HYPERTENSION MANAGEMENT: LIFESTYLE INTERVENTIONS IN A TRANSCULTURAL CONTEXT

Hypertension is a risk factor for cardiovascular and kidney diseases. According to estimation, the prevalence of hypertension will increase unless extensive and effective preventive measures are implemented. The diversity of languages and cultures of the hypertensive patients requiring adequate blood pressure control make communications difficult in many instances. Nursing intervention for patients to adopt a healthy lifestyle requires effective communication. But the communication problems encountered in a culturally diverse context can result in undesirable outcomes for the patients and the health‐care team. This paper describes the production of a document to assist staff address the difficulty in intercultural communication, which could be used anywhere in the world. This document can facilitate nursing intervention to achieve optimal hypertension management in a transcultural context, responding to the challenge regarding preventive measures to halt increase in hypertension prevalence.     

Epidemiological Typing of Bordetella pertussis Isolates: Recommendations for a Standard Methodology

 Pertussis is re-emerging in vaccinated populations, and to gain insight into the reasons for this development population-based studies are necessary. Unfortunately, various techniques are used to study Bordetella pertussis populations, hampering comparison between studies. A standard methodology for epidemiological typing of Bordetella pertussis isolates is proposed which is based on serotyping, pulsed-field gel electrophoresis and gene typing. Such a standard approach will allow comparisons between studies performed in different laboratories. Comparisons may reveal whether the epidemiological differences observed between countries are due for instance to different Bordetella pertussis populations or different vaccines used.     

Antimicrobial, antioxidant, antitumour-promoting and cytotoxic activities of different plant part extracts of Garcinia atroviridis griff. ex T. anders

Crude extracts (methanol) of various parts, viz. the leaves, fruits, roots, stem and trunk bark, of Garcinia atroviridis were screened for antimicrobial, cytotoxic, brine shrimp toxic, antitumour-promoting and antioxidant activities. The crude extracts exhibited predominantly antibacterial activity with the root extract showing the strongest inhibition against the test bacteria at a minimum inhibitory dose (MID) of 15.6 microg/disc. Although all the extracts failed to inhibit the growth of most of the test fungi, significant antifungal activity against Cladosporium herbarum was exhibited by most notably the fruit (MID: 100 microg), and the leaf (MID: 400 microg) extracts. None of the extracts were significantly cytotoxic, and lethal towards brine shrimps. The root, leaf, trunk and stem bark extracts (except for the fruits) showed strong antioxidant activity exceeding that of the standard antioxidant, alpha-tocopherol. Antitumour-promoting activity (>95% inhibition) was shown by the fruit, leaf, stem and trunk bark extracts.     

Differences of circulating Bordetella pertussis population in Argentina from the strain used in vaccine production

In Argentina, as in other countries, the number of pertussis cases has been increasing, even in highly vaccinated zones. Many reports suggest that the decline of vaccine efficacy due to antigenic shifts in the circulating Bordetella pertussis might be among the factors that contribute to pertussis re-emergence in different parts of the world. To evaluate the incidence of this factor in Argentina, we decided to characterize the circulating bacteria of an important demographic area of this country in comparison with the strain used for vaccine production. From 1997 to 2003 we collected nasopharyngeal samples from pediatric patients with signs of Bordetella infection hospitalized in the metropolitan area of Buenos Aires and La Plata, Argentina. From these samples we identified 28 B. pertussis, which were characterized by biochemical techniques, PCR, DNA fingerprint, prn and ptx genes sequencing, and lipopolysaccharides (LPS) pattern. BOX-PCR from B. pertussis isolates yielded one cluster containing 13 isolates and some smaller ones, being all fingerprints different from the vaccine strain. Differences between Argentinean circulating bacteria and the vaccine strain were also observed for the Prn and Ptx variants as well as for the LPS pattern. Moreover, this last pattern seemed to change over the years. In addition, we identified two B. bronchiseptica. The presence of this Bordetella species together with the observed differences between circulating B. pertussis and the strain used in vaccine production should be considered for the development of an improved vaccine.     

Bordetella pertussis protein pertactin induces type-specific antibodies: one possible explanation for the emergence of antigenic variants?

Divergence has been found between Bordetella pertussis vaccine strains and circulating strains. Polymorphism in pertactin (Prn) is essentially limited to region 1, which is made up of repeats. Today, the 3 most prevalent Prn variants are Prn1-3. Vaccine strains produce Prn1, whereas Prn2 is the predominant type found in circulating strains. We investigated how variation in region 1 affects the production of human serum antibodies. Individuals infected by Prn2 strains had significantly fewer antibodies to Prn1 did than those infected by Prn3 strains and those immunized with a booster dose of acellular vaccines containing Prn1. Moreover, in contrast to vaccine recipients and subjects infected by Prn3 strains, individuals infected by Prn2 strains had hardly any antibodies specific to the variable region of Prn1. These results indicate that conformational changes have occurred in the variable region of Prn, which may offer a possible explanation for the emergence of Prn2 strains in certain countries.