Hypertension in Jordanian children: a retrospective analysis of 70 cases

Seventy patients, aged 1–20 years, were seen at Jordan University Hospital with high blood pressure (BP) over a 3-year period. BP values ranged from 140 to 230 mmHg for systolic pressure and from 90 to 130 mmHg for diastolic pressure. Essential hypertension was seen in only 6 patients (8.6%); secondary hypertension (n=64 or 91.4%) was due to renal parenchymal diseases (RPD) in 46 patients (65.7%), reno-vascular lesions in 8 (11.4%), renal transplantation in 5 (7.2%), teenage pregnancy in 4 (5.7%), and phaeochromocytoma in 1 patient (1.4%). The aetiologies of RPD were as follows: end-stage renal disease requiring dialysis in 14 patients, acute glomerulonephritis in 14, idiopathic nephrotic syndrome in 10, chronic renal insufficiency in 5, and polycystic kidney in 3 patients. Surgical cure of hypertension was achieved in 5 of the children with reno-vascular lesions and in the patient with phaeochromocytoma.     

The αvβ6 integrin plays a role in compromised epidermal wound healing

The alphavbeta6 integrin is an exclusively epithelial integrin that is highly expressed during fetal development. In adult tissue, alphavbeta6 integrin is expressed during inflammation, carcinogenesis, and in wound healing. We previously reported that alphavbeta6 integrin is highly expressed in poorly healing human wounds and its over-expression is associated with chronic wounds in a mouse model. The objective of this study was to investigate the role of alphavbeta6 integrin in compromised wound healing induced by hydrocortisone treatment or aging by using young and old mice deficient in or overexpressing the beta6 integrin subunit in the epidermis. Untreated aged beta6 integrin-deficient (beta6-/-) animals showed a significant delay in wound healing when compared to their age-matched controls or younger beta6-/- mice. The most significant delay was observed at the stages where granulation tissue deposition was occurring. Hydrocortisone treatment significantly delayed wound healing in wild-type and beta6 integrin-deficient mice in comparison with the untreated controls. However, hydrocortisone treatment in beta6 integrin overexpressing animals did not cause a significant delay in wound healing. The results of this study suggest that alphavbeta6 integrin plays an important role in wound healing in animals compromised by either age or stress mimicked by hydrocortisone.     

Adding Bupivacaine to High-potassium Cardioplegia Improves Function and Reduces Cellular Damage of Rat Isolated Hearts after Prolonged, Cold Storage

Background: Bupivacaine retards myocardial acidosis during ischemia. The authors measured function of rat isolated hearts after prolonged storage to determine whether bupivacaine improves cardiac protection compared with standard cardioplegia alone.

Methods: After measuring cardiac function on a Langendorff apparatus, hearts were perfused with cardioplegia alone (controls), cardioplegia containing 500 [mu]m bupivacaine, or cardioplegia containing 2 mm lidocaine; were stored at 4[degrees]C for 12 h; and were then reperfused. Heart rate and left ventricular developed pressures were measured for 60 min. Maximum positive rate of change in ventricular pressure, oxygen consumption, and lactate dehydrogenase release were also measured.

Results: All bupivacaine-treated, four of five lidocaine-treated, and no control hearts beat throughout the 60-min recovery period. Mean values of heart rate, left ventricular developed pressure, maximum positive rate of change in ventricular pressure, rate-pressure product, and efficiency in bupivacaine-treated hearts exceeded those of the control group (P < 0.001 at 60 min for all). Mean values of the lidocaine group were intermediate. Oxygen consumption of the control group exceeded the other groups early in recovery, but not at later times. Lactate dehydrogenase release from the bupivacaine group was less than that from the control group (P < 0.001) but did not differ from baseline.     

Obstacles to family practitioners' use of screening tests: determinants of practice?

The effect of nine obstacles on family physicians' screening practices is reported. Family physicians, responding to a survey of periodic health screening practices, were asked to check the obstacles that affected their use of the screening tests listed. In the survey, 129 members of the American Academy of Family Physicians and 146 members of the Society of Teachers of Family Medicine responded. The most frequently reported obstacles to screening were cost to the patient, patient refusal, inconvenience to the patient, and lack of facilities or equipment. The tests for which the most obstacles were reported were sigmoidoscopy, tonometry, and mammography. The Society of Teachers of Family Medicine physicians were more likely to list cost, patient reluctance, inconvenience to the patient, "the literature does not recommend to use the test," time to perform the tests, and high rate of false positives and negatives. American Academy of Family physicians were more likely to report two obstacles, lack of facilities or equipment and risk to the patient. An analysis of the relationship between obstacle report and test utilization indicated that for only five of the nine obstacles were physicians who listed the obstacle less likely to use the test than physicians who did not list the obstacle. Obstacles related with decreased test use were those that affected the physician's ability to perform the test or the efficacy of the test itself while "inactive" obstacles were those that more directly affected and emanated from patients.     

The effect of adherent peritoneal exudate cells (APECs) and their products on the RPC-5 plasmacytoma growth in vitro

The ability of peritoneal exudate cells (PECs) and their adherent (APECs) and nonadherent (NAPECs) fractions to enhance RPC-5 plasmacytoma growth in vitro was studied. The capability of these cells to bind RPC-5 cells and influence of the binding on cytolysis tumor cells by activated with C. parvum macrophages was also determined. The effector cells were harvested from mice injected i.p. with pristane, thioglicollate medium or C. parvum or from intact mice. The effect of supernatants from the in vitro cultured PECs, APECs or NAPECs on growth RPC-5 cells were also tested. It was found that the RPC-5 plasmacytoma growth was enhanced only by cells obtained from mice treated with pristane, or by supernatants from cultured PECs and APECs derived from pristane treated mice. The adherent cells from pristane treated mice were able to bind tumor cells. The tumor cells preexposed to adherent cells from pristane stimulated mice were resistant to lysis by activated with C. parvum macrophages.     

Ascaris–Trichuris association and malnutrition in Brazilian children

This work was designed to evaluate the role of intestinal parasites on nutritional status in three rural areas of Brazil. A total of 520 children aged 1–12 years were studied through a questionnaire concerning housing, socio-economic conditions and a 24-h food intake recall. Measurements of weight and height were also performed, and three stool samples were collected on consecutive days for parasitological analysis. Scores of the standard deviation (z-scores) for the weight-for-height and height-for-age were used to characterise the growth profile. A high prevalence of intestinal parasites was detected, with Giardia lamblia (44%), Endolimax nana (43%), Ascaris lumbricoides (41%) and Trichuris trichiura (40%) being the most prevalent. Eleven per cent of the children were classified as showing stunting. Inadequate daily caloric intake was observed in 78% of the population and the proportion of those with inadequate protein intake was 34%. Logistic regression analysis was employed for the multivariate study. Stunting was significantly associated with estimators of low economic income, inadequate protein intake and polyparasitism, especially the association between Ascaris lumbricoides and Trichuris trichiura .