bluuebunny/crossref_metadata_2025 huggingface dataset:
Attitudes of Hungarian healthcare professional students to tobacco and alcohol
Authors: Nagy K. , Barabás K. , Nyári T.
Published: January 2004

Tobacco represents the single most preventable cause of disease and death in the world today. There were an estimated 3 million deaths annually at the end of the 20th century and it has been estimated that this will rise to more than 10 million by 2030. A disproportionate share of the burden of mortality is already being borne in the Russian Federation and the countries of Eastern Europe. For example, some of the highest rates worldwide of cigarette consumption and smoking prevalence are in the Czech Republic, Hungary and Poland. Cancer is one of the major tobacco‐related causes of disease and death and Hungary has the highest male incidence rates in the world for both oropharyngeal and lung cancer. A consequence of this is that the mortality rate of middle‐aged (50–60‐year‐old) men in Hungary today is higher today than it was in the 1930s, particularly among the lower socioeconomic groups. Of the many different approaches to tobacco cessation and control, advice or intervention by healthcare professionals ranks high in effectiveness; a recent survey indicated that requests from healthcare professionals to quit ranked second in effectiveness after requests by the smoker's own family. If healthcare professionals are to play a role in reducing death and disease from tobacco related cancers it is necessary to assess the attitudes and behaviours among healthcare professional students. Our survey assesses perceptions, behaviour and consequences among university students.
Antismoking education in Czech medical and dental faculties
Authors: Hrubá D. , Slezák R.
Published: January 2004

Smoking education has been included in the curricula in all the medical faculties of the Czech Republic, although the scope of the education varies. At each of the faculties, a member of the staff has been appointed as co‐ordinator of smoking education. These co‐ordinators promote a sharing of experience and distribution of teaching materials. At the majority of faculties, obligatory workshops are held for all students to learn about smoking and smoking treatment within the framework of preventive medicine. In addition, selected students undertake selected studies on smoking and health as part of their research. At the Medical Faculty of Masaryk University, Brno, smoking education is included in the majority of theoretical and clinical subjects and its effectiveness is repeatedly assessed during the 6‐year course study by testing the students' knowledge and smoking behaviour. The evaluation provides a basis for further modification and improvement of the education. Currently, a fundamental transformation of dental education is being undertaken in all medical faculties of the Czech Republic. These new curricula will benefit from the curriculum of the Medical Faculty, at Hradec Králové, where the changes that were made 5 years ago involve theoretical and practical education in the risks of smoking for oral health throughout the 5‐year stomatology courses. Postgraduate medical education involves professional 2‐day seminars for general practitioners on approaches to smoking cessation and smoking dependence treatment, and professional materials such as smoking cessation guidelines are published in medical and specialist journals.
Smoking and tobacco control in Poland
Authors: Bałczewska E.
Published: January 2004

The study presents information on the use of tobacco and the health consequences over the past 20 years in Poland. During this time, Poland has been among the countries with the highest cigarette consumption in the world and a correspondingly high number of tobacco‐related deaths. Data show that nowadays about 10 million Polish people smoke; in 1998 average annual, adult, cigarette consumption was over 3000. The greatest rate of smoking among men (64%) was recorded in 1974 and among women (33%) in 1986. Recently, there has been a significant decrease in the rate of smoking among men to 40%, and among women to 23%. This favourable change has improved health indices such as infant mortality, life expectancy, and a lower rate of increase in male deaths from lung cancer. Government organizations as well as medical organizations and universities have become involved in prevention of smoking and tobacco control in Poland and the latest legislation is described.
Tobacco control and the role of the medical community in the Slovak Republic
Authors: Kavcová E. , Kocan I. , Squier C.
Published: January 2004

The Slovak Republic (SR) is located in central Europe and has a population of about 5.4 million. Epidemiological data indicate that trends in smoking prevalence and incidence of lung cancer have not shown any tendency to decrease in the SR. Surveys of Martin residents and of medical students at Comenius University provided important data on many aspects of cigarette smoking and tobacco dependence and served as a basis for planning and implementing focused tobacco control activities at the regional and national levels. The activities were focused not only on the Slovak public but also the medical community. With assistance from international organizations, Slovak doctors are learning to take direct responsibility for treatment and prevention and also a public responsibility to influence governmental policies. As a result, tobacco control activities in the SR enjoy collaboration between different agencies, community participation and personal involvement of health professionals.
Engineering clinician leadership and success in tobacco control: recommendations for policy and practice in Hungary and Central Europe
Authors: Hovell M. , Roussos S. , Hill L. , Johnson N. W. , Squier C. , Gyenes M.
Published: January 2004

Decades of research and advocacy to control tobacco use and related public‐health harm have not counterbalanced the tobacco industry's successful stronghold, which is ever‐increasing in countries with weaker anti‐tobacco leadership. Current rates of tobacco use and harm in Hungary and other Central European countries mark them as some of the industry's greater successes. Following the Behavioural Ecological Model, a framework for behavioural and cultural change, this paper reviews important ways that dentists, physicians and other healthcare providers can counter the tobacco industry's influence on patients, communities, and the nation. The analysis includes policies and practices shown to be effective in controlling and undermining the tobacco industry, and outlines new policies and practices that show promise based on the behavioural change framework. The components of an all‐encompassing tobacco‐control programme are described through explicit recommendations for research, practice and policy that are necessary to establish a professional and societal culture that extinguishes the influence and harm of the tobacco industry in Hungary, Central Europe and developing countries worldwide.
Composite type of breast carcinoma with endocrine differentiation: A cytological and immunohistochemical study
Authors: Kurisu Yoshitaka , Tsuji Motomu , Akashi Komei , Kobayashi Mitsuhiro , Sumiyoshi Kazuaki , Nohara Fumihiro , Tanigawa Mitsuhiko , Akutagawa Hiroshi , Egashira Yutaro , Shibayama Yuro
Published: January 2004

We describe a case of breast carcinoma with endocrine differentiation containing a mixture of three different histological features that occurred in a 71‐year‐old woman. Histologically, the tumor was predominantly intraductal, but slightly invasive. In the intraductal lesion, the tumor consisted mainly of ovoid to round cells with a modest to abundant amount of granular eosinophilic cytoplasm or intracytoplasmic mucin (mucin‐producing carcinoma in situ). It also consisted, in part, of plump spindle cells with scant cytoplasm that contained argyrophilic granules in a trabecular pattern or an arrangement of perivascular pseudorosettes (atypical carcinoid tumor like‐features). Mucous lake and tumor cells floating in mucin were seen in the invasive lesion (mucinous carcinoma). Immunohistochemical staining revealed endocrine differentiation of the tumor cells of both intraductal and invasive lesions. These findings suggest that the different histological features derived from pluripotent cells upon endocrine differentiation, and that endocrine differentiation of the tumor cells had already occurred at an earlier stage of carcinogenesis, prior to the appearance of the mucinous carcinoma. Cytologically, plasmacytoid tumor cells appeared in loosely cohesive clusters or as sparsely single cells in a background of a mucinous substance.
Effect of morpholino antisense oligonucleotide against lumican mRNA in human embryonic kidney (HEK) 293 cells
Authors: Ishiwata Toshiyuki , Fujii Takenori , Ishiwata Shunji , Ikegawa Shigeo , Naito Zenya
Published: January 2004

Lumican is a member of the small‐leucine‐rich proteoglycan (SLRP) family and is overexpressed during wound healing of the cornea, in ischemic and reperfused heart, and in several cancer tissues. Lumican is considered to regulate the collagen fibril diameter and interfibrillar spacing. However, the effect of lumican on cell growth has not been adequately examined. In the present study, we attempted to clarify whether lumican contributes to human embryonic kidney (HEK) 293 cell growth, using the morpholino antisense oligonucleotide (m‐anti oligo) against lumican mRNA. M‐anti oligo is a novel oligonucleotide and exhibits a higher antisense activity, higher water solubility, and greater resistance to nucleases in target cells than phosphorothioate types of oligonucleotide. After delivery of m‐anti oligo against lumican mRNA, the fluorescein 5‐isothiocyanate (FITC) conjugated oligonucleotides were observed in the cytoplasm and nucleus of HEK 293 cells at 24 h by confocal laser microscopy. M‐anti oligo for lumican mRNA strongly inhibited the synthesis of lumican protein in the HEK 293 cells, and the HEK cell growth rate was higher than those in the control groups. These findings may indicate that lumican protein has an inhibitory effect on HEK 293 cell growth in vitro.
Intraductal oncocytic papillary neoplasm of the liver
Authors: Terada Tadashi , Taniguchi Masami
Published: January 2004

A very rare case of intraductal oncocytic papillary carcinoma of the liver is reported. A 63‐year‐old Japanese man was admitted to our clinic because of abdominal pain and jaundice. Imaging techniques revealed a unilocular cystic neoplasm of 14 cm diameter in the medial segment of the left hepatic lobe. Combined percutaneous and endoscopic retrograde cholangiographies revealed the unilocular cystic neoplasm contained a lot of mucus and communicated with the left segmental intrahepatic bile duct, and that mucus filled the left segmental and hepatic ducts. Left lobectomy was performed. The postoperative course was good, and the patient is free of disease 30 months after operation. Pathological examination revealed that the cavity of the neoplasm was continuous with the left segmental intrahepatic bile duct, and that a lot of mucus was present in the neoplasm, as well as in the left segmental and hepatic ducts. The neoplasm consisted of papillary growth of atypical epithelial cells with oncocytic changes. Atypical goblet cells were also recognized. No invasion into the surrounding liver was noted. Non‐tumorous intrahepatic bile ducts near the lesion occasionally showed epithelial dysplasia and contained a lot of mucus. Immunohistochemically, the tumor cells were rich in mitochondria and were immunoreactive for cytokeratins 7, 18 and 19, carbohydrate antigen 19‐9, and hepatocyte‐specific antigen. Some tumor cells were immunoreactive for pancreatic alpha‐amylase and lipase. Ultrastructurally, the tumor cells showed numerous mitochondria and mucus droplets. Intraductal neoplasm communicating with the intrahepatic bile ducts has rarely been reported. The present case suggests that intraductal oncocytic papillary neoplasm, as described in the pancreas, may also occur in the intrahepatic bile ducts, and that such hepatic intraductal neoplasm may express hepatocellular and pancreatic acinar phenotypes.
Retroperitoneal mucinous cystadenoma: Report of two cases and review of the literature
Authors: Isse Kumiko , Harada Kenichi , Suzuki Yasuo , Ishiguro Kaname , Sasaki Masatoshi , Kajiura Shinya , Nakanuma Yasuni
Published: January 2004

Primary retroperitoneal cystic tumor is extremely rare, and its histogenesis and biological behavior remain speculative. Two surgical cases of retroperitoneal mucinous cystadenoma (Case 1, an 18‐year‐old woman; and Case 2, an 85‐year‐old woman) are reported. The cystadenomas in these cases were mainly lined by a monolayer of columnar or thin flat cells. Case 1 was positive for mucin and epithelial membrane antigen, whereas Case 2 was positive for a mesothelial marker (calretinin). Ciliated epithelium was also interspersed in Case 2. Some parts showed papillary projections, resembling well‐differentiated papillary mesothelioma. Within the cyst walls of both cases, ovarian‐like stroma that was positive for both estrogen and progesterone receptors was found. Interestingly, focal nodular hyperplasia of the liver was also detected in Case 1. We believe the retroperitoneal mucinous cystadenoma might have arisen from the peritoneum via mucinous epithelial metaplasia with a phenotype of extragenital Mullerian system.
Rhinoscleroma associated with Rosai–Dorfman reaction of regional lymph nodes
Authors: Kasper Hans‐Udo , Hegenbarth Veit , Buhtz Peter
Published: January 2004

Rhinoscleroma is an uncommon chronic, destructive infection of the respiratory mucosa caused by Klebsiella rhinoscleromatis. This coccobacillus can be found in the typical histiocytes, the Mikulicz cells. Extranasal and nodal involvement in this disease is rare, but documented. Rosai–Dorfman disease or sinus histiocytosis with massive lymphadenopathy is also a rare, non‐hereditary disorder. Bilateral cervical lymphadenopathy with emperipolesis, as the main histological characteristic, is the most common presentation. It can also occur extranodally. We report a case of rhinoscleroma occurring in a 62‐year‐old woman since 1984, who developed parotid gland and lymph node involvement. The changes in the nasal mucosa and the parotid gland showed chronic inflammation with Mikulicz cells. In the lymph nodes, features characteristic of Rosai–Dorfman disease were seen. Taking into consideration the literature dealing with both of these diseases, we discuss that Rosai–Dorfman disease could be a special type of lymph node reaction and is not necessarily an entity of its own. Therefore, it should be known as Rosai–Dorfman lymph node reaction. Furthermore, there seems to be an interconnection between Rosai–Dorfman disease and rhinoscleroma.
Adenocarcinoma arising from mature cystic teratoma of the ovary
Authors: Kushima Miki
Published: January 2004

An extremely rare adenocarcinoma arising from a mature cystic teratoma is reported. A 58‐year‐old woman underwent bilateral salpingo‐oophorectomy because of a tumor in each ovary. The right ovarian tumor (solid, 9.6 × 9.6 × 6.3 cm) was a benign thecoma. Histology revealed the left ovarian cystic tumor (multilocular, 6.4 × 4.8 × 2.8 cm) was a mature cystic teratoma containing skin, fatty tissue and respiratory epithelial tissue. In addition, there was a small focal adenocarcinomatous lesion contiguous to the teratomatous ciliated columnar epithelium without stromal invasion (so‐called adenocarcinoma in situ) that was suggestive of respiratory epithelium origin. However, goblet cells were present in the glandular structures of the lesion and immunohistochemical staining was segmentally strongly positive for CK20 and uniformly negative for CK7. These results suggested that the adenocarcinomatous lesion had a mucin secretory gastrointestinal phenotype. Further investigation and the collection of more cases is necessary to determine the origin and growth mechanism of adenocarcinoma arising from mature cystic teratoma of the ovary.
Evidence‐Based Medicine and Women: Do the Principles and Practice of EBM Further Women's Health?
Authors: Rogers Wendy
Published: January 2004

Clinicians and policy makers the world over are embracing evidence‐based medicine (EBM). The promise of EBM is to use summaries of research evidence to determine which healthcare interventions are effective and which are not, so that patients may benefit from effective interventions and be protected from useless or harmful ones. EBM provides an ostensibly rational and objective means of deciding whether or not an intervention should be provided on the basis of its effectiveness, in theory leading to fair and effective healthcare for all.

In this paper I closely examine these claims from the perspective of healthcare for women, using relevant examples. I argue that the current processes of evidence‐based medicine contain a number of biases against women. These biases occur in the production of the research that informs evidence‐based medicine, in the methods used to analyse and synthesise the evidence, and in the application of EBM through the use of guidelines. Finally, the biomedical model of health that underpins most of the medical research used by EBM ignores the social and political context which contributes so much to the ill‐health of women.
On Our Obligation to Select the Best Children: A Reply to Savulescu
Authors: De Melo‐Martín Inmaculada
Published: January 2004

The purpose of this paper is to examine critically Julian Savulescu's claim that people should select, of the possible children they could have, the one who is expected to have the best life, or at least as good a life as the others, based on the relevant, available genetic information, including information about non‐disease genes. I argue here that in defending this moral obligation, Savulescu has neglected several important issues such as access to selection technologies, disproportionate burdens on women, difficulties in determining what is best, problems with aggregate effects of individual choices, and questions about social justice. Taking these matters into account would call such a moral requirement into serious question.
Reforming Europe's Common Foreign and Security Policy
Authors: Thym Daniel
Published: January 2004

Abstract:  The reform of the constitutional foundations of Europe's Common Foreign and Security Policy (CFSP) featured prominently on the agenda of the European Convention. To the great surprise of many observers the much lamented absence of a common European response to the war in Iraq did not prevent the Convention from agreeing upon an ambitious reform package in the foreign‐policy field. This article explores the legal implications of the new institutional balance for European foreign policy envisaged by the Convention against the background of the achievements and deficiencies of Europe's existing foreign policy regime. Thereby, we shall see in how far the Convention has met the original goal set by the Laeken European Council to consider reform steps to strengthen the Union's ability to ‘shoulder its responsibilities in the governance of globalisation.’1
Horizontal Coherence and the External Competences of the European Union
Authors: Gauttier Pascal
Published: January 2004

Abstract:  The concept of horizontal coherence, or inter‐pillar coherence, appears to be consubstantial with the external action of the EC/EU: it can be defined as the absence of contradictions between the policies of the European Community and the Common Foreign and Security Policy, or CFSP (consistency) on the one hand, and the achievement of a synergy between these policies (coherence) on the other hand. First considered as a political requirement, its best expression is located in the Article 3 of the Treaty on the European Union. The practice of European foreign policy has demonstrated the importance of this requirement: the control of exports of dual‐use goods as well as the adoption of sanctions, whether on the basis of Article 301 EC, or in application of international agreements with third states, have given the example of overlapping competences. Besides, this overlap has been reflected in the internal organisation of the institutions (allocation of portfolios in the European Commission, conflict between the Political Committee and the Committee of the Permanent Representatives in the Council of the EU). However, the answers to these problems have been far too timid: the adoption of an integrated approach (conflict prevention) as well as the institutional adaptations of the Treaty of Amsterdam do not compensate for the absence of a vision of the European foreign policy which would overcome the old cleavage between federalism and intergovernmentalism. Indeed, it seems to us that much more innovative solutions are needed, such as an evolution towards the binding character of the coherence requirement, which would pave the way to a coherent European foreign policy, comprising external relations and CFSP (including the defence dimension).
Provisional Court Protection in Administrative Disputes in Europe: The Constitutional Status of Interim Measures Deriving from the Right to Effective Court Protection. A Comparative Approach
Authors: Sierra Susana de la
Published: January 2004

Abstract:  Interim protection in remedies against the public administration has proved to be one of the key issues in today's justice. In effect, the slowness of judicial proceedings means that final judicial decisions cannot guarantee the rights and interests of the litigants any more, because those decisions arrive too late. Thus, effective judicial protection is at stake. On the other hand, public administrations have traditionally disposed of privileges, one of the most important of them being the so‐called executive character of administrative acts. The national debate on the equilibrium between both principles—effective judicial protection and the executive character of administrative acts—needs to be exported to the Community law context. Community law should therefore learn from national experiences, as other legal orders, such as the Spanish one, have done, turning to comparative law in order to improve their own model of interim protection.
Greater and more rapid depletion of mitochondrial DNA in blood of patients treated with dual (zidovudine+didanosine or zidovudine+zalcitabine) vs. single (zidovudine) nucleoside reverse transcriptase inhibitors
Authors: Reiss P , Casula M , De ronde A , Weverling GJ , Goudsmit J , Lange JMA
Published: January 2004

Background

Most toxicities associated with nucleoside analogue reverse transcriptase inhibitors (NRTIs) are thought to result from mitochondrial toxicity. These toxicities include peripheral neuropathy, pancreatitis, lactic acidosis, and peripheral lipoatrophy. Unfortunately, there are no validated laboratory markers for clinically assessing, let alone predicting, the onset of mitochondrial toxicity associated with NRTI therapy.

Objectives To provide preliminary evidence of the potential clinical utility of an assay which has been developed for quantifying mitochondrial DNA (mtDNA) in clinical samples from HIV‐infected patients.

Methods A single‐tube duplex real‐time DNA‐nucleic acid sequence‐based amplification (NASBA) assay (MitoxTM, Primagen, Amsterdam, the Netherlands) was used to quantify mtDNA in cryopreserved peripheral blood mononuclear cells (PBMC) obtained from HIV‐1‐infected patients during their prior participation in a randomized placebo‐controlled trial comparing zidovudine (ZDV) monotherapy with combinations of ZDV plus either dideoxycytidine (ddC) or didanosine (ddI) (the Delta trial). Patients were antiretroviral naïve prior to entering the trial. Samples obtained during the initial 48 weeks of treatment were tested.

Results A significant decline of mtDNA, both in an intent‐to‐treat and in an as‐treated analysis, was observed in patients treated with ZDV+ddC and ZDV+ddI, but not with ZDV alone, consistent with the results expected from the degree of mtDNA depletion described for each of these drugs in vitro.

Conclusions This single‐tube duplex real‐time DNA‐NASBA assay was shown to measure mtDNA accurately in PBMC. Treatment with a combination of two NRTIs was associated with greater reductions in mtDNA than obtained for ZDV monotherapy. The relevance of these results in predicting treatment toxicity requires further evaluation.
Increased microvascular network in bone marrow of HIV‐positive haemophilic patients
Authors: Patsouris E , Katsarou O , Korkolopoulou P , Kotsi P , Kouramba A , Androulaki A , Karafoulidou A
Published: January 2004

Objectives Angiogenesis has been associated with the pathogenesis of myelodysplastic syndromes (MDSs). However, less is known about the significance of this process in the bone marrow of HIV‐positive patients with myelodysplastic features (MDF).

Methods Trephines from 22 HIV‐positive haemophilic patients were immunostained for CD34 antigen, and the microvessel density (MVD) was quantitatively evaluated and compared with that of 21 biopsies from patients with primary MDS and with that of 12 control bone marrows with no evidence of marrow disease.

Results Bone marrow MVD in HIV‐positive haemophilic patients was similar to that in patients with MDS; however, both groups revealed significantly higher MVD counts than those of control bone marrows (P=0.002). Mean MVD counts of HIV‐positive haemophilic patients were significantly associated with HIV RNA levels (P=0.008). In contrast, no correlation was found between MVD and clinical HIV stage or CD4 counts at the time of biopsy.

Conclusions These results suggest a direct involvement of HIV in the pathogenesis of MDF in HIV infection. Elucidation of the mechanisms underlying bone marrow angiogenesis in HIV‐positive patients may provide further insights into the pathobiology of AIDS.
The onset of HIV infection in the Leningrad region of Russia: a focus on drug and alcohol dependence
Authors: Krupitsky E , Zvartau E , Karandashova G , Horton NJ , Schoolwerth KR , Bryant K , Samet JH
Published: January 2004

Objectives  Within 5 years, 5 million Russians may be infected with HIV. Currently, injection drug use is the major risk factor for HIV. As Russia's alcohol consumption per capita is among the highest in the world, alcohol‐associated behaviours may be an important contributor to the HIV epidemic. Our objective was to examine the prevalence of HIV infection among drug‐ and alcohol‐dependent patients in a regional narcology hospital and in the general population in Leningrad.

Methods  All patients in the Narcology Hospital, Leningrad Regional Center of Addictions (LRCA), were tested for HIV antibody between 1997 and 2001. We reviewed these clinical records (i.e. serostatus, gender, age, and addiction) and data from the HIV/AIDS Center in the Leningrad Region (1997–2001).

Results  From 1997 to 2001, HIV prevalence at the LRCA increased from 0 to 12.7% overall, 33.4% among drug‐dependent patients and 1.2% among alcohol‐dependent patients. During the same 5‐year period (1997–2001), 2826 persons were registered at the HIV/AIDS Center: 6, 6, 51, 780, and 1983 persons in 1997, 1998, 1999, 2000 and 2001, respectively.

Conclusions  HIV infection is exploding in the Leningrad Region, currently in injection drug users (IDUs) but potentially more broadly. The known high per capita alcohol intake in Russia heightens concern regarding the sexual transmission of HIV. Interventions to prevent such a development should include use, and assessment of the effectiveness, of known HIV prevention measures for at‐risk and infected individuals.
Correlates of antiretroviral treatment breaks
Authors: Grierson JG , Misson SA , Pitts MK
Published: January 2004

Objective  To identify key relationships between the decision to take a break from antiretroviral treatments and potential clinical and social antecedents.

Methods  An analysis of a self‐completed survey of various clinical and social aspects of the lives of people living with HIV/AIDS (PLWHA) distributed nationally in Australia was carried out.

Results  The questionnaire was completed by a sample of 894 PLWHA. From this sample, three groups of interest were identified: a ‘no break’ group that had been using antiretrovirals continuously (n=378), a ‘lifestyle break’ group that had taken a break for purely lifestyle reasons on their last occasion (n=76), and a ‘clinical break’ group that had taken a break for purely clinical reasons on their last occasion (n=99). Clinical breaks were found to be longer than lifestyle breaks and involved more consultation with doctors. Differences were also found between the two break types in effects on the respondents' health and well‐being. The clinical break group was further found to experience a higher level of health difficulties on a range of variables, while the lifestyle break group was younger, had a longer experience of HIV and its consequences, and engaged in greater participation in activities associated with both pleasure and risk.

Conclusions  The analyses offer a pattern of health and social factors that places the HIV‐positive individual, as a social actor, squarely within the experience of treatment interruptions. Understanding the social motivations and correlates of treatment interruption offers new challenges in maximizing the efficacy of health maintenance and support for PLWHA.
Evaluation of the impact of highly active antiretroviral therapy on immune recovery in antiretroviral naive patients
Authors: Al‐Harthi L , Voris J , Patterson BK , Becker S , Eron J , Smith KY , D'amico R , Mildvan D , Snidow J , Pobiner B , Yau L , Landay A
Published: January 2004

Objectives
To examine the extent of immune reconstitution in treatment‐naive patients with CD4 T‐cell counts <500 cells/μL following 48 weeks of highly active antiretroviral therapy (HAART).

Methods
Thirteen antiretroviral naive patients were evaluated longitudinally for 48 weeks on HAART utilizing immune functional and lymphocyte phenotyping assays, including lymphocyte proliferation assay, flow cytometric evaluation of cell surface markers, and delayed type hypersensitivity skin tests. Virologic responses were monitored using commercially available viral load assays and gag/pol mRNA quantification using simultaneous immunophenotyping/UltraSensitive fluorescence in situ hybridization (ViroTect In Cell HIV‐1 Detection Kit; Invirion, Frankfort, MI). Thymic function was evaluated for a subset of four patients using real‐time polymerase chain reaction (PCR) for T‐cell receptor excision circle (TREC) quantification and thymic scans using computerized axial tomography (CT) of the thymus.

Results
HAART initiation resulted in a significant decline in plasma viremia and percentage of infected peripheral blood cells, and a rise in CD4 T cells from a baseline median of 207 cells/μL to a week‐48 median of 617 cells/μL. The rise was predominately in CD4 memory cells. Naive T cells also increased in number, but at a slower rate. Activated (HLA‐DR CD38) CD4 and CD8 T cells were elevated at baseline (24 and 62%, respectively) and declined by week 48 (17 and 36%, respectively) but did not reach normal levels. The number of Fas CD4 T cells increased from a baseline median of 169 to 381 cells/μL at week 48. Both soluble interleukin (IL)‐2 and tumour necrosis factor (TNF) II receptors declined by week 48. HIV p24 lymphocyte proliferation assay responses were transiently detected in three patients. TREC values increased from a median 6400 copies/μg at baseline to a week‐48 median value of 26 697 copies/μg.

Conclusion
Immune functional reconstitution was not achieved in these HAART naive patients.
Periods of Cluster Headache Induced by Nitrate Therapy and Spontaneous Remission of Angina Pectoris During Active Clusters
Authors: Ekbom K , Sjöstrand C , Svensson DA , Waldenlind E
Published: January 2004

Glyceryl trinitrate (GTN) is known to induce single extra attacks of cluster headache (CH) during active cluster periods, most probably via actions of nitric oxide (NO). Induction of whole periods of CH by organic nitrates has, however, attracted little attention in the literature. We report on eight patients with episodic CH and coexistent effort-induced angina pectoris. Cases 1-6 had been free of their headaches for many years but got recurrence of CH within a few weeks after the administration of long-acting organic nitrates (isosorbide-dinitrate, isosorbide-5-mononitrate or slow-release GTN) aimed at treating their chest pains. These nitrate-induced headache periods were more severe and had a longer duration than the previous spontaneous ones. Furthermore, one of the subjects and two additional cases experienced a marked reduction of their anginal attacks during successive CH periods. Exercise time to effort-induced angina was increased in all three patients and one of them revealed a markedly elevated threshold for eliciting ischaemic cardiac symptoms by standardized physical exercise on a cycle ergometer. We hypothesize whether extra CH periods elicited by sustained nitrate therapy and remission of angina pectoris during active clusters are caused by central mechanisms involving inhibition of sympathetic tone and effects on both cranial vessels and cardiac functions.
Sleep and Migraine: An Actigraphic Study
Authors: Bruni O , Russo PM , Violani C , Guidetti V
Published: January 2004

The aim of the study was to evaluate sleep of children with migraine during the interictal period and the modifications of sleep which precede, are concomitant with, or follow migraine attacks. Eighteen patients with migraine without aura were compared with a group of 17 healthy age-matched children. Sleep parameters were monitored for two full weeks by means of actigraphs and self-report diaries. Headache diaries were also filled out in order to evaluate the occurrence and the characteristics of migraine attacks. Fifty-seven attacks were recorded during the monitoring period. During the interictal period, sleep parameters of children suffering from migraine did not differ from those of controls; only sleep onset latency was slightly prolonged in the migraine group. Timing of the attack affected nocturnal motor activity which presented the lowest values on the night preceding the attack, indicating a decrease in cortical activation during sleep preceding migraine attacks. Further studies should clarify if the observed reduction in nocturnal motor activity close to the attack is related to neurotransmitter imbalance.
Vertigo and Dizziness Related to Migraine: A Diagnostic Challenge
Authors: Neuhauser H , Lempert T
Published: January 2004

Vertigo and dizziness can be related to migraine in various ways: causally, statistically or, quite frequently, just by chance. Migrainous vertigo (MV) is a vestibular syndrome caused by migraine and presents with attacks of spontaneous or positional vertigo lasting seconds to days and migrainous symptoms during the attack. MV is the most common cause of spontaneous recurrent vertigo and is presently not included in the International Headache Society classification of migraine. Benign paroxysmal positional vertigo (BPPV) and Ménière's disease (MD) are statistically related to migraine, but the possible pathogenetic links have not been established. Moreover, migraineurs suffer from motion sickness more often than controls. Persistent cerebellar symptoms may develop in the course of familial hemiplegic migraine. Dizziness may also be due to orthostatic hypotension, anxiety disorders or major depression which all have an increased prevalence in patients with migraine.
The distribution of mast cells in the human area postrema
Authors: Porzionato Andrea , Macchi Veronica , Parenti Anna , De Caro Raffaele
Published: January 2004

The topography and phenotype of mast cells in the human area postrema, together with correlation between mast‐cell density and microvessel density (MVD), were analysed in 16 brains. Transverse serial sections of formalin‐fixed, paraffin‐embedded brainstems were stained with toluidine blue and alcian blue/safranin stainings, and with anti‐tryptase and anti‐CD31 monoclonal antibodies. The mean (± SD) numbers of mast cells per section were 1.3 ± 0.8 and 1.2 ± 0.7 with toluidine blue and alcian blue/safranin, respectively, whereas anti‐tryptase monoclonal antibody showed a mean of 5.1 ± 2.4 cells. Mast cells were alcian blue‐ and safranin‐positive in 56%, because of the coexistence of low‐sulphated (blue‐staining) and high‐sulphated (red‐staining) granules. No significant linear correlation between mast‐cell density (4.9 mm−2) and MVD (114.5 mm−2) was found (r2 = 0.19, P = 0.09). Mast cells were frequently located close to blood vessels (55%) (33% to venules, 22% to arterioles), indicating that their products play a role in the regulation of blood flow and in vessel permeability in the area postrema. Mast cells were located subependymally in 44% and close to the dorsal aspect of the nucleus of the tractus solitarius in 31%, suggesting a subregional distribution.
Fission of pancreatic islets during postnatal growth of the mouse
Authors: Seymour Philip A. , Bennett William R. , Slack Jonathan M. W.
Published: January 2004

A cell composition analysis was made of the pancreatic islets in postnatal H253 mice. This line has a lacZ insertion on the X chromosome so that in female hemizygotes 50% of cells should be positive for β‐galactosidase and 50% negative. Immediately after birth, the islets were of a heterogeneous cell composition. However, by 4 weeks some islets have become homogeneous. This suggests that islets progress towards monoclonality in a similar way to the intestinal crypts and stomach gastric glands. Pancreatic islets may therefore represent ‘structural proliferative units’ in the overall histological organization of the pancreas. Reduction of genetic heterogeneity might arise from cell turnover, fission of islets or both. Analysis of the cell composition of the X‐inactivation mosaic mice also provides the first clear evidence for islet fission in pancreatic development. Irregularly shaped islets resembling dumb‐bells, with a characteristic neck of α‐cells, were observed with decreasing frequency with increasing age. Three‐dimensional reconstruction confirmed their resemblance to conjoined islets. The cell composition analysis showed: (1) the relatedness of the two sides of a dumb‐bell islet is significantly higher than between two non‐dumb‐bell islets and (2) the relatedness of two randomly selected islets decreases as the distance between them increases. This suggests that dumb‐bell islets are in a state of fission rather than fusion, and that islet fission is a mode of islet production in the postnatal pancreas.
Studies on the storage stability of oil‐based paneer pickle
Authors: Shukla F C , Vaid J
Published: January 2004

The recipe for oil‐based paneer pickle was standardized on the basis of sensory evaluation. During storage, there was a significant decrease in moisture, fat and protein content and a significant increase in acidity, free fatty acids and peroxide value at both room temperature and refrigeration temperature in all the packaging materials. The sensory score of the pickle remained in the ‘liked very much’ range up to the end of the storage period. The pickle remained microbiologically safe and was acceptable up to 2 months of storage at both storage temperatures. The pickle packed in glass jars and stored at refrigeration temperature was found to be the most acceptable.
Antibiotic resistance and incidence of Enterococcus species in Turkish white cheese
Authors: Çitak Sumru , Yucel Nihal , Orhan Sati
Published: January 2004

Thirty samples of Turkish white cheese were analysed for the presence of Enterococcus spp., and presumptive isolates were identified by morphological, cultural and biochemical tests and confirmed by the API 20 Strep System. Among the 101 isolates of Enterococcus spp., 62 were E. faecalis, 25 were E. faecium, seven were E. durans, five were E. mundtii and two were E. hirae/dispar. The resistance of the isolates to 13 different antibiotics was determined by the Kirby–Bauer disc diffusion test. Resistance to streptomycin, erythromycin, oxacillin and vancomycin was frequently found in these enterococci, and resistance to vancomycin was found in 96.8% of E. faecalis isolates and 76%E. faecium. The most effective antimicrobials were ampicillin (69.3% of isolates inhibited) and imipenem (76.3% of isolates inhibited). This examination confirmed the presence of enterococci, especially vancomycin‐resistant strains, in Turkish white cheese, indicating poor sanitary conditions during production and processing and a significant health risk for consumers.
Effect of temperature and salt on the maturation of white‐salted cheese
Authors: Al‐Otaibi Mutlag M , Wilbey R Andrew
Published: January 2004

White‐salted cheeses were prepared from ultrafiltered (UF) cows’ milk and salted to give final salt‐in‐moisture (SM) levels of 2.5, 3.2 and 4.0%. The cheeses were stored at 5°C and 10°C for up to 15 weeks. The microflora was dominated by lactic acid bacteria (LAB) but some mould growth was evident within 15 weeks at all SM levels and both temperatures. Levels of water‐soluble nitrogen (WSN), attributed to chymosin activity, increased significantly with time, the rate being inversely proportional to the SM level and increasing with storage temperature. Similar effects were noted for trichloroacetic acid‐soluble nitrogen (TCA‐SN) and free amino acid (FAA) levels, both of which would also be affected by bacterial protease activity. The proteolytic activity was reflected by changes in the hardness and fracturability of the cheeses.
Substitution of natural whey starter by mixed strains of Lactobacillus helveticus in the production of Reggianito Argentino cheese
Authors: Perotti M C , Bernal S M , Meinardi C A , Candioti M C , Zalazar C A
Published: January 2004

Reggianito Argentino cheeses were manufactured with mixed strains of Lactobacillus helveticus cultured in free viable bacteria whey. As controls, cheeses with natural whey starter were made. Gross composition of cheeses did not differ significantly. The number of total termophilic lactic acid bacteria at the end of ripening was near 107 CFU/g, but when the strain Lh 209 was present in the mixture, this number was 106 CFU/g. Soluble nitrogen at pH 4.6 did not differ between control and experimental cheeses, but soluble nitrogen in tricloroacetic acid 12% and phosphotungstic acid 2.5% showed significant differences at the end of ripening, being higher the values when the strain Lh 209 was present in the mixture. Electrophoretic profiles for control and experimental cheeses were very similar at 0, 90 and 180 days of ripening. An increase in the acid degree value of fat during ripening was noticeable indicating a lipolytic activity in the cheese matrix that was similar for the different strains mixtures. Results from sensory analysis did not show differences among the cheeses of these tests. Despite some differences in the production tricloroacetic and phosphotungstic acid soluble nitrogen were observed for mixtures in which Lh 209 was present, all cheeses were good quality Reggianito Argentino cheeses. These results open and interesting prospective for the use of selected strains culture in whey in substitution of natural whey.
The effect of systemic administration of lipopolysaccharide on cerebral haemodynamics and oxygenation in the 0.65 gestation ovine fetus in utero
Authors: Peebles Donald M. , Miller Suzanne , Newman James P. , Scott Rosemary , Hanson Mark A.
Published: January 2004

Objective
To investigate the effect of intravenous lipopolysaccharide on systemic and cerebral haemodynamics and oxygenation in the preterm ovine fetus.

Design
Prospective observational study.

Setting
Research centre for perinatal brain injury.

Sample
Nine fetal sheep at circa 93 days of gestation (0.65).

Methods
Fetal sheep were chronically instrumented with arterial and venous catheters and a flow probe in the carotid artery. Near‐infrared spectroscopy was used to measure changes in cerebral oxygenation and total haemoglobin concentration. Three days after surgery, each fetus was given 100 ng/kg Escherichia coli lipopolysaccharide. Observations were continued for 48 hours post‐injection and compared with baseline control values.

Main outcome measures
Fetal heart rate, mean arterial pressure, carotid blood flow.

Results
Three fetuses died after administration of the lipopolysaccharide. In the survivors fetal heart rate rose from 193 (SEM 7) to a mean maximal level of 226 (SEM 31 bpm) (P= 0.01) after 6.5 (SEM 1.0) hours. The mean arterial pressure decreased from 40.5 (SEM 4.2) to 29.4 (SEM 1.6) mmHg (P < 0.05) after 7.0 (SEM 2.0) hours, and carotid blood flow increased from 29.6 (SEM 1.6) to 45.8 (SEM 5.7) mL/min (P= 0.0002) at 12 (SEM 3) hours. All values returned to control levels by 48 hours. Histological assessment showed evidence of periventricular leucomalacia in three out of six brains studied.

Conclusion
These data do not suggest that cerebral ischaemia is the main aetiological factor in endotoxin‐related fetal brain injury. Fetal tachycardia and cerebral vasodilation may indicate endotoxaemia in fetuses exposed to prenatal infection.
Levels of antibodies against cytomegalovirus and Chlamydophila pneumoniae are increased in early onset pre‐eclampsia
Authors: von Dadelszen Peter , Magee Laura A. , Krajden Mel , Alasaly Kadria , Popovska Vesna , Devarakonda Rajashree M. , Money Deborah M. , Patrick David M. , Brunham Robert C.
Published: January 2004

Objective
The origins of pre‐eclampsia/eclampsia lie in a mismatch between feto‐placental demands and utero‐placental supply, a situation that also arises in normotensive intrauterine growth restriction (IUGR). Could reactivated chronic infection be both a trigger for these differential maternal responses to the same underlying pathology and a link between pre‐eclampsia and its attendant lifelong risks of atherosclerosis?

Design
Nested case–control study.

Setting
Tertiary obstetric centre.

Population
Cases of pre‐eclampsia, normotensive IUGR and controls.

Methods
A nested case–control study of serum from a population‐based bank was performed. Seroprevalence and levels of anti‐cytomegalovirus (CMV) and Chlamydophila pneumoniae immunoglobulin G (IgG) were compared (non‐parametrically) between women with early onset pre‐eclampsia (<34 weeks of gestation, n= 9), late onset pre‐eclampsia (≥34 + 0 weeks of gestation, n= 29), normotensive IUGR (birthweight less than third centile, n= 33) and matched normal pregnancy (n= 113, up to 2 per case).

Results
There was a significant difference in both anti‐CMV and Chl. pneumoniae antibodies between groups (Kruskal–Wallis test, P < 0.05). Women with early onset pre‐eclampsia had higher anti‐CMV levels (median: 79, 95% confidence interval [95% CI] = 47, 164) than women with late onset pre‐eclampsia (26 [95% CI = 22, 82], P < 0.05), normotensive IUGR (40 [95% CI = 31, 72], P < 0.05) and normal pregnancy (49 [95% CI = 45, 70], P < 0.05). Women with normotensive IUGR had significantly lower anti‐Chl. pneumoniae antibodies (0.10 [95% CI = 0.08, 0.38]) than did normal pregnancy controls (0.21 [95% CI = 0.20, 0.28], P < 0.05).

Conclusions
The anti‐CMV and anti‐Chl. pneumoniae antibodies were higher in early onset pre‐eclampsia than in late onset pre‐eclampsia, normotensive IUGR and normal pregnancy. This may provide a pathophysiological link between pre‐eclampsia and the known increased risk for subsequent atherosclerosis.