Effects of microbiota-directed foods in gnotobiotic animals and undernourished children

To examine the contributions of impaired gut microbial community development to childhood undernutrition, we combined metabolomic and proteomic analyses of plasma samples with metagenomic analyses of fecal samples to characterize the biological state of Bangladeshi children with severe acute malnutrition (SAM) as they transitioned, after standard treatment, to moderate acute malnutrition (MAM) with persistent microbiota immaturity. Host and microbial effects of microbiota-directed complementary food (MDCF) prototypes targeting weaning-phase bacterial taxa underrepresented in SAM and MAM microbiota were characterized in gnotobiotic mice and gnotobiotic piglets colonized with age- and growth-discriminatory bacteria. A randomized, double-blind controlled feeding study identified a lead MDCF that changes the abundances of targeted bacteria and increases plasma biomarkers and mediators of growth, bone formation, neurodevelopment, and immune function in children with MAM.

Antiatherosclerotic effects of nicardipine and nifedipine in cholesterol-fed rabbits

Dutch-belted rabbits fed a 2% cholesterol diet for 8 weeks developed atherosclerotic lesions that covered 37.2% +/- 3.5% of the aortic luminal surface. In samples of aortic arch, accumulation of cholesterol and triglyceride was also observed. Oral administration of nicardipine or nifedipine at dosages of 40 mg/kg twice daily for 8 weeks reduced plaque area by 49.2% and 58.7%, respectively. Nicardipine and nifedipine reduced cholesterol accumulation in the aortic arch by 74.5% and 69%, respectively. Triglyceride accumulation was totally abolished. Neither drug significantly altered cholesterol concentration of plasma low density lipoprotein or high density lipoprotein, although nicardipine produced a 42% reduction in cholesterol concentration of the d less than 1.006 g/ml fraction. The above results suggest potential therapeutic utility of nicardipine in atherosclerosis.

Eicosanoid effects on cell proliferation in vitro: relevance to atherosclerosis

Several eicosanoids were tested for ability to inhibit proliferation of cells in culture. In rabbit aortic smooth muscle cells and mouse B16BL6 melanoma cells, order of potency was: 12-HETE greater than PGJ2 greater than PGA1 greater than or equal to PGE1 greater than PGE2 greater than or equal to PGD2 greater than or equal to PGA2. PGB1 was active in smooth muscle cells (greater than PGD2) but not in B16 cells. 5-HETE and Leukotriene B4 were weakly active in smooth muscle cells, and PGB2, PGF2 alpha and TXB2 were inactive in both cells types. In Swiss albino mouse 3T3 fibroblasts, PGJ2 and PGE1 showed much lower relative potency than in the other two cell lines, although the profile was otherwise similar. These findings may be relevant to the anti-atherosclerotic (and perhaps anti-tumor activity) of some eicosanoids.

Prostaglandin D synthase in human megakaryoblastic cells

The cytosol fraction of human platelets did not convert prostaglandin (PG) H2 to PGD2. However, a homogenate of human megakaryoblastic CMK cells (precursor cells of platelets) produced PGD2 from PGH2. The PGD synthase activity was localized in the cytosol of CMK cells, and absolutely required glutathione. The catalytic properties and Western and Northern blottings indicated that the enzyme was PGD synthase of the hematopoietic type rather than the lipocalin type. When CMK cells were differentiated to megakaryocytes with phorbol ester along with induction of cyclooxygenase-1, the PGD synthase activity increased about 2-fold for 2 days and then decreased. In another human megakaryoblastic cell line, Dami, the PGD synthase increased about 10-fold by the addition of phorbol ester. Thus, the PGD synthase, which was undetectable in platelets, appeared during differentiation of megakaryoblasts to megakaryocytes.

On the identification and biological properties of prostaglandin J2

Prostaglandin D2 spontaneously decomposes at physiological pH and temperature to 9-deoxy-delta 9-PGD2 (designated PGJ2). We developed a TLC procedure for the isolation of PGJ2 which was identified by both proton-NMR and mass spectrometry. Freshly prepared PGJ2 was active in inhibiting aggregation induced by ADP in citrated human platelet rich plasma. As reported by Fukushima et al. (1). PGJ2 was less active (x 0.1-0.25) than PGD2 as an inhibitor. Concentrations of PGJ2 that markedly inhibited aggregation of human platelets were generally incapable of inhibiting aggregation of rat or guinea pig platelets. Using a heterologous system of human platelets mixed with guinea pig plasma samples (2), it was shown that the ability of PGJ2 to inhibit platelet aggregation was lost immediately following intravenous injection in anesthetized guinea pigs. This apparent rapid uptake and/or degradation of PGJ2 might also explain why PGJ2 had no effect on blood pressure of anesthetized guinea pigs. PGJ2 was potent in inhibiting proliferation of cultured vascular smooth muscle cells, mouse melanoma cells and mouse fibroblasts. Less potent anti-proliferative effects were seen with two other degradation products of PGD2, one of which was the delta 12 metabolite reported (3,4) to be formed from PGJ2 in a reaction catalyzed by serum albumin.

Two-wavelength fundus autofluorescence and macular pigment optical density imaging in diabetic macular oedema

PURPOSE

To evaluate the application of 488 and 514 nm fundus autofluorescence (FAF) and macular pigment optical density (MPOD) imaging in diabetic macular oedema (DMO) and to demonstrate the typical imaging features.

PATIENTS AND METHODS

A hundred and twenty-five eyes of 71 consecutive patients with diabetic retinopathy who underwent examination at a specialist university clinic employing a modified Heidelberg Retina Angiograph, using two different light sources of 488 and 514 nm wavelength, were retrospectively reviewed. MPOD images were calculated using modified Heidelberg Eye Explorer software. All images were evaluated by two independent masked graders. Features from FAF and MPOD images were correlated with optical coherence tomography (OCT) imaging findings and inter-grader variability, sensitivity and specificity were calculated using OCT as reference.

RESULTS

Sixty-seven eyes had DMO on OCT. The inter-grader variability was 0.84 for 488 nm FAF, 0.63 for 514 nm FAF and 0.79 for MPOD imaging. Sensitivity and specificity for detection of DMO were 80.6 and 89.7% for 488 nm FAF; 55.2 and 94.8% for 514 nm FAF; and 80.6 and 91.4% for MPOD imaging. In 488 nm FAF and MPOD imaging, DMO was better visualised in comparison with 514 nm FAF imaging, P<0.01. MPOD revealed displacement of macular pigment by intraretinal cysts.

CONCLUSION

MPOD imaging, and particularly its combination with 488 nm and 514 nm FAF, provides a valuable addition to OCT in the evaluation of DMO and is clinically useful in rapid en-face assessment of the central macula.

Induction of cyclooxygenase and suppression of 12-lipoxygenase in human erythroleukemia cells upon phorbol ester-induced differentiation

When human erythroleukemia (HEL) cells were incubated with arachidonic acid, both fatty acid cyclooxygenase and arachidonate 12-lipoxygenase activities were exhibited. Subcellular localization of these enzymes were examined by differential centrifugation, and both the cyclooxygenase and the 12-lipoxygenase were present predominantly in the microsomes rather than the cytosol of the cells. The cyclooxygenase activity was stimulated by 12-O-tetradecanoylphorbol 13-acetate (TPA) in a dose-dependent and time-dependent manner. Actual increase in the cyclooxygenase protein by TPA was demonstrated by immunoprecipitation and Western blot analysis of the enzyme with the aid of an anti-cyclooxygenase antibody. Furthermore, the cyclooxygenase mRNA level increased as assessed by RNA blot analysis using a cDNA probe for the enzyme. In contrast, the TPA treatment reduced the activity of 12-lipoxygenase. By RNA blot analysis using a cDNA probe of HEL cell 12-lipoxygenase, the mRNA level of the enzyme was shown to decline by the TPA treatment. Taken together, the TPA treatment of HEL cells brought about the induction of cyclooxygenase and the suppression of 12-lipoxygenase.

Gender disparity in care-seeking behaviours and treatment outcomes for dehydrating diarrhoea among under-5 children admitted to a diarrhoeal disease hospital in Bangladesh: an analysis of hospital-based surveillance data

INTRODUCTION

Despite economic development and augmented literacy rates, Bangladeshi households are still discriminating against girls when it comes to seeking medical care. We examined gender disparities in diarrhoeal disease severity and the treatment outcomes of under-5 children.

SETTING

A tertiary level diarrhoeal disease hospital in Dhaka, Bangladesh.

PARTICIPANTS

13 361 under-5 children admitted to the hospital between January 2008 and December 2017.

OUTCOME VARIABLES AND METHODS

The primary outcome of interest was severity of diarrhoea, defined as 'dehydrating diarrhoea' or 'non-dehydrating diarrhoea'. Multivariable logistic regression analyses were performed to assess the association between 'gender' and admission to hospital for dehydrating diarrhoea.

RESULTS

Data on 13 321 children under 5 years of age were analysed, of whom 61.5% were male and 38.5% were female. The mean (±SD) age of children with diarrhoea was 5.63 (±3.49) months. The median distance travelled to come to the hospital for admission was 10 miles (IQR: 6-25) and was significantly higher for boys (10 miles, IQR: 6-25) than girls (9.5 miles, IQR: 6-23) (p<0.001). Girls had 1.11 times higher odds (adjusted OR: 1.11, 95% CI 1.03 to 1.20, p=0.007) of presenting with dehydrating diarrhoea than boys at the time of hospital admission. Almost 20% of children received two or more medications during the period of hospital admission and this did not differ by gender. The median duration of hospital stay was 11 hours and was similar in both sexes. No gender-based disparity was observed in the management of diarrhoea and in the hospital outcome of children.

CONCLUSION

We found that girls were more likely to have dehydrating diarrhoea when they were presented to the Dhaka hospital of International Centre for Diarrhoeal Disease Research, Bangladesh. No gender-based disparity was observed in the hospital outcome of children.

Purification and some properties of NADP+ -specific isocitrate dehydrogenase from an extreme thermophile, Thermus flavus AT-62

Thermostable NADP+ -specific isocitrate dehydrogenase (EC 1.1.1.42) was purified from crude extract of an extremely thermophilic bacterium Thermus flavus AT-62 through DEAE-cellulose column, acetone fractionation, DEAE-Sephadex A-50 column and isoelectric focussing. The enzyme was purified about 500-folds in its specific activity and purity was found to be about 96%. The enzyme was not inactivated after 60 min at 70 degrees C, but 20 and 80% of the activity were lost after 60 min at 80 degrees and 90 degrees C, respectively. Oxalacetate plus glyoxylate (each 1 nM) demonstrated 75% inhibition of the activity in concerted manner. The degree of the inhibition and the affinity of the enzyme for isocitrate and NADP+ decreased with the rise of temperature, especially above 60 degrees C. The activation energy below and above 60 degrees C were 14,500 and 8,000 cal per mole respectively. In CD spectra negative bands at 210 and 220nm were observed and alpha-helix content was calculated to be about 26%. In the course of heating up to 60 degrees practically no change in CD bands are observed, but above 60 degrees the depth of CD bands decreased gradually and remarkably above 80 degrees C. The effect of temperature on kinetic parameters and secondary structures of the enzyme was discussed in relation to the temperature adaptation of the organism.

Thromboxane synthesizing system in rat liver

Thromboxane B2 (TXB2), along with other primary prostaglandins, was synthesized when rat liver microsomes were incubated with radioactive arachidonic acid. TXB2 was identified directly by chemical ionization mass spectrometry and indirectly by using specific inhibitors of TX synthetase, viz., imidazole and OKY-1555 ((E)-3(4-(3-pyridyl-methyl) phenyl)-2 methyl acrylic acid HCl). The supernatant fraction obtained after centrifugation at 105,000 X g for 60 min contained a possible regulatory component that suppressed thromboxane synthesis. The regulatory influence is lost after partial hepatectomy.

Protein in the food prolongs DNA synthesis in the liver of rats after starvation

After a period on protein-free diet and then starvation, high protein diet induces DNA synthesis in rat liver for a longer period than diet containing an equivalent amount of amino acids. The requirement for high protein diet is limited to an early part of the prereplicative period and administration of the high protein diet later did not prolong DNA synthesis.

Implementation of and experiences with new automation

In an environment where cost, timeliness, and quality drives the business, it is essential to look for answers in technology where these challenges can be met. In the Novartis Pharmaceutical Quality Assurance Department, automation and robotics have become just the tools to meet these challenges. Although automation is a relatively new concept in our department, we have fully embraced it within just a few years. As our company went through a merger, there was a significant reduction in the workforce within the Quality Assurance Department through voluntary and involuntary separations. However the workload remained constant or in some cases actually increased. So even with reduction in laboratory personnel, we were challenged internally and from the headquarters in Basle to improve productivity while maintaining integrity in quality testing. Benchmark studies indicated the Suffern site to be the choice manufacturing site above other facilities. This is attributed to the Suffern facility employees' commitment to reduce cycle time, improve efficiency, and maintain high level of regulatory compliance. One of the stronger contributing factors was automation technology in the laboratoriess, and this technology will continue to help the site's status in the future. The Automation Group was originally formed about 2 years ago to meet the demands of high quality assurance testing throughput needs and to bring our testing group up to standard with the industry. Automation began with only two people in the group and now we have three people who are the next generation automation scientists. Even with such a small staff,we have made great strides in laboratory automation as we have worked extensively with each piece of equipment brought in. The implementation process of each project was often difficult because the second generation automation group came from the laboratory and without much automation experience. However, with the involvement from the users at 'get-go', we were able to successfully bring in many automation technologies. Our first experience with automation was SFA/SDAS, and then Zymark TPWII followed by Zymark Multi-dose. The future of product testing lies in automation, and we shall continue to explore the possibilities of improving the testing methodologies so that the chemists will be less burdened with repetitive and mundane daily tasks and be more focused on bringing quality into our products.

SHadow Under the Lamp (SHUL): Smoking behavior of the health professionals

Background

Smoking cessation is the best option a health professional can offer to the patients for averting the preventable causes of mortality and morbidity.

Purpose

To determine smoking behavior, preferred cessation methods, and attitudes towards smoking cessation amongst health professionals.

Methods

The cross-sectional study, conducted in six countries, included doctors and nurses working at different hospital settings. Participants responded anonymously to an online questionnaire.

Results

Among 1109 participants, 36% were from Saudi Arabia, 14% from Nepal, 14% from Indonesia, 12% from Australia, 12% from Jordan, and 12% from Pakistan. Mean age was 33 years, 61% were females and 58% were nurses. One in eight (12%) was daily smoker. Among current smokers, 42% smoked 2-9 cigarettes/day, and 26% had their first cigarette within 5-30 minutes after waking up. Half of the smokers perceived it as 'very important' to quit smoking, 30% had tried to quit in the last six months, and 31% preferred to have a group quit program with the same health professionals. Only 17% had formal training on smoking cessation, but 57% were interested to receive one. Half of the participants said they (53%) 'always' asked patients if they smoked, but 89% said they advised to quit, 76% said they assessed intention to quit, 28% said they assisted by providing materials on cessation, and 33% said they arranged follow up for cessation. Compared to current smokers, never smokers were more likely to 'always' ask patients if they smoked (78% vs. 22%, p = 0.044, ORs 1.39, 95%CIs 1.01-1.91), assist smokers by setting quit dates (74% vs. 26%, p = 0.039, ORs 1.54, 95%CIs 1.03-2.29), arrange follow up (77% vs. 23%, p = 0.044, ORs 1.40, 95%CIs 1.01-1.94).

Conclusions

Health professionals reported moderately good behavior around advice to smokers, but it is much worse among current smokers. Health professionals who smoke should be both encouraged to quit and to better support their patients to do so.

Key messages

Smoking cessation support for patients was not good among health professionals, who were smokers. Health professionals need to quit smoking in order to provide better cessation support for patients.

Socio-demographic predictors of obesity among 12,975 adult ever married Egyptian women of reproductive age group: evidence from nationwide survey

AIM

We aimed to explore the predictors associated with obesity among adult ever-married Egyptian women aged 20-49 years based on the Egyptian Demographic and Health Survey (EDHS).

METHOD

We included adult ever married women from the EDHS conducted in 2014 that initially recruited 21,903 women. Univariate and multivariable analysis was conducted to identify socio-demographic predictors of women's obesity.

RESULT

We included 12,975 Egyptian women. Among them, 76% of the total respondents were obese where as 24% were with normal body mass index (BMI). In multivariable analysis, the results revealed that increasing age, higher wealth index, listening to radio at least once a week and women with primary and secondary education were at significant odds of developing obesity (p < 0.05). However, we found no association between residence of participants and the frequency of watching television upon the development of obesity (p > 0.05).

CONCLUSION

Appropriate and targeted interventions should be implemented among the Egyptian reproductive age women to reduce the obesity as well as non-communicable diseases load associated with obesity. National Health Service policy makers should take multilevel approach targeting high risk sub-groups to raise awareness and to provide prevention against obesity and the subsequent complications.

Mechanism of stimulation by human interferon of prostaglandin synthesis in human cell lines

Human interferon beta (IFN-beta) stimulated the synthesis of prostaglandin E (PGE) and prostaglandin F2 alpha in IFN-sensitive RSa and GM258 cell lines, but not in IFN-resistant HEC-1 cells. IFN-beta at a concentration of 1000 units/ml elicited 2- to 3-fold increases in PGE production in these cell lines. In the presence of exogenous arachidonic acid (1 microgram/ml), IFN-pretreated cells produced 5-fold more PGE compared to the cell cultures in the absence of arachidonic acid. Prednisolone, an inhibitor of phospholipase A2, at a concentration of 2 micrograms/ml inhibited the enhanced synthesis of PGE by IFN-pretreated cells. Indomethacin (4 micrograms/ml), a potent fatty acid cyclooxygenase inhibitor, also inhibited the increased synthesis of PGE. IFN stimulated the release of [14C]arachidonic acid from phospholipids but did not stimulate the activity of fatty acid cyclooxygenase. These data suggest that IFN stimulates prostaglandin synthesis by promoting the release of arachidonic acid from phospholipids. Since cycloheximide and actinomycin D inhibited the stimulation of PGE synthesis, the stimulation of prostaglandin synthesis by IFN seemed to be due to de novo enzyme synthesis which catalyzes the release of fatty acid. Addition of exogenous PGE suppressed the growth of RSa and GM258 cells. Prednisolone and iodomethacin partially inhibited anti-cell growth activity of IFN, suggesting a possibility that IFN-inhibited cell growth was partly mediated by prostaglandin.

Predictive Value of Waist Height Ratio, Waist Hip Ratio and Body Mass Index in Assessing Angiographic Severity of Coronary Artery Disease in Myocardial Infarction Patients

Coronary artery disease (CAD) is the leading cause of mortality and morbidity both in developed and developing countries. The body mass index (BMI), waist hip ratio (WHR) and waist height ratio (WHtR) are some of the clinical tools enabling clinicians to assess obesity. Although for decades there have been controversy regarding the relationship between obesity and CAD; it has been assumed that high BMI is a risk factor for CAD. However, the findings of some recent studies were paradoxical. The aim of this study was to identify the best tool among BMI, WHtR and WHR to evaluate angiographically severe CAD in myocardial infarction patients. This was a cross-sectional analytical study carried out in the Department of Cardiology, Chattogram Medical College and Hospital (CMCH), Chattogram, Bangladesh from January 2017 to December 2017. Three hundred and thirty two consecutive MI patients undergoing CAG during the study period were included in the study as per inclusion and exclusion criteria. Severity of CAD was calculated by using Gensini score. Patients were categorized and compared according to anthropometric indices and CAD severity. The mean±SD of the age of study population was 53.62±10.36 years (range 25-92) and 276(83.1%) were male. Regarding cardiovascular risk factors, 113(34%) patients had diabetes mellitus, 108(32.5%) had dyslipidaemia, 137(41.3%) had hypertension, 205(61.7%) were current or ex-smokers and 59(17.8%) had a family history of CAD. The mean±SD of the patients' BMI was 24.05±3.24kg/m² (range 16.14-32.72), mean±SD of their WHR was 0.964±0.052 (range 0.823-1.125) and mean±SD of their WHtR was 0.546±0.059 (range 0.389-0.748). The mean±SD of the severity of CAD according to the Gensini score was 41.11±28.66 (ranged from 2 to 244). Study findings showed a positive correlation between the severity of CAD with WHtR and WHR but not with BMI, according to Gensini scores (p=0.004, p=0.023 and p=0.43 respectively). Receiver Operating Characteristics (ROC) curve analysis revealed that waist height ratio had the highest area under the curve (AUC) among the three anthropometric parameters for predicting presence of severe CAD. Study showed the superiority of WHtR over WHR and BMI for predicting angiographic severity of CAD in patients with MI. WHtR should therefore be considered as a screening tool.