Air quality and exercise-related health benefits from reduced car travel in the midwestern United States

Background: Automobile exhaust contains precursors to ozone and fine particulate matter (PM ≤ 2.5 µm in aerodynamic diameter; PM_2.5), posing health risks. Dependency on car commuting also reduces physical fitness opportunities.Objective: In this study we sought to quantify benefits from reducing automobile usage for short urban and suburban trips.Methods: We simulated census-tract level changes in hourly pollutant concentrations from the elimination of automobile round trips ≤ 8 km in 11 metropolitan areas in the upper midwestern United States using the Community Multiscale Air Quality (CMAQ) model. Next, we estimated annual changes in health outcomes and monetary costs expected from pollution changes using the U.S. Environmental Protection Agency Benefits Mapping Analysis Program (BenMAP). In addition, we used the World Health Organization Health Economic Assessment Tool (HEAT) to calculate benefits of increased physical activity if 50% of short trips were made by bicycle.Results: We estimate that, by eliminating these short automobile trips, annual average urban PM_2.5 would decline by 0.1 µg/m³ and that summer ozone (O₃) would increase slightly in cities but decline regionally, resulting in net health bene-fits of $4.94 billion/year [95% confidence interval (CI): $0.2 billion, $13.5 billion), with 25% of PM_2.5 and most O₃ bene-fits to populations outside metropolitan areas. Across the study region of approximately 31.3 million people and 37,000 total square miles, mortality would decline by approximately 1,295 deaths/year (95% CI: 912, 1,636) because of improved air quality and increased exercise. Making 50% of short trips by bicycle would yield savings of approximately $3.8 billion/year from avoided mortality and reduced health care costs (95% CI: $2.7 billion, $5.0 billion]. We estimate that the combined benefits of improved air quality and physical fitness would exceed $8 billion/year.Conclusion: Our findings suggest that significant health and economic benefits are possible if bicycling replaces short car trips. Less dependence on automobiles in urban areas would also improve health in downwind rural settings.     

A review of pramipexole and its clinical utility in Parkinson's disease

Parkinson's disease (PD) is a common neurodegenerative disorder characterised by selective loss of dopaminergic neurones in the substantia nigra and resulting in progressive disability. Therapy has focused on replacing depleted dopamine (DA) via supplementation with levodopa or DA agonists. Pramipexole (Mirapex), Pharmacia Corp.) has recently been approved for the treatment of PD. Evidence from preclinical studies and clinical trials have proven the effectiveness of this agent in ameliorating the symptoms of PD. There is also non-human evidence that pramipexole may be neuroprotective and could therefore possibly slow disease progression; however, this has yet to be proven in humans. The use of pramipexole may be limited by its side effect profile compared to standard therapies and its relatively higher cost compared to levodopa. Despite these concerns, pramipexole does have a role in the treatment of PD in all stages of the illness and may arguably be the treatment of choice in early disease. In addition to its use in PD, pramipexole has shown some utility in the treatment of restless legs syndrome (RLS), depression and schizophrenia.     

Use of a food frequency questionnaire in American Indian and Caucasian pregnant women: a validation study

Background  

Food frequency questionnaires (FFQs) have been validated in pregnant women, but few studies have focused specifically on low-income women and minorities. The purpose of this study was to examine the validity of the Harvard Service FFQ (HSFFQ) among low-income American Indian and Caucasian pregnant women.     

Safer injections following a new national medicine policy in the public sector,Burkina Faso 1995 – 2000

Background  

The common failure of health systems to ensure adequate and sufficient supplies of injection devices may have a negative impact on injection safety. We conducted an assessment in April 2001 to determine to which extent an increase in safe injection practices between 1995 and 2000 was related to the increased access to injection devices because of a new essential medicine policy in Burkina Faso.     

Novel anticholinesterases based on the molecular skeletons of furobenzofuran and methanobenzodioxepine

Reductive cyclization of 5-hydroxy-3-methyl-3-methoxycarbonylmethylenebenzofuran-2(3H)-one (4) gave 5-hydroxy-3a-methyl-2,3,3a,8a-tatrahydrofuro[2,3-b]benzofuran (5) and the rearrangement product 7-hydroxy-4,5-dihydro-2,5-methano-1,3-benzodioxepine (6). Reaction of compounds 5 and 6 with different isocyanates provided two series novel carbamates (7-12) whose structures were confirmed by X-ray crystallography. These were assessed for anticholinesterase action against freshly prepared human enzyme and proved to be potent inhibitors of either acetyl- (AChE) or butyrylcholinesterase (BChE) with specific compounds exhibiting remarkable selectivity. Because the two series of carbamates (7-12) differ in their phenolic moieties, their respective potency and selectivity for AChE versus BChE was governed by their N-substituted groups. This same characteristic was also present in a series of physovenine analogues (1, 13, 15, 17) and physostigmine analogues (2, 14, 16, 18). These structure-activity relations proved valuable in elucidating the mechanisms underpinning the interaction between carbamate-based cholinesterase inhibitors and their enzyme target. In addition, because physostigmine analogues have demonstrated activity in lowering the Alzheimer's disease protein, amyloid precursor protein (APP), examples of the two new series of carbamates were characterized in culture assays of quantifying cell viability and synthesis of APP.     

A conduit between epidemiological research and regional health policy

Objective : To transform data from a research setting into a format that could be used to support strategies encouraging healthy lifestyle choices and service planning within local government. Methods : Details of the health status and lifestyle behaviours of the Geelong, Victoria, population were generated independently by the Geelong Osteoporosis Study (GOS), a prospective population‐based cohort study. Recent GOS follow‐up phases provided evidence about patterns of unhealthy diet, physical inactivity, smoking and harmful alcohol use. These factors are well‐recognised modifiable risk factors for chronic disease; the dataset was complemented with prevalence estimates for musculoskeletal disease, obesity, diabetes, cardiovascular disease, asthma and cancer. Results : Data were provided to Healthy Together Geelong in aggregate form according to age, sex and suburb. A population statistics company used the data to project health outcomes by suburb for use by local council. This data exchange served as a conduit between epidemiological research and policy development. Conclusion and implications : Regional policy makers were informed by local evidence, rather than national or state health survey, thereby optimising potential intervention strategies.     

Gender Differences in Drug Misuse and Related Problem Behaviors among Arrestees in the UK

Traditionally, the addiction literature has focused on male drug users and less attention has been given to female users. More recently, research investigating gender differences in drug use and associated problem behaviors has emerged. This article contributes to the growing research base by drawing on data collected from structured interviews with 2,682 male and 453 female arrestees conducted as part of the New English and Welsh Arrestee Drug Abuse Monitoring (1999–2002) program. Clear gender differences in drug use and associated behaviors are identified. Women were found to be more serious drug users and to experience more associated problems than men. The research and policy implications of the research are discussed and the study's limitations are noted.     

Effects of intragastric fructose and dextrose on mesenteric microvascular inflammation and postprandial hyperemia in the rat

Objectives: Fructose superfused on the mesenteric venules of rats induces microvascular inflammation via oxidative stress. It is unknown whether intragastric fructose exerts a similar effect and whether fructose impairs postprandial hyperemia (PPH). The goals were to determine whether intragastric fructose administration promotes leukocyte adherence and whether fructose, owing to its oxidative properties, may also impair nitric oxide–dependent PPH in the mesenteric microcirculation of rats. Methods: Leukocyte adherence to mesenteric venules, arteriolar velocity, and diameter were measured in Sprague‐Dawley rats before and 30 minutes after intragastric (1 mL 0.5 M, ~0.3 g/kg) dextrose (n = 5), fructose (n = 6), and fructose after intravenous injection of the antioxidant α‐lipoic acid (ALA, n = 6). Results: Only fructose increased leukocyte adherence: control 2.3 ± 0.3 per 100 µm; fructose 9.7 ± 1.4 per 100 µm (P < .001). This effect was independent of changes in venular shear rate: control 269 ± 48 s^?1; fructose 181 ± 27 s^?1 (P > .05, r ² = 0.083 for shear rate vs leukocyte adherence). Dextrose had no effect on leukocyte adherence: control 1.52 ± 0.13 per 100 µm; dextrose 2.0 ± 0.7 per 100 µm (P > .05). ALA prevented fructose‐induced leukocyte adherence: control 1.9 ± 0.2 per 100 µm; fructose + ALA 1.8 ± 0.3 per 100 µm (P > .05). Neither fructose nor dextrose induced PPH: arteriolar velocity: control 3.3 ± 0.49 cm/s, fructose 3.06 ± 0.34 cm/s (P > .05); control 3.3 ± 1.0 cm/s, dextrose 3.15 ± 1.1 cm/s (P > .05); arteriolar diameter: control 19.9 ± 1.10 µm, fructose 19.7 ± 1.0 µm (P > .05); control 21.5 ± 2.6, dextrose 20.0 ± 2.7 µm (P > .05). Conclusions: Intragastric fructose induced leukocyte adherence via oxidative stress. Neither dextrose nor fructose induced PPH, likely because of the inhibitory effect of anesthesia on splanchnic vasomotor tone.     

In vitro synergy studies with Clostridium difficile.

Agar dilution anaerobic susceptibility studies using rifampin, vancomycin, metronidazole, and bacitracin individually and in combination were performed with Clostridium difficile. Fifty-five strains of C. difficile were studied. Eighty-five percent of strains tested (29 of 34) were synergistically inhibited by the combination of bacitracin and rifampin (fractional inhibitory concentration, less than or equal to 0.50).     

Magnesium toxicity secondary to catharsis during management of theophylline poisoning

Multiple doses of oral activated charcoal are used increasingly to promote elimination of toxins that have already reached the bloodstream; this is often referred to as gastrointestinal dialysis. Cathartics usually are used in conjunction to hasten transit of the charcoal-adsorbed toxin. In the present case, a regimen of activated charcoal and magnesium citrate was used to treat a patient with theophylline poisoning. It was effective in lowering the patient's serum theophylline concentration but produced an elevated magnesium level associated with decreased responsiveness, confusion, and diminished deep tendon reflexes. Magnesium citrate may not be the optimal cathartic for use in gastrointestinal dialysis, at least in selected patients. Sorbitol has been shown to produce a more rapid catharsis without disturbing magnesium serum concentrations. Therefore, the use of sorbitol in place of magnesium citrate, at least in selected patients, may be preferred.