Immunological and In-Vivo Neurological Studies on a Benzoic Acid-Specific T-Cell-Derived Antigen-Binding Molecule from the Serum of a Toluene-Sensitive Patient

T-cell-derived antigen-binding molecules (TABMs) specific for benzoic acid were isolated from the serum of a toluene-sensitive patient. The resulting purified TABMs (BA-TABMs) did not contain immunoglobulin G and were associated with the cytokine transforming growth factor-β (TGF-β). BA-TABMs bound to benzoic acid conjugated to human serum albumin (BA-HSA), as well as to other chemicals conjugated to human serum albumin—including dinitrophenol and oxazolone. The binding of BA-TABMs to the conjugated chemicals increased the level of detectable TGF-β, and a similar effect was observed with the unconjugated chemicals, benzoic acid and 2,4-dinitrophenol glycine. The increase in TGF-β was critically dependent on the ratio between BA-TABMs and the conjugated or unconjugated chemicals; the increase was optimum at intermediate concentrations and absent at low and high concentrations. The authors used an established animal model in vivo and demonstrated that TGF-β enhanced the inflammatory response induced by the release of neuropeptides from sensory nerves; this enhancement occurred in a dose-dependent manner. The BA-TABMs also enhanced this neurogenic inflammatory response in a dose-dependent manner, and this effect was blocked by anti-TGF-β antibody. When the authors added either BA-HSA or benzoic acid, the effect of BA-TABMs on neurogenic inflammation was further enhanced at intermediate concentrations of antigen and was unaltered or reduced at higher concentrations. TABMs specific to particular chemicals, as a result of their association with cytokines (e.g., TGF-β), may be implicated in symptom production in chemically sensitive patients.     

Same Strategy Different Industry: Corporate Influence on Public Policy

In March 2013 a state judge invalidated New York City’s proposal to ban sales of sugar-sweetened beverages larger than 16 ounces; the case is under appeal. This setback was attributable in part to opposition from the beverage industry and racial/ethnic minority organizations they support. We provide lessons from similar tobacco industry efforts to block policies that reduced smoking prevalence. We offer recommendations that draw on the tobacco control movement’s success in thwarting industry influence and promoting public health policies that hold promise to improve population health.Tobacco control policies, including cigarette taxes and smoke-free air laws, are largely responsible for dramatic declines in smoking rates over the past several decades.1 Likewise, public policies that seek to influence the food and physical activity environment hold promise for reducing the prevalence of obesity.2 However, policies that aim to limit access to unhealthy foods or tobacco products are often met with opposition by industries concerned that new regulations may have a negative impact on product sales. Evidence from statewide tobacco control efforts has demonstrated that effective grassroots advocacy is an important strategy to counter this opposition and engage policymakers and legislators in efforts to implement policies to improve population health.3,4 As such, organizations that represent racial/ethnic minority groups have particularly important roles to play when one considers the disproportionately higher burden of preventable disease among these groups compared with that among Whites. For example, African Americans have obesity rates that are approximately 40% greater than rates among Whites.5Yet, during New York City’s (NYC’s) recent attempt to restrict sales of sugar-sweetened beverages (SSBs) as part of a strategy to reverse negative trends in obesity rates, it was leading minority organizations, such as the National Association for the Advancement of Colored People (NAACP), who sided with the beverage industry to strongly oppose the policy. In this article, we explore parallels between the tobacco industry’s strategies to prevent grassroots support for tobacco control policies, particularly among minority-led organizations, and recent actions taken by the beverage industry to impede the regulation of SSB sales. We offer recommendations, which draw on the success of the tobacco control movement, to minority organizations and the public health community for promoting obesity-related policy initiatives.     

Hypoglycemic activity of leaves of Acanthus montanus T.Anderson (Acanthaceae) in rats

Hypoglycemic activity of Acanthus montanus, used locally in Nigeria to “cure” diabetes, was evaluated. Phytochemical tests and acute toxicity tests were carried out on the methanolic extract. Using normoglycemic and alloxanized (alloxan monohydrate 70 mg/kg IV body weight) rats, pre-treatment was done with 400 mg/kg of the extract and glibenclamide 10 mg/kg as reference drug orally. Blood glucose levels of the rats were measured at various time intervals (0, 1, 2, 3, 4, 6 h). In addition, a dose dependency test was also done with alloxanized rats using 100 and 200 mg/kg of the extracts. Glucose levels were analyzed statistically using ANOVA and Dunnett’s tests. The extract revealed abundance of alkaloids, terpenoids, glycosides and flavonoids. Acute toxicity tests showed an oral LD₅₀ of 4,800 mg/kg. With the exception of glibenclamide 10 mg/kg (glucose reduction to 44 mg/dl, p?<?0.01) there was no significant reduction in glucose level in normoglycemic rats in all the treatments at 6 h. In alloxanized rats, there was significant reduction of glucose level by the extract and glibenclamide compared to control 2 h after treatment. Mean percentage reduction of glucose showed a time dependent increase in glucose reduction by the extract with a maximum reduction of 67.1%, P?<?0.01, at 6 h. A dose dependent glucose reduction was seen with increasing doses of the extract till the 6 h time after treatment. This study suggests that the methanolic extract of Acanthus montanus T.A possesses a hypoglycemic effect.     

An RCT of the effect of motivational interviewing on medication adherence in hypertensive African Americans: rationale and design

BACKGROUND: Hypertension disproportionately affects African Americans compared to whites, and it is the single most common explanation for the disparity in mortality between African Americans and whites. Adherence with antihypertensive medications can help reduce risk of negative hypertension-related outcomes. Motivational interviewing is a promising patient-centered approach for improving adherence in patients with chronic diseases. In this paper we describe the rationale and design of an ongoing randomized controlled trial testing the effectiveness of motivational interviewing versus usual care in improving medication adherence among 190 African American uncontrolled hypertensive patients, who receive care in a primary care setting. METHODS: The usual care group receives standard medical care, while those in the intervention group receive standard care plus four sessions of motivational interviewing at 3-month intervals for a period of 1 year. This technique consists of brief, patient-driven counseling sessions to facilitate initiation and maintenance of behavior change. The primary outcome is adherence to prescribed antihypertensive medication, assessed with the electronic medication events monitoring system (MEMS) and the Morisky self-report adherence questionnaire. Secondary outcomes are within-patient changes in blood pressure, self-efficacy, and intrinsic motivation between baseline and 12 months. We report the baseline sociodemographic and clinical characteristics of the participants. CONCLUSIONS: Despite the potential utility of motivational interviewing, little is known about its effectiveness in improving medication adherence among hypertensive patients, especially African Americans. In addition to the baseline data this study has generated, this trial should provide data with which we can assess the effectiveness of this approach as a behavioral intervention.     

Socio-cultural factors as correlates of maternal mortality in Edo South Senatorial District,Nigeria

ObjectiveTo investigate the socio-cultural factors that contribute to Maternal Mortality in Edo South Senatorial District.MethodsThe population of the study was made up of 2 157 females of reproductive age and multi-stage random sampling technique was used. The instrument for data collection was a self developed structured and validated questionnaire with a reliability of 0.82. Focus group discussion (FGD) and in-depth interview guide were employed to complement the instrument. Inferential statistics of multiple regressions were also employed to test the hypotheses at 0.05 level of significance.ResultsThe results showed that the socio-cultural variables when taken together contributed positively to maternal mortality [R² = 0.32; CV = 16.5; df = 7). The finding further revealed that six, out of seven of the independent variables in the study significantly contributed to maternal mortality in Edo South Senatorial District. The implications of these findings in maternal and child health care were highlighted.ConclusionsThe study had shown that in addition to medical causes of maternal mortality, there are socio-cultural factors that contribute to women dying during pregnancy, labour and pueperium.     

The impact of perceived hypertension status on anxiety and the white coat effect

Background: The white coat effect can lead to overdiagnosis of hypertension and unnecessary pharmacologic treatment. Mechanisms underlying the white coat effect remain poorly understood but are critical to improving the accuracy of clinic blood pressure measurement.Purpose: This study investigated whether perceived hypertension status was associated with state anxiety levels during a clinic visit and the magnitude of the white coat effect, independent of true blood pressure status.Methods: This observational study included 214 normotensive and mildly hypertensive participants who were 18 to 80 years old, had no cardiac history, and were willing to discontinue antihypertensive medications for 8 weeks. Participants underwent 36 hr ambulatory blood pressure monitoring and physician blood pressure measurement. Outcome measures were state anxiety reported during the clinic visit and the white coat effect.Results: An analysis of covariance indicated that participants who perceived themselves as hypertensive reported greater state anxiety (p<.001) and showed larger white coat effects (ps<.01) compared with those who perceived themselves as normotensive. True hypertension status based on ambulatory blood pressure was not related to either outcome. Anxiety accounted for approximately 19% of the association between perceived hypertension status and the white coat effect.Conclusions: These findings suggest that the perception of being hypertensive is associated with greater anxiety during clinic blood pressure measurement and a larger white coat effect, independent of the true blood pressure level. Anxiety appears to be a mechanism by which perceived hypertension status contributes to the white coat effect. Preparation of this article was supported in part by the National Heart, Lung, and Blood Institute, National Institutes of Health, Grants HL47540 and HL76857, T. G. Pickering, Principal Investigator. The sponsors had no role in the study design; in the collection, analysis, or interpretation of the data; in the writing of this article; or in the decision to submit the article for publication.