What do children look like after longitudinal intestinal lengthening.

The longitudinal intestinal lengthening, described by Bianchi in 1980, has been shown to be effective in improving intestinal function, absorption and transit time in patients with short-bowel syndrome. We report the long-term results of 18 survivors of a series of 25 intestinal lengthening procedures performed since 1984. Mean age of the patients was 18 months (range of 5 to 52 months), mean follow-up 6 years (0.9 to 12 years). Parenteral nutrition was progressively reduced in all patients and discontinued after 1 to 10 months (mean 5.1 months). Frequently encountered problems during long-term follow-up are hyperphagia, hyponatremia and hypochloremia, metabolic acidosis, including D-lactic acidosis, cholelithiasis and urolithiasis, gastro-esophageal reflux, dystrophy and symptoms caused by secondary dilatation of the lengthened bowel loops: a protruding abdomen, enteral stasis, leading to constipation or diarrhea with bacterial overgrowth. Overall performance has been acceptable in 13 out of 18 patients. Longitudinal intestinal lengthening is effective enabling patients with short-bowel syndrome to be weaned from parenteral nutrition, allowing for long-term survival. However, it is only one step on a long and difficult way. Multiple problems have to be searched for and adequately dealt with to achieve an acceptable and future worth living.     

Quantification of Intraoral Pressures During Nutritive Sucking: Methods with Normal Infants

We report quantitative measurements of ten parameters of nutritive sucking behavior in 91 normal full-term infants obtained using a novel device (an Orometer) and a data collection/analytical system (Suck Editor). The sucking parameters assessed include the number of sucks, mean pressure amplitude of sucks, mean frequency of sucks per second, mean suck interval in seconds, sucking amplitude variability, suck interval variability, number of suck bursts, mean number of sucks per suck burst, mean suck burst duration, and mean interburst gap duration. For analyses, test sessions were divided into 4 × 2-min segments. In single-study tests, 36 of 60 possible comparisons of ten parameters over six pairs of 2-min time intervals showed a p value of 0.05 or less. In 15 paired tests in the same infants at different ages, 33 of 50 possible comparisons of ten parameters over five time intervals showed p values of 0.05 or less. Quantification of nutritive sucking is feasible, showing statistically valid results for ten parameters that change during a feed and with age. These findings suggest that further research, based on our approach, may show clinical value in feeding assessment, diagnosis, and clinical management.     

Gypsies/Travellers and health: risk categorisation versus being ‘at risk’

Risk categorisation provides a routine and necessary contribution to the way people make sense of and impute predictability in a complex human world of which their knowledge is limited. It is a precursor to the development of risk management strategies. Risk categorisation schemes can vary depending on the underlying perspective and knowledge used in their construction. There are estimated to be between 120,000 and 300,000 Gypsies and Travellers in the United Kingdom. They have been categorised on the one hand as a group that is ‘at risk’ suffering wide-ranging inequalities and on the other they can be seen as the archetypical ‘other’ posing risks to normative stability. Public policies to manage their health risks have been limited in contrast to policies to address their ‘otherness’ status which have aimed to exclude, relocate and forcibly remove them from public space. Little is understood about the way in which Gypsies and Travellers categorise and manage the risks to their health within the context of adverse public policies. In-depth qualitative interviews were undertaken during 2010 and 2011 with 39 Gypsies and Travellers aged between 18 and 66 years comprising 20 females and 19 males living in an area of South East England. Respondents framed risk in terms of threats to their health, culture and traditional way of life and issues of trust were central to this. They sought to devise risk management strategies that would maintain boundaries between their community and outsiders who were perceived to be the source of risks to their health. A consequence of their risk management strategies was the potential perpetuation of threats to their health and well-being.     

From the Cover: Distemper,extinction, and vaccination of the Amur tiger

Canine distemper virus (CDV) has recently emerged as an extinction threat for the endangered Amur tiger (Panthera tigris altaica). CDV is vaccine-preventable, and control strategies could require vaccination of domestic dogs and/or wildlife populations. However, vaccination of endangered wildlife remains controversial, which has led to a focus on interventions in domestic dogs, often assumed to be the source of infection. Effective decision making requires an understanding of the true reservoir dynamics, which poses substantial challenges in remote areas with diverse host communities. We carried out serological, demographic, and phylogenetic studies of dog and wildlife populations in the Russian Far East to show that a number of wildlife species are more important than dogs, both in maintaining CDV and as sources of infection for tigers. Critically, therefore, because CDV circulates among multiple wildlife sources, dog vaccination alone would not be effective at protecting tigers. We show, however, that low-coverage vaccination of tigers themselves is feasible and would produce substantive reductions in extinction risks. Vaccination of endangered wildlife provides a valuable component of conservation strategies for endangered species.

Tigers (Panthera tigris), among the world’s most iconic carnivore species, are highly threatened. Having once occupied vast swathes of Asia from Turkey to the Sea of Japan, fewer than 3,500 tigers now survive with breeding populations in just eight countries, all of which are fragmented and acutely vulnerable to extinction (1). The Amur tiger subspecies (P. tigris altaica) numbers fewer than 550 individuals in two discrete populations in the Russian Far East and neighboring areas of China.     

Syndrome of symptomatic adult acetabular dysplasia (SAAD syndrome)

OBJECTIVES: To determine the prevalence of acetabular dysplasia in subjects presenting with hip pain to primary care and its relationship with radiographic osteoarthritis (OA) of the hip. DESIGN: Cross sectional analysis of a prospective cohort. SETTING: 35 general practices across the UK. SUBJECTS: 195 patients (63 male, 132 female) aged 40 years and over presenting with a new episode of hip pain RESULTS: The prevalence of acetabular dysplasia in this study of new presenters with hip pain was high (32%). There was no significant relationship between acetabular dysplasia and radiographic OA overall. CONCLUSIONS: The high prevalence of acetabular dysplasia across all grades of OA severity suggests that dysplasia itself may be an important cause of hip pain ("symptomatic adult acetabular dysplasia").     

Beta-blockers versus diuretics in hypertensive men: main results from the HAPPHY trial

Men aged 40-64 years with mild to moderate hypertension [diastolic blood pressure (DBP) 100-130 mmHg] were randomized to treatment with a diuretic (n = 3272) or a beta-blocker (n = 3297), with additional drugs if necessary, to determine whether a beta-blocker based treatment differs from thiazide diuretic based treatment with regard to the prevention of coronary heart disease (CHD) events and death. Patients with previous CHD, stroke or other serious diseases, or with contraindications to diuretics or beta-blockers were excluded. If normotension (DBP less than 95 mmHg) was not achieved by monotherapy, other antihypertensive drugs were added, but the two basic drugs were not crossed over. Patients were assessed at 6-monthly intervals. The mean follow-up for end-points was 45.1 months. Blood pressure (BP) side effects and end-points were recorded in a standardized manner. Entry characteristics and the BP reduction achieved were very similar in both treatment groups. All analyses were made on an intention-to-treat basis. The incidence of CHD did not differ between the two treatment groups. The incidence of fatal stroke tended to be lower in the beta-blocker treated group than in the diuretic treated group. Total mortality and the total number of end-points were similar in both groups. The percentage of patients withdrawn due to side effects was similar, whereas the number of reported symptoms, according to a questionnaire, was higher for patients on beta-blockers. The incidence of diabetes did not differ between the two groups. Subgroup analyses did not detect a difference in the effect of beta-blockers compared with diuretics in smokers as opposed to non-smokers, and beta-blockers also had the same effects as diuretics in the quartile with the highest predicted risk for CHD. Beta-blockers and thiazide diuretics were approximately equally well tolerated. The two drugs had a similar BP reducing effect although additional drugs had to be given more often in the diuretic group. Antihypertensive treatment based on a beta-blocker or on a thiazide diuretic could not be shown to affect the prevention of hypertensive complications, including CHD, to a different extent.     

Electrocortical evidence for rapid allocation of attention to threat in the dot-probe task

Threatening stimuli have been shown to preferentially capture attention using a range of tasks and measures. However, attentional bias to threat has not typically been found in unselected individuals using behavioral measures in the dot-probe task, one of the most common ways of examining attention to threat. The present study leveraged event-related potentials (ERPs) in conjunction with behavioral measures in the dot-probe task to examine whether more direct measures of attention might reveal an attentional bias to threat in unselected individuals. As in previous dot-probe studies, we found no evidence of an attentional bias to threat using reaction time; additionally, this measure exhibited poor internal reliability. In contrast, ERPs revealed an initial shift of attention to threat-related stimuli, reflected by the N2pc, which showed moderate internal reliability. However, there was no evidence of sustained engagement with the threat-related stimuli, as measured by the late positive potential (LPP). Together, these results demonstrate that unselected individuals do initially allocate attention to threat in the dot-probe task, and further, that this bias is better characterized by neural measures of attention than traditional behavioral measures. These results have implications for the study of attention to threat in both unselected and anxious populations.     

BAX/BCL-2 mRNA and protein expression in human breast MCF-7 cells exposed to drug vehicles-methanol and dimethyl sulfoxide (DMSO) for 24 hrs

Background:

Methanol and DMSO are commonly used as carrier solvents for lipophilic chemicals in in-vitro experiments. However, very little information is available regarding the effects of these solvents on the expression of pro and anti-apoptotic genes and proteins.

Materials and Methods:

In this study, we examined the cytotoxic effects of methanol and dimethylsulfoxide at 0.5% (final concentrations recommended for in-vitro toxicity assays) on human breast cancer MCF-7 cells. We also investigated the effects of these solvents on the mRNA and immunocytochemical expression of apoptotic proteins BAX and BCL-2.

Results:

The results of neutral red cell viability assay showed that methanol and DMSO concentrations of 0.5% exhibited no cytotoxic effects on MCF-7 cells following a 24 hour exposure. Gene expression and Immunofluorescence results showed that methanol but not DMSO reduced the expression of the BAX pro-apoptotic protein, while both solvents did not alter the expression of the BCL-2 oncoprotein.

Conclusion:

Our results suggest that while methanol concentrations at 0.5% may be appropriate for in vitro toxicity studies in human breast cancer MCF-7 cells, it could alter the results of gene and protein expression experiments.     

Measuring the Humoral Immune Response in Cats Exposed to Feline Leukaemia Virus

Retroviruses belong to an important and diverse family of RNA viruses capable of causing neoplastic disease in their hosts. Feline leukaemia virus (FeLV) is a gammaretrovirus that infects domestic and wild cats, causing immunodeficiency, cytopenia and neoplasia in progressively infected cats. The outcome of FeLV infection is influenced by the host immune response; progressively infected cats demonstrate weaker immune responses compared to regressively infected cats. In this study, humoral immune responses were examined in 180 samples collected from 123 domestic cats that had been naturally exposed to FeLV, using a novel ELISA to measure antibodies recognizing the FeLV surface unit (SU) glycoprotein in plasma samples. A correlation was demonstrated between the strength of the humoral immune response to the SU protein and the outcome of exposure. Cats with regressive infection demonstrated higher antibody responses to the SU protein compared to cats belonging to other outcome groups, and samples from cats with regressive infection contained virus neutralising antibodies. These results demonstrate that an ELISA that assesses the humoral response to FeLV SU complements the use of viral diagnostic tests to define the outcome of exposure to FeLV. Together these tests could allow the rapid identification of regressively infected cats that are unlikely to develop FeLV-related disease.