Clade specific neutralising vaccines for HIV: an appropriate target?

The enormous diversity of the human immunodeficiency virus (HIV) has led to the idea that designing vaccines to specific geographic regions, or clades, could simplify the complexity of the task. Yet, despite the sequence diversity, all HIV viruses known to date interact with the same cellular receptors (CD4 and/or a coreceptor, CCR5 or CXCR4). In this review we examine the existing evidence to support a clade-specific vaccine strategy for induction of neutralising antibodies. We concentrate on lessons learnt from natural infection of humans. In short, the vast majority of studies to date indicate that neutralisation of HIV-1 is not clade specific. Potent sera tend to neutralise a range of heterologous viruses with no apparent clade preference, and none of the human neutralising monoclonal antibodies so far generated demonstrate significant clade preference. All but one of the most broadly neutralising antibodies are to functional regions involved in receptor interactions and plasma membrane fusion. Given these facts, we suggest that vaccine approaches that focus on 'clade-specific' and 'clade-generic' vaccines will logically converge on the same functionally conserved envelope structures. It still remains to be determined whether or not the task of designing a 'clade-generic' vaccine could be simplified by focusing on the viral envelopes with 'transmitting phenotypes'.     

Free moment contribution to quiet standing in able-bodied and scoliotic girls

Adolescent idiopathic scoliosis girls are known to display standing imbalance. In addition to a motor deficit problem, the axial torsion of the spine and trunk torsion could reflect an imbalance around the vertical axis. Unlike the excursion of the center of pressure (COP), the forces and moments were rarely addressed to characterize the quiet standing balance. Nonetheless, one dynamical parameter, called free moment (T _V), representing the vertical torque on the feet can reflect the oscillation around the vertical axis associated to the standing imbalance. The objectives of this study were to test if the free moment variability can be utilized to characterize standing balance in a group of able-bodied and non-treated scoliotic girls and to determine if it was associated with that of the COP among each group of subjects tested. Forty-six adolescent girls with half of them presenting an adolescent idiopathic scoliosis were tested during quiet standing balance. Standing balance was assessed with the subjects standing upright and bare feet on a force plate. RMS and range of COP excursions and free moment were calculated.The scoliotic group displayed higher variability in COP excursion by about 24% than the able-bodied girls. Similarly, the T _V RMS (P = 0.00136) and range (P = 0.00197) were statistically higher by about 42% in the scoliotic group. The variability of T _V was associated with that of the COP in both groups. In the medio-lateral direction, the significant correlations between the RMS and range of the free moment and those of the COP were about 0.7 for the able-bodied group and 0.5 for the medio-lateral COP range for the scoliotic group girls. Along the antero-posterior axis, the only statistically significant correlations were observed for the scoliotic group. The free moment variability about the COP measured during quiet standing can be suggestive of an asymmetry control of the trunk around the vertical axis during standing balance. Its variability was more pronounced in scoliotic girls and was associated with the antero-posterior COP variability reflecting both biomechanical and motor control deficits. Free moment calculation could be a supplement insight into the standing balance of scoliotic subjects.     

MRI monitoring of focal cerebral ischemia in peroxisome proliferator-activated receptor (PPAR)-deficient mice

Peroxisome proliferator-activated receptors (PPARs) are a potential target for neuroprotection in focal ischemic stroke. These nuclear receptors have major effects in lipid metabolism, but they are also involved in inflammatory processes. Three PPAR isotypes have been identified: alpha, beta (or delta) and gamma. The development of PPAR transgenic mice offers a promising tool for prospective therapeutic studies. This study used MRI to assess the role of PPARalpha and PPARbeta in the development of stroke. Permanent middle cerebral artery occlusion induced focal ischemia in wild-type, PPARalpha-null mice and PPARbeta-null mice. T(2)-weighted MRI was performed with a 7 T MRI scan on day 0, 1, 3, 7 and 14 to monitor lesion growth in the various genotypes. General Linear Model statistical analysis found a significant difference in lesion volume between wild-type and PPAR-null mice for both alpha and beta isotypes. These data validate high-resolution MRI for monitoring cerebral ischemic lesions, and confirm the neuroprotective role of PPARalpha and PPARbeta in the brain.     

Musculoskeletal disorders in nursing workers: evidences associated to work conditions

This paper presents a review of national scientific articles that researched about musculoskeletal disorders in nursing workers. It was analyzed the articles published in MEDLINE, LILACS, BDENF-BIREME data basis, during the period of 1996 to 2005. The following selection criteria were adopted: musculoskeletal outcomes, nursing workers' population and publications in national journals indexed in the BIREME system. Fifteen articles met all the selection criteria. In most of them, the inappropriate work conditions were identified as risk factors for the development of musculoskeletal disorders. In these articles, the authors debate the necessity, not only, of a more in-depth research method about musculoskeletal disorders related to the nursing job, but also, the necessity to rethink the work organization.     

Influenza burden of illness: estimates from a national prospective survey of household contacts in France

BACKGROUND: The burden of influenza among ambulatory patients is still relatively unknown, although this knowledge is crucial for evaluating strategies against influenza. We estimated the impact of influenza in terms of uncomplicated morbidity and its consequences on health care utilization and lost workdays. METHODS: A national prospective household contact study between January 4, 2000, and March 15, 2000, in France recruited the households of 946 persons who visited a physician (index cases); 395 households with influenza-positive index cases completed the follow-up, which assessed the clinical impact of influenza, medical visits, treatment, and lost workdays in these index cases and their contacts. RESULTS: Of 817 assessable household contacts, 313 developed clinical influenza (secondary cases); 178 (57%) of them visited a physician at least once (consulting secondary cases). The median duration of illness was 8 days (95% confidence interval [CI], 7-8 days) in index cases, 7 days (95% CI, 7-8 days) in consulting secondary cases, and 4 days (95% CI, 3-5 days) in nonconsulting secondary cases (P<.001); the median duration of treatment in these groups was 8 days (95% CI, 8-9 days), 8 days (95% CI, 7-10 days), and 5 days (95% CI, 4-6 days), respectively (P<.001); and their mean +/- SD number of lost workdays was 4.0 +/- 2.8, 2.9 +/- 2.5, and 0.3 +/- 0.6, respectively, in working adults (P<.001). CONCLUSIONS: These results confirm the substantial burden of illness of influenza. The results should be useful for evaluating the cost-effectiveness of strategies against influenza.     

Risk factors for iron-deficiency anemia in children and adolescents with intestinal helminthic infections]

OBJECTIVE: To investigate risk factors for iron-deficiency anemia in children and adolescents (7 to 17 years of age) with intestinal helminthic infections. METHODS: A cross-sectional study was carried out with 1 709 children and adolescents living in Jequié, a town in the state of Bahia, Brazil, who had mild to moderate infection by Schistosoma mansoni, Ascaris lumbricoides, Trichuris trichiura, or hookworms. We obtained data concerning hemoglobin levels (using a portable hemoglobinometer), dietary habits (24-hour dietary recall), parasitic infections (Kato-Katz method), sanitary conditions (water supply, sewage connection, garbage collection), housing conditions (type of construction, number of persons per room), income, and amount of schooling of the parents or guardians. The risk factors for anemia were studied based on a hierarchical model of causality. RESULTS: The prevalence of parasitic infection was 74.8% for T. trichiura, 63.0% for A. lumbricoides, 55.5% for S. mansoni, and 15.7% for hookworms. Among the children and adolescents studied 32.2% were anemic. After adjustment for confounding variables, the results of the multivariate analysis showed that the following variables were significantly associated with anemia: per capita family income below US$ 27 (equal to one fourth of the Brazilian minimum wage), male sex, age of 7 to 9 years, and inadequate intake of bioavailable iron. CONCLUSIONS: The initiatives to control anemia in the group at greatest risk, as identified in this study, should seek to increase the consumption of iron-rich foods, boost the bioavailability of the iron ingested, and improve socioenvironmental conditions.