Heme oxygenase-1 induction protects against hypertension associated with diabetes: effect on exaggerated vascular contractility

Disturbances in vascular reactivity are important components of diabetes-evoked hypertension. Heme oxygenase-1 (HO-1) is a homeostatic enzyme upregulated in stress. This study aims to investigate the protective effect of HO-1 against diabetes-evoked hypertension. Rats were left 8 weeks after diabetes induction with streptozotocin to induce vascular dysfunction in the diabetic groups. HO-1 inducers, hemin and curcumin, were daily administrated in the last 6 weeks in the treated groups after 2 weeks of induction. Then, at the end of the study (8 weeks), HO-1 protein level was assessed by immunofluorescence; blood pressure (BP) was recorded; isolated aorta reactivity to phenylephrine (PE) and KCl was studied; reactive oxygen species (ROS) generation was determined; and serum level of glucose, advanced glycation end products (AGEs), and tumor necrosis factor alpha (TNF-α) were determined. While not affected by diabetes, HO-1 protein expression was strongly induced by hemin or curcumin administration. Compared with control animals, diabetes increased systolic and pulse BP. Induction of HO-1 by hemin or curcumin significantly reduced elevated systolic BP and abolished elevated pulse BP without affecting the developed hyperglycemia or AGEs level. The possibility that alterations in vascular reactivity contributed to diabetes-HO-1 BP interaction was investigated. Diabetes increased contractile response of the aorta to PE and KCl, while HO-1 induction by curcumin or hemin prevented aorta-exaggerated response to PE and KCl. Furthermore, the competitive HO inhibitor, tin protoporphyrin, abolished the protective effect of hemin. Diabetes was accompanied with elevated level of TNF-α and ROS generation, while HO-1 induction abrogated increased TNF-α and ROS generation. Collectively, induction of HO-1 protects against hypertension associated with diabetes via ameliorating exaggerated vascular contractility by reducing TNF-α and aortic ROS levels.

Gene Diversity of Trichomonas vaginalis Isolates

BACKGROUND

Trichomonas vaginalis is protozoan parasite responsible for trichomoniasis and is more common in high-risk behavior group such as prostitute individuals. Interest in trichomoniasis is due to increase one's susceptibility to viruses such as herpes, human papillomavirus and HIV. The aim of this study was to find genotypic differences between the isolates.

METHODS

Forty isolates from prisoners' women in Tehran province were used in this study. The random amplified polymorphic DNA (RAPD) technique was used to determine genetic differences among isolates and was correlated with patient's records. By each primer the banding pattern size of each isolates was scored (bp), genetic differences were studied, and the genealogical tree was constructed by using NTSYS software program and UPGMA method.

RESULTS

The least number of bands were seen by using primer OPD8 and the most by using OPD3. Results showed no significant difference in isolates from different geographical areas in Iran. By using primer OPD1 specific amplified fragment with length 1300 base pair were found in only 8 isolates. All these isolates were belonged to addicted women; however, six belonged to asymptomatic patients and two to symptomatic ones.

CONCLUSION

There was not much genetic diversity in T vaginalis isolates from three different geographical areas.

Molecular diagnosis of trichomoniasis in negative samples examined by direct smear and culture

BACKGROUND

Trichomoniasis is an extremely common sexually transmitted infection (STI) worldwide and is associated with important public health problems, including amplification of HIV transmission. This disease is in forms of symptomatic and asymptomatic in women and may depend on host as well as parasite variables. Most of the studies reported from females are based on examination of vaginal secretions and urine samples by direct smear and culture in modified Diamond's media. The aim of this study was checking the samples, which were negative by direct smear and culture, with PCR technique.

METHODS

The urine samples and vaginal discharge of patients attending Gynecology Clinics of Mazandaran Province, Iran with different symptoms rechecked for Trichomonas vaginalis by PCR technique using primers targeting a conserved region of the beta-tubulin genes of the parasite. Data were analyzed by Epi Info software program

RESULTS

Out of 161 negative samples by direct smear and culture, seven samples (4.3%) were positive by PCR technique.

CONCLUSION

Diagnosis of trichomoniasis by PCR is a sensitive and specific method that could play important role to help the physicians for properly treatment and control of infection.

Giant cell arteritis: recent advances and guidelines for management

This article reviews some of the recent work in epidemiology and pathology of giant cell arteritis (GCA), with particular regard to the immuno-histochemical findings in temporal artery biopsy (TAB) specimens. The diagnostic as well as prognostic role of biopsy histology is discussed. The role of novel imaging techniques e.g. duplex ultrasonography and FDG-PET scanning in diagnosis and staging of disease extent is reviewed. Existing evidence on the treatment is also discussed to propose guidelines on management of GCA.

The Chakaria food system study: household-level, case-control study to identify risk factor for rickets in Bangladesh

OBJECTIVE

A comprehensive, multiround survey of local food systems in a rickets-endemic area of Bangladesh was conducted to identify household-level risk factors for rickets.

DESIGN

A household-level, case-control study was conducted in a rickets-endemic area, Chakaria, with planned comparisons between households with one or more rachitic child and neighboring households with no affected children.

SETTING

A rickets-endemic area of southeastern Bangladesh, Chakaria.

SUBJECTS AND METHODS

An interview-based survey was conducted in six villages in Chakaria with 199 households with at least one child showing physical signs consistent with rickets and 281 households with no affected children.

RESULTS

Households with rachitic children in Chakaria had more children, more pregnant or lactating women, and fewer adults than unaffected households in that community. Affected households tended to rely on farming for their livelihood and tended to have less economic activity as indicated by less outstanding debt than their neighbors. Households with rickets were at significantly greater risk of pneumonia than were other households. Calcium undernutrition was severe and widespread in Chakaria due to a food system that offered very little of the element in accessible forms. Household diets were based on cereals and starchy vegetables. Rice and fish constituted the major source of calcium for most households, although dairy products, when used, were very important calcium sources, particularly for young children. In fact, the use of dairy products was the only household choice that led to substantial increases in the calcium intakes of children, and households that used dairy products tended to show increased calcium intakes for all of their members.

CONCLUSIONS

The risk of a Chakarian household having a child with rickets appeared to be related to its economic status. Although this might be expected to be manifest as limitations in food access and/or use, rickets households failed to show a dietary pattern associated with rickets. Calcium undernutrition was prevalent and, thus, would appear to be a predisposing factor for rickets; however, calcium undernutrition was prevalent in Chakarian households with and without rickets. Therefore, it is probable that another precipitating factor(s) play a role(s) in the etiology of rickets in Chakaria.

Effect of high-dose intravenous immunoglobulin on suppression of alloantibodies against hla in highly sensitized transplant candidates

Sensitization can present a virtually insurmountable barrier to kidney transplantation. Ten to twenty percent of patients on waiting lists for renal transplantation have developed broadly reactive cytotoxic antibodies against HLA antigens caused by pregnancy, blood transfusion, or a prior failed allograft. These sensitized end-stage renal disease patients often wait more than 5 years for a kidney to be offered. Potent immunosuppressives, plasma exchange and/or immunoadsorption have been used but the risk of infection limited their use. Some reports, have demonstrated in small numbers of patients the use of Intravenous Immunoglobulin (IVIG) as potential modality for the treatment of these sensitized patients. The goal of this study was to investigate the extent of the efficacy and to assess the utility of this modality of treatment on a relatively larger number of patients. The study included 11 patients with end stage renal disease who were waiting for living related renal allotransplantation. All patients had persistently positive crossmatches with their living related donors and PRA titer >/=20%. They received IVIG for a period of two weeks and a total of 6 doses. None of these patients, however, attained significant suppression of anti-HLA antibodies titer or a negative crossmatch reaction. We found that IVIG alone couldn't effectively inhibit preformed anti-HLA antibodies to allow successful renal transplantation.

Food consumption, energy and nutrient intake and nutritional status in rural Bangladesh: changes from 1981-1982 to 1995-96

OBJECTIVE

To determine and evaluate changes in nutritional status, food consumption, energy and nutrient intake in rural Bangladesh, using appropriate statistical analyses.

DESIGN

Repeated cross-sectional surveys. Two seasons in 1981-1982 and 1995-1996.

SETTING

Two villages with different production patterns.

SUBJECTS

Anthropometric measurements of 1883 individuals, food consumption data of 404 households.

METHODS

Repeated measurements of one-day food weighing and anthropometry in two seasons in 1981-1982 and 1995-1996. Mixed model analyses were used to evaluate and quantify temporal changes and their interactions with determinants.

RESULTS

Prevalence of underweight children decreased from 82 to 70% (P=0.015), wasted children from 34% to 18% (P=0.009) and chronic energy deficient adults decreased from 78 to 64% (P<0.0001). Intake of fish and green leafy vegetables increased from (l.s. mean+/-s.e.) 23+/-3.0 to 40+/-1.8 g/person/day (P<0.001) and from 28+/-4.5 to 41+/-2.7 g/person/day (P=0.019), respectively. Rice intake remained unchanged: 463+/-12 g raw/person/day in 1981-1982 and 450+/-7.3 g raw/person/day in 1995-1996 (P=0.355). Calcium and iron intakes increased by 40% (P<0.0001) and 16% (P=0.0002), respectively, whereas vitamin A intake remained unchanged.

CONCLUSIONS

Nutritional status improved and intakes of nutrient dense food groups, fat, iron and calcium increased from 1981-1982 to 1995-1996.

Food chain aspects of arsenic contamination in Bangladesh: effects on quality and productivity of rice

The total arsenic content of 150 paddy rice samples collected from Barisal, Comilla, Dinajpur, Kaunia, and Rajshahi districts, and from the BRRI experimental station at Rajshahi city in the boro and aman seasons of 2000 was determined by hydride generation-inductively coupled plasma emission spectroscopy (ICP). Arsenic concentrations varied from 10 to 420 microg/kg at 14% moisture content. Rice yields and grain arsenic concentrations were 1.5 times higher in the boro (winter) than the summer (monsoon) season, consistent with the much greater use of groundwater for irrigation in the boro season. Mean values for the boro and aman season rices were 183 and 117 microg/kg, respectively. The variation in arsenic concentrations in rice was only partially consistent with the pattern of arsenic concentrations in drinking water tube wells. There was no evidence from yield or panicle sterility data of arsenic toxicity to rice. Processing of rice (parboiling and milling) reduced arsenic concentrations in rice by an average of 19% in 21 samples collected from households. Human exposure to arsenic through rice would be equivalent to half of that in water containing 50 microg/kg for 14% of the paddy rice samples at rice and water intake levels of 400 g and 4 L/cap/day, respectively.

Live-donor renal transplantation at the Urology & Nephrology Center of Mansoura: 1976-1998

Based on more than 1,200 living donor transplants performed at the Urology & Nephrology Center at Mansoura University between 1976-1998, we report: 1. The overall graft survival rate was 75.8% and 51.9% at 5 and 10 years, respectively, with a projected half-life of 10.7 years. 2. Three factors acted as independent variables that significantly influenced graft survival: the number of HLA mismatches, the number of acute rejection episodes and the presence of posttransplant hypertension. a. Grafts with 2 or fewer HLA-A, -B and -DR mismatches had a significantly better survival rate. b. The incidence and the number of early acute rejection episodes had a significant negative impact on graft survival. c. A significant reduction in graft survival was associated with hypertension uncontrolled by or newly developed after transplantation. 3. Bilharziasis had no impact on the outcome. 4. Despite improvements in tissue matching and immunosuppression, an important proportion of grafts is still lost following living-donor kidney transplantation. 5. Efforts must be directed to identify better regimens, which can provide adequate immunosuppression and minimal nephrotoxicity.