development of hyperamylasemia (both P < 0.001). Interleukin-6 was produced in the pancreas after pancreatitis was more fully developed (P< 0.001). IL-1 and TNF- were subsequently produced in large amounts in lung, liver, and spleen but never within kidney, cardiac muscle, or skeletal muscle.A significant delay between pancreatic and distant organ cytokine production was always observed.It is concluded that proinflammatory cytokines are produced within the pancreas and within organs known to develop dysfunction during severe pancreatitis. Cytokine production is tissue specific,correlates with disease severity, and occurs within the pancreas first and subsequently within distant organs.     

Could urine be useful for the diagnosis of Chlamydia trachomatis pneumonia in infancy?

A 9-week-old infant presented with respiratory distress. The presumptive diagnosis of Chlamydia trachomatis pneumonia was ultimately made in a novel manner by a positive nucleic acid amplification test on a urine sample.