Greek experiences with integration of public health aspects into training programmes for general practitioners

Objectives  

Promotion and integration of training in public health into the vocational training schemes for general practitioners in order to fulfill the needs of the expanded role of the general practitioners under the strategy ”Health for All“.     

Improved outcome of facial nerve repair in rats is associated with enhanced regenerative response of motoneurons and augmented neocortical plasticity

Within a recent study on the vibrissae motor performance after facial nerve repair in strains of blind (SD/RCS) and sighted (SD) rats we found that, despite persisting myotopic disorganization in the facial nucleus, the blind animals fully restored vibrissal whisking. Here we searched for morphological substrates of better recovery in the regenerating motoneurons and in the cerebral motor cortex. Expression analyses of the neurite growth-related proteins f-actin, neuronal class III beta-tubulin and plasticity-related gene-1, and stereological estimates of growth cone densities revealed a more vigorous regenerative response in the proximal nerve stump of blind SD/RCS rats compared with SD animals at 5-7 days after buccal nerve transection. Using c-Fos immunoreactivity as a marker for neuronal activation, we found that the volume of the cortex acutely responding to nerve transection (facial muscles reactive volume, FMRV) in both hemispheres of intact sighted rats was twofold smaller than that measured in blind animals. One month after transection and suture of the right facial nerve (FFA) we found a twofold increase in the FMRV in both rat strains compared with intact animals. The FMRV in SD/RCS animals, but not in SD rats, returned to the values in intact rats 2 months after FFA. Our findings suggest that enhanced plasticity in the CNS and an augmented regenerative response of the injured motoneurons contribute to better functional recovery in blind rats.     

Neuro-ophthalmologic Complications and Manifestations of Upper and Lower Motor Neuron Facial Paresis

The facial nerve (cranial nerve VII) courses a long pathway beginning in the precentral gyrus and ending at the facial muscles, lacrimal and salivary glands, and structures of the inner ear. Lesions along this pathway, clinically divided into upper and lower motor neuron lesions, present with unique characteristics that assist the physician in identifying the lesion site. The sequelae particularly of peripheral CN VII palsies, may result in significant and chronic damage to the cornea that may be challenging for the physician and patient.     

Social capital and regular alcohol use and binge drinking in adolescence: A cross-sectional study in Greece

Aims: The purpose of this study is to examine the gender-specific associations of different dimensions of individual-level social capital with regular alcohol consumption and binge drinking in 16–17 years old adolescents in Crete, Greece.

Methods: Of the 835 randomly selected students, 708 completed the Youth Social Capital Scale and the Health Behaviours in School-aged Children (HBSC) questionnaire from April through June 2008 and 650 (92%) were included in this analysis. The outcome of interest was regular alcohol use and binge drinking. A gender specific backward stepwise logistic multivariate regression was performed adjusted for potential confounders.

Findings: For both boys and girls, higher score on some structural social capital subscales was associated, per unit increase, with increased likelihood of regular drinking. Neighbourhood connections were also associated with increased binge drinking in girls. Cognitive social capital subscales were associated with decreased likelihood of binge drinking in girls. For both genders, total social capital-score was positively associated with the probability of regular, but not of binge drinking.

Conclusions: Cognitive and structural social capital dimensions have different patterns of association with regular and binge alcohol use in adolescent boys and girls. Social capital's dimensions should receive greater emphasis for the design of effective preventive interventions in adolescence, particularly in the light of an increasing prevalence of alcohol consumption in modern societies.     

Nitrosoglutathione suppresses cochlear potentials and DPOAEs but not outer hair cell currents or voltage-dependent capacitance

Biochemical and pharmacological evidence support a role for nitric oxide (NO) and glutathione (GSH) in the cochlea. GSH combines with NO in tissue to form nitrosoglutathione (GSNO) that can act as a storage form for GSH and NO. Therefore, we tested GSNO on sound-evoked responses of the cochlea (cochlear microphonic, CM; summating potential, SP; compound action potential, CAP; cubic distortion product otoacoustic emission, DPOAE), on the endocochlear potential (EP), on isolated outer hair cell (OHC) currents and voltage-dependent capacitance, and on Deiters' cell currents. In vivo application of GSNO in increasing concentrations reversibly reduced low-intensity sound-evoked CAP, SP and DPOAEs starting at about 1 mM (CAP) and 3.3 mM (SP, DPOAE). However, even at 10 mM, GSNO had little effect on the EP. In vitro, salicylate (10 mM) but not GSNO (3 and 10 mM) suppressed the early capacitative transients of OHCs. GSNO (3 and 10 mM) had no effect on the whole cell currents of OHCs or Deiters' cells. Results show that GSNO suppresses cochlear function. This suppression may be due to an effect of GSNO on the cochlear amplifier. The actions of GSNO were different from those of other NO donors; therefore, the effects of GSNO may not be mediated by NO. The mechanisms underlying GSNO effects seem to be different from those of salicylate.     

Immune surveillance as a rationale for immunotherapy?

The majority of pathogen vaccines are used within the prophylactic setting as opposed to the therapeutic setting proposed for cancer vaccines. Due to the intricate role of the immune system in tumorigenesis, tumor immunotherapy may have to borrow approaches from autoimmunity. The size of the malignant population that has to be eliminated, the associated immunosuppressive effects of the tumor, the diversion of inflammatory and immune processes by the organized stroma surrounding the tumor, the antigenic diversity of the tumor cell population leading to immune escape, all present barriers that predestine the failure of most attempts for active immunotherapy. Tumor immune suppression necessitates adhering to the adjuvant mode of immunotherapy, i.e. after the removal of large tumor masses. Understanding immune tolerance as active, threshold dependent and redundant processes helps to rationalize the reshaping and repair, rather than breaking, of tolerance as a tumor immunotherapy objective. Instead of true vaccines, the emerging concept is rather of immunomodulators that target the interface of innate and adaptive immunity.