Comparison of energy expenditure estimated in healthy infants using the doubly labelled water and energy balance methods

The doubly labelled water method was used to estimate energy expenditure in 20 formula-fed infants (10 aged 1 month and 10 aged 4 months). We then compared the energy expenditure values with energy balance values calculated from energy intake and energy cost of growth. Our purpose was to compare various published equations for calculating CO2 expiration rates (and thus energy expenditure values) from the isotopic data. Those equations in which we used measured values for 18O and 2H isotope dilution spaces and estimated or measured values for insensible water losses yielded energy expenditure values (69.7 +/- 8.4 kcal/kg/d) that agreed most closely with energy balance data (70.3 +/- 11.9 kcal/kg/d). Equations in which we used a constant ratio of 1.03 between the 2H and 18O isotope dilution spaces resulted in energy expenditure values (66.3 +/- 10.2 kcal/kg/d) lower than those predicted by the energy balance data. Data analysis by nonlinear curve fitting compared to logarithmic transformation did not alter the estimates of energy expenditure obtained in these infants.     

Contrasting Effects of thc on Adult Murine Lymph Node and Spleen Cell Populations Stimulated with Mitogen or Anti-CD3 Antibody

Marijuana, and specifically its psychoactive component, THC, can up or down regulate lymphocyte proliferation in murine spleen cells depending in part on the method used to stimulate the cells. This study identifies a difference in THC induced disregulation using cells derived from two different secondary lymphoid organs, the spleen and the lymph node. It was found that THC treatment of mitogen (concanavalin A or phytohemagglutinin) stimulated cells derived from either organ resulted in suppression of the proliferative response. In contrast, spleen cells stimulated with anti-CD3 antibody and treated with low doses of THC displayed an enhanced proliferation whereas the response in lymph nodes did not change. The cell type involved with this THC immunoenhancement in spleen cells was found to be the Ly2 cell. Further differences in the THC modulation of Ly2 spleen cells as compared to lymph node cells were noted following stimulation with PHA. Proliferation of Ly2 cells of splenic origin was inhibited with low doses of THC whereas the Ly2 cells of lymph node origin were more resistant to this drug induced suppression. This study, therefore, demonstrates differences in the immunomodulatory capability of THC dependent upon the organ source of the lymphocytes.     

Providence School Asthma Partnership: School-based Asthma Program for Inner-City Families

Over 3 years, 972 families participated in an after-school asthma program at their child's school. Parents and children attended concurrent 2¹/₂ -hour workshops. Parents were 74% Latino; 45% non-English speaking, with 77% of children on Medicaid. Asthma symptoms were significantly reduced, from multiple times per week to less than once per week on average. Oral steroid use decreased to one third of baseline use. Hospital days decreased from 11% to 2%; emergency visits decreased 35% to 4%; and school days missed decreased 48% to 20%. This program has now become sustainable with both private and Medicaid insurance coverage.     

The effects of illicit drug use and HIV infection on sex hormone levels in women.

Drug use and HIV infection may affect sex hormone levels in women. One hundred and ninety-six women with and without a history of illicit drug use (50 HIV-negative and 148 HIV-infected), with regular menses, who never used antiretrovirals, were evaluated. Luteinizing hormone levels were significantly higher in women with a CD4 cell count <200/microl (p < 0.002). Current methadone use was associated with lower levels of total testosterone (p = 0.03) and higher levels of prolactin (p = 0.002); mean estradiol levels were 43% lower in women who used intravenous drugs (p < 0.001). Alcohol and crack cocaine use was not associated with sex hormone levels. Age, race, body mass index and degree of HIV immunosuppression were also associated with differences in sex hormone levels.     

Effects of an anti-interleuktn-6 (IL-6) murine monoclonal antibody in a patient with acute monoblastic leukemia

Because IL-6 has been involved in the pathogenesis of acute monoblastic leukemia, we investigated thein vitro anti-proliferative effect and thein vivo anti-tumoral effect of an anti-IL-6 murine monoclonal antibody (mAb) in a patient with MSB type acute leukemia. In the current study, we clearly show the IL-6 dependence of monoblastic cell viability and proliferationin vitro in short-term cultures of malignant cells and the clinical activity of the anti-IL-6 murine mAb. The complete neutralization of IL-6in vivo was associated with a transient but complete disappearance of malignant monoblastic cells in the peripheral blood, with improvement or even normalization of several other biological parameters of disease activity, No immunization against the anti-IL-6 murine mAb was observed.     

Ocular infections associated with Eikenella corrodens

Eikenella corrodens is a gram-negative, facultative rod-shaped anaerobe that colonizes the human mouth, nasopharynx, gut, and genitourinary tract. We treated a corneal ulcer from which E. corrodens was the primary isolate in an otherwise healthy man. We treated another patient who had recurrent bacterial endophthalmitis from which Eikenella was identified in mixed culture. Named for its ability to form pits in agar, the corroding bacillus is gaining recognition for its role in head and neck infections. Certain E. corrodens strains are mobile on moist surfaces and elaborate an endotoxin, which may destroy human tissues directly and indirectly by means of the immune system. The organism is usually resistant to aminoglycosides and penicillinase-resistant penicillins yet is susceptible to penicillin and some cephalosporins.     

Otitis media in children born to human immunodeficiency virus-infected mothers.

Acute otitis media (AOM) is thought to occur frequently in children infected with human immunodeficiency virus (HIV). We compared experience with AOM of 28 HIV-infected children with that of 33 children who seroreverted to HIV antibody negative status by age 18 months. The mean number of episodes/year of AOM for children who seroreverted decreased from 1.33 in the first year of life to 0.13 in the third year, whereas the mean number of episodes/year in HIV-infected children increased from 1.89 to 2.40. By age 3 years, all HIV-infected children had experienced 1 or more episodes of AOM, and 80% had experienced 6 or more, whereas 75% of children who seroreverted had experienced 1 or more episodes, and none had had 6 or more. HIV-infected children with normal T4 lymphocyte counts had a mean of 1.18 episodes of AOM in the first year of life compared with 2.35 episodes in HIV-infected children with decreased counts (P = 0.023). HIV-infected children with low counts had a nearly 3-fold increased risk of recurrent AOM (47% vs. 18%).