HIV-infected patients show impaired cellular immune response to influenza vaccination compared to healthy subjects

Detailed data on cellular immune response to influenza vaccination in HIV-infected patients are lacking. We analyzed cellular (IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IFN-γ, TNF-α, GM-CSF) and humoral (IgG and IgM) immune response in 81 HIV-infected and 30 HIV-negative subjects, before (T0) and 4 weeks (T1) after receiving a single dose of trivalent MF59-adjuvanted influenza vaccine. No difference in humoral response (IgG or IgM) was demonstrated between the two groups. While an increase in most cytokines from T0 to T1 was observed in HIV-uninfected subjects, cytokines production did not significantly increased in HIV-infected patients. Exploring Th1 response, higher CD8 cells count was significantly associated with lower post-vaccination IFNγ levels, while a higher CD4 cells count was associated with a greater response. Exploring Th2 response, higher HIV viral load was significantly associated with reduced post-vaccination IL-10 levels. In conclusion, in HIV-infected patients influenza vaccination could have good efficacy in sustaining humoral response but cellular response appeared impaired.     

Update of the follow-up of mortality and cancer incidence among European workers employed in the vinyl chloride industry.

Although vinyl chloride is an established cause of liver angiosarcoma, the evidence is inconclusive on whether it also causes other neoplastic and nonneoplastic chronic liver diseases as well as neoplasms in other organs. Furthermore, the shape of the dose-response relation for angiosarcoma is uncertain. We have extended for approximately 8 years the mortality and cancer incidence follow-up of 12,700 male workers in the vinyl chloride industry in four European countries. All-cause mortality was lower than expected, whereas cancer mortality was close to expected. A total of 53 deaths from primary liver cancer (standardized mortality ratio 2.40, 95% confidence interval = 1.80-3.14) and 18 incident cases of liver cancer were identified, including 37 angiosarcomas, 10 hepatocellular carcinomas, and 24 liver cancers of other and unknown histology. In Poisson regression analyses we observed a marked exposure response for all liver cancers, angiosarcoma, and hepatocellular carcinoma. The exposure-response trend estimated for liver cancer in analyses restricted to cohort members with cumulative exposures of <1,500 parts per million-years was close to that estimated for the full cohort (relative risk of 2.0 per logarithmic unit of cumulative dose). No strong relation was observed between cumulative vinyl chloride exposure and other cancers. Although cirrhosis mortality was decreased overall, there was a trend with cumulative exposure.     

Indicators of adolescents’ preference to receive oral health information using social media

Objectives: To assess (1) adolescents’ preference to use social media (SM) to receive oral health information (OHI) and (2) factors associated with this preference.

Materials and methods: A cross-sectional survey was conducted in 2016, Eastern Province, Saudi Arabia including male middle school students. A questionnaire assessed explanatory variables including background, previous OHI seeking practices, internet use purposes, convenience of using SM for OHI and perceived usefulness of obtained OHI. The outcome variable was respondents’ preference to use SM to receive OHI. Simple and multiple logistic regression models were used for statistical analysis.

Results: The response rate was 91.2% (456/500). Of those, 57.5% preferred using SM to receive OHI. The odds for this were significantly associated with being Saudi (OR?=?3.12, 95%CI?=?1.36, 7.18), previously using Twitter (OR?=?4.59, 95%CI?=?1.77, 11.89) and Instagram for OHI (OR?=?2.60, 95%CI?=?1.51, 4.45), frequent use of the internet to obtain OHI (OR?=?1.25, 95%CI?=?1.02, 1.54) and ease of obtaining OHI using the Internet (OR?=?2.69, 95%CI?=?1.5, 4.39).

Conclusion: Most adolescents preferred using SM to receive OHI. This was associated with previous OHI seeking practices and convenience of using SM. These findings have implications for designing SM-based health education campaigns targeting adolescents.     

Elevation of blood levels of zinc protoporphyrin by radiomimetic drugs and Friend leukemia virus

Sublethal doses of whole-body irradiation induced the elevation of zinc protoporphyrin (ZPP). Experiments were conducted to determine if recovery from radiomimetic drugs also resulted in elevation of ZPP. Daily injections with hydroxyurea and other cytotoxic drugs for 10 days caused ZPP elevation and a dose of radiation too low to cause ZPP elevation by itself caused ZPP elevation when hydroxyurea was administered prior to irradiation. Friend leukemia virus also brought about an elevation of ZPP. However, not all factors that increased erythropoiesis brought about ZPP elevation. The elevated erythropoiesis in response to hypoxia and the enhanced erythropoiesis that followed administration of folic acid to folic acid-deficient mice was not accompanied by ZPP elevation.     

Gallstones at autopsy and cholecystectomy: a comparative study

An examination of 613 post-mortems gave a prevalence of biliary disease at autopsy of 36.5%, higher than reported previously in Australia. This consisted of an asymptomatic gallstone prevalence of 18.9%, with a further 5.7% of the autopsies having granular biliary sludge and 11.9% having had a previous cholecystectomy. Although the rate of occurrence of cholesterol gallstones was approximately half that of the pigment gallstones and pigment biliary sludge combined, no significant association between the sex of the postmortems and stone type was observed at autopsy (chi 2(1) = 0.1: P greater than 0.05). The ratio of biliary disease between females and males was approximately 2:1. Gallstones and biliary sludge from 310 cholecystectomy patients showed that cholesterol gallstones were approximately twice as common in men, and approximately six times as common in women than pigment gallstones. In this group of patients there was a significant association between the sex of the patient and the rate of occurrence of stone type. The rate of occurrence of cholesterol gallstones was significantly higher than pigment gallstones in both the males and females at cholecystectomy (chi 1(2) = 18.97; P less than 0.0001). A female to male ratio of approximately 2:1 was also observed. A statistically significant higher rate of pigmented biliary disease was observed at autopsy than at cholecystectomy. (chi 2 = 101.0; P less than 0.0001). Analyses on biliary sludge, a filterable, fine granular pigmented material in bile, suggest that it may be the direct precursor for a number of different gallstone types.     

Deletion of 8p: a report of a child with normal intelligence

The case is presented of a female infant with a distal deletion of 8p (8p23.1-->pter) whose development was monitored over a 5-year period from 12 months of age. Although previous literature has suggested that 8p deletion is associated with mild to moderate intellectual disability, the child reported here has normal intelligence. Despite initial delays in gross motor and language skills, cognitive development (assessed with the Bayley Scales of Infant Development) and intellectual ability (measured on the Stanford-Binet Intelligence Scale) were within average range. It is argued that the small number of previous case reports may have created a misleading impression of intellectual development in individuals with distal deletions of 8p.     

Alternative therapies for musculoskeletal conditions

The use of complementary and alternative medicine is complex and nuanced. Patterns of use of complementary and alternative medicine differ among racially and ethnically different groups. Multivariate models of utilization indicate that ethnicity plays an independent role in the implementation of these modalities, in seeking practitioners and in health problems for which assistance is required. Moreover, there are many reasons why people use complementary and alternative medicine: conventional treatment may not be working as well as they would like; they want greater relief of symptoms and/or disability; they have issues with side-effects of pharmaceutical treatment; they wish to reduce some of the stress that comes from living with a chronic illness and want to cope better; they believe that complementary and alternative therapies are safer and 'natural'; and they are influenced by the widespread advertising and attractive claims that are made for many natural products. Although there are more than 150 different kinds of syndromes and conditions associated with arthritis, this review will focus on currently available evidence-based medicine for the two most common conditions diagnosed in Western countries - osteoarthritis and rheumatoid arthritis - for which people seek and then implement complementary and alternative medicine modalitites.