Smoking habits and attitudes of medical students towards smoking and antismoking campaigns in nine Asian countries. The Tobacco and Health Committee of the International Union Against Tuberculosis and Lung Diseases.

As part of a world survey of the habits, knowledge and attitudes of medical students regarding tobacco we report a study in 15 medical schools from nine Asian countries. Some 1646 first year and 1587 final year students were included, of whom 59% were male. The prevalence of daily smoking in males was 4% in first year and 11% in final year; of occasional smoking 18% and 24% respectively, both with considerable variations between countries. The rates were very low in women. Male exsmokers varied from 3% to 24% in different centres. Overall, 33% of smokers had made a serious attempt to quit; 44% expected to have succeeded within 5 years. Over 80% of non- or exsmokers, but only 60% of smokers, thought smoking was harmful to health. There was gross underestimation of tobacco's causal role in a number of important diseases, e.g. coronary artery disease, peripheral vascular disease, emphysema, bladder cancer and neonatal mortality. There were notable defects both in training and in motivation to counsel smoking patients. There was only partial knowledge of legislative and other measures to discourage smoking, e.g. only 44% of final year students (26% of smokers) thought increased taxation an important measure. In knowledge and attitudes there was little difference between the sexes, but in most aspects smokers had notably lower scores.     

Evaluation of a new generation of plastic evacuated blood-collection tubes in clinical chemistry, therapeutic drug monitoring, hormone and trace metal analysis.

Polyethylene terephthalate (PET) tubes have several advantages over glass tubes: they are unbreakable, lighter and more easily disposed of. Despite a steady increase in their use and an expansion of the range of available tubes, few studies validating their use have been published in the literature. This paper describes the various studies that have been performed to compare VENOJECT glass, VENOSAFE PET and VENOSAFE PET/heparin tubes for the assay of a panel of analytes in routine clinical chemistry, immunochemistry, hormone and tumor marker analysis and trace metal determination. These studies demonstrate that VENOSAFE PET tubes are a suitable alternative to glass tubes.     

First analysis of the proteome in two nematomorph species, Paragordius tricuspidatus (Chordodidae) and Spinochordodes tellinii (Spinochordodidae).

The proteome of most parasite species is currently unknown. Hairworms (Nematomorpha), 300 species distributed around the world, are parasitic in arthropods (mainly terrestrial species) when juveniles, but they are free-living in aquatic environments when adult. Most aspects of their systematics and biology are currently unknown. The aim of this paper was (i) to report a novel and reproducible protocol for the analysis of the proteome of hairworms using two-dimensional gel electrophoresis (2-DGE) and mass spectrometry (matrix laser desorption ionization-time of flight mass spectrometry (MALDI-TOF)) and (ii) to determine the level of proteomic divergence between two sympatric but taxonomically unrelated nematomorph species in the adult stage, Paragordius tricuspidatus Dufour (Nematomorpha, Gordiidae) and Spinochordodes tellinii Camerano (Nematomorpha, Gordiidae). In total, 689 protein spots were observed for P. tricuspidatus, 575 for S. tellinii. Only 36.2% spots were shared between the two species. Quantitative analysis of the proteins which are common to both parasite species reveals substantial differences in the pattern of protein expression. These results suggest a rapid evolutionary divergence between these two nematomorph families. Also, to test the value of our MALDI-TOF protocol, we used Actin-2 (Act-2), a protein highly conserved in the course of evolution. Peptide mass fingerprint (PMF) data obtained for Act-2 of P. tricuspidatus and S. tellinii suggest a very high homology with Act-2 of different worms species belonging to the Bilateria phylum (Annelida and Nematoda) and more specifically to Lumbricus terrestris (Annelida, Lumbricidae) and Caenorhabditis elegans (Nematoda, Rhabditidae). We discuss our results in relationship with current ideas concerning the use of proteomics in systematics.     

Baseline heart rate may predict hypotension after spinal anesthesia in prehydrated obstetrical patients

PURPOSE: Hypotension is the most frequent complication of spinal anesthesia in pregnant patients. This study was designed to identify patients at risk for postspinal hypotension based on preoperative vital signs before and after an orthostatic challenge. METHODS: Forty healthy women scheduled for elective Cesarean section were enrolled in this prospective trial. Blood pressure (BP) and heart rate (HR) were recorded with the patient in the lateral supine position and after standing up. After a bupivacaine spinal anesthetic, BP was obtained every two minutes for 30 min. Ephedrine treatment was administered based on the degree of hypotension observed. Hemodynamic parameters were correlated to ephedrine requirements (Spearman's rank order correlation). RESULTS: There was a significant correlation in baseline maternal HR and ephedrine requirements (P=0.005). The degree of orthostatic changes in mean arterial BP and HR did not correlate with postspinal hypotension. CONCLUSIONS: Baseline HR may be predictive of obstetric spinal hypotension. Higher baseline HR, possibly reflecting a higher sympathetic tone, may be a useful parameter to predict postspinal hypotension.     

Die Insuffizienz der intraabdominellen Infektabwehr bei der eitrigen Peritonitis — Folge einer gestörten Fremdkörperopsonierung

Summary Despite a high concentration of serum proteins and intact phagocytes peritonitis exudates contain a large number of viable, pathogenic bacteria. The reason for this biological paradox is unknown. Our investigations reveal a pronounced defect in humoral opsonization of foreign particles in peritonitis exudate. We evaluated a modified chemiluminescence system allowing the determination of opsonic activity in serum and exudate. In serum we found a close correlation between opsonic activity and immunologically measurable levels of C₃-complement and IgG. In purulent peritonitis exudates, however, the actual opsonizing activity was much less than expected according to the opsonin concentrations. We found a pronounced difference between immunologically determined opsonin levels and impaired opsonic function. Employing crossed immunoelectrophoresis massive C₃-splitting into smaller fragments could be demonstrated in peritonitis exudates. In these exudates we found very high concentrations of granulocyte proteolytic (elastase) and oxidative (myeloperoxidase) enzymes which may lead to a functional destruction of opsonins followed by impaired opsonization in peritonitis exudate. The great number of bacteria and foreign particles in addition can cause a pronounced physiological consumption of complement components. The almost complete breakdown of intact C₃-complement in intraabdominal exudate explains the deficient host defence in patients with severe peritonitis.

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Abkürzungsverzeichnis CL Chemilumineszenz - IgG Immunglobulin G - OK Opsonierungskapazität     

Interpretation of antitoxoplasma antibody findings

Between reactions assessing one class of immunoglobulins and reactions detecting all serum immunoglobulins comprehensively such as CFT, there is, as might be expected, a very poor quantitative correlation and thus in individual sera the result of one reaction cannot be reliably added to the result of another (CFT:ELISA/IgG). Even the correlation between reactions focused on the same Ig class (ELISA/IgG: IFT/IgG) is no better. Among reactions assessing specific IgM we consider ELISA/IgM better than IFT/IgM because there is not the risk of false negativity caused by concurrence of IgG. A combination of ELISA/IgG and ELISA/IgM gives good results as a statistical group: the distribution of results revealed agglomerations of sera corresponding to the assumed age of the infection derived from the generally accepted pattern of antibody formation. The applicability of the combination of these two reactions alone for evaluation of individual sera is a promising procedure but awaits further confirmation. Long-term investigations revealed within two years after infection a marked decline of CFT antibodies in the majority of cases but it was not sufficiently clear in ELISA/IgG. Despite the technical advantages of ELISA reactions, elimination af the CFT reaction is not foreseen in the near future. As the minimal combination of methods which provides adequate information we may consider at the present time CFT for assessment of total antibodies and ELISA/IgM for more marked differentiation of the acute stage. Evaluation of the lowest CFR titres considered hitherto as "practically negative" must be obviously revised in subjects with immunosuppression and organ donors for transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)