Evaluation of the Impact of Exposure To Heat and to By-Products of Combustion on the Health of Firefighters

Firefighters are often exposed to high temperatures and by-products of combustion, which can affect their health. In this study, we assessed the impact of acute exposure of firefighters in fire simulators. Twenty male firefighters were exposed to fire simulators, and observed in four phases: pre-exposure (group 0, control) and after the end of the first (group 1), second (group 2), and fourth (group 3) weeks of training. Blood samples were collected and dosed to evaluate the response of the immune, inflammatory (C-reactive protein, IL6, and IL10), and endocrine systems (cortisone, total testosterone, free testosterone, SHBG, bioavailable testosterone, TSH, and free T4). In groups 0, 1, and 3, a thermographic evaluation was also carried out to study the temperature and body heat flow of the participants. Regarding the inflammatory process, an increase in C-reactive protein and a reduction in IL-10 were observed. With respect to hormonal markers, an increase in cortisol and reduced levels of free T4 and bioavailable testosterone were found after exposure, with recovery of testosterone levels in the final week of training. Thermoregulatory adaptation of the organism has been associated with changes in heat flow in the organism in people subjected to extreme temperatures, with emphasis on the performance of the lower limbs. Our findings demonstrate an inflammatory response with hormonal changes after exposure to fire and an adaptive response of thermal balance, which could aid understanding of the physiology of the human body in extreme situations.

Using Electric Cell-Substrate Impedance Sensing (ECIS) as a novel method to evaluate bacterial urinary tract infections

Urinary tractinfections (UTIs) are commonly acquired bacterial infections that cause significant morbidity, worsened by the rise of antimicrobial resistance among uropathogenic bacteria. Understanding the dynamics of bacterial UTIs is essential to the proper use of antimicrobial therapies in patient treatment. In this study, Electric Cell-Substrate Impedance Sensing (ECIS) technology was used to monitor bacterial-mediated cytotoxicity in-vitro enabling evaluation of antibiotics. Using the ECIS system, real-time changes of barrier function were recorded for human bladder epithelial cells infected with either antibiotic sensitive or resistant bacteria. This study employed four common uropathogens: Pseudomonas aeruginosa, Escherichia coli, Enterococcus species, and Klebsiella pneumoniae. The effect of different antimicrobials, antibiotic titers, and organism concentrations were evaluated. The addition of an antibiotic helped confirm and differentiate sensitive and resistant bacterial strains. Antibiotic concentrations at sensitive and resistant breakpoints were not as effective at high organism concentrations but were completely effective at lower more clinically relevant bacterial loads. The data showed bacterial strains resistant to co-cultured antibiotic took longer on average to degrade the cell monolayer than sensitive strains. Overall, these results indicate that antibiotic resistance is often associated with a fitness cost. Our findings support the use of ECIS to augment routine susceptibility data allowing the direct phenotypic measurement of bacterial virulence and the effects of antibiotic treatment on these strains.

Physicians', nurses' and community health workers' knowledge about physical activity in Brazil: A cross-sectional study

OBJECTIVES

To measure knowledge of current recommendations of physical activity and consequences of physical inactivity among healthcare providers throughout Brazil.

METHODS

A phone survey of 1600 randomly selected primary healthcare units in Brazil was conducted between January and July 2011. At each unit, a physician, nurse or community healthcare worker (n = 798) responded to a 40-minute survey, eliciting information about demographics, knowledge, and health behaviors pertaining to physical activity.

RESULTS

Among nurses and community healthcare workers, > 95% reported needing more information on physical activity guidelines. Among physicians this proportion was 80%. Nearly 40% of the professionals incorrectly believed 90-min of moderate-intensity physical activity per week is the recommended amount for health benefits; nearly 30% believed that 90-min of vigorous-intensity activity per week is needed for the same purpose. More than 75% of all groups reported that type II diabetes, hypertension, depression, and coronary heart disease might result from physical inactivity, but on average only 60% from each group are aware of osteoporosis as a possible consequence of physical inactivity.

CONCLUSIONS

Training health professionals in how to convey all relevant information about physical activity to their patients is critical for health promotion within the primary care system in Brazil.

Small bowell perforation and mesentery injury after an unusual blunt abdominal trauma-Case report

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Blunt abdominal trauma after injury with a straw of bale in a rural hospital.

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Prompt evaluation with FAST and computed tomography did not show small bowell perforation.

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Despite this the patient went to surgery wich revealed jejunal perforation.

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Missed or another perforation needing re-surgery.

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Highly clinical suspicion depending on the mechanism of abdominal trauma.

Introduction

In blunt abdominal trauma, lesions of the small bowell and mesentery are often underdiagnosed; although unusual, they represent the third most injured organ, with increasing morbidity and mortality.

Presentation of case

The authors present the case of a 68 years old male, admitted to the emergency department after being hit by a bale of straw, weighing around 300 kg, in the abdomen. After successful ressuscitation, a CT scan was performed, suggesting hemoperitoneum because of vascular lesion of the right colon bleeding. An exploratory laparotomy was performed, confirming the presence of blood in the abdominal cavity and identifying jejunal perforation, an apparently innocent hematoma of the small bowel mesentery (beside the bowel wall) distally to the first lesion and a laceration of the sigmoid serosa; a segmental jejunal resection and suture of the colon serosa were performed. In the early post-operative period, an enteric discharge was noticed, mandating surgical reexploration; a previously unnoticed bowel perforation, in the mesenteric border where the hematoma was identified, justified an additional enterectomy, after what the patients recovery progressed uneventfully.

Discussion

In this case, a sudden increase in abdominal pressure could explain that missed rupture of the mesenteric border of the jejunum, also causing the mesenteric hematoma, or, in spite of that, a state of low perfusion could have lead to total wall ischemia of an already irrigation compromised segment.

Only noted after surgical exploration, despite prior evaluation with a computed tomography. Small bowell and mesenteric injuries are potentially missed due to decreased exploratory laparotomies for blunt abdominal trauma.

Conclusion

Although uncommon, small bowel and mesenteric injuries are associated with high morbidity and mortality. High clinical suspicion is essential for an early diagnosis

Web-based participatory surveillance of infectious diseases: the Influenzanet participatory surveillance experience

To overcome the limitations of the state‐of‐the‐art influenza surveillance systems in Europe, we established in 2008 a European‐wide consortium aimed at introducing an innovative information and communication technology approach for a web‐based surveillance system across different European countries, called Influenzanet. The system, based on earlier efforts in The Netherlands and Portugal, works with the participation of the population in each country to collect real‐time information on the distribution of influenza‐like illness cases through web surveys administered to volunteers reporting their symptoms (or lack of symptoms) every week during the influenza season. Such a large European‐wide web‐based monitoring infrastructure is intended to rapidly identify public health emergencies, contribute to understanding global trends, inform data‐driven forecast models to assess the impact on the population, optimize the allocation of resources, and help in devising mitigation and containment measures. In this article, we describe the scientific and technological issues faced during the development and deployment of a flexible and readily deployable web tool capable of coping with the requirements of different countries for data collection, during either a public health emergency or an ordinary influenza season. Even though the system is based on previous successful experience, the implementation in each new country represented a separate scientific challenge. Only after more than 5 years of development are the existing platforms based on a plug‐and‐play tool that can be promptly deployed in any country wishing to be part of the Influenzanet network, now composed of The Netherlands, Belgium, Portugal, Italy, the UK, France, Sweden, Spain, Ireland, and Denmark.

Developing a research agenda for promoting physical activity in Brazil through environmental and policy change

OBJECTIVE

To identify the highest priorities for research on environmental and policy changes for promoting physical activity (PA) in Brazil; to uncover any gaps between researchers' and practitioners' priorities; and to consider which tools, methods, collaborative strategies, and actions could be useful to moving a research agenda forward.

METHODS

This was a mixed-methods study (qualitative and quantitative) conducted by Project GUIA (Guide for Useful Interventions for Activity in Brazil and Latin America) in February 2010-January 2011. A total of 240 individuals in the PA field (186 practitioners and 54 researchers) were asked to generate research ideas; 82 participants provided 266 original statements from which 52 topics emerged. Participants rated topics by "importance" and "feasibility;" a separate convenience sample of 21 individuals categorized them. Cluster analysis and multidimensional scaling were used to create concept maps and pattern matches.

RESULTS

Five distinct clusters emerged from the concept mapping, of which "effectiveness and innovation in PA interventions" was rated most important by both practitioners and researchers. Pattern matching showed a divergence between the groups, especially regarding feasibility, where there was no consensus.

CONCLUSIONS

The study results provided the basis for a research agenda to advance the understanding of environmental and policy influences on PA promotion in Brazil and Latin America. These results should stimulate future research and, ultimately, contribute to the evidence-base of successful PA strategies in Latin America.

Comparative study of bipolar eletrocoagulation versus argon plasma coagulation for rectal bleeding due to chronic radiation coloproctopathy

BACKGROUND AND STUDY AIM

Chronic radiation coloproctopathy (CRCP) is a well-recognized complication of radiotherapy, with rectal bleeding the most common presentation. It is frequently refractory to conservative management, but the optimal endoscopic treatment of bleeding secondary to CRCP is still controversial. The efficacy and safety of bipolar eletrocoagulation (BEC) and argon plasma coagulation (APC) in the management of bleeding from CRCP were evaluated and compared.

PATIENTS AND METHODS

30 patients (mean age 67.4 years) with active and chronic bleeding from telangiectasias, were randomly allocated to BEC or APC and stratified by severity of CRCP according to clinical severity and endoscopic findings (Saunders score). Success was defined as eradication of all telangiectasias, and therapeutic failure as need for more than seven sessions or for other treatment. Complications were categorized as minor (e.g. fever, anal or abdominal pain) or major (hemorrhagic).

RESULTS

Both treatments were equally effective for the treatment of CRCP rectal bleeding. Only one failure was observed in each group (P = 1.000). There was no significant difference between the two groups regarding number of sessions, minor or major complications, or relapse. However, overall complication rate was significantly higher in the BEC group (P = 0.003).

CONCLUSIONS

BEC and APC are both effective for the therapy of bleeding telangiectasias from CRCP. There are probably no major differences between them. Although APC seemed safer than BEC in this investigation, further studies, involving a much larger population, are needed to assess the complication rates and determine the best management option.

The incidence of bacteraemia after argon plasma coagulation in patients with chronic radiation proctocolitis

AIM

Argon plasma coagulation (APC) is considered a safe treatment for haemorrhagic chronic radiation proctocolitis (CRPC), but bacteraemia is a rare complication. The study aimed to evaluate the frequency of bacteraemia after APC.

METHOD

A prospective study of 21 patients who underwent APC (30 procedures) for CRPC was carried out. Blood cultures (Bactec(®) ) were obtained before and 30 min after the procedure (60 samples total). Patients were monitored for 48 h after the procedure to detect signs of infection.

RESULTS

None of the 21 patients had fever or any sign suggestive of infection after any of the 30 sessions. All baseline blood cultures were negative and two (7%) of the 30-min blood cultures were positive (Staphylococcus hominis n = 1; Streptococcus bovis and Rhodotorula sp n = 1). The first was likely to be a contaminant and the second patient had no evidence of any other colonic disease (neoplasia or polyps) beside CRPC.

CONCLUSION

APC is a low-risk procedure regarding bacteraemia and does not warrant prophylactic antibiotic administration.

Severe malaria--clinical case

We report a clinical case of severe malaria, where the rate of initial parasitaemia by Plasmodium falciparum was 43 %. Multiple organ dysfunction, including ARDS, forced admission in a close surveillance unit, with survival of the same. A brief review of the subject is made, focusing on severity and general conduct, alerting and awareness for this entity, whose expression, among us, could take on increasing importance.

Bond strength and nanoroughness assessment on human pretreated cementum surfaces

OBJECTIVES

To determine the bond strength of seven adhesive systems to human cementum, and to assess the promoted surface roughness.

METHODS

Extracted human canines were used for the present study. The mesial surface from the cervical third of the roots were ground flat with wet 600-grit silicon carbide paper and bonded. Seven adhesive systems were employed: an etch-and-rinse adhesive (Single Bond), two two-step self-etching (Clearfil SE Bond and Resulcin Aquaprime) and four one-step self-etching (One-up Bond F, Prompt-L-Pop, Etch and Prime 3.0 and NRC+Prime&Bond NT). Composite build-ups were constructed and stored in a humid environment for 24h at 37 degrees C. Specimens were sectioned into 1mm(2) beams and tested for microtensile bond strength (MTBS). Additional surfaces were conditioned for atomic force microscopy (AFM) analysis. Results were analyzed with ANOVA and Student-Newman-Keuls tests (P<0.05).

RESULTS

Single Bond showed the highest MTBS values. No differences were found between Resulcin Aquaprime, One-up Bond and Prompt-L-Pop. Clearfil SE Bond, Etch and Prime and NRC+Prime&Bond NT obtained the lowest bond strength values. H(3)PO(4) acid treatment of cementum and Resulcin Aquaprime showed the highest nanoroughness parameters and One-up Bond the lowest.

CONCLUSION

The etch-and-rinse adhesive and the two-step self-etching adhesive with the lowest pH value promoted the highest bond strength to human cementum surfaces.

A preliminary study of insect fauna on pig carcasses located in sugarcane in winter in southeastern Brazil

Minimum post-mortem intervals can be estimated based on analyses of the pattern of insect succession on a carcass. In order to successfully apply this approach, insect development rates must be considered with regard to local regional climatic conditions. This study is the first to analyse insect succession on carcasses decomposing in a sugarcane crop in Brazil. In all seasons, Chrysomya albiceps (Wiedemann) (Diptera: Calliphoridae) and Cochliomyia macellaria (Fabricius) were frequent visitors during the fresh and bloated stages of decomposition, whereas Dermestes maculatus (De Geer) (Coleoptera: Dermistdae), Necrobia rufipes (De Geer) (Coleoptera: Cleridae) and Oxelytrum sp. (Coleoptera: Silphidae) were characteristic at the most advanced decomposition stages. The fact that climatic variations influence the occurrence of insect species and vegetation in the tropics may help to solve crimes through sampling of the local insect fauna, as may the fact that only certain groups of insects occur in specific regions of large countries like Brazil.

Comparison of the antibody in lymphocyte supernatant (ALS) and ELISPOT assays for detection of mucosal immune responses to antigens of enterotoxigenic Escherichia coli in challenged and vaccinated volunteers

In the present study we compared the ELISPOT and antibody in lymphocyte supernatants (ALS) assays as surrogate measures of mucosal immunity. In separate studies, 20 inpatient volunteers received oral doses of 6 x 10(8) or 4 x 10(9)cfu of ETEC strain E24377A (LT+, ST+, CS1+, CS3+) and 20 subjects received 1 (n = 9) or 2 (n = 11) oral doses of the attenuated ETEC vaccine, PTL-003 expressing CFA/II (CS1+ and CS3+) (2 x 10(9)cfu/dose). Peripheral blood mononuclear cells (PBMCs) from all subjects were assayed for anti-colonization factor or toxin-specific IgA antibody responses using the ALS and ELISPOT procedures. ALS responses were measured using a standard ELISA, as well as by time-resolved fluorescence (TRF). Following challenge with E24377A, significant anti-CS3, CS1 and LT ALS responses were detected in the lymphocyte supernatants of 75-95% of the subjects. A similar proportion (75%) of subjects mounted an ALS response to CFA/II antigen after vaccination with the PTL-003 vaccine. Inter-assay comparisons between ALS and ELISPOT methods also revealed a high degree of correlation in both immunization groups. ALS sensitivity versus the ELISPOT assay for LT, CS3 and CS1-specific responses following challenge were 95%, 94% and 78%, respectively and 83% for the ALS response to CFA/II antigen after vaccination with PTL-003. Correlation coefficients for the LT and CS3 antigens were 0.94 (p<0.001) and 0.82 (p<0.001), respectively after challenge and 0.78 (p<0.001) after vaccination. The association between ALS and ELISPOT for the CS1 antigen was however, significant only when ALS supernatants were tested by TRF (r = 0.91, p<0.001). These results demonstrate the value and flexibility of the ALS assay as an alternative to ELISPOT for the measurement of mucosal immune responses to ETEC antigens, particularly when the complexities of ELISPOT may make it impractical to perform.

Safety and immunogenicity of an oral, inactivated, whole-cell vaccine for Shigella sonnei: preclinical studies and a Phase I trial

Orally delivered, inactivated whole-cell vaccines are safe methods of inducing local and systemic immunity. To increase surface proteins associated with adherence and invasion, Shigella sonnei were grown in BHI broth containing deoxycholate. A whole-cell vaccine (SsWC) was then produced by formalin inactivation. In pre-clinical studies, the SsWC vaccine was immunogenic and protected against S. sonnei-induced keratoconjunctivitis in the guinea pig model. In a randomized, double-blind, placebo-controlled, Phase I study, 10 evaluable subjects received either three doses of SsWC on Days 0, 14, and 28 (N = 3); five doses of SsWC on Days 0, 2, 4, 6, and 28 (N = 4); or placebo (N = 3). Each dose contained 2.0 x 10(10) inactivated cells. Serum and fecal antibodies against SsWC, LPS, and IpaC were measured by ELISA. A > or = 4-fold increase in titer was considered significant. Both SsWC dosing regimens were well tolerated. No fever or severe gastrointestinal symptoms were noted by any of the vaccinated subjects. Antibody responses were similar in the two dosing groups. Serum IgG or IgA responses to SsWC were seen in six of seven vaccinees (86%), to LPS in four of seven (57%), and to IpaC in five of seven (61%). Fecal IgA responses to these three antigens developed in five of five, three of five, and three of five subjects, respectively. Among the seven vaccinees, geometric mean rises in serum IgA levels to all three immunogens were significant; IgG increases trended toward significance (paired one-tailed t-test). We conclude that SsWC was immunogenic and protective in animal studies and well tolerated and immunogenic in a Phase I trial.

Effect of calcium removal on dentin bond strengths

OBJECTIVE

The purpose of this in vitro study was to determine the microtensile bond strengths (mu TBS) of 3 dental adhesives when applied to dentin decalcified with ethylenediaminetetraacetic acid (EDTA). The null hypothesis tested was that the removal of calcium from dentin would not influence the bond strengths.

METHOD AND MATERIALS

Eighteen extracted human molars were cut in 2 equal halves. One half served as the control, having no EDTA treatment, while the other half was assigned to 1 of 3 periods (1 hour, 24 hours, or 100 hours) of decalcification with buffered 0.5 mol/L EDTA. Middle dentin was bonded with 1 of 3 dentin adhesive groups: a self-etching primer, Clearfil SE Bond (SE); an acetone-based total-etch adhesive, Prime&Bond NT (NT); and an ethanol- and water-based total-etch adhesive, Single Bond (SB). The specimens were restored with Z-250 resin composite and sectioned in 0.9 +/- 0.2 mm2 sticks that were tested in tensile mode.

RESULTS

For each adhesive, the control group (not decalcified) resulted in statistically higher bond strengths than the treatment groups. For specimens that were not decalcified, SE and SB had statistically similar bond strengths, but both resulted in statistically higher bond strengths than NT. For specimens decalcified for 1 hour, SE resulted in statistically higher bond strengths than either SB or NT, which were ranked in the same statistical group. SE was the only dentin adhesive to result in measurable mu TBS after decalcification with EDTA for 24 hours, while SB/24 hour and NT/24 hour specimens debonded spontaneously prior to testing. All the specimens treated with EDTA for 100 hours debonded prior to testing.

CONCLUSION

Three conclusions were drawn: (1) All 3 adhesive systems included in this project bonded significantly better to calcified than to decalcified dentin, regardless of their composition; (2) The self-etching primer-based adhesive ranked consistently equal to or better than the 2 total-etch-based adhesives, regardless of the EDTA decalcification time; and (3) Removal of calcium may be more detrimental for adhesives that rely on dentin acid etching than for adhesives based on self-etching primers.

Bond strengths of new simplified dentin-enamel adhesives

PURPOSE

To compare the in vitro shear bond strengths (SBS) of five simplified dentin adhesives. The tested hypothesis was that the recently introduced simplified adhesive systems would have similar or higher SBS than an existing simplified acetone-based adhesive used as a control.

MATERIALS AND METHODS

100 flat bonding sites were polished to 600-grit on the labial surface of bovine incisors mounted in acrylic resin. 50 teeth were ground to expose enamel, while the remaining 50 specimens were prepared to expose middle dentin. The specimens were randomly divided into five equal groups to be treated with simplified dentin adhesives: Dentastic Uno, EasyBond, Gluma One Bond, One Coat Bond, and One-Step (control). A composite post was bonded to each treatment area. After thermo-cycling, enamel and dentin shear bond strengths were determined using an Instron testing machine and the data were submitted to statistical analyses.

RESULTS

Mean enamel bond strengths ranged from 14.6-28.4 MPa. One Coat Bond had the highest mean enamel SBS, but it was not significantly higher than those of Gluma One Bond and Dentastic Uno. EasyBond and One-Step had statistically similar mean enamel SBS and these were significantly lower than the mean enamel SBS of the other three adhesives. For dentin, mean SBS ranged from 14.8-21.7 MPa. Dentastic Uno had the highest mean dentin SBS, but it was not significantly greater than those of One Coat Bond and Gluma One Bond. Although One Step had the lowest mean dentin SBS, it was not significantly different from those of either EasyBond or Gluma One Bond.

A hand immersion test under laboratory-controlled usage conditions: the need for sensitive and controlled assessment methods

Exaggerated test conditions were frequently used to investigate the cutaneous tolerance of detergent products in the past. As the sensitivity of newly designed biometric methods is steadily improving, the trend towards more realistic test conditions should be encouraged. A hand immersion test under laboratory-controlled usage conditions is presently described, fulfilling such principles. Panelists soaked their hands in 2 different hand dishwashing liquids, 2x daily for 10 min each (with successive in-solution/out-of-solution cycles) for 4 consecutive days. Products were at usual dilution for dishwashing liquids and were randomized between the dominant and non-dominant hands of panelists. Visual scoring of erythema and dryness developing on the whole hands (scoring scales including interdigital areas and joints) during the week did not allow discrimination between the 2 products. However the dominant hands were significantly more susceptible to alterations than the non-dominant hands, regardless of product attribution. In contrast, skin electrical measurements (Corneometer CM800 and Skicon 200) on the dorsum of the hands (muscle mass between thumb and index) and squamometry analysis of tape stripping (harvested from the same site) yielded significant differences between the 2 products. In conclusion, a hand immersion test under realistic conditions has been described, which discriminates between products when sensitive assessment methods are used to explore skin sites partially protected from daily-life skin aggressions.

The timing of conscious experience: a critical review and reinterpretation of Libet's research

An extended examination of Libet's works led to a comprehensive reinterpretation of his results. According to this reinterpretation, the Minimum Train Duration of electrical brain stimulation should be considered as the time needed to create a brain stimulus efficient for producing conscious sensation and not as a basis for inferring the latency for conscious sensation of peripheral origin. Latency for conscious sensation with brain stimulation may occur after the Minimum Train Duration. Backward masking with cortical stimuli suggests a 125-300 ms minimum value for the latency for conscious sensation of threshold skin stimuli. Backward enhancement is not suitable for inferring this latency. For determining temporal relations between stimuli that correspond to subjects' reports, the end of cerebral Minimum Train Duration should be used as reference, rather than its onset. Results of coupling peripheral and cortical stimuli are explained by a latency after the cortical Minimum Train Duration, having roughly the same duration as the latency for supraliminal skin stimuli. Results of coupling peripheral stimuli and stimuli to medial lemniscus (LM) are explained by a shorter LM latency and/or a longer peripheral latency. This interpretation suggests a 230 ms minimum value for the latency for conscious sensation of somatosensory near-threshold stimuli. The backward referral hypothesis, as formulated by Libet, should not be retained. Long readiness potentials preceding spontaneous conscious or nonconscious movements suggest that both kinds of movement are nonconsciously initiated. The validity of Libet's measures of W and M moments (Libet et al., 1983a) is questionable due to problems involving latencies, training, and introspective distinction of W and M. Veto of intended actions may be initially nonconscious but dependent on conscious awareness.

[Women's opinion on abortion legalization in a middle size county in southern Brazil]

INTRODUCTION

Induced abortion is the main cause of maternal death in Brazil. Question of its legalization has been the subject of frequent discussion.

MATERIAL AND METHOD

In order to assess the influence of the variables affecting the opinion of women of reproductive age, a population-based systematic sample in the county of Rio Grande (Southern Brazil) was examined.

RESULTS

Of a total of 1,456 interviews 30% endorsed the legalization, whatever the circumstances; this percentage was directly associated with age, schooling, family income and previous induced abortion (p < 0.01). Adjusted analysis using logistic regression showed a significant effect of schooling and previous induced abortion on favourable opinion.

CONCLUSION

Schooling and previous induced abortion were the main determinants of women's favorable opinions regarding abortion legalization.

Evaluation of Peru-15, a new live oral vaccine for cholera, in volunteers

A new live oral cholera vaccine, Peru-15, was studied for safety, immunogenicity, and excretion in 2 groups of healthy volunteers. Twelve inpatient volunteers received freshly harvested vaccine in doses of either 10(7) or 10(9) cfu. Subsequently 50 outpatient volunteers received freeze-dried vaccine in doses of 10(8) or 10(9) cfu or placebo in a three-cell, double-masked, placebo-controlled trial. The strain was well tolerated at all dose levels, and it stimulated high levels of vibriocidal antibodies in most inpatient volunteers and in all outpatient volunteers. Although antitoxin responses were less frequent and of lower magnitude than the vibriocidal responses, antitoxin responses were seen in >60% of the outpatient volunteers. About 60% of the volunteers excreted the vaccine in their feces; however, fecal excretion did not correlate with serologic responses. It is concluded that Peru-15 is a safe and immunogenic oral vaccine for cholera.

Human alveolar macrophage cytokine release in response to in vitro and in vivo asbestos exposure

The lung macrophage is proposed to be involved in the development of asbestos-induced pulmonary fibrosis. Knowledge of the effects of long-term asbestos exposure on lung macrophage cytokine release should better define the role of the macrophage in fibrogenesis. This study examines the effects of acute in vitro asbestos exposure and chronic in vivo asbestos exposure on human alveolar macrophage cytokine release. As indicators of asbestos-induced macrophage activation, the cellular release of IL-1 beta, TNF-alpha, IL-6, GM-CSF, and PGE2 was measured during a 24-h in vitro culture. Alveolar macrophages from normal volunteers were cultured in vitro with chrysotile asbestos. Of the factors measured, only TNF-alpha was elevated in response to asbestos exposure. Alveolar macrophages from asbestos-exposed individuals were placed into one of two groups based on their exposure history. These two groups were matched for age, smoking history, and diagnosis; none met the criteria for asbestosis. Cells isolated from subjects that had been exposed to asbestos for more than 10 years secreted enhanced basal amounts of IL-1 beta, TNF-alpha, IL-6, and PGE2, while those who had been exposed for less than 10 years did not. The results indicate that while asbestos had minimal acute effects on cytokine production by the human alveolar macrophage, intense, chronic exposure to asbestos leads to the enhanced basal release of significant amounts of several cytokines that have activity for the fibroblast, even in the absence of overt fibrosis.

Inferior mesenteric artery branch avulsion from blunt trauma--CT findings. Case report

Mesenteric arterial injuries are uncommon following blunt abdominal trauma. We describe the computed tomography (CT) findings of a patient with avulsion of a branch of the inferior mesenteric artery following a low-speed motor vehicle accident.

A homeodomain protein binds to gamma-globin gene regulatory sequences

Developmental regulation of gamma-globin gene expression probably occurs through developmental-stage-specific trans-acting factors able to promote the interaction of enhancer elements located in the far upstream locus control region with regulatory elements in the gamma gene promoters and 3' A gamma enhancer located in close proximity to the genes. We have detected a nuclear protein in K562 and baboon fetal bone marrow nuclear extracts capable of binding to A+T-rich sequences in the locus control region, gamma gene promoter, and 3' A gamma enhancer. SDS/polyacrylamide gel analysis of the purified K562 binding activity revealed a single protein of 87 kDa. A K562 cDNA clone was isolated encoding a beta-galactosidase fusion protein with a DNA binding specificity identical to that of the K562/fetal bone marrow nuclear protein. The cDNA clone encodes a homeodomain homologous to the Drosophila antennapedia protein.

Effect of isoetharine on cardiac conduction in man

The effects of isoetharine on the His bundle electrogram were studied in 10 patients with heart disease. Recordings were made at varied heart rates using atrial pacing. Isoetharine significantly reduced the AH interval with atrial pacing, but it had no effect on the HV interval. Second degree heart block occurred at higher pacing rates after isoetharine treatment as compared to the control state. The heart rate and blood pressure showed no significant change after isoetharine. The functional and effective refractory period were measured with the use of the extra-stimulus technique. The functional refractory period of the AV node, as well as the effective refractory period of the atrium, significantly decreased after isoetharine. Thus, isoetharine can improve conduction through the atrioventricular node. The drug does have a cardiac effect as measured by its action on the human conduction system.

Left ventricular wall motion improvement after phentolamine: a case report

Left ventricular wall motion abnormalities are commonly seen in coronary artery disease patients. The differentiation between reversibly ischemic areas an irreversibly damaged areas is 1 was of predicting which patient might gain improved ventricular function from surgical correction. One patient with coronary artery disease is presented here who showed poor septal movement on his echocardiogram. After the IV administration of phentolamine, the septal movement became normal. Thus, phentolamine should be considered as an agent that can detect reversible areas of wall motion abnormalities.