Three new and two rare furanoeremophilanes from Senecio asirensis

Three new furanoeremophilanes have been obtained from the aerial parts of Senecio asirensis (N. O. Asteraceae), and characterized as 6-hydroxylmethyl-9-methoxyl-4,11-dimethylnaphtho[2,3-b]furan, designated asirensane-a (1), 6-hydroxyl-1,2-dimethoxyl-4,6,11-trimethyl-6-hydronaphtho[2,3-a]furan-7-one, named asirensane-b (2), and (6,12-dihydroxyl-9-methoxyl-4-methyl-11-acetyl-3,4-dihydronaphtho[2,3-b]furan-3-yl)methyl (2'Z)-2'-methylbut-2'-enoate, designated asirensane-c (3). In addition, two rare furanoeremophilanes have also been isolated and characterized from this source, namely 9-methoxyl-4,11-dimethylnaphtho[2,3-b]furan, named 14-nordehydrocalohastine (4), and 4,11-dimethylnaphtho[2,3-b]furan-6,9-dione, designated as maturinone (5). Their structures have been elucidated on the basis of spectral analysis. The alcoholic extract was also tested for anti-inflammatory activity, which decreased edema by 22% at a dose of 500 mg kg^-1 after 3 h with respect to the control group treated only with carrageenan, while the standard drug phenylbutazone showed a 50% decrease at a dose of 100 mg kg^-1, indicating that the extract has moderate anti-inflammatory activity.     

Immunophenotypic characterization of hepatic inflammatory cell infiltrates in common dolphins (Delphinus delphis)

Of 14 common dolphins, 12 showed non-specific reactive hepatitis and three chronic parasitic cholangitis with lymphoid proliferation. Non-specific reactive hepatitis was shown immunohistochemically to be associated with small clusters of CD3(+) cells in portal areas and hepatic sinusoids. Polyclonal antibody against S100 protein reacted with a variable number of lymphocytes from portal areas and hepatic sinusoids, as well as with Kupffer cells and epithelial cells of the bile ducts. The majority of plasma cells observed in portal areas and hepatic sinusoids were IgG(+). In lymphonodular lesions of chronic parasitic cholangitis, the distribution of immunoreactive cells was similar to that found in the cortex of lymph nodes. The presence of stellate cells similar to follicular dendritic and interdigitating cells expressing S-100 protein and MHC class II antigen in lymphonodular lesions suggested that these were highly organized structures developed to enhance antigen presentation to B and T cells.     

Dialysis membrane and modality in acute renal failure: understanding discordant meta-analyses

Meta-analyses of the published literature are increasingly being used, allowing similar clinical trials to be combined quantitatively, thereby increasing the precision of the estimation of treatment effect. Four meta-analyses were recently published comparing the impact of dialysis membranes or dialysis modality on clinical outcomes of patients with acute renal failure (ARF) requiring renal replacement therapy. Two studies compared dialysis membranes in intermittent hemodialysis (IHD) and two studies compared continuous renal replacement therapy (CRRT) to IHD. The findings between each pair of meta-analyses were discordant. This was due in part to the differences among meta-analyses in inclusion and exclusion criteria, the paucity of randomized controlled trials, variation in individual study quality, and heterogeneity in the study populations and settings. Understanding these issues is important to properly interpret results from these meta-analyses.     

Crescentic fibrillary glomerulonephritis associated with hepatitis C viral infection

Fibrillary glomerulonephritis (FGN) is a pathological diagnosis that is rarely associated with systemic disorders. In this case report, we describe a woman who presented with FGN of the crescentic type in association with hepatitis C viral infection. The existing literature on the association between these 2 disorders is reviewed, and postulated therapy is presented.     

Antioxidant and oxidative stress indices in dialysis-dependent acute renal failure

BACKGROUND: Experimental animal models and in vitro studies have established a role for reactive oxygen species and the therapeutic potential for free radical scavengers in acute renal failure (ARF). Little is known of the effects of hemodialysis and other clinical variables on antioxidant defenses and oxidative stress among patients with ARF. METHODS: We examined antioxidant defenses and oxidative stress status in 24 patients with ARF requiring hemodialysis (HD). Blood samples were drawn prior to the first dialysis session (baseline), as well as before and after the third and sixth dialysis sessions. At each time point, the following parameters were measured: plasma alpha-tocopherol (vitamin E), plasma glutathione peroxidase (GSH-Px), serum total oxygen radical absorbance capacity (ORAC), plasma thiobarbituric acid reactive substances (TBARS), plasma tumor necrosis factor-alpha (TNF-alpha), and interleukin-10 (IL-10). Multivariate linear regression analyses were performed to examine clinical/laboratory variables associated with antioxidant/oxidative stress indices. The changes in antioxidant/oxidative stress indices over time after initiation of hemodialysis was evaluated in a subgroup of patients (n = 11) who completed six dialysis sessions. Intradialytic changes in antioxidant/oxidative stress indices and the differential impact of cellulose acetate vs. polysulfone dialyzers were also evaluated. RESULTS: Factors associated with alpha-tocopherol level were serum albumin (301 microg/dl upward arrow for each 1 g/dl upward arrow in albumin) and ORAC (188 microg/dl upward arrow for each 1,000 micromol Trolox Eq/l upward arrow in ORAC). Age was independently associated with plasma GSH-Px levels (55 U/l downward arrow for each 10-year age upward arrow ). Factors associated with ORAC were alpha-tocopherol (85 micromol Trolox Eq/l upward arrow for each 100 microg/dl upward arrow in alpha-tocopherol) and total bilirubin (30 micromol Trolox Eq/l downward arrow for each 1 mg/dl upward arrow in total bilirubin). Total bilirubin was independently associated with TBARS (0.2 microM upward arrow for each 1 mg/dl upward arrow in total bilirubin). GSH-Px and ORAC levels declined over time between baseline and the sixth dialysis session (p < 0.05 for both). Finally, there was a significant intradialytic decline in ORAC levels, which appeared to be more pronounced with use of cellulose acetate compared with polysulfone dialyzer membranes (p < 0.05). CONCLUSIONS: These observations indicate that antioxidant and oxidative stress indices in ARF patients are associated with several clinical and laboratory variables as well as the dialysis procedure. Further studies are needed to investigate the therapeutic role of anti-oxidant therapy in these patients.     

Lack of acculturation is a risk factor for diabetes in arab immigrants in the US

OBJECTIVE: To examine the relationship between dysglycemia (impaired fasting glucose, impaired glucose tolerance, and diabetes) and acculturation, physical activity, and perceived stress in Arab immigrants in the U.S. RESEARCH DESIGN AND METHODS: In a cross-sectional population-based study, we examined 520 Arab Americans, aged 20-75 years, who were born in the Middle East and immigrated to southeastern Michigan. Dysglycemia was assessed by history and with a 2-h 75-g oral glucose tolerance test. Acculturation, physical activity, and perceived stress were measured with standardized questionnaires. RESULTS: Associations were found between dysglycemia in men and older age at immigration, unemployment, speaking Arabic with friends, being less active in Arabic organizations, more frequent consumption of Arabic food, and less integration into American society. Dysglycemia in women was associated with being raised in rural areas of the Middle East, older age at immigration, longer length of stay in the U.S., not being employed outside the home, less than high school education, not attending Arabic or American schools, and not being able to read Arabic. Among men, older age at immigration, shorter length of stay in the U.S., less activity in Arab organizations, and eating Arabic food were associated with dysglycemia independent of age and BMI. Among women, acculturation was very low and was confounded with age and BMI as powerful risk factors for dysglycemia. No association was found between physical activity, perceived stress, and the risk of dysglycemia in either sex. CONCLUSIONS: Lack of acculturation is an important risk factor for dysglycemia in immigrant Arab Americans. Intervention programs aimed at diabetes prevention should consider the acculturation process.     

A Relational Approach to Counseling Women with Alcohol and Other Drug Problems

Examination of the change strategies associated with successful long-term sobriety remains an understudied area in addiction research. The following study recruited individuals with long-term sobriety (range 16–25 years continuous abstinence). Subjects (n = 11) were surveyed on demographic information, problem history, Alcoholics Anonymous (AA) affiliation, and helping behaviors within several life domains over the course of sobriety. General helping behaviors increased from lower levels in the month prior to getting sober, to moderate levels at 1 year of sobriety, but did not continue to increase with additional years of sobriety. Levels of general help to others at home, work, and 12-step programs were similar at varying lengths of sobriety. Whereas overall levels of general help given to others were similar across settings, helping other alcoholics, as opposed to helping others at home or work, was rated as contributing the most to staying sober. Across time, alcoholics increased participation in helping behaviors specific to 12-step programs. The utility of helping others as a behavioral strategy to maintain successful addictive behavioral change is discussed.     

Structuring and destructuring the coarse of illness: the Alzheimer's disease experience

Abstract The course of illness is examined as a location for the assignment of developmental structure. Textual analysis and field data indicate that the stock of developmental codes for structuring the course of illness in the Alzheimer's disease experience is as varied as the manifold interests of those concerned. Structuring is practical and occasioned, realised in its variety in an 'ameliorative' mode of communicative usage. In the 'tribulation' mode, in contrast, the course of illness is destructured. A discussion of communicative usage, as a critique of developmentalism, follows.     

Cervical spine causes for referred otalgia.

OBJECTIVE: Present experience in diagnosis and treatment for referred otalgia secondary to cervical spine degenerative disease (CSDD). STUDY DESIGN: A retrospective study of 123 patients with ear pain. SUBJECTS AND METHODS: All patients had a normal otologic examination and diagnosed with unspecified otalgia. The causes for referred otalgia were categorized into Group I: otalgia from non-cervical spine disease (n = 72), and Group II: cervical spine disease-referred otalgia (n = 51). Pain relief following cervical spine physical therapy (CSPT) was assessed. RESULTS: The most common cause for referred otalgia in Group I was Temporomandibular joint (TMJ) dysfunction (46%); most common cervical spine finding in Group II was CSDD (88%). CSPT in those documented patients all reported subjective pain relief. CONCLUSION: As the population in America ages, CSDD in the elderly will begin to emerge as a major etiologic source for referred otalgia. With a targeted medical history and physical examination one can use directed studies to diagnose CSDD-referred otalgia, and this pain can be alleviated with CSPT.