GSTM1, GSTP1, and NQO1 Polymorphisms and Susceptibility to Atopy and Airway Hyperresponsiveness among South African Schoolchildren

Glutathione-S-transferases (GSTM1 and GSTP1) and nicotinamide quinone oxidoreductase (NQO1) genes play an important role in cellular protection against oxidative stress which has been linked to asthma pathogenesis. We investigated whether common, functional polymorphisms in GSTM1, GSTP1 and NQO1 influence airway hyperreactivity (AHR) and atopy among schoolchildren in South Africa. Genomic DNA was extracted from 317 primary schoolchildren, aged 9-11 years, from urban, low socioeconomic communities of Durban, South Africa. GSTM1 (null vs. present genotype), GSTP1 (Ile105Val; AA → AG + GG), and NQO1 (Pro/187Ser; CC → CT/TT) genotypes were determined using polymerase chain reaction (PCR) methods. Atopy was defined as a positive skin-prick test to any of several common allergens. Airway hyperreactivity (AHR) was evaluated by pulmonary function testing before and after methacholine challenge. Among the children, 30% were GSTM1 null, 65% carried the G allele for GSTP1, and 36% carried the C allele for NQO1. The frequency of GSTM1, GSTP1, and NQO1 variants among our South African sample was similar to frequencies found in similar ethnic groups worldwide. Marked airway reactivity (PC₂₀ ≤ 2 mg/ml) was found in 10.3% of children and approximately 40% of them were atopic. No significant associations for GSTM1 and NQO1 with either AHR or atopy were identified. A significant protective effect against atopy was found among children with one or two copies of the GSTP1 G allele.     

Clinical inter-professional education activities: Students' perceptions of their experiences

Background and purposeStudents from different health disciplines should learn together during certain periods of their education to acquire skills necessary for solving the health problems. The Faculty of Health Sciences of University of the Witwatersrand created inter-professional education (IPE) activities for students to assess clinical IPE groups'' perceptions of IPE experiences and to identify lessons learnt during IPE sessions.MethodsThis was a qualitative study with review of the students'' post IPE feedback forms. The students were granted ‘protected time’ of three full days over a period of two months to participate in IPE activities.ResultsStudents felt that knowledge about health team members was gained and that IPE groups should have more than one person from each field with the same level of clinical exposure. The students indicated the need to have regular IPE activities and if possible to incorporate this into clinical practice for them to experience it in daily clinical practice.ConclusionParticipating in the IPE activity made students gain appreciation and respect for other health professionals'' roles and scope. When student groups are big, patient observations can be done as this does not compromise IPE learning outcomes. Group composition should be kept in mind to cater for the learning needs of all students. If it is not possible to meet the needs of all professions, smaller groups with professions applicable to case can be created.     

Active pulmonary tuberculosis: experience with resection in 106 cases

The surgical management of pulmonary tuberculosis has evolved since collapse therapy was the mainstay of treatment. Despite this, resection for active tuberculosis is viewed with circumspection. Details of 106 patients with pathologically proven active pulmonary tuberculosis, who were operated on from January 1997 to January 2005, were reviewed retrospectively. Demographic data, radiographic profiles, indications for surgery, sputum status, and preoperative drug therapy were analyzed in relation to outcomes. The indications for surgery included multidrug-resistant tuberculosis in 27 patients, hemoptysis in 44, bronchiectasis in 27, and diagnostic dilemmas where a tumor could not be excluded in 8. All patients were operated on while receiving antituberculous therapy, and 17 were sputum positive at the time of surgery. Two (1.9%) patients died postoperatively. Morbidity was 16.9%, including 6 cases of postpneumonectomy empyema and one of bronchopleural fistula. Surgery for active tuberculosis may be undertaken with acceptable morbidity and mortality.     

ER and aging—Protein folding and the ER stress response

The endoplasmic reticulum (ER) is a multifunctional organelle which co-ordinates protein folding, lipid biosynthesis, calcium storage and release. Perturbations that disrupt ER homeostasis lead to the misfolding of proteins, ER stress and up-regulation of a signaling pathway called the ER stress response or the unfolded protein response (UPR). The UPR is characterized by the induction of chaperones, degradation of misfolded proteins and attenuation of protein translation. Age-related declines and activity in key molecular chaperones and folding enzymes compromise proper protein folding and the adaptive response of the UPR. This review will highlight age-related changes in the protein folding machinery and in the UPR.     

The quality of life of Palestinians living in chronic conflict: assessment and determinants

This study assessed the quality of life (QoL) of Palestinians living in conditions of chronic conflict and examined its determinants. An adapted World Health Organization quality of life (WHOQoL-Bref) instrument was used in a representative sample of 1,008 adults. Factor analysis and multiple regression were conducted to determine associations between demographic and socioeconomic characteristics and scores of extracted principal determinants, and estimated overall and domain-specific QoL scores. Men, older persons and those less educated reported lower QoL than their counterparts. Negative associations were also found with higher distress and fear levels, and lower financial and freedom status. The chronic and entrenched conflict over generations resulted in lower QoL for the population of the Occupied Palestinian Territory.

Oral health & HIV/AIDS

Oral lesions are common in women and children with HIV/AIDS and may decrease the overall quality of life in these patients because of pain, dry mouth, and difficulty in eating. An oral cavity screening is an easy, noninvasive, quick, and inexpensive procedure that provides nurses with invaluable information about the need for referral, treatment, and health education. Nurses can use the information obtained from a careful oral screening to decrease the symptoms experienced with oral lesions and optimize a patient's ability to chew and enjoy food. Common oral manifestations of HIV infection include fungal, viral, and bacterial infections, although neoplasms, periodontal disease, salivary gland disease, and lesions of uncertain origin are also seen. Oral lesions such as candidiasis, oral hairy leukoplakia, herpetic ulcers, and Kaposi's sarcoma are often among the first symptoms of HIV infection.