Elderly patients on chronic hemodialysis: Effect of the secondary hyperparathyroidism on the hemoglobin level

In patients on chronic hemodialysis (CHD)hyperparathyroidism (HPTH) is associated withanemia and resistance to erythropoietin (EPO). This study included 86 CHD elderly pts (meanage 74.8 y, mean time on CHD = 50.5 mos); theywere divided into two groups: I (n = 31) – PTH> 250 pg/mL and II (n = 55) – PTH < 250 pg/mL.All these patients had been on CHD for> 6 mos. No differences were found betweengroups in respect to age, sex distribution andtime on CHD. The levels of creatinine, BUN, Ca,Al, Fe, albumin and ferritin were similar.Group I had a higher P level (5.4 vs 4.3 mg/dL,p = 0.001) and Ca x P (53.5 vs 43.7, p =0.009). Also the Hct (31 vs 33.5%, p = 0.008)and the Hb (10.4 vs 11.2 g/dL, p = 0.009) values werelower in Group I. The EPO dose (88 vs 85 U/kg/week,p = ns) was similar in the two groups.Our data showed that elderly patients with HPTHhave lower Hct and Hb levels than do youngerpatients on a similar EPO dose. We believethese patients will need a more aggressivetherapy with calcitriol.     

Validation of a quantitative method for defining CAD/CAM socket modifications.

A quantitative method was developed for defining manual socket modifications, averaging these modifications over a series of amputees, and using the average modifications as a template in commercial CAD/CAM systems. The CADVIEW programme (i.e. software for viewing and analysing CAD sockets) was rewritten to provide comparison functions for aligning sockets to a common axis, visualising the differences between sockets, generating modification outlines, assigning apex point values, and averaging the modification outlines. A CAD template generated in this manner should be the best general representation of a prosthetist's modification style. To test this hypothesis, 13 people with trans-tibial amputations were fitted with both a manual and a CAD/CAM socket. Questionnaires were completed by the subjects and by the prosthetist to obtain information on prosthetic comfort, function, and overall satisfaction. Ground reaction force and stride parameter data were also collected for each prosthesis during gait laboratory testing. No significant differences were found between the manually designed socket and the CAD/CAM designed socket for all data except the vertical peak forces on the amputated side. These results support the clinical application of this quantitative technique for making the transition from manual to CAD/CAM prosthetic modification procedures.     

Lymphocyte migration through the blood–brain barrier (BBB) in feline immunodeficiency virus infection is significantly influenced by the pre‐existence of virus and tumour necrosis factor (TNF)‐α within the central nervous system (CNS): studies using an in vitro feline BBB model

Aims: In human immunodeficiency virus infection, macrophage‐tropic and lymphotropic viruses exist in the host. Central nervous system (CNS) infection is an early and ongoing event, important to understand when developing strategies to treat infection. Some knowledge exists on macrophage‐tropic virus interactions with the blood–brain barrier (BBB), and the aim of this study was to investigate lymphotropic lentivirus interactions with the BBB. Methods: Interactions of the lymphotropic feline immunodeficiency virus (FIV) with an in vitro model of the feline BBB were evaluated in scenarios to mimic in vivo infections. Results: Cell‐free FIV crossed the BBB in very low quantities, and in the presence of tumour necrosis factor (TNF)‐α, BBB integrity was unaffected. However, cell‐associated FIV readily crossed the BBB, but BBB integrity was not significantly altered. Transmigration of uninfected and infected lymphocytes increased in response to TNF‐α, accompanied by a moderate disruption of barrier integrity and an upregulation of vascular cell adhesion molecule‐1 rather than intercellular adhesion molecule‐1. Significant enhancement of migration and disruption of BBB tight junctions occurred when infected cells and TNF‐α were added to the brain side of the BBB and this enhancement was not mediated through additional TNF‐α production. Conclusions: Small quantities of virus in the brain together with TNF‐α have the potential to stimulate greater cell and viral entry into the CNS and this is likely to involve important factors other than further TNF‐α production. Lymphotropic lentivirus entry to the CNS is governed by many factors similar to macrophage‐tropic strains.     

Contraceptive Implant Discontinuation in Huambo and Luanda,Angola: A Qualitative Exploration of Motives

Introduction The Government of Angola is engaged in ongoing efforts to increase access to contraceptives, in particular contraceptive implants (CIs). Discontinuation of CIs, however, has been identified as being a challenge to this work, hindering the improvement of contraceptive prevalence, and in turn, maternal and child health. The objective of this study was to understand motives for contraceptive implant discontinuation in Luanda and Huambo, Angola. Methods We conducted 45 in-depth interviews and six focus groups amongst former and current contraceptive implant clients and family planning nurses in eight clinics across the provinces of Huambo and Luanda. Data collectors transcribed and translated key information from Portuguese into English. We used a combined deductive/inductive approach to code and analyze data. Results Participants described adverse side effects, desire for pregnancy, partner dissatisfaction, quality of care, alternative or lack of information, and religion as motives for discontinuation. Adverse side effects, including prolonged bleeding, amenorrhea, and headaches were most commonly cited by both clients and providers. Discussion Motives for discontinuation reflect existing findings from other studies in similar settings, in particular the influence of adverse side effects and desire for pregnancy as motivating factors. We contextualize these findings in the Angolan setting to tease out the relationship between cultural norms of ideal family size and the perceived role of women in regards to fertility and child-bearing. We suggest that programs enter into dialog with communities to address these concerns, rather than working exclusively on improving service delivery and quality.     

Approach on smoking cessation by training public health providers

The study evaluated the results of a smoking cessation training program including 40 public health providers from November 2004 to March 2007. A total of 3,419 smokers received minimum individual intervention and 982 had group intervention. Of all, 9.2% quit smoking. The main difficulties for smoking cessation reported by health providers were: low patient compliance (11%); lack of medications (38%); and lack of health unit infrastructure/support (29%). The training allowed to reaching out a larger population through smoking cessation approaches at health units.     

Sports participation improves metabolic profile in adolescents: ABCD growth study

To analyze the impact of participation in sports with different cardiorespiratory fitness (CRF) demands on changes in metabolic and cardiovascular markers in adolescents. Longitudinal study with 12 months of follow‐up (Analysis of Behaviors of Children During Growth [ABCD Growth Study]). Overall, 184 adolescents (age 15.6 ± 2.1) were classified according to sports participation: non‐sport (control), low CRF sports, and high CRF sports. Metabolic outcomes were total cholesterol (TC) and its fractions, triacylglycerol (TG), glucose, insulin levels, and the insulin resistance index. Cardiovascular outcomes were arterial thickness (carotid and femoral [ultrasound]), blood pressure, and resting heart rate. Adolescents engaged in sports classified as high CRF demand presented a significant increase in HDL‐c (1.2 mg/dL [95%CI: ?0.5 to 3.0]) when compared to the non‐sport group (?2.4 mg/dL [95%CI: ?4.4 to ?0.5]). Regular engagement in high CRF sports was significantly related to changes in TC (β = ?0.027 [95%CI: ?0.048 to ?0.005]), HDL‐c (β = 0.009 [95%CI: 0.001 to 0.019]), LDL‐c (β = ?0.032 [95%CI: ?0.049 to ?0.016]), and glucose (β = ?0.017 [95%CI: ?0.025 to ?0.008]), while engagement in low CRF sports was related to changes in TG (β = ?0.065 [95%CI: ?0.112 to ?0.019]). No significant relationships for cardiovascular parameters were observed in the low CRF group, but one significant relationship was found between high CRF sports and changes in SBP (β = ?0.063 [95%CI: ?0.117 to ?0.009]). In conclusion, engagement in sports seems to be beneficial for improvements in metabolic and cardiovascular parameters in adolescents, mainly sports with higher CRF demand.     

Cationic nanoparticles induce caspase 3-, 7- and 9-mediated cytotoxicity in a human astrocytoma cell line

On a daily basis we are exposed to cationic nanoparticulates in many different ways. They are known to distribute to many organs of the body, and while some evidence suggests that these nanoparticles are toxic to cells, the mechanism of their toxicity is not clear. Here we apply a combination of biochemical and imaging techniques to study the mechanism by which amine-modified polystyrene nanoparticles induce cell death in a human brain astrocytoma cell line. Flow cytometry analysis of cells exposed to cationic nanoparticles revealed an increase in cell membrane permeability of the dyes YoPro-1 and propidium iodide, indicating onset of an apoptotic followed by a secondary necrotic response. Activation of caspases 3/7 and 9 and cleavage of poly(ADP-ribose) polymerase (PARP)-1 was also detected, providing clear molecular evidence of the apoptotic pathway induced by the nanoparticles. Transmission electron microscopy also revealed that these nanoparticles induce morphological changes in lysosomes and mitochondria, consistent with our observation of a rapid increase in the formation of reactive oxygen species in these cells. Together these results suggest that amine-modified polystyrene nanoparticles can mediate cell death through an apoptotic mechanism mediated by damage to the mitochondria.     

Human Group A Streptococci Virulence Genes in Bovine Group C Streptococci

Phage-encoded virulence genes of group A streptococci were detected in 10 (55.6%) of 18 isolates of group C streptococci that had caused bovine mastitis. Bovine isolates carried other genetic determinants, such as composite transposon Tn1207.3/Φ10394.4 (100%) and antimicrobial drug resistance genes erm(B)/erm(A) (22.2%), linB (16.6%), and tet(M)/tet(O) (66.7%), located on mobile elements.