Comparison of inflammatory and cytotoxic lung responses in mice after intratracheal exposure to spores of two different Stachybotrys chartarum strains

Stachybotrys chartarum is an important toxigenic fungus that has been associated with respiratory disease onset in animals and humans. While it can be separated into macrocyclic trichothecene- and atranone-producing chemotypes based on secondary metabolite production, effects of spores of the two chemotypes on lungs are poorly understood. In this study we used bronchoalveolar lavage fluid (BALF) to investigate dose-response (30, 300, 3000 spores/g body weight [BW]) and time-course (3, 6, 24, 48, 96 h post instillation [PI]) relationships in mice to exposure of macrocyclic trichothecene- (JS 58-17) and atranone-producing (JS 58-06) S. chartarum strains, as well as Cladosporium cladosporioides spores. BALF total protein, albumin, pro-inflammatory cytokine (IL-1beta, IL-6, and tumor necrosis factor-alpha [TNF-alpha]), and lactate dehydrogenase (LDH) concentrations showed significant (p < 0.05) fungal species (S. chartarum vs. C. cladosporioides) and strain (58-17 vs. 58-06), spore dose and time dependent changes. The no adverse effect level (NOAEL) due to exposure to spores of JS 58-17 and JS 58-06 was < 30 spores/g BW; for C. cladosporioides it was < 300 spores/g BW. At moderate and high S. chartarum doses, BALF composition reflects differences in strain toxicity while at the lowest dose, BALF composition of either S. chartarum strain were similar. This suggests that at low spore doses, it is spore sequestered factors common to both strains not strain dependent toxins that are contributing to lung disease onset.

Electron heat transport measured in a stochastic magnetic field

New profile measurements have allowed the electron thermal diffusivity profile to be estimated from power balance in the Madison Symmetric Torus where magnetic islands overlap and field lines are stochastic. The measurements show that (1) the electron energy transport is conductive not convective, (2) the measured thermal diffusivities are in good agreement with numerical simulations of stochastic transport, and (3) transport is greatly reduced near the reversal surface where magnetic diffusion is small.

Which primary shoulder and elbow replacement? A review of the results of prostheses available in the UK

To assist surgeons select a suitable prosthesis, we have undertaken a detailed review of all shoulder and elbow replacements currently marketed in the UK. Twenty shoulder and 8 elbow implants, manufactured by 16 companies, have been identified. Twelve of the shoulder and one of the elbow implants have been introduced or modified in the last 8 years and have no clinical results published in peer-reviewed journals. Only the Biomodular, Bipolar, Copeland, Isoelastic, Neer hemi, Neer II, Roper-Day and Select shoulders accounting for less than 40% of the UK shoulder market, possess published results. The Capitello-condylar, Coonrad-Morrey, GSB III, Kudo, Liverpool, Roper-Tuke and Souter-Strathclyde elbows all have published results. These account for over 95% of all UK elbow replacements. The implications of these findings in an era of evidence-based medicine is discussed. Reviewing the clinical results should be of primary importance in the selection of a suitable prosthesis. Implants with a proven long-term record must represent the 'gold standard'. New or modified implants should only be used if they are part of a properly conducted clinical trial.

PCG boards. Social climbers

A national survey of PCG chief executives and social services representatives on PCG boards showed that most consider the social services role 'very useful'. Most social services representatives spent two to four days a month on PCG business. Two-thirds felt they needed more time. Almost half felt they had little or no support. Better feedback mechanisms are needed for social services representatives.

Strategic pooling of compounds for high-throughput screening

Bringing new medicines to the market depends on the rapid discovery of new and effective drugs, often initiated through the biological testing of many thousands of compounds in high-throughput screening (HTS). Mixing compounds together into pools for screening is one way to accelerate this process and reduce costs. This paper contains both theoretical and experimental data which suggest that careful selection of compounds to be pooled together is necessary in order to reduce the risk of reactivity between compounds within the pools.

Joint working. Prospects of partnership

Joint working between organisations and professions is a key part of many of this government's initiatives, including health action zones. To work effectively together, professionals must overcome the problems of different cultures and different patterns of accountability. Teamworking across the boundaries of health and social care is generally inadequate.

Joint working. Take your partners

The white paper proposals for partnerships in the NHS of the future are much less developed than those for performance. It is unclear whether collaborative activities are discretionary or mandatory. Effective inter-agency co-operation will require central government to give joint working a higher priority.

Joint working. Local differences

The interface between social care and primary healthcare remains underdeveloped. Where joint working is effective, it is the result of co-operation, trust and mutual respect. Successful local networks take account of professional autonomy.

Children's services. The youth of today

Few authorities have joint commissioning of mental health services for children and adolescents. But the introduction of children's services plans in April offers an important opportunity, argues Bob Hudson.

Electric response audiometry in young children before cochlear implantation: a short latency component

OBJECTIVE

Evaluation of a short latency component (SLC) observed in profoundly deaf young children during recordings of the auditory brain stem response (ABR) before cochlear implantation.

DESIGN

Seventy young children (ages 2 to 11 yr) were investigated as part of their routine audiologic and diagnostic assessment, before cochlear implantation. The ABR was evoked using click stimuli and tone pips (500 Hz and 1 kHz) at intensity levels up to 105 dB nHL. The incidence of the SLC arising at a latency of 3 msec with high level click stimuli, in addition to residual ABR waves, was assessed.

RESULTS

An SLC was observed in a total of 18 of the 70 children investigated. It was present in 15 out of 31 congenitally deaf children (48%) compared with only 2 out of 33 children deafened after meningitis (6%). A chi-squared test employing a 2 x 2 contingency table shows that this dependency on etiology of deafness is highly statistically significant (p < 0.001). The presence of the SLC in the congenitally deaf children is related to age at the time of the Electric Response Audiometry test and is more likely to be observed in the younger child (p < 0.01).

CONCLUSIONS

Interpretation of the ABR in profoundly deaf children should take into consideration the possible presence of the SLC. An evoked potential arising from stimulation of the vestibular system, particularly the vestibular nuclei, is proposed as a likely origin for this component. Damage to sensory cells in the vestibular portion of the labyrinth might explain why an SLC is seen rarely in cases of deafness after meningitis.

Genetic variation in Australian spotted fever group rickettsiae

Rickettsiae were isolated by cell culture of buffy coat blood from six patients with spotted fever from southeastern Australia and Flinders Island in Bass Strait. The isolates were genetically compared with two previous Rickettsia australis patient isolates. The genus-specific 17-kDA genes from the isolates were compared after DNA amplification and restriction fragment analysis of the amplified DNA. This comparison revealed that mainland rickettsial isolates from southeastern Australia were identical to two previous isolates of R. australis from northeastern Australia. Rickettsial isolates from Flinders Island were distinct from the mainland isolates. The 16S rRNA gene sequences from the isolates were determined and compared. The Flinders Island rickettsial agent was most closely related (0.3% structural divergence) to Rickettsia rickettsii, Rickettsia conorii, and Rickettsia slovaca. The Flinders Island rickettsial agent was 1.3 and 2.1% structurally divergent from R. australis and Rickettsia akari, respectively. The 16S rRNA gene sequence from the Flinders Island agent shows that this rickettsia is more closely related to the rickettsial spotted fever group than is R. australis. We conclude that there are two populations of spotted fever group rickettsiae in Australia and propose that the genetically distinct causative organism of Flinders Island spotted fever be designated Rickettsia honei. The extent of distribution and animal host reservoirs remain to be elucidated.

Developing-country travel and endemic diseases

Australians increasingly travel to developing countries for holiday and business and encounter new health risks that arise from changes in lifestyle, climate, geography or cultures, and exposure to infectious agents. Rare exotic tropical infections are possible but uncommon.