The capacity of normal murine alveolar macrophages to function as antigen-presenting cells for the initiation of primary antibody-forming cell responses to sheep erythrocytes in vitro

The precise role of resident alveolar macrophages (AM) in the induction of immune responses to inhaled antigens is not known. In order to gain insight into the immune functions of AM in vivo, the present studies were performed to characterize several immune functional capacities of normal murine AM, to compare these with normal peritoneal macrophages (PM), and to determine the capacity of AM to serve as antigen-presenting cells for the induction of primary antibody-forming cell (AFC) responses to sheep erythrocytes (SRBC) in vitro. We compared the capacities of normal murine AM and of PM to: elaborate interleukin-1 (IL-1), express surface membrane Ia antigen, serve as accessory cells for mitogen-induced blastogenesis, and induce generation of primary AFC responses to SRBC in Mishell-Dutton cultures. We observed that: AM and PM elaborate equivalent IL-1 activity after stimulation with phorbal myristate acetate (PMA); AM "conditioned" with supernatants of concanavilin-A-stimulated spleen cells express surface Ia but do so proportionately less than similarly treated PM; normal AM can serve as accessory cells for mitogen-induced blastogenesis but do so significantly less effectively than do PM; AM substitute poorly for PM with respect to the induction of primary AFC responses to SRBC in standard Mishell-Dutton cultures; however, AM exert potent suppressive activity in these cultures, and this suppression can be reversed by the addition of indomethacin and catalase to cultures, suggesting that both prostaglandins and hydrogen peroxide play suppressive roles; after reversal of suppression in drug-modified Mishell-Dutton cultures, AM can induce primary AFC responses to SRBC but do so less effectively than do similarly treated PM.(ABSTRACT TRUNCATED AT 250 WORDS)     

Adolescent Substance Use Behavior Change Through School Intervention Is Improved by Teacher and School Implementation Support Together,Especially for Girls

Prevention Science - An earlier trial of a school-based, preventative intervention, HealthWise South Africa, demonstrated some efficacy in preventing adolescent drinking and smoking in the Western...     

Multi-Disciplinary Trauma Evaluation and Management Simulation (MD-TEAMS) training for emergency medicine and general surgery residents

BackgroundSuccessful trauma resuscitation relies on multi-disciplinary collaboration. In most academic programs, general surgery (GS) and emergency medicine (EM) residents rarely train together before functioning as a team.MethodsIn our Multi-Disciplinary Trauma Evaluation and Management Simulation (MD-TEAMS), EM and GS residents completed manikin-based trauma scenarios and were evaluated on resuscitation and communication skills. Residents were surveyed on confidence surrounding training objectives.ResultsResidents showed improved confidence running trauma scenarios in multi-disciplinary teams. Residents received lower communication scores from same-discipline vs cross-discipline faculty. EM residents scored higher in evaluation and planning domains; GS residents scored higher in action processes; groups scored equally in team management. Strong correlation existed between team leader communication and resuscitative skill completion.ConclusionMD-TEAMS demonstrated correlation between communication and resuscitation checklist item completion and communication differences by resident specialty. In the future, we plan to evaluate training-related resident behavior changes and specialty-specific communication differences by residents.     

Characterization of perioperative androgen profiles in men with bladder cancer undergoing radical cystectomy

BackgroundPrior studies have demonstrated declines in androgen levels in men with cancer and patients undergoing anesthesia and surgery. In this study, we hypothesized that decreased serum androgen levels are prevalent in male patients undergoing radical cystectomy (RC) for bladder cancer and that it persists in the postoperative period. We characterized perioperative androgen hormonal profiles and examined for associated changes indicative of sarcopenia on computed tomography scans in men undergoing RC.MethodsWe implemented a prospective observational trial in men with newly diagnosed non-metastatic bladder cancer undergoing RC. Baseline pre-operative total testosterone (TT), free testosterone (FT), and luteinizing hormone (LH) were obtained on morning lab draws with 30 days of surgery. TT and FT were then repeated on postoperative days (POD) 2, 3, 30, and 90. The threshold for normal TT was defined as >300 ng/dl, consistent with the AUA Guidelines for Evaluation and Management of Testosterone Deficiency. We evaluated postoperative changes in weight and psoas muscle cross-sectional area using computed tomography scans to assess for sarcopenic changes.ResultsUnivariable statistical analysis was performed. 25 patients were enrolled. The mean patient age was 68.9 years. The mean pre-operative TT was 308 ng/dl, and 12/23 (52.5%) patients had low testosterone. Mean TT onPOD 2 and 3 were 166 ng/dl and 161 ng/dl, respectively (range 24–345). 19/20 (95%) of men who had morning lab draws had decreased TT. The mean TT at 30 days was 253 ng/dl with 37.5% of men having low TT. Mean TT at 90 days was 306 ng/dl. The mean FT levels were 43 ng/dl, 29.25 ng/dl, 28.2 ng/dl, 40.89 ng/dl, and 42.62 ng/dl at baseline, POD 2, POD 3, POD 30, and POD 90, respectively. Mean LH at baseline was 9.9 IU/L. Average weight loss at 30- and 90- days postop was -4.29 and -4.38 kilograms, respectively. Weight loss was persistent with only 3/23 (13%) returning to their presurgery weight by 90 days. Despite significant declines in weight and perioperative TT, no significant differences in psoas muscle cross-sectional area were observed (net change -92 mm², P= 0.13)ConclusionsPerioperative disruption of androgen levels is prevalent in men undergoing RC. Our trial demonstrates a pre-op, immediate postop, 30- and 90-day postoperative prevalence of low TT of 52%, 95%, 63%, and 37.5%, respectively. Significant changes in baseline weight were noted, although no significant changes in psoas muscle cross-sectional area were observed, limiting conclusions regarding a link between changes in androgens and sarcopenia in this setting.     

Leisure Boredom,Timing of Sexual Debut,and Co-Occurring Behaviors among South African Adolescents

Archives of Sexual Behavior - Sex during adolescence is normative; however, there are substantial individual differences in the timing and context of sexual debut. Leisure boredom is an...     

How do patch clamp seals form? A lipid bleb model

Individual ion channels are electrically isolated and studied in living cells with the tight patch voltage clamp method. Channels are identified, categorized, and sometimes named on the basis of the biophysical properties obtained with this method. Although it is usually presumed that these recordings are from native, undisturbed membrane, the physical basis of this technique is not well established. Observations that lipid blebs readily form when suction is applied to patch clamp electrodes suggest that many single channel recordings are from ion channels in these blebs.     

What healthcare can learn from TQM's past

Common characteristics and management processes that have caused noteworthy increases in market share, customer satisfaction, and cost reduction can be attributed to TQM initiatives. These common management characteristics and processes include: senior management leadership, strategies centered on customer judgments, strategically aligned department measurements, and an environment that fosters learning.     

Reaching a stationary global population: what we have learnt, and what we must do

The onset of fertility decline in France during the late 18th century and broader decline during the last third of the 19th century in Western Europe and the English-speaking European colonies demonstrates that humans are willing to control their fertility. Fertility transition was a social phenomenon. It has also been observed that the idea of fertility decline can spread and be acted upon elsewhere. The events of the International Conference on Population and Development (ICPD) are described and the need to control population growth in sub-Saharan Africa is discussed. While the ICPD's advocacy of improving women's autonomy, status, education, and reproductive health is laudable, those goals are opposed to that of completing the demographic transition. The existence of this opposition indicates that there have been changes in longstanding intellectual and technical aid consensuses. In the wake of the ICPD, developed country governments may never again emphasize the need for family planning programs in developing countries. The largest effect of such a course will probably be upon the demographic transition in sub-Saharan Africa. However, those interested in improving reproductive health in the Third World may join forces with the population movement when they realize that well-funded family planning programs are the key to improving reproductive health services.     

Comparison of measured and FTC-predicted nicotine uptake in smokers

Cigarette smokers have a wide variety of tar and nicotine yields to choose from in the current market, ranging from 0.5 mg tar and less than 0.05 mg nicotine to 27 mg tar and 1.8 mg nicotine by the Federal Trade Commission (FTC) method. To understand better the relationship between FTC nicotine yields and actual nicotine uptake in smokers, we have studied nicotine uptake in 33 smokers of self-selected products representing four tar groupings: 1 mg tar (1 MG), ultra-low tar (ULT), full-flavor low tar (FFLT), and full flavor (FF) cigarettes. These cigarette categories had mean FTC nicotine yields of 0.14, 0.49, 0.67, and 1.13 mg/cigarette, respectively. The subjects smoked their usual brand of cigarette ad libitum and provided a 24-h urine sample for total nicotine uptake analysis over a period during which the number of cigarettes smoked was recorded. Nicotine uptake was determined by monitoring urinary nicotine and its metabolites, including the glucuronide conjugates. Daily nicotine uptake was 9.1±7.3 mg (range 1–21 mg) for 1 MG, 19.2±10.0 mg (range 4–42 mg) for ULT, 21.8±9.4 mg (range 13–38 mg) for FFLT, and 37.1±14.4 mg (range 21–60 mg) for FF smokers. On a per cigarette basis, yields were 0.23±0.11, 0.56±0.23, 0.60±0.18, and 1.19±0.43 mg nicotine, respectively. Although individual variability was fairly large (CVs of 0.39–0.80), means for the different groups showed that lower FTC yield smokers not only absorb less nicotine per 24-h period, but also per cigarette smoked. These data suggest that nicotine uptake is a function of individual smoking behavior within product design limits. We conclude from these data that, while FTC yield cannot precisely predict nicotine uptake for an individual smoker, it is useful in predicting and comparing actual nicotine uptake by smokers who select cigarettes with a particular FTC yield.