Northwest African and Middle Eastern food and dietary change of indigenous peoples

This paper describes cultural and ecological characteristics of Northwest African and Middle Eastern food patterns and discusses the forces contributing to rapid dietary change. Focus is given to indigenous/tribal/ethnic/minorities in these areas with contributions to definitions of these groups, the extent of their diversity, and the importance of their traditional knowledge of local food resources. Urbanization, particularly for those facing extreme poverty in the urban environment, is recognized as a significant force to dietary change and consequent poor nutrition, especially for children. Examples of food systems are given for the coastal zone of West Africa and the semi-arid and desert zones of North Africa and the Middle East, also including the food system of Pharaonic times. Trends in dietary change are presented as data derived from FAO Food Balance Sheets.     

Care of older people in nursing homes: an Intensive Programme as an educational activity within Erasmus-Socrates

The paper describes and discusses an Intensive Programme as a European educational activity within Erasmus-Socrates. As nurses and European citizens, it is important to know and understand each other's culture and to be able to work within a united Europe. Education plays a leading role in the preparation of professionals who will have to develop these skills. Based on the aims of Erasmus-Socrates, an Intensive Programme entitled 'Care of Older People in Nursing Homes' was designed, sponsored, and implemented over three continuous academic years with the participation of five European countries. The topic was selected due to its importance for Europe, as it is a region with an ageing population. A wide range of themes was covered using lectures, group discussion, exercises and study visits as teaching strategies. Evaluation suggests that the aims of the programme were achieved.     

Home apnea monitor use in preterm infants discharged from newborn intensive care units

PURPOSE: To identify current factors associated with home apnea monitor use in preterm infants and to determine whether home monitor use was associated with a shorter length of hospital stay. SETTING: We evaluated neonates who were < or =34 weeks' estimated gestational age and admitted for neonatal intensive care. We excluded neonates with congenital anomalies, neonates transferred out before discharge, and neonates who died. METHODS: Using a database created with a computer-assisted tool that generates hospital notes, we reviewed the epidemiology of monitor use. Differences between neonates sent home with an apnea monitor and those who were not were evaluated by using stepwise logistic regression analysis to identify which factors were independently associated with a neonate being discharged with a monitor. RESULTS: We studied 14,532 neonates; 1588 (11%) were sent home with monitors and 12,944 (89%) were not. The most important variables associated with being discharged with a monitor were site of care and a diagnosis of apnea. Site variation remained significant when adjusted for gestational age, diagnosis of apnea, and a history of use of methylxanthines. When corrected for gestational age, monitor use was not associated with shorter hospital stays. CONCLUSION: The data suggest that monitor use is more dependent on physician preference than medical indication and is not associated with earlier hospital discharge.     

In vitro analysis of CD40-CD154 and CD28-CD80/86 interactions in the primary T-cell response to allogeneic "nonprofessional" antigen presenting cells

BACKGROUND: Recently, several ligand interactions have been examined in detail as potential mediators of costimulatory signaling. The CD154/CD40 and CD28/B7 interactions have been highlighted as being among the more-significant contributors to proper activation of unprimed T lymphocytes. Human keratinocytes (HK) and human dermal fibroblasts (HF) are capable of expressing Class II HLA and CD40 antigens after interferon-gamma exposure, yet neither express significant levels of B7. HK and HF have been characterized as "nonprofessional" antigen presenting cells (APC) and their poor APC function has been partially attributed to deficient costimulatory activity. METHODS: In this study, we examined whether substituting for costimulatory signaling events through the addition of cross-linked monoclonal antibodies against the T-cell ligand/s (CD28 and/or CD154) could restore allostimulation. Mixed lymphocyte reactions were performed combining enriched human peripheral blood T cells and allogeneic HK or HF with or without stimulatory anti-CD28 and/or anti-CD154 antibodies. RESULTS: The results show that the addition of anti-CD28 alone permitted HF but not HK to present alloantigen effectively. In contrast, addition of both anti-CD154 and anti-CD28 was required to generate even a moderate proliferative response to allogeneic HK. Further, adding a monomorphic anti-HLA-DR antibody substantially inhibited these responses. Additional experiments suggest that signaling through CD40/CD154 directs HK to produce TGF-beta, which would adversely affect T-cell activation. CONCLUSIONS: The data presented highlight significant differences in signaling capacities for HK versus HF and provide evidence for a partial mechanism by which allogeneic human skin equivalents might be immunologically null upon engraftment.     

Diabetology at the threshold of the 21st century

Scientific advances in the 19th and 20th centuries led to the discovery of insulin, the fundamental therapeutic means for treatment of diabetes mellitus type 1 at the onset of the twenties, to the introduction of sulfonylurea derivatives and biguanides in the fifties and sixties. The discovery of the principle of radioimmunoassay at the end of the fifties made it possible to investigate insulin secretion and to achieve a more accurate understanding of the pathogenesis of type 1 and 2 diabetes. Understanding of insulin resistance made it possible to introduce an euglycaemic hyperinsulin clamp at the end of the seventies. Insulin resistance was presented in context with metabolic syndrome X. Insulin is administered at the break of the millenium in subcutaneous injections, insulin dispensers and insulin pumps, experimentally also by the intraperitoneal and inhalatory route. In the nineties in the practice of diabetes 1 therapy ultrashort-term and finally als long-term insulin analogues were developed. For type 2 diabetes mellitus inhibitors of alpha-amylase were introduced and as a quite new group of oral antidiabetics thiazolidindiones. The possibility of 24-hour monitoring of the blood sugar level by means of a subcutaneous glucose sensor was introduced. The end of the century is characterized also by attempts to administer growth factors in the treatment of non-patent vascular obstructions in the diabetic foot syndrome. In mice and rats transformation of the ductal cell of the exocrine pancreas to the Langerhans islet cell proved successful. Further progress in diabetology will depend, similarly as in the rest of medicine, in particular on advances in cellular and molecular biology and genetics, as well as advances in microelectronics and new materials. Emphasis on the community understanding of this disease and consequential primary prevention of diabetes and secondary prevention of its complications are important.     

Comparative study between gadobenate dimeglumine and gadobutrol in rats with brain ischemia: evaluation of somatosensory evoked potentials

RATIONALE AND OBJECTIVES: The present study had two main objectives: to validate a rat model of brain ischemia in terms of somatosensory evoked potentials (SEPs) and to compare, using the validated model, the potential activity on the somatosensory function of the new, approved contrast agent gadobenate dimeglumine with that of gadobutrol, a specific contrast agent, for magnetic resonance imaging of the brain. METHODS: Rats were prepared for SEP recording at least 5 days before ischemia induction. Ischemia was induced by 30-minute right middle cerebral artery occlusion and 3-day reperfusion. The SEP responses, evoked contralaterally to the stimulated upper limb, were recorded from the primary somatosensory cortical area. Model validation, on day 3 after occlusion, was performed using iopromide, an iodinated contrast agent poorly neurotolerated in rats, intravenously injected at 7 g I/kg. The comparative study between gadobenate dimeglumine and gadobutrol was performed at an intravenously injected dose of 2 mmol/kg. Somatosensory evoked potential responses were measured as peak latencies (P2 and N2) and peak-to-peak amplitude (P2N2). The brain concentration of iopromide was measured by high-performance liquid chromatography, whereas that of the gadolinium contrast agent was measured by inductively coupled plasma-atomic emission spectrometry analysis; given the absence of metabolism for both contrast agents, the gadolinium content values can be interpreted as representing unmetabolized contrast agent. RESULTS: In the ischemic rats, the SEP responses of the lesioned hemisphere showed significant increases in P2, N2, and interpeak N2-P2 latencies and a significant reduction in peak-to-peak (P2N2) amplitude. In the validation experiments, iopromide dramatically increased the P2N2 amplitude of the SEP responses recorded from both hemispheres of ischemic rats without affecting the P2, N2, and interpeak N2-P2 latencies. The iopromide effect was coupled with high concentrations of the contrast agent in the brain. Iopromide had no effect on healthy rats. In the comparative study, gadobenate dimeglumine did not induce any alteration in SEP components of either the lesioned or unlesioned hemisphere of ischemic rats. In fact, no significant difference was found between responses obtained before and after gadobenate dimeglumine injection. Gadobutrol, administered at the same dose, on the whole showed the same behavior as gadobenate dimeglumine, although a slight but significant decrease in the P2 latency, a sign of excitatory activity, was observed 2 hours after injection. Analytic data indicated higher levels of contrast agent in the lesioned hemisphere versus the unlesioned hemisphere 2 hours after injection. CONCLUSIONS: Based on these results, three conclusions can be drawn: (1) the evaluation of SEPs in ischemic rats is a useful tool for assessing the potential neurological effects of a new contrast agent because ischemic and contrast agent effects can be clearly differentiated; (2) the experimental conditions used allow the contrast agents to penetrate into the brain, where their activity can be manifested and evaluated; and (3) the complete absence of neurological activity of gadobenate dimeglumine shows its safety profile and confirms its suitability for use in neurological diseases for which contrast-enhanced magnetic resonance imaging is indicated.     

Evidence for clonal anergy as a mechanism responsible for the maintenance of transplantation tolerance

The main stimulus triggering early acute allograft rejection is known to be delivered by the allogeneic “passenger” leukocytes present within the grafts. Once these cells have been replaced by cells of recipient origin, subsequent rejection episodes are generally less frequent and less acutely destructive. How this replacement affects the cell populations responsible for allograft rejection is not known. Here we report that rat alloreactive non-cytotoxic AS (RT1¹) anti-August (RT1^C) CD4⁺ T cells, that were shown to be specific for RT1.B^C+ August spleen stimulators, were able to cause acute rejection of normal August kidney allografts transplanted into sublethally irradiated AS recipients. These cells, however, failed to reject passenger cell-depleted (PCD) August kidneys, despite the substantial expression of RT1.B^C+ products on the graft tubular epithelium. In experiments in vitro, August kidney tubular epithelial cells expressing RT1.B^C+ antigens were found to be unable to stimulate the alloreactive T cells to proliferate. Moreover, preincubation with class II-positive August kidney epithelial cells specifically abrogated the alloreactivity of the T cells. Adding recombinant interleukin-2, however, restored the response to alloantigens. These results are consistent with the hypothesis that T cell populations capable of mediating early acute allograft rejection are different from those mediating late rejection, when donor passenger leukocytes are no longer present. They also suggest clonal anergy as one of the mechanisms responsible for maintaining long-term transplantation tolerance.     

Functional discrimination between interleukin 6 and interleukin 1

In this study we have investigated the specificity of bioassays in which interleukin (IL)1 and/or IL6 are active. The thymocyte assay cannot be used to discriminate between IL1 and IL6; both monokines are active in this assay. Moreover the detection limit for both IL1 and IL6 is around 100 pg/ml. IL6 activity can be measured with a murine hybridoma cell line (B9). The detection limit for human as well as murine IL6 is about 0.5 pg/ml. The assay is specific for IL 6 and is not influenced by a variety of other cytokines except for murine IL4 which shows some activity in this assay. IL1 can be measured specifically with D10 cells. The detection limit for IL1α and IL1β is around 1 pg/ml whereas IL6 is not active in this assay at all. Upon stimulation by IL1 and/or IL2 D10 cells produce IL6. However, this IL6 does not seem to be involved in the proliferation of these cells.     

儿童肺炎支原体感染状况分析

目的 探讨儿童的肺炎支原体(MP)感染现状及早期诊断的意义。方法 检测181例就诊儿童血液标本分析MP感染的状况。结果 肺炎支原体感染率为29.8％;男性患儿MP检测阳性率(35.7％)明显高于女性患儿(16.4％)(P<0.01);5岁以下患儿阳性率超过50％,且有3例婴儿检测阳性;10-12月份支原体肺炎发病率明显增加,占全年的40.7％。结论 针对儿童支原体肺炎的发病情况,早诊断,早治疗,利于患儿尽早康复,防止肺部病变迁延及肺外并发症的发生。