The relationship between changes in daily air pollution and hospitalizations in Perth, Australia 1992-1998: a case-crossover study

A case-crossover study was undertaken to investigate the relationship between daily air pollutant concentrations and daily hospitalizations for selected disease categories in Perth, Western Australia. Daily measurements of particles (measured by nephelometry and PM2.5), photochemical oxidants (measured as ozone), nitrogen dioxide (NO2) and carbon monoxide (CO) concentrations were obtained from 1992 to 1998 via a metropolitan network of monitoring stations. Daily PM2.5 concentrations were estimated using monitored data, modelling and interpolation. Hospital morbidity data for respiratory, cardiovascular (CVD), gastrointestinal (GI) diseases, chronic obstructive pulmonary diseases (COPD) excluding asthma; pneumonia/influenza diseases; and asthma were obtained and categorized into all ages, less than 15 years and greater than 65 years. Gastrointestinal morbidity was used as a control disease. The data were analyzed using conditional logistic regression. The results showed a small number of significant associations for daily changes in particle concentrations, nitrogen dioxide and carbon monoxide for the respiratory diseases, CODP, pneumonia, asthma and CVD hospitalizations. Changes in ozone concentrations were not significantly associated with any disease outcomes. These data provide useful information on the potential health impacts of air pollution in an airshed with very low sulphur dioxide concentrations and lower nitrogen dioxide concentrations commonly found in many other cities.

A candidate gene approach to searching for low-penetrance breast and prostate cancer genes

Most cases of breast and prostate cancer are not associated with mutations in known high-penetrance genes, indicating the involvement of multiple low-penetrance risk alleles. Studies that have attempted to identify these genes have met with limited success. The National Cancer Institute Breast and Prostate Cancer Cohort Consortium--a pooled analysis of multiple large cohort studies with a total of more than 5,000 cases of breast cancer and 8,000 cases of prostate cancer--was therefore initiated. The goal of this consortium is to characterize variations in approximately 50 genes that mediate two pathways that are associated with these cancers--the steroid-hormone metabolism pathway and the insulin-like growth factor signalling pathway--and to associate these variations with cancer risk.

[Plasma cell leukaemia]

We report a case of primary plasma cell leukaemia, with an absolute count of plasma cells of 53 Giga/L, diagnosed in a 83-year-old woman. The patient's condition improved, with no circulating plasma cells after 3 weeks of treatment, in response to the combination of thalidomide and dexamethasone administered for 5 days followed by thalidomide alone. The clinical presentation, the morphological, flow cytometric and pathophysiological characteristics of the plasma cell leukaemia and the treatment are summarised in this paper.

Suggestive linkage of schizophrenia to 5p13 in Costa Rica

Schizophrenia afflicts roughly 1% of all people worldwide. Remarkably, despite differing cultures and environments, the expression of illness is essentially the same. Family, twin, and adoption studies identify schizophrenia as a genetically influenced disease. Linkage studies suggest many positive regions of interest, but as a complex genetic disorder most of the pathogenic loci have not yet been found. Isolated populations are commonly used to study rare Mendelian inherited diseases due to the more homogenous genetic background of the subjects and are thought to be useful for detecting linkage in complex genetic disorders such as schizophrenia. This study aims to define areas of the genome that exhibit co-inheritance with schizophrenia in one large, Mendelian-like family from the central valley of Costa Rica. The whole genome scan analysis of this pedigree, which included 11 cases of schizophrenia and schizoaffective disorder, identified a number of markers on chromosome 5p that appear to co-segregate with the disease with a maximum lod score of 2.70 at marker D5S426. Current studies include investigating additional Costa Rican pedigrees to replicate these findings and identify additional loci linked to the disease.

The Role of COX-2 in Acute Pain and the Use of Selective COX-2 Inhibitors for Acute Pain Relief

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of therapy for the management of acute pain. Cyclooxygenase (COX) enzyme is of particular interest because it is the major target of NSAIDs. Although NSAIDs are remarkably effective in the management of pain and inflammation, their use is limited by several adverse effects including gastrointestinal bleeding and ulceration, impaired renal function, and inhibition of platelet aggregation. Discovery of a second cyclooxygenase, COX-2, led to the hypothesis that NSAID side effects could be decreased, as the inhibition of COX-2 is more directly implicated in ameliorating inflammation while the inhibition of COX-1 is related to adverse effects in the GI tract. This stimulated the development of selective COX-2 inhibitors (coxibs) that are better tolerated than nonselective NSAIDs but comparable in analgesic efficacy. This article provides an overview on the therapeutic use of selective COX-2 inhibitors for relief of acute pain, largely based on clinical trials in patients undergoing the surgical removal of impacted third molars, with focus on analgesic efficacy and the potential safety associated with their use compared to dual COX-1/COX-2 inhibitors.

The effect of water hyacinths for wastewater treatment under Cuban climatic conditions

The purification capacity of systems using floating aquatic plants depend on the climatic conditions under which they are used. This study from Cuban conditions evaluate the effects of the organic loading rate, hydraulic loading rate and water depth on the purification capacity of water hyacinths, as well as the effect of some climatic variables on the kinetics of the treatment processes. The experimental system consisted of two consecutive tanks simulating a system of ponds in series. The water depths used were 0.5 m and 1.12 m. In the shallower system with shorter retention times and greater superficial organic loading higher removal efficiencies are obtained. With the data obtained, empirical relations were sought. From these correlations it is possible to determine the values for some parameters used in the design of aquatic treatment systems with water hyacinths. The results revealed a relationship between the purification capacity of the water hyacinth and its velocity of growth. The specific velocity of growth varied with the months of the year and was associated with the temperature and the solar radiation. A multiple correlation equation describing these relations was obtained.

New York City syndromic surveillance systems

New York City's first syndromic surveillance systems were established in 1995 to detect outbreaks of waterborne illness. In 1998, daily monitoring of ambulance dispatch calls for influenza-like illness began. After the 2001 World Trade Center attacks, concern about biologic terrorism led to the development of surveillance systems to track chief complaints of patients reporting to emergency departments, over-the-counter and prescription pharmacy sales, and worker absenteeism. These systems have proved useful for detecting substantial citywide increases in common viral illnesses (e.g., influenza, norovirus, and rotavirus). However, the systems have not detected more contained outbreaks earlier than traditional surveillance. Future plans include monitoring school health and outpatient clinic visits, augmenting laboratory testing to confirm syndromic signals, and conducting evaluation studies to identify which of these systems will be continued for the long term.

Human T cell lymphotropic virus type 1 infection and early neurologic development: a pilot study of 48 children

To determine whether human T cell lymphotropic virus type 1 (HTLV-1) infection is associated with delayed neurological development, we examined 48 Peruvian children with exposure to HTLV-1 who were identified at the Instituto Materno-Perinatal. Compared with 38 HTLV-1-seronegative children, the 10 seropositive children did not have higher rates of neurodevelopmental delay. Long-term follow-up is planned.

Efficacy of mometasone furoate microemulsion in the treatment of erosive-ulcerative oral lichen planus: pilot study

BACKGROUND

Oral lichen planus (OLP) is a frequent immunological chronic disease, having different clinical forms: asymptomatic and symptomatic. Symptomatic OLP has been palliated with topical corticosteroids with different levels of efficacy and safety. The purpose of this pilot phase II clinical trial was to determine the efficacy of mometasone furoate microemulsion upon the symptoms and signs of erosive-ulcerative OLP.

METHODS

Forty-nine patients with clinical and histologically confirmed erosive-ulcerative OLP were enrolled in this study (36 women and 13 men). Their average age was 56.4 years (from 28 to 78). The treatment consisted of 0.1% mometasone furoate microemulsion mouthwash three times a day over 30 days. Pain, erythema and ulceration were assessed after 15 and 30 days of treatment. The data was processed and statistically analysed by student's t-test for paired samples.

RESULTS

Mometasone caused a statistically significant reduction in pain (3.58 vs. 0.65, P = 0.0000). Treatment significantly reduced the surface area of erythema (155.2 vs. 21.9 mm(2), P = 0.0001) and ulceration (30.7 vs. 7.3 mm(2), P = 0.0000). None of these patients suffered severe adverse effects.

CONCLUSIONS

Mometasone furoate microemulsion is a safe and effective therapy in the treatment of symptomatic erosive-ulcerative OLP.

Creatine monohydrate enhances strength and body composition in Duchenne muscular dystrophy

OBJECTIVE

To determine whether creatine monohydrate (CrM) supplementation increases strength and fat-free mass (FFM) in boys with Duchenne muscular dystrophy (DD).

METHODS

Thirty boys with DD (50% were taking corticosteroids) completed a double-blind, randomized, cross-over trial with 4 months of CrM (about 0.10 g/kg/day), 6-week wash-out, and 4 months of placebo. Measurements were completed of pulmonary function, compound manual muscle and handgrip strength, functional tasks, activity of daily living, body composition, serum creatine kinase and gamma-glutamyl transferase activity and creatinine, urinary markers of myofibrillar protein breakdown (3-methylhistidine), DNA oxidative stress (8-hydroxy-2-deoxyguanosine [8-OH-2-dG]), and bone degradation (N-telopeptides).

RESULTS

During the CrM treatment phase, there was an increase in handgrip strength in the dominant hand and FFM (p < 0.05), with a trend toward a loss of global muscle strength (p = 0.056) only for the placebo phase, with no improvements in functional tasks or activities of daily living. Corticosteroid use, but not CrM treatment, was associated with a lower 8-OH-2-dG/creatinine (p < 0.05), and CrM treatment was associated with a reduction in N-telopeptides (p < 0.05).

CONCLUSIONS

Four months of CrM supplementation led to increases in FFM and handgrip strength in the dominant hand and a reduction in a marker of bone breakdown and was well tolerated in children with DD.

Apoptosis in primary lymphoid organs with aging

Age-associated changes in the immune system are responsible for an increased likelihood of infection, autoimmune diseases, and cancer in the elderly. Immunosenescence is characterized by reduced levels of the peripheral naive T cell pool derived from thymus and the loss of immature B lineage cells in the bone marrow. Primary lymphoid organs, i.e., bone marrow and thymus, exhibit a loss of cellularity with age, which is especially dramatic in the thymus. A summary of major changes associated with aging in primary lymphoid organs is described in this article. The participation of apoptosis in cell loss in the immune system, a change associated with age, as well as a description of molecular machinery involved, is presented. Finally, the involvement of different hormonal and non-hormonal agents in counteracting apoptosis in thymus and bone marrow during aging is explained. Here, we underlie the important role of glucocorticoids as immunodepressors and melatonin as an immunostimulatory agent.

Modified direct agglutination test for simplified serologic diagnosis of leishmaniasis

Human leishmaniasis is a severe health problem in many countries around the world. Hence, a cheap, reliable, and accurate diagnostic test is required to fight this disease. Perhaps the direct agglutination test (DAT) meets these criteria, but antigen elaboration involves many difficulties. We have developed a new antigen elaboration method, the EasyDAT method, that avoids the problems associated with the DAT. In this study, we compared the traditional DAT antigen method with our EasyDAT antigen method by using canine sera. The sensitivities (100%) and specificities (98.7%) were the same for both methods; we therefore concluded that the EasyDAT Leishmania antigen method simplifies serologic diagnosis, making this method easier and cheaper to use.

Melatonin and cell death: differential actions on apoptosis in normal and cancer cells

Melatonin is a natural compound synthesized by a variety of organs. It has been shown to function as a cell-protective agent. Since 1994, when the first paper was published documenting the role of melatonin in apoptosis, the number of reports in this area has increased rapidly. Much of the research conducted falls into three major categories: first, the role of melatonin in inhibiting apoptosis in immune cells; second, the role of melatonin in preventing neuronal apoptosis and finally, the role of melatonin in increasing apoptotic cell death in cancer cells. The mechanisms whereby melatonin influences apoptosis have not clarified, although a number of mechanistic options have been suggested. Apoptotic cell death is a physiological phenomenon related to homeostasis and proper functioning of tissues and organs; however, a failure in the apoptotic program is related to a number of diseases. The participation of melatonin in apoptosis in numerous cell types and its potential importance in a variety of diseases such as immunodeficiency, neurodegeneration and cancer is summarized in this review.

Modulation of ERG25 expression by LDL in vascular cells

BACKGROUND

Plasma low density lipoproteins (LDL) play a key role in the pathogenesis of atherosclerosis. LDL modify gene expression in vascular cells leading to disturbances in the functional state of the vessel wall.

METHODS

Expression levels of C-4 sterol methyl oxidase gene (ERG25), sterol regulatory element binding protein (SREBP)-1 and -2 were evaluated in porcine aortic endothelial cells (PAEC), porcine and human smooth muscle cells (SMC) and in the vascular wall from normolipemic and hyperlipemic pigs by RT-PCR. SREBP-1 protein levels were assessed by Western blot and SREBP-SRE binding by EMSA. SREBP-2 was overexpressed by transient transfection with lipofectin.

RESULTS

We have identified expression of the ERG25 in vascular cells and analyzed its regulation by LDL. ERG25, an enzyme involved in cholesterol biosynthesis, is expressed in vascular endothelial and SMC from porcine and human origin and is downregulated by LDL in a time- and dose-dependent manner. Downregulation of ERG25 by LDL was abolished by an inhibitor of neutral cysteine proteases (N-acetyl-leucyl-leucyl-norleucinal) that abrogates SREBP catabolism. LDL downregulated SREBP-2 mRNA levels but not SREBP-1 expression in these cells and both ERG25 and SREBP-2 gene expression was significantly decreased in the vascular wall of diet-induced hypercholesterolemic swine. Finally, in cell transfection experiments SREBP-2 overexpression blocks ERG25 downregulation caused by LDL.

CONCLUSIONS

Our results indicate that LDL modulate ERG25 expression in the vascular wall and suggest the involvement of SREBP-2 in this mechanism.