bluuebunny/crossref_metadata_2025 huggingface dataset:
Gross morphology of multiporous plate sensilla in the Hymenoptera (Insecta)
Authors: Basibuyuk Hasan H. , Quicke Donald L. J.
Published: March 2003

Both external and internal gross morphology of multiporous plate sensilla were investigated throughout the Hymenoptera, with particular reference to nonaculeate families, using SEM. Several scenarios concerning the origin of multiporous plate sensilla are discussed. Shape, attachment, position, and reinforcing structures, were found to vary between the families, and the possible phylogenetic implications of these are discussed.
What do we know about chrysidoid (Hymenoptera) relationships?
Authors: Carpenter James M.
Published: March 2003

The phylogeny of the superfamily Chrysidoidea is reviewed. Relationships among the families proposed byCarpenter (1986)were confirmed byBrothers & Carpenter (1993). The status of knowledge of phylogenetic relationships within families is assessed. Cladistic analyses have been undertaken only within Plumariidae (byRoig‐Alsina 1994; a manual analysis of genera), Chrysididae (byKimsey & Bohart 1991; a manual analysis of subfamilies and tribes, and genera within subfamilies) and Bethylidae (bySorg 1988; a manual analysis of subfamilies, and genus groups within three of these; and byPolaszek & Krombein 1994; a quantitative cladistic analysis of the genera of Bethylinae). These analyeses are critically evaluated, and the current classifications within all the families examined cladistically. Generic relationships are investigated within Scolebythidae and Embolemidae; subfamily relationships are investigated within Sclerogibbidae and Dryinidae.
A phylogenetic assessment of the branchiobdellidan family Branchiobdellidae (Annelida, Clitellata) using spermatological and somatic characters
Authors: Cardini Andrea , Ferraguti Marco , Gelder Stuart R.
Published: March 2003

The spermatozoa of six species belonging to the branchiobdellidan family Branchiobdellidae (i.e. Xironogiton victoriensis, Cirrodrilus kawamurai, Ankyrodrilus legaeus, Xironodrilus formosus, Branchiobdella kobayashii, Branchiobdella orientalis) were studied and compared to the other sperma‐tozoa already described in the group. A parsimony analysis was performed on the spermatozoal data of the species examined, as well as on their somatic characters. The results of the two analyses were contrasted and a further parsimony analysis was run on the matrix comprising both sets of characters. The study of sperm ultrastructure confirmed the genera recognized with traditional somatic characters and the monophyly of the branchiobdellidans. Xironodrilus was proved to be the sister species of Ankyrodrilus and its inclusion into the family Branchiobdellidae was supported. Evolutionary hypotheses on intergeneric differences in the family consistent with its biogeography can be suggested by the cladograms: Xironogiton is an early offshoot of branchiobdellidan lineage migrating to North America and probably radiating only in recent times; Branchiobdella kobayashii has a spermatozoon completely different from that of the other species of the genus, thus suggesting a complex story for this widespread taxon with a disjunct distribution.
A cave leech (Hirudinea, Erpobdellidae) from Croatia with unique morphological features
Authors: Sket Boris , Dovč Peter , Jalžić Branko , Kerovec Mladen , Kučinić Mladen , Trontelj Peter
Published: March 2003

Croatobranchus mestrovi is a troglobitic leech from deep shaft‐like caves in the Velebit Mountain, Dinaric karst, Croatia, living in cold (4–6 °C) water. Its oral sucker extends to form four pairs of triangular tentacles, each with about five finger‐like papillae, but widening into a marginally crenulated disc when attached to a substrate. Pairs of stiff, finger‐like lateral projections, probably gills, occur along the body behind the clitellum. Somites are simple five‐annulate. Despite the unique head morphology and the presence of lateral outgrowths, the anatomy and 18S rRNA gene sequence of this species indicate that it is a member of the Erpobdellidae, closely related to Dina.
The phylogenetic position of the Prolecithophora (Rhabditophora, ‘Platyhelminthes’)
Authors: Noren Michael , Jondelius Ulf
Published: March 2003

Complete 18S ribosomal DNA (rDNA) sequences and partial 28S rDNA sequences from a selection of rhabditophoran taxa were obtained and used in combination with literature data to determine the phylogenetic position of the Prolecithophora and of two families sometimes included in the Prolecithophora, the Urastomidae and the Genostomatidae. The results are largely compatible with earlier molecular studies when supported clades are considered, and adjusting for the denser taxonomic sampling of this study. The position of the Proseriata is not compatible with the taxon Seriata, which is rejected. The Rhabdocoela excluding the Fecampiida and the Neodermata is monophyletic. The phylogenetic position of the Neodermata cannot be determined, but its placement is not compatible with the proposed taxa Revertospermata and Mediofusata Kornakova & Joffe, 1999, which are rejected. The Urastomidae and the Genostomatidae in all analyses group with the Fecampiida, and it is our recommendation that these taxa be included in the Fecampiida. The amended Fecampiida always group separately from the Prolecithophora sensu stricto, the Rhabdocoela, and the Neodermata. Our analyses reveal the existence of a strongly supported clade consisting of Prolecithophora + Tricladida + the amended Fecampiida, and we propose the name Adiaphanida for this clade. Tentatively the sister group of the Prolecithophora is a clade consisting of the Tricladida + amended Fecampiida.
Morphology and evolution of the tarsal plantulae in Hymenoptera (Insecta), focussing on the basal lineages
Authors: Schulmeister Susanne
Published: March 2003

The morphology of the plantulae (= tarsal pulvilli = plantar lobes), structures attached to the underside of the tarsus in Hymenoptera, was examined in 55 genera from all 14 families of the basal lineages of Hymenoptera (‘Symphyta’) and a few species of Apocrita, using scanning electron microscopy. Two distinct types of plantula were found: (1) integrated, an unsclerotized patch positioned ventro‐distally on each tarsomere, and (2) distal, a membranous vesicle attached to the apical end of each tarsomere. The evolution of these two types is discussed in the light of current phylogenetic hypotheses. The plantulae exhibit an astonishing variety of form and structural details; their potential phylogenetic and taxonomic value is discussed.
Scorpion ARMS primers for SNP real‐time PCR detection and quantification of Pyrenophora teres
Authors: Bates Jayne A. , Taylor Emily J. A.
Published: March 2003

summary

We have developed a quantitative PCR detection method that can be used to determine the seed infection levels of Pyrenophora teres, a seed‐borne fungal pathogen of barley. This method uses Scorpion Amplified Refractory Mutation System (ARMS) technology with real‐time PCR detection. Scorpion ARMS primers were designed and optimized such that a single nucleotide base mismatch in the primer sequence could distinguish P. teres from P. graminea, a closely related seed‐borne pathogen of barley. It is necessary to distinguish between these two agriculturally important pathogens since different disease management decisions are made, based on the presence and level of infection measured for each. The advance in development of sensitive and specific fluorescent probes has enabled the current PCR test to detect Pyrenophora spp. pathogenic on barley to be enhanced with the advantage that it can now specifically detect P. teres in a single reaction, whilst previously, two reactions were required to discriminate P. teres from P. graminea.
Functional analysis of cysteine residues of ECP elicitor proteins of the fungal tomato pathogen Cladosporium fulvum
Authors: Luderer Rianne , De Kock Maarten J. D. , Dees Robert H. L. , De Wit Pierre J. G. M. , Joosten Matthieu H. A. J.
Published: March 2003

summary

A striking feature of all elicitor proteins of Cladosporium fulvum that are specifically recognized by tomato is that they contain an even number of cysteine residues. These cysteine residues are thought to be involved in disulphide bridges. In this study, a mutational analysis of the cysteine residues of ECP1, ECP2 and ECP5 was performed, to examine their role in stability and hypersensitive response‐inducing activity of the proteins. We show that not all cysteine residues of the ECPs are critical for the hypersensitive response‐inducing activity of the proteins, and we propose that the role of cysteine residues in the ECPs is more complex than anticipated.
Nursing and politics: a South African perspective
Authors: Ehlers V. J. , Phil Litt et
Published: March 2003

Abstract

The purpose of this paper is to provide a general introduction to politics, and to describe some political changes which have affected the rendering of multi‐disciplinary health care services in the Republic of South Africa since 1994. Political issues which will be addressed include: changed provincial borders; opening up of the Republic of South Africa’s international borders; increased emphasis on primary health care services; enhanced international involvement of the Republic of South Africa; changes in the statutory bodies governing the nursing profession; and changed legislation affecting health care workers.

Political know‐how is essential for professional survival. Unless nurses in the Republic of South Africa collaborate proactively as a united group representing the largest proportion of health care professionals in the country, the nursing profession and nursing education might become irrelevant to the political realities of the country and its people. Unless nurses can succeed in engaging in successful political debates and in negotiating their rights, they might become an increasingly voiceless, faceless and powerless female profession in the Republic of South Africa. However, politically knowledgeable nurses may help to ensure that the people will get the nurses and the nursing care they deserve, whilst the nurses will enjoy the benefits to which they are entitled, including market‐related salaries.
Clinical networks for nursing research
Authors: Gillibrand W. P. , Burton C. , Watkins G. G.
Published: March 2003

As a central feature of national research and development strategies, clinical effectiveness emphasizes the importance of rigorous experimental research in nursing. It is naïve to assume that over‐worked practitioners, with little research training and supervision, can undertake this type of research. Traditional approaches to research support rely on the practitioner registering for a higher degree and academic supervision. This assumes that the responsibility for research lies with practice, with higher education adopting a reactive stance in supporting research and development in nursing. The literature demonstrates a growing number of innovative models for facilitating nursing research. These, however, tend to focus on single appointments with limited and predefined access to clinical areas and patient populations. This article details a new initiative from the Clinical Nursing Practice Research Unit (CNPRU) that aims to support programmatic research in nursing practice through Clinical Networks for Nursing Research. Our research strategy is to contribute to the development of nursing science by facilitating effective collaboration between clinicians and higher education in core clinical specialties, including stroke rehabilitation, diabetes, mental health and community nursing. Each researcher has developed networks with a number of clinical areas, locally, regionally or nationally, through seminars, conferences or newsletters, to link practitioners and generate answerable research questions. Network communications also rely heavily on the establishment of interactive websites. This strategy has resulted in a number of collaborative, evaluative studies including clinical trials in rehabilitation, diabetic nursing and primary care.
Submitting terms to the International Classification for Nursing Practice (ICNP®)
Authors: Feringa M. M. , Goossen W. T. F. , Coenen A.
Published: March 2003

The purpose of this article was to illustrate how nurses can contribute to the development and improvement of the International Classification for Nursing Practice (ICNP®). It provides researchers and students with an example of how to submit terms to the ICNP® Programme for review. The article provides a brief general background on the ICNP® and explains the process of how to identify and develop nursing phenomena and actions. It continues to describe the method of validating new terms, reviewing the literature to support it and how to submit the term to the International Council of Nurses (ICN). Examples are provided.
Nursing Research in Africa
Authors: Tlou Sheila Dinotshe
Published: March 2003

The research priorities outlined below are based on input from colleges of nursing and national nurses' associations throughout the African region and from nurses attending a consultative meeting at ICN's 21st Quadrennial Congress in Vancouver.
Nursing Research in Asia
Authors: Kim Mo‐Im
Published: March 2003

The following summaries of the nursing research status in eight Asian countries are based on country reports presented at a meeting convened by the WHO West Pacific Regional Office and organized by Yonsei University's WHO Collaborating Centre for Nursing/Midwifery. The aim was to discuss the establishment of an Asian Nursing Research and Training Network.
Use of Giger and Davidhizar's Transcultural Assessment Model by Health Professions
Authors: Dowd Steven B. , Giger Joyce Newman , Davidhizar Ruth
Published: March 2003

Nursing science is increasingly gaining recognition. Witness the growing use by other disciplines of nursing's models and ideas. One example is the adoption of the Giger and Davidhizar Model of Transcultural Assessment by non‐nursing disciplines to understand and address the needs of a pluralistic multicultural society. Below the authors describe a model to understand culturally diverse clients and show how health professions are using it to provide culturally competent care.
Global Overview of HIV/AIDS–A Challenge for Nurses
Authors: Anderson Sandra
Published: March 2003

The human immunodeficiency virus (HIV) continues to spread around the world, insinuating itself into communities previously little troubled by the epidemic and strengthening its grip on areas where AIDS is already the leading cause of death in adults. (See global estimates on page 176.) Below, the evolving picture region by region.
Petits différends: a reflection on aspects of Lyotard's philosophy for quality of care
Authors: Drummond John S.
Published: March 2003

Abstract This paper relates to Lyotard's philosophy of a différend. The paper has a dual purpose. The first is to explain what is meant by a différend and also a petit différend. The intention here is to preserve both the intrinsic validity and ethico‐political value of the concept in cases where its legitimacy might easily be denied. This feeds into the second and main purpose of the paper, which is to testify to a petit différend in quality of care, so that care may be taken in how the term ‘quality of care’ is actually used. It is here that the implications of a petit différend in quality of care are opened up from the perspective of cared‐for and professional carers, respectively. It will be shown that the idea of quality of care is open to multiple interpretations, and therefore to disputes that judgement cannot resolve to the satisfaction of all parties.
Thinking about change1
Authors: Hussey
Published: March 2003

Abstract Beginning by offering a conceptual analysis of change – a statement of what change of any kind is – the paper sets out to examine possible ways of understanding a very common and important variety of change that may be called ‘evolutionary’. These changes include anything from the production of a clay pot on a potter's wheel to the emergence of a system of management, or from the effects of an analgesic drug to the development of a new programme of care. As few philosophers have discussed such topics, theories are borrowed from the philosophy of science that attempt to explain the development and rationality of science. The ideas of Karl Popper and Thomas Kuhn are discussed and criticized, before turning to evolutionary theories: Darwinian and Lamarckian. The paper ends by offering a model that, it is hoped, may help in thinking about a wide range of changes.
Solubilisation de filtres‐UV dans des melanges ternaires de phases apolaires, optimisation par l'utilisation de reseaux centres
Authors: MARTI‐MESTRES G. , LAGET J.P. , MAILLOLS H. , FERNANDEZ C.
Published: March 2003

De nombreuses molecules photoprotectrices sont insolubles dans l'eau et parfois peu solubles dans les solvants utilisables dans le domaine dermo‐cosmetique. La formulation des emulsions impose de faibles teneurs en phase grasse pour obtenir un toucher agreable, il est donc necessaire de connaitre la solubilite maximale des filtres utilises dans les differents solvants pour eviter leur recristallisation. Deux filtres‐UV insolubles dans l'eau sont etudies a differentes concentrations dans plusieurs melanges ternaires de phases grasses, ce travail est optimise a l'aide de reseaux centres. Pour chaque diagramme ternaire les courbes d'isoreponses sont presentees et cet outil permet au formulateur de choisir judicieusement les melanges les plus appropries. Synopsis This paper is concerned with the solubility of UV filters. Emulsions are perfect formulations used for sunscreens, but to give the skin silky feel without being greasy, the oily phase content is low. Considerations of sunscreen solubility can help to solve specific problems of stability in formulations. It is important to determine what solvent dissolves them and what mixture of solvent improves their solubility. Two water insoluble sunscreens were tested at several concentrations in various non‐polar solvents. A strategy with simplex centroid design was used to optimize this work. The graphical interpretation of the data assists our understanding of the solubility of UV filters.
Environmental fate and effects of dimethicone and cyclotetrasiloxane from personal care applications
Authors: Stevens C.
Published: March 2003

This paper summarizes the environmental fate and effects of dimethicone and cyclotetrasiloxane, which are used extensively in personal care applications. Dimethicone and cyclotetrasiloxane differ fundamentally in their physicochemical properties, and as a consequence display different environmental fate paths. Cyclotetrasiloxane partitions into the atmosphere, whereas sediments and soils are the most important environmental compartments for dimethicone. Information is presented to show the environmental degradation of these two materials in their respective environmental compartments. In both cases, after a non‐biological step to initiate the process, the degradation occurs biologically. Ultimately, both dimethicone and cyclotetrasiloxane are degraded to inorganic constituents, carbon dioxide, silicic acid and water. No adverse effects have been detected in experimental organisms representative of the environmental compartments in which dimethicone and cyclotetrasiloxane may be found. Monitoring of key environmental compartments, namely sediments and soil, reveals that average concentrations are well below the no‐observed adverse effect level. This work therefore continues to support the environmental acceptability of dimethicone and cyclotetrasiloxane for personal care applications.
New and unexpected cosmetic properties of perfumes. Effects upon free radicals and enzymes induced by essential oils, absolutes and fragrant compounds
Authors: Étienne  , Pham. Duc  , Simonet  , Derbesy
Published: March 2003

Synopsis

The biological properties of several different perfume components have been investigated. It has been demonstrated, through appropriate test methods, that essential oils, absolutes and even compounds show significant (anti/pro)‐radical, (anti/pro)‐elastasic and (anti/pro)‐tyrosinasic activities.

These unexpected properties open up new opportunities for the formulation of cosmetic products and could contribute to the understanding of activities traditionally attributed to essential oils by Aromatherapy.

Résumé

Les propriétés biologiques de plusieurs composants différents utilisés en parfumerie ont étéétudiées. On a montré, à l’aide de méthodes expérimentales appropriées, que les huiles essentielles, les absolues et même des compositions parfumantes présentent des activités significatives pro‐ ou antiradicalaires, pro‐ ou antiélastasiques et pro‐ ou antityrosinasiques.

Ces propriétés innattendues offrent de nouvelles opportunités pour la formulation des produits cosmétiques et pourraient contribuer à la compréhension des activités traditionnellement attribuées aux huiles essentielles par l’Aromathérapie.
Effect of germinated seeds extract on the respiratory activity of human skin fibroblasts and sheep liver mitochondria. Influence on cell viability and proliferation and their uselfulness as active cosmetic ingredient
Authors: Benaiges A. , Armengol R. , Mateu B. , Sagristá M. L. , Mora M.
Published: March 2003

Synopsis

The present work studies the ability of a germinated seeds extract (alfalfa, radish, wheat, soy) to influence cell respiration of skin fibroblasts and the respiratory activity of sheep liver isolated mitochondria, and the cytotoxicity of the product on cultured skin fibroblasts. The content of free and total amino acids present in this extract was determined. Aspartic acid represented 37.52% of free amino acids in the extract, but 48.07% glutamic acid was found when total amino acids obtained by acid hydrolysis were quantified. The extract contains more than 6.5% free serine, glutamic acid and alanine. Arginine, serine, aspartic acid and threonine are the other amino acids that represent more than 4.5% total amino acids. Respiration of sheep liver mitochondria and human skin fibroblasts (Foreskin ATCC CRL‐1635) was checked polarographically. The results obtained show the ability of this extract to stimulate cellular respiration of both in vitro models, but the effect is more marked on cell cultured fibroblasts, and its dose dependency. The role of acidic amino acids, aspartic and glutamic acids, on the increase of oxygen consumption by mitochonria is suggested. Cytotoxicity of the germinated seeds extract was tested by the assessment of the viability, the morphological changes and the proliferation of cell cultured human skin fibroblasts. It has been shown that germinated seeds extract are non‐toxic to cell cultures at doses of up to 10 mg mL−1; neither morphological changes nor membrane integrity alterations or changes in cell proliferation were observed.
Validation of a high performance liquid chromatography method for sunscreen determination in cosmetics
Authors: Dutra E. A. , Kedor‐Hackmann E. R. M. , Santoro M. I. R. M.
Published: March 2003

Synopsis

The aim of this research was the development and validation of a high performance liquid chromatography (HPLC) method for the simultaneous and quantitative determination of benzophenone‐3, octyl methoxycinnamate and octyl salicylate contained in sunscreen emulsions. The separation and quantitative determination was achieved using a LiChrospher® 100 RP‐18 (5 µm) Merck column, a mobile phase constituted of methanol/water (85/15, v/v), a flow‐rate of 1.0 mL min−1 and UV detection at 310 nm. The correlation coefficients and percentage of recovery for benzophenone‐3, octyl methoxycinnamate and octyl salicylate were 0.9999 and 99.46%; 0.9995 and 98.85%; 0.9998 and 98.84%, respectively. The relative standard deviations (RSD) for commercial samples were between 0.50 and 0.70%.
Green chemistry procedure for the synthesis of cyclic ketals from 2‐adamantanone as potential cosmetic odourants
Authors: Genta M. T. , Villa C. , Mariani E. , Longobardi M. , Loupy A.
Published: March 2003

Synopsis

Some cyclic ketals derived from 2‐adamantanone were obtained in excellent yields by microwave activation under solvent‐free conditions, as a ‘green chemistry’ procedure. A number of experiments were performed to evaluate the most efficient catalytic conditions. The best results were obtained using a simple heterogeneous mixture of reagents and p‐toluenesulphonic acid as the catalyst, without any solvent or support. The data are reported and compared with those obtained by other microwave‐mediated syntheses or by classical method.

In order to check the possible intervention of non‐thermal microwave effects, the best experiment in ‘dry media’ was carried out with considerable lower yield by conventional heating, in a thermostated oil bath, under the same conditions as under microwaves (time, temperature and vessel).

All the synthesized compounds were tested for their olfactive character and for a potential cosmetic use. The odour evaluation is reported.
Natural ingredients for colouring and styling
Authors: Dweck A. C.
Published: March 2003

Synopsis

This paper examines some of the existing methods for colouring the hair and skin using natural material (such as henna) and proposes a parallel technology that exists in the dyeing of wool and fabrics to extend the colour range. Many of the listed plants and their derivatives are not found in Annex IV of the Cosmetic Directive and may not be used as colours; however, they do have other properties which may justify their inclusion into a product, for example, as astringent or anti‐inflammatory agents. The paper concludes with some reported antigreying and hair styling preparations cited in the literature.
Lack of desquamation – the Achilles heel of the reconstructed epidermis
Authors: Ponec M. , Kempenaar J. , Weerheim A.
Published: March 2003

Synopsis

The use of human skin equivalents for screening tests aiming to assess repetitive application of various test agents is hampered by the lack of desquamation in vitro. The present study was undertaken to examine whether the desquamation can be induced by various treatments including mechanical stress, application of various agents that should decrease the surface pH and calcium level, activate the enzymes involved in desquamation process or UV irradiation. In addition, the effect of α‐hydroxyacids, known to enhance desquamation and to improve the stratum corneum barrier function in vivo, was examined as well. Human epidermis reconstructed on de‐epidermized dermis or on fibroblast‐populated collagen matrices during a 2‐week culture at the air–liquid interface underwent various treatments during an additional 3‐week period. The effects of treatments were evaluated on the basis of tissue morphology and lipid composition. The results of the present study revealed that cell shedding could only be induced by a mild repetitive mechanical treatment. The lack of desquamation, under most in vitro conditions, has a practical consequence, since it may hamper the use of reconstructed epidermis for various screening studies aiming to examine the repetitive exposure to topical agents or UV irradiation. The gradual thickening of the stratum corneum will lead to its higher resistance to the environmental stimuli and in this way affect the outcome of the tests. Furthermore, from the results obtained in the present study, it became evident that one should be careful in selecting endpoints when, for example, the effects of agents known to modulate melanogenesis are examined.
Dietary sphingomyelin and other sphingolipids in health and disease
Authors: Schmelz Eva M.
Published: March 2003

Sphingolipids are found in all eukaryotic and some prokaryotic cells and therefore most foods contain varying amounts. They are digested in the intestinal tract, and the bioactive metabolites (i.e. ceramide, sphingosine) are released. In mouse models, the supplementation of the diet with complex sphingolipids significantly reduced early stages in colon carcinogenesis and tumour formation, providing an insight into the association between diet and cancer.
Thirst: or, why do people drink?
Authors: Saltmarsh Mike
Published: March 2003

Summary Over half the human body is water, which is essential for the correct functioning of virtually all living cells. The body has developed mechanisms to maintain water balance under conditions of mildly fluctuating availability and generally, consumption of 1.5 L of liquid per day is sufficient, in conjunction with the liquid ingested as a component of food, to replace the water lost throughout the day. However, the mechanisms do not trigger the sensation of needing to drink until there is already a water deficit. In normal circumstances in temperate climates this does not matter, but athletes, the young, the elderly and those working in hot climates have to take special steps to ensure they drink regularly and before they feel thirsty. As with all food, variety is good because the drinks supply other useful components of the diet in addition to water. While the rate of rehydration is rarely important in temperate climates, in circumstances where it does matter, such as in some illnesses, the addition of carbohydrate and salt has been shown to improve the rate of transfer of water from the gut into the body.
Coronary heart disease: pathophysiological events and risk factors
Authors: Ferns Gordon A A. , Lamb David J.
Published: March 2003

Summary Cardiovascular disease remains the major cause of morbidity and mortality in the UK, causing more than 110 000 deaths per annum. Coronary risk is multifactorial, being a composite of genetic and environmental determinants. Its major risk factors include hypertension, dyslipidaemia, obesity, plasma clotting factor concentrations, smoking and diabetes mellitus. The overall heritability of coronary heart disease has been estimated to be between 15 and 50%, and hence, there is a substantial potential role for environmental factors, including diet, to modify coronary risk. Studies in experimental animal models have permitted a more detailed analysis of the cellular events by which atherosclerosis is initiated and progresses. This work has identified the endothelium as a primary site of injury, leading to endothelial dysfunction. Detailed histological and radiological studies in man have led to the identification of features of atherosclerotic plaques that make them more vulnerable to abrupt rupture. The possible role of infection and inflammation in this process is supported by epidemiological data. These new insights into the pathogenesis of atherosclerosis have been accompanied by the identification of a new generation of risk factors.
Improving the nutritional status of older residents in care – new national minimum standards
Authors: Stanner Sara
Published: March 2003

Summary
On 1st April 2002, national minimum standards for care homes for older people came into force in England and Wales (Department of Health 2002). These were published in accordance with the Care Standards Act 2000 and replaced the Registered Homes Act of 1984. The Care Standards Act also created the National Care Standards Commission (NCSC), an independent non‐governmental public body to regulate social and health care services (previously regulated by local councils and health authorities). Meeting the new standards is a core requirement for all care homes providing accommodation and nursing or personal care for older people and will form the basis on which the new NCSC will determine whether homes for older people meet the needs and secure the welfare and social inclusion of those who live in them. Several of the key topics highlighted in the Act relate explicitly to food and food provision (including health and personal care, daily life and social activities and staffing). For example, specifications are made about the type of food that is acceptable, when it should be eaten, the appropriate number of meals per day and their distribution throughout the day. This article outlines the main nutrition related issues in the new standards and highlights some available resources that may help care home owners to meet them.
The genetic epidemiology of thinness
Authors: Bulik C. M. , Allison D. B.
Published: March 2003

Most genetic research in the area of human obesity asks the question ‘Why are certain people obese?’ Considerably less attention has been paid to the question of why certain people are not obese, particularly given the obesogenic environment that permeates the western culture. We present data from human and animal studies and evolutionary arguments supporting the notion that genetic studies of thinness or obesity resistance may yield important and complementary findings to genetic studies of obesity. We offer strategies for further refining the definition of thinness, weigh the advantages and disadvantages of potential sampling strategies and suggest candidate genes for thinness or obesity resistance.
Clinical aspects of transfusional iron overload
Authors: Wonke Beatrix , De Sanctis Vincenzo
Published: March 2003

Most of our knowledge of transfusional iron overload has been obtained from patients with β‐thalassemia major (TM). Iron overload causes multiple endocrinopathies presenting in the first decade of life with growth disturbance, followed by thyroid dysfunction. By the second decade of life, carbohydrate metabolism is disturbed in up to 25% of patients and failure of sexual development, even in well‐chelated patients, appears as the commonest endocrine complication. In the third and fourth decades of life, osteopenia and osteoporosis are the causes of morbidity in over 50% of well‐chelated and transfused TM patients. Cardiac disease, secondary to iron damage, causes death in developed countries as a result of noncompliance to desferrioxamine mesylate (DFX) from the third decade of life. In underdeveloped countries, cardiac death starts from 12 years of age, due to the nonavailability of the iron chelating agent DFX. With the emergence of the advanced cardiac magnetic resonance imaging technique, early diagnosis of heart iron will allow the use of parenteral and oral chelators in an innovative way to improve survival and the quality of life for TM patients.
RESULTSOF UNRELATED UMBILICAL CORD BLOOD HEMATOPOIETIC STEM CELL TRANSPLANTATION
Authors: Gluckman Eliane , Rocha Vanderson , Chevret Sylvie
Published: March 2003

The number of umbilical cord blood transplants is increasing worldwide. The purpose of Eurocord is to evaluate the results and to compare the outcome of umbilical cord blood transplants with allogeneic bone marrow transplants. Data have been reported to Eurocord by multiple transplant centers. Close links have been established with the cord blood banks through Netcord. Bone marrow transplant data have been provided by transplant centers and also through the European Group for Blood and Marrow Transplantation (EBMT) and International Bone Marrow Transplant Registries (IBMTR). Eurocord has analyzed the outcome of unrelated umbilical cord blood transplants from 121 transplant centers and 29 countries. The results showed that survival with unrelated mismatched umbilical cord blood transplants was comparable to that with unrelated bone marrow transplants. Engraftment with cord blood was delayed, resulting in an increased incidence of early transplant complications. The incidence of acute and chronic graft‐vs.‐host disease was reduced with cord blood grafts even in human leukocyte antigen (HLA)‐mismatched transplants and in adults. In patients with leukemia, the rate of relapse was similar to the rate of relapse after bone marrow transplant. The overall event‐free survival with umbilical cord blood transplantation was not statistically different when compared to bone marrow transplants. This large registry study confirms the potential benefit of using umbilical cord blood hematopoietic stem cells for allogeneic transplants.
MONOCLONAL GAMMOPATHIES OF UNDETERMINED SIGNIFICANCE
Authors: Kyle Robert A. , Rajkumar S. Vincent
Published: March 2003

The term ‘monoclonal gammopathy of undetermined significance’ denotes the presence of a monoclonal protein in patients without evidence of multiple myeloma, macroglobulinemia, amyloidosis or related plasma cell proliferative disorders. The disorder has been found in approximately 3% of persons older than 70 years and in approximately 1% of persons older than 50 years. A population‐based study included 1384 patients from south‐eastern Minnesota who had the disorder diagnosed at the Mayo Clinic from 1960 through 1994. Risk of progression was about 1% per year, but patients were at risk of progression even after 25 years or more of stable monoclonal gammopathy of undetermined significance. The risk for development of multiple myeloma was increased 25‐fold; the risk of macroglobulinemia, 46‐fold; and the risk of primary amyloidosis, 8.4‐fold. Concentration and type of monoclonal protein were the only independent predictors of progression. The presence of a urine monoclonal protein and the reduction of one or more uninvolved immunoglobulins were not risk factors for progression. Monoclonal gammopathy of undetermined significance may be associated with various disorders, including lymphoproliferative diseases, leukemia, von Willebrand disease, connective tissue diseases and neurologic disorders.
MANAGEMENT OF MULTIPLE MYELOMA
Authors: Harousseau Jean‐Luc
Published: March 2003

There has been no improvement in the treatment of multiple myeloma (MM) during the last decades and two meta‐analyses of randomized trials recorded no significant survival benefit for combination chemotherapy compared to the classic melphalan‐prednisone combination. However the past 15 years has seen several innovative strategies which have dramatically modified the management of MM. In younger patients, high‐dose therapy with autologous stem cell transplantation is considered to be superior to conventional chemotherapy and is used as part of front‐line therapy. A number of issues have been addressed in recent trials in order to improve the results of autologous transplantation (source of stem cells, conditioning regimen, impact of double transplants, maintenance therapy). Bisphosphonates reduce the incidence of skeletal‐related events and improve the quality of life. Recombinant erythropoietin reduces red blood cell transfusion need and improves the quality of life. Thalidomide has been introduced more recently. Phase II studies with thalidomide alone or combined with dexamethasone have shown impressive response rates and this drug is currently being evaluated as part of front‐line therapy. Finally, analysis of prognostic factors such as β2 microglobulin and cytogenetics define subgroups of patients with a completely different outcome and help the process of selecting therapeutics strategies.
Euthanasia: from the perspective of HIV infected persons in Europe
Authors: Andraghetti R , Foran S , Colebunders R , Tomlinson D , Vyras P , Borleffs Cj , Fleerackers Y , Schrooten W , Borchert M
Published: March 2003

1

Institute of Tropical Medicine, Antwerp, Belgium,

2

St Mary's Hospital, London, UK,

3

General Hospital of Athens, Athens, Greece and

4

University Hospital Utrecht, Utrecht, the Netherlands

Background  In the debate about legalization of euthanasia very little attention has so far been given to the opinion of the patient.

Objective  To assess the opinion of persons with HIV infection in Europe.

Methods  A cross‐sectional survey of persons with HIV infection attending HIV/AIDS treatment centres or HIV support organizations in 11 European Union Member States was performed. A total of 2751 anonymous patient self‐administered questionnaires were distributed between August 1996 and September 1997. The questionnaire contained 108 questions concerning a variety of topics about HIV care, including five questions on euthanasia.

Results  One thousand three hundred and seventy‐one people with HIV infection completed the questionnaire, of whom 1341 (98%) responded to the questions concerning euthanasia. Seventy‐eight percent of respondents agreed with the legalization of euthanasia in case of severe physical suffering, 47% if there was severe psychological suffering and 24% simply at the patient's request. For physical suffering and at a clear patient's request, accepted practices were: alleviation of pain with double effect (81%), medical euthanasia (62%) and physician assisted suicide (45%). Fifty percent would consider euthanasia for themselves if all treatment options were exhausted. Social indicators such as educational level and employment seemed to play a more significant role in determining attitudes towards legalization, and personal interest in, euthanasia than indicators related to disease status.

Conclusion  In this study a majority of HIV infected persons in Europe favoured the legalization of euthanasia.
Pulmonary pathology in patients with AIDS: an autopsy study from Mumbai
Authors: Lanjewar DN , Duggal R
Published: March 2003

Objective Although India has a high prevalence of HIV/AIDS, the associated pathologies responsible for morbidity have not been evaluated previously in a representative study. Hence, an autopsy study was carried out to analyse the spectrum of pulmonary lesions in patients with HIV/AIDS.

Methods A retrospective and prospective autopsy study was carried out during 1988–2000 at Mumbai, India. Lungs from 143 adults, with at least 10 sections from each case, were examined using routine and special stains.

Results The risk factors for 97 men (68%) and 38 women (27%) included: heterosexual sex with multiple partners (135 cases, 95%); blood transfusions (three cases; 2%); sex between men (two cases; 1%); and unknown risk factors (three cases, 2%). Pulmonary pathology was observed in 126 (88%) cases. The lesions identified were tuberculosis (85 cases, 59%), bacterial pneumonia (26 cases, 18%), cytomegalovirus (CMV) infection (10 cases, 7%), cryptococcosis (eight cases, 6%), Pneumocystis carinii pneumonia (seven cases, 5%), aspergillosis (four cases, 3%), toxoplasmosis (two cases, 1%), Kaposi's sarcoma (one case, 1%), squamous cell carcinoma (one case, 1%). Two or more infections were observed in 18 (13%) cases.

Conclusions Pulmonary diseases and risk factors among patients with AIDS in India differ from those reported in industrialized countries. Tuberculosis was the most frequently observed pulmonary infection, followed by bacterial pneumonia and CMV pneumonitis. In contrast with industrialized countries, PCP remains less common in our patients. The information on opportunistic infections obtained in this study will be useful for managing HIV/AIDS cases at district level hospitals where diagnosing specific HIV‐associated diseases is not always possible.
Body composition changes in protease inhibitor‐naive HIV‐infected patients treated with two nucleoside reverse transcriptase inhibitors
Authors: Tsekes G , Chrysos G , Douskas G , Paraskeva D , Mangafas N , Giannakopoulos D , Papanikolaou M , Georgiou E , Lazanas MC
Published: March 2003

Objectives

In the era of highly active antiretroviral treatment (HAART), there are insufficient data regarding lipodystrophy syndromes in HIV‐1‐infected patients treated with regimens that do not include protease inhibitors (PIs). We studied changes in body composition in HIV‐1‐infected patients before and 2 years after starting a non‐PI‐containing antiretroviral treatment regimen.

Methods

We studied retrospectively the whole body dual energy X‐ray absorptiometry (DEXA) scans of 23 PI‐naive HIV‐1‐infected patients (17 males, six females), aged 37.4 ± 9.3 years with mean CD4 count 401 ± 130 cells/µL. Thirteen patients were on zidovudine (ZDV) + lamivudine (3TC) and 10 on ZDV + didanosine (ddI). Subjects were evaluated before the beginning of antiretroviral treatment and approximately 24 months later. For each patient body weight, CD4 T‐cell counts, bone mineral content (BMC), bone mineral density (BMD) and whole body as well as regional fat and lean body mass were evaluated.

Results

A significant decrease in BMC was observed, although the T scores remained within the normal limits. Our patients also exhibited a significant decrease in body weight due almost exclusively to fat loss, while lean mass was minimally affected. Fat loss was statistically significant in the arms and legs, but not in the trunk. The above changes were most prominent in the ZDV + 3TC treatment group; in this group of patients, fat loss was also evident in the trunk. Patients on ZDV + ddI, on the other hand, only showed a significant increase in their legs' lean mass; they preserved their total fat mass and exhibited no other significant changes between the two assessments.

Conclusions

Dual NRTI therapy contributes to fat loss and reduction of bone mineral content in otherwise healthy, clinically stable, PI‐naive HIV‐infected adults. Compared with patients on ZDV + ddI, patients on ZDV + 3TC had a more prominent fat loss in all body regions.
Endogenous cytokine production protects T cells from spontaneous apoptosis during highly active antiretroviral therapy
Authors: Ensoli F , Fiorelli V , De Cristofaro M , Collacchi B , Santini Muratori D , Alario C , Sacco G , Iebba F , Aiuti F
Published: March 2003

Background

The availability of therapeutic regimens that effectively interfere with HIV‐1 replication provides novel opportunities to investigate mechanisms of T‐cell depletion as well as repopulation in infected individuals.

Methods

Nineteen HIV‐1‐infected individuals were investigated during one‐year follow‐up of highly active retroviral therapy (HAART). The frequencies of apoptotic T cells, as determined by propidium iodide, staining, TUNEL assay and analysis of annexin V, were assessed either in the absence or in the presence of anti‐interleukin (IL)2 and anti‐IL‐4 neutralizing Ab. Spontaneous and lectin‐induced cytokine production were assessed by ELISA.

Results

Increments of both naive and memory CD4 and CD8 T cells during HAART are accompanied by a decrease of T‐cell apoptosis that, after 12 months of HAART, reaches normal levels. This is associated with increments of both spontaneous and activation‐induced production of IL‐2 and IL‐4 by peripheral blood mononuclear cells (PBMCs), though only the latter was found defective at enrolment. During HAART, blocking of either IL‐2 or IL‐4 production by PBMCs using neutralizing Ab restores levels of T‐cell apoptosis consistent with those determined at enrolment. These data suggest that both IL‐2 and IL‐4 produced by PBMCs during HAART provide anti‐apoptotic signals that can contribute to an increased survival of T cells and may thus play a part in long‐term immune reconstitution.

Conclusions

An effective viral suppression and, possibly, effects of PI on molecular targets other than viral components, can support a progressive normalization of T‐cell survival that, at least in part, depends upon the restoration of proper soluble signals. These results provide evidence of a supporting role of endogenous cytokine production in peripheral T‐cell repopulation during an effective and prolonged viral suppression. This may be relevant for the definition of immune‐intervention targets aimed at immune reconstitution in HIV‐1‐infected patients.