A Modelling Approach to Estimate the Impact of Sodium Reduction in Soups on Cardiovascular Health in the Netherlands

Hypertension is a major modifiable risk factor for cardiovascular disease and mortality, which could be lowered by reducing dietary sodium. The potential health impact of a product reformulation in the Netherlands was modelled, selecting packaged soups containing on average 25% less sodium as an example of an achievable product reformulation when implemented gradually. First, the blood pressure lowering resulting from sodium intake reduction was modelled. Second, the predicted blood pressure lowering was translated into potentially preventable incidence and mortality cases from stroke, acute myocardial infarction (AMI), angina pectoris, and heart failure (HF) implementing one year salt reduction. Finally, the potentially preventable subsequent lifetime Disability-Adjusted Life Years (DALYs) were calculated. The sodium reduction in soups might potentially reduce the incidence and mortality of stroke by approximately 0.5%, AMI and angina by 0.3%, and HF by 0.2%. The related burden of disease could be reduced by approximately 800 lifetime DALYs. This modelling approach can be used to provide insight into the potential public health impact of sodium reduction in specific food products. The data demonstrate that an achievable food product reformulation to reduce sodium can potentially benefit public health, albeit modest. When implemented across multiple product categories and countries, a significant health impact could be achieved.     

Identification of minor histocompatibility antigens based on the 1000 Genomes Project

Minor histocompatibility antigens are highly immunogeneic polymorphic peptides playing crucial roles in the clinical outcome of HLA-identical allogeneic stem cell transplantation. Although the introduction of genome-wide association-based strategies significantly has accelerated the identification of minor histocompatibility antigens over the past years, more efficient, rapid and robust identification techniques are required for a better understanding of the immunobiology of minor histocompatibility antigens and for their optimal clinical application in the treatment of hematologic malignancies. To develop a strategy that can overcome the drawbacks of all earlier strategies, we now integrated our previously developed genetic correlation analysis methodology with the comprehensive genomic databases from the 1000 Genomes Project. We show that the data set of the 1000 Genomes Project is suitable to identify all of the previously known minor histocompatibility antigens. Moreover, we demonstrate the power of this novel approach by the identification of the new HLA-DP4 restricted minor histocompatibility antigen UTDP4-1, which despite extensive efforts could not be identified using any of the previously developed biochemical, molecular biological or genetic strategies. The 1000 Genomes Project-based identification of minor histocompatibility antigens thus represents a very convenient and robust method for the identification of new targets for cancer therapy after allogeneic stem cell transplantation.     

Current Status of Palliative Care—Clinical Implementation,Education, and Research

Palliative and end‐of‐life care is changing in the United States. This dynamic field is improving care for patients with serious and life‐threatening cancer through creation of national guidelines for quality care, multidisciplinary educational offerings, research endeavors, and resources made available to clinicians. Barriers to implementing quality palliative care across cancer populations include a rapidly expanding population of older adults who will need cancer care and a decrease in the workforce available to give care. Methods of integrating current palliative care knowledge into care of patients include multidisciplinary national education and research endeavors, and clinician resources. Acceptance of palliative care as a recognized medical specialty provides a valuable resource for improvement of care. Although compilation of evidence for the importance of palliative care specialities is in its initial stages, national research grants have provided support to build the knowledge necessary for appropriate palliative care. Opportunities are available to clinicians for understanding and applying appropriate palliative and end‐of‐life care to patients with serious and life‐threatening cancers. CA Cancer J Clin 2009;59:327–335. © 2009 American Cancer Society, Inc.     

Effect of Administered Ethanol on Protein Kinase C in Human Platelets

There are numerous reports of the effect of ethanol on protein kinase C (PKC) in animals or with in vitro systems. However, the effect of ethanol on PKC in humans has not been extensively investigated despite the large number of studies involving PKC and human platelets. In this study, we administered ethanol to human volunteers and determined the level of PKC before and after a 0.4 g/kg dose of ethanol. We studied Native Americans and Caucasians of both sexes. There was an increase in PKC activity 60 min after ethanol administration. There were no ethnic, age, nor gender differences detected, nor was there any correlation between family history of alcoholism and the basal or stimulated platelet PKC levels. Neither was there any correlation of basal or stimulated PKC activity with the genotypes for ADH2, ADH3, ALDH2, CYP2E1, and CYP1A2.     

Loss of resistance technique for locating the epidural space: evaluation of glass and plastic syringes

Location of the epidural space in epidural anaesthesia usually involves the measurement of loss of resistance using glass or plastic syringes. In the present study two varieties of glass syringe and one plastic type were evaluated to determine the resistive forces associated with plunger movement. The mean static (fs) and dynamic (fd) forces for polished glass syringes having a ground plunger only were fs = 0.47 × 10^?3 ± 0.22 × 10^?3 N and fd=0.37 × 10^?3 ± 0.19 × 10^?3 N and for polished glass syringes having a ground barrel and plunger were fs = 0.43 × 10^?3 ± 0.16 × 10^?3 N and fd = 0.38 × 10^?3 ± 0.I5 × 10^?3 N. Each of these values was significantly lower (P < 0.5) than those for plastic syringes fs = 2.22 × 10^?3 ± 0.48 × 10^?3 N and fd = 1.46 × 10^?3 ± 0.37 × 10^?3 N. It is concluded that glass syringes are favoured over plastic for locating the epidural space because frictional forces developed with glass syringes were significantly lower than with plastic.

     

Pressure within the thoracic duct modulates lymph composition

The amount of lymph received by the thoracic duct depends on each contributing organ's ability to produce interstitial fluid and generate a pressure differential moving lymph into the central lymphatic circulation. It has been reported that varying the pressure within the thoracic duct could alter each organ's contribution to thoracic duct flow. The thoracic duct above the diaphragm was cannulated to obtain lymph from the liver, gut, and lower body. Pressure within the thoracic duct was elevated serially by increasing the lymphatic cannula outflow height. This caused lymph protein concentration to increase while chyle concentration (measured by absorbance) decreased. The data demonstrate that as thoracic duct pressure increases, the percentage contribution of gut lymph flow (as represented by chyle concentration) decreases while the contribution of lymph originating within the liver (as indicated by higher protein concentration) increases. We conclude that pressure variation within the central lymphatic system affects the amount of lymph or edema fluid leaving any given organ.     

The coloured elderly in Cape Town--a psychosocial, psychiatric and medical community survey. Part I. Introduction and psychosocial data

A survey of 150 non-institutionalized Coloured persons over the age of 65 years living in Cape Town was undertaken to examine their psychosocial, psychiatric and medical condition. This article covers procedural and psychosocial aspects; Parts II and III will deal with others. Overall, respondents were poorly educated, with low income and occupational status. Social functioning and life satisfaction were reported to be good in over 80%. Family and social support appeared to be strong. Many respondents were involved in household duties (87%), child care (46%) and activities outside the home (66%). The high degree of satisfaction in the face of economic adversity may be due to family support and role maintenance. Findings are compared with those of previous studies, and the possibility that changes in circumstances are occurring is noted.     

Use of monetary reinforcers by cocaine-dependent outpatients.

Monetary reinforcers have not been widely used as contingent reinforcers in the treatment of drug abuse, despite their demonstrated effectiveness. This is primarily due to concern that drug abusers will use monetary reinforcers to procure drugs. The present study addressed this concern by examining 48 cocaine-dependent outpatients' biweekly self-reports of how they used their earned reinforcers. For each subject, their reinforcement usage was classified into 12 higher-order categories and 34 subcategories. Usage proportions were calculated for each. Results indicated that monetary reinforcers were used very infrequently to acquire drugs or alcohol (2%). Reinforcers were used primarily for daily life activities (25%) (e.g., food and gas), money-related uses (18%) (e.g., savings and repaying debts), personal use (15%) (e.g., cosmetics and clothes), and household items (11%) (e.g., rent and bills). These findings challenge the concern that drug abusers use monetary reinforcers to purchase drugs and have important implications for the use of contingent monetary reinforcers in treatment settings.     

Life events in Xhosas in Cape Town

A life events scale for research into Xhosa speaking people of Cape Town was developed. It was standardised on 131 residents of Cape Town's three major Black suburbs. Measures of perceived impact and rate of occurrence were elicited. The Spearman Rank correlation between prevalence and impact scores was not significant (r=0.04). Items were ranked according to composite impact scores. Cultural and social factors were considered to play a part in explaining differences between the present findings and those of other studies.Limitations on the applicability of the scale and methodological issues were discussed. The problems in direct comparison between different cultural groups were emphasized, with particular stress on constraints on life events research in an African setting.