Impact of age, height, and body mass index on arterial diameters in infants and children: a model for predicting femoral artery diameters prior to cardiovascular procedures.

PURPOSE: To measure common femoral artery (CFA) diameters in infants and children referred for cardiac catheterization and investigate if CFA diameters can be predicted upon the basis of age, body mass index (BMI), and height. METHODS: CFA diameters were measured in 84 infants and children (50 boys; age range 1- 220 months) referred for diagnostic or therapeutic cardiac interventions. Sonographic measurements were made in a supine position utilizing a 7.5-MHz linear transducer; diameters were defined as the intima to intima distance. Age was described in months and height in centimeters. The Spearman correlation coefficient (rho) was used to test the similarity of diameters between sides; the Pearson correlation coefficient (r) was used to analyze the influence of age, height, and BMI on CFA diameter. RESULTS: Diameters of the right and left CFA were similar (rho=0.951). Age and height were highly correlated (rho=0.956), but not BMI and height (rho=0.279). The best model was CFA diameter = -0.838 + 0.031 height + 0.046 BMI. Height was the most relevant determinant for CFA diameter (p<0.0001, 90% CI 0.027 to 0.036; BMI: p=0.093, 90% CI 0.001 to 0.090, and the intercept: p=0.032, 90% CI-1.475 to-0.200). CONCLUSIONS: Common femoral artery diameter can be sufficiently predicted from height and BMI of infants and children prior to femoral catheterization or surgical reconstruction.     

Global epidemiology of tuberculosis: prospects for control

The burden of tuberculosis (TB) is now very slowly decreasing globally. However, the rate of decline is too slow to reach all the epidemiological impact targets set for 2015. The prospects for reaching the TB elimination target set for 2050 are even bleaker. Implementation of the World Health Organization's Stop TB Strategy is currently lagging behind the envisioned scale-up pace, particularly with regard to TB/HIV collaborative activities and management of drug resistant TB. To ensure long-term TB control there is, first, a need to ensure that all components of the Stop TB Strategy are scaled up according to plans, with special attention to improved access for the poor. However, this may not be enough. Recent analyses suggest that the impact of current efforts to reduce TB incidence is less than expected and that improved diagnostic and curative efforts need to be combined with additional preventive efforts. New and more effective vaccines and drugs for preventive treatment would revolutionize TB control. A stronger focus on prevention would also entail more concerted actions to limit the impact of TB risk factors, including HIV/AIDS, smoking, malnutrition, alcoholism, diabetes, crowded living conditions, and indoor air pollution, which may all contribute a considerable proportion of the global TB burden.     

Serum lipids of Greenland Inuit in relation to Inuit genetic heritage, westernisation and migration

BACKGROUND: The reputed low prevalence of cardiovascular disease among the Inuit has recently been challenged. Studies have shown total cholesterol among the Inuit to differ little from that of western populations and the association between cholesterol and atherosclerosis to be inconsistent. METHODS: We studied serum lipids in a population survey among 2114 Inuit living in Denmark or in West Greenland. Blood tests were supplemented by structured interviews, anthropometry and measurements of blood pressure. FINDINGS: Compared with the general population of Denmark, total cholesterol was higher among Inuit women, while HDL-cholesterol was higher among Inuit men. Triglyceride was lower among Inuit of both sexes. Cholesterol and triglyceride varied according to westernisation, diet, alcohol consumption and smoking. In a multivariate analysis, serum lipids also differed significantly between pure and genetically mixed Inuit: HDL-cholesterol was higher among the genetically pure Inuit, while among men triglyceride was lower and among women total and LDL-cholesterol were higher. INTERPRETATION: Among the Inuit, serum lipids are significantly associated with westernisation and genetic heritage. The effect of westernisation is to some extent due to dietary changes. From a cardiovascular health point of view, westernisation within Greenland is associated with unfavourable lipid changes while migration to Denmark is associated with favourable lipid changes.     

Ethanol-induced malfunction of neutrophils respiratory burst on patients suffering from alcohol dependence

Background: Polymorphonuclear, neutrophil granulocytes (PMN) play a major role in the control of infections, and people who abuse alcohol are susceptible to infections. Resistance against infections ensues intracellularly following initial phagocytosis of microorganisms with the oxygen‐dependent respiratory burst, the key enzyme of which is the respiratory burst oxidase, whereby oxygen radicals are produced for microbial destruction. To date there is insufficient information available in connection with the process of impaired defence against infection in patients suffering from alcohol dependence. Therefore, our investigation was carried out to determine the influence of alcohol exposition on the formation of oxygen radicals and the respiratory burst. Methods: 4.5 ml of whole blood was taken from 10 healthy adults and 10 patients suffering from alcohol dependence. An additional 3.5 ml of whole blood was taken from the alcoholic patients for determination of the blood alcohol concentration. The respiratory burst of PMN was tested using the Four‐Colour‐Continuous Flow Cytometer. Each experimental procedure consisted of 4 test samples [negative controls, Escherichia coli, FMLP‐supplement (N‐formyl‐l‐methionyl‐l‐leucyl‐l‐phenylalanin), PMA‐supplement (phorbol‐12‐myristate‐13‐acetate)]. Differing concentrations of ethanol were also introduced to each of the tests performed (0.20 to 4.00 g/l). Results: Ethanol revealed a marked decrease of burst activity in those patients suffering from alcoholism with increased alcohol concentration. A dependence between the burst activity and the ethanol concentration was seen to be statistically significant. This effect was only evident after stimulation with E. coli and FMLP in those patients with alcohol dependence. Conclusion: The results presented in this study show an impairment in the function of PMN in those patients addicted to alcohol due to the decrease in burst activity. In view of the results of the different stimuli, the second‐messenger effects were not evident. A clarification of this phenomenon could well be assumed as an allosteric receptor effect on the burst oxidase, namely, a direct effect on the phagocytosis interaction between circulating granulocytes and causative organisms.     

Variation near the hepatocyte nuclear factor (HNF)-4α gene associates with type 2 diabetes in the Danish population

Aims/hypothesis The hepatocyte nuclear factor (HNF)-4 is an orphan nuclear receptor, which plays crucial roles in regulating hepatic gluconeogenesis and insulin secretion. The gene encoding HNF-4 (HNF4A) is located on chromosome 20q12–q13 in a region that in several studies has shown linkage with type 2 diabetes. Recently, two independent studies identified single nucleotide polymorphisms (SNPs) in a 90-kb region spanning HNF4A, which showed strong association with type 2 diabetes in the Finnish and Ashkenazi Jewish populations. In an attempt to replicate and extend these findings, we selected four SNPs in the same HNF4A region, which in the Finnish and Ashkenazi Jewish populations were associated with type 2 diabetes, and examined their relationships with type 2 diabetes and prediabetic phenotypes in the Danish Caucasian population.Methods The rs1884614, rs2425637, rs1885088 and rs3818247 were analysed in case-control studies of 1387, 1429, 1417 and 1371 type 2 diabetic patients and 4766, 4727, 4665 and 4748 glucose-tolerant subjects respectively. Genotype–quantitative trait analyses comprised 4430, 4394, 4336 and 4413 middle-aged glucose-tolerant subjects from the population-based Inter99 cohort for the rs1884614, rs2425637, rs1885088 and rs3818247 respectively.Results The risk allele of the rs1884614, which is located 4 kb upstream of the HNF4A P2 promoter, was associated with type 2 diabetes (odds ratio [OR]=1.14, p=0.02) and with a subtle increase in post-OGTT plasma glucose levels in glucose-tolerant subjects (additive model, p=0.05).Conclusions/interpretation Consistent with results from studies of Finnish and Ashkenazi Jewish subjects, variation near the P2 region of HNF4A is associated with type 2 diabetes in the Danish population.     

The sand rat (psammomys obesus) as an experimental animal in studies of diabetes mellitus

Summary The sand rat has some unique attributes, which make it a valuable experimental animal. The occurrence of increased plasma insulin levels and of hyperglycemia is linked to an increased food intake. As in the human maturity-onset type diabetes, there seems to be an element of insulin resistance, and this can be demonstratedin vitro by the relative unresponsiveness of sand rat adipose tissue to increasing doses of pork insulin. Prophylactic treatment with acetohexamide seems to have some protective effect against the diabetogenic results of a high calory diet. — It is expected that the diabetic syndrome in sand rats, which can be so easily induced by dietary manipulation, will be a valuable tool in helping to clarify some of the possible mechanisms in the syndrome of diabetes mellitus.This work was carried out during the tenure of Research Career Awards from the U. S. Public Health Service to Drs.Hackel (HE-K6-14, 188) andSchmidt-Nielsen, (K6-GM-21, 522) a Career Development Award to Dr.Lebovitz (K3-AM-17, 954), and a Research Fellowship to Dr.Horton (F3-AM-32, 326); supported by grants from the U. S. Public Health Service (AM-08949, AM-1324, and HE-0228), Eli Lilly Co., the Duke University Research Council, and the Mary Duke Biddle Foundation.     

The -250G>A promoter variant in hepatic lipase associates with elevated fasting serum high-density lipoprotein cholesterol modulated by interaction with physical activity in a study of 16,156 Danish subjects

CONTEXT: Hepatic lipase plays a pivotal role in the metabolism of high-density lipoprotein (HDL) and low-density lipoprotein by involvement in reverse cholesterol transport and the formation of atherogenic small dense low-density lipoprotein. OBJECTIVES: The objective was to investigate the impact of variants in LIPC on metabolic traits and type 2 diabetes in a large sample of Danes. Because behavioral factors influence hepatic lipase activity, we furthermore examined possible gene-environment interactions in the population-based Inter99 study. DESIGN: The LIPC -250G>A (rs2070895) variant was genotyped in the Inter99 study (n = 6070), the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care Denmark screening cohort of individuals with risk factors for undiagnosed type 2 diabetes (n = 8662), and in additional type 2 diabetic patients (n = 1,064) and glucose-tolerant control subjects (n = 360). RESULTS: In the Inter99 study, the A allele of rs2070895 associated with a 0.057 mmol/liter [95% confidence interval (CI) 0.039-0.075] increase in fasting serum HDL-cholesterol (HDL-c) (P = 8 x 10(-10)) supported by association in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care study [0.038 mmol/liter per allele (95% CI 0.024-0.053); P = 2 x 10(-7)). The allelic effect on HDL-c was modulated by interaction with self-reported physical activity (P(interaction) = 0.002) because vigorous physically active homozygous A-allele carriers had a 0.30 mmol/liter (95% CI 0.22-0.37) increase in HDL-c compared with homozygous G-allele carriers. CONCLUSIONS: We validate the association of LIPC promoter variation with fasting serum HDL-c and present data supporting an interaction with physical activity implying an increased effect on HDL-c in vigorous physically active subjects carrying the -250 A allele. This interaction may have potential implications for public health and disease prevention.     

Characterisation of a monoclonal antibody detecting Atlantic salmon endothelial and red blood cells,and its association with the infectious salmon anaemia virus cell receptor

Endothelial cells (ECs) line the luminal surfaces of the cardiovascular system and play an important role in cardiovascular functions such as regulation of haemostasis and vasomotor tone. A number of fish and mammalian viruses target these cells in the course of their infection. Infectious salmon anaemia virus (ISAV) attacks ECs and red blood cells (RBCs) of farmed Atlantic salmon (Salmo salar L.), producing the severe disease of infectious salmon anaemia (ISA). The investigation of ISA has up to now been hampered by the lack of a functional marker for ECs in Atlantic salmon in situ. In this study, we report the characterisation and use of a novel monoclonal antibody (MAb) detecting Atlantic salmon ECs (e.g. vessel endothelium, endocardial cells and scavenger ECs) and RBCs. The antibody can be used with immunohistochemistry, IFAT and on Western blots. It appears that the epitope recognised by the antibody is associated with the ISAV cellular receptor. Besides being a tool to identify ECs in situ, it could be useful in further studies of the pathogenicity of ISA. Finally, the detection of an epitope shared by ECs and RBCs agrees with recent findings that these cells share a common origin, thus the MAb can potentially be used to study the ontogeny of these cells in Atlantic salmon.