bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Intracarotid Glucose Injection Towards the Brain Induces Specific c‐fos Activation in Hypothalamic Nuclei: Involvement of Astrocytes in Cerebral Glucose‐Sensing in Rats
Authors: Guillod‐Maximin E. , Lorsignol A. , Alquier T. , Pénicaud L. 
Published: April 2004

AbstractThe detection of changes in glucose level constitutes the first step of the control of glucose homeostasis. Glucose sensors are therefore expected to be present in different parts of the body and particularly in the central nervous system. Some studies have already attempted to determine glucose‐sensitive cerebral structures either after a glucoprivic stimulus or after prolonged hyperglycaemia. By analogy to beta cells, it was postulated that the glucose sensors in the brain could involve GLUT2, glucokinase and/or ATP‐sensitive K+ channels. Surprisingly, GLUT2 was mainly found in astrocytes. Thus, the aims of the present investigation were to determine, in awake rats: (i) the hypothalamic areas that respond to acute hyperglycaemic condition induced by an intracarotid injection of glucose and (ii) the involvement of astrocytes in glucose‐sensing by the use of a glial drug, methionine sulfoximine. Rats were given intracarotid injections of glucose solution to trigger a transient insulin secretion without change in peripheral glycaemia, thus involving only central nervous regulation. Hypothalamic activation was determined by immunodetection of the immediate early gene c‐fos protein. Acute glucose injection induces significant activation of arcuate and paraventricular nuclei. This stimulation mainly affects neurones in both nuclei, but also astrocytes in the former as illustrated by double immunohistochemistry (Fos and neuronal nuclei or glial fibrillary acidic protein). After specific impairment of astrocyte metabolism by methionine sulfoximine, cerebral activation disappears in the arcuate nucleus, correlated with the lack of cerebral glucose‐induced insulin secretion. Therefore, arcuate and paraventricular hypothalamic nuclei are able to detect acute cerebral hyperglycaemia, leading to a peripheral stimulation of insulin secretion. Arcuate nucleus and more especially astrocytes in this nucleus play a pivotal role in glucose‐sensing.
Relationships Between Aromatase Activity in the Brain and Gonads and Behavioural Deficits in Homozygous and Heterozygous Aromatase Knockout Mice
Authors: Bakker J. , Baillien M. , Honda S. , Harada N. , Balthazart J. 
Published: April 2004

AbstractThe present study was carried out to determine whether aromatase knockout (ArKO) mice are completely devoid of aromatase activity in their brain and gonads and to compare aromatase activity in wild‐type and ArKO mice, as well as in heterozygous (HET) mice of both sexes that were previously shown to display a variety of reproductive behaviours at levels intermediate between wild‐type and ArKO mice. Aromatase activity was extremely low, and undetectable by the tritiated water assay, in homogenates of the preoptic area‐hypothalamus of adult wild‐type mice, but was induced following a 12‐day treatment with testosterone. The induction of aromatase activity by testosterone was significantly larger in males than in females. Even after 12 days exposure to testosterone, no aromatase activity was detected in the brain of ArKO mice of either sex whereas HET mice showed intermediate levels of activity between ArKO and wild‐type. Aromatase activity was also undetectable in the ovary of adult ArKO females but was very high in the wild‐type ovary and intermediate in the HET ovary. In wild‐type mice, a high level of aromatase activity was detected on the day of birth even without pretreatment with testosterone. This neonatal activity was higher in males than in females, but females nevertheless appear to display a substantial level of oestrogen production in their brain. Aromatase activity was undetectable in the brain of newborn ArKO males and females and was intermediate between wild‐type and ArKO in HET mice. In conclusion, the present study confirms that ArKO mice are unable to synthesize any oestrogens, thereby validating the ArKO mouse as a valuable tool in the study of the physiological roles of oestradiol. In addition, it demonstrates that the intermediate behaviour of HET mice presumably reflects the effect of gene dosage on aromatase expression and activity, that aromatase activity is sexually differentiated in mice during the neonatal period as well as in adulthood and, finally, that the neonatal female brain produces substantial amounts of oestrogens that could play a significant role in the sexual differentiation of the female brain early in life.
Effects of interferon and ribavirin combination therapy on CD4+ proliferation, lymphocyte activation, and Th1 and Th2 cytokine profiles in chronic hepatitis C
Authors: Marinho R. T. , Pinto R. , Santos M. L. , Lobos I. V. , Moura M. C. 
Published: April 2004

Summary.  We studied the relationship between immunological markers such as CD4+ proliferation, cytokines profile and lymphocyte activation markers in patients with chronic hepatitis C, having different responses to interferon (IFN) and ribavirin (RBV) treatment. A prospective study of 20 patients was conducted, six had received IFN‐alpha‐2b alone and 14 IFN in combination with RBV.The proliferative immune responses of peripheral blood mononuclear cells to hepatitis C virus peptides and the lymphocyte activation markers (CD25+, CD38+ and CD69+) were assessed before treatment, at 1 week, and 1, 3 and 6 months of treatment. Cytokines interleukin (IL)‐2, IFN‐γ, IL‐4 and IL‐10 were determined in supernatants before onset of treatment and at 1 and 6 months thereafter.Stimulation indices (SI) were higher in the sustained responders (SR), in comparison with those with no response (NR), before treatment (5.2 ± 3.7 to 3.3 ± 1.9, P = 0.028) and also at 6 months (7.8 ± 1.9 to 4.1 ± 1.2, P = 0.021). Patients with SR also had high SI to NS3 when compared with those with transitory response or no response (NR) (4.9 ± 2.5 and 3.3 ± 1.1, P = 0.033). At 1 month, SR had higher supernatant IL‐2 than those with NR (133.8 ± 119.2 to 56.0 ± 89.3 pg/mL, P = 0.023) and lower levels of IL‐10 (13.8 ± 10.1 and 167.1 ± 272.0 pg/mL, P = 0.023) in response to NS3. Combination therapy induced a higher percentage of the lymphocyte activation markers CD69+ and CD38+.In conclusion, we found that SR is associated with higher CD4+ proliferation particularly in response to the NS3 region, promoting a T‐helper (Th)1/Th0 profile of cytokines, and that combination therapy induced a higher percentage of lymphocyte activation than therapy with IFN alone.
Evidence for increased metabolism of chloroquine during the early third trimester of human pregnancy
Authors: Chukwuani Mercilina C. , Bolaji Oluseye O. , Onyeji Cyprian O. , Makinde O. N. , Ogunbona Festus A. 
Published: April 2004

SummaryObjective  To examine the possibility of a different extent of chloroquine (CQ) metabolism in human pregnancy by determining blood level profiles of the drug and its major metabolite, desethylchloroquine (CQM).Methods  Five women in the early third trimester of pregnancy and five non‐pregnant women received each a single 600 mg oral dose of CQ and blood samples were collected at pre‐determined intervals following drug administration. Plasma concentrations of CQ and CQM were analysed by an established HPLC method.Results  The Cmax and AUC0‐‐48 h of CQM were significantly higher in the pregnant than the non‐pregnant group (P = 0.009). The ratio AUC(CQ)/AUC(CQM) ranged from 0.09 to 0.35 among pregnant women, and from 1.70 to 4.81 among non‐pregnant women.Conclusion  Results from this preliminary study indicate an occurrence of induction of metabolism of CQ in the early third trimester of pregnancy. In view of toxicological importance of CQ metabolites, it is suggested that caution should be exercised in evaluation of higher dosage regimen of CQ in pregnant women.
A randomized trial on acceptability of voluntary HIV counselling and testing
Authors: Fylkesnes Knut , Siziya Seter 
Published: April 2004

SummaryObjectives  To examine factors affecting readiness for and acceptability of voluntary HIV counselling and testing (VCT).Methods  Participants in a population‐based HIV survey conducted in an urban population in Zambia in 1996 were offered VCT. Although 29% of them expressed interest in being tested (readiness), only 4% of this group used the services (i.e. acceptability). When the survey was repeated 3 years later, VCT was designed differently to assess acceptability. At the cluster level the participants were randomly allocated to VCT either at the local clinic (similar to 1996, n = 1102) or at an optional location (n = 1343).Results  Readiness varied significantly by age group (47% in age group 20–24 years vs. 18% in age group 40–49 years). There were contrasts between young (15–24 years) and older age groups (25–49 years) regarding the main factors associated with readiness. Whereas self‐perceived risk of being HIV infected was the only significant factor among the young, poor self‐rated health and ever HIV tested were important factors among the older. The acceptability was 11.8% among the group allocated to VCT at the local clinic compared with 55.8% for the group allocated to an optional location (RR, 4.7).Conclusions  Perceived risk of HIV infection had a major influence on VCT readiness among young people, whereas declining general health status, as indicated by self‐rated health, was most evident among those of older age. A strong effect of placement on acceptability of VCT was demonstrated, indicating this barrier to be important in explaining low demands for VCT in the past. Differences in perceptions of how confidentiality is handled at the two locations might be an important underlying factor.
Evaluation of an algorithm for integrated management of childhood illness in an area of Vietnam with dengue transmission
Authors: Phuong Cao Xuan Thanh , Nhan Ngo Thi , Kneen Rachel , Bethell Delia , Dep Le Thi , Nga Nguyen Thi Thuy , Thuy Pham Thi Thu , Luat Truong Dinh , Solomon Tom , Wills Bridget , Parry Christopher M. ,   The Dong Nai/WHO Study Team
Published: April 2004

SummaryObjectives  To determine whether nurses, using the WHO/UNICEF algorithm for integrated management of childhood illness (IMCI), modified to include dengue infection, satisfactorily classified children in an area endemic for dengue haemorrhagic fever (DHF).Methods  Nurses assessed and classified, using the modified IMCI algorithm, a systematic sample of 1250 children aged 2 months to 10 years (n = 1250) presenting to a paediatric hospital in Dong Nai Province, Vietnam. Their classification was compared with that of a paediatrician, blind to the result of the nurses’ assessment, which could be modified in the light of simple investigations, e.g. dengue serology.Results  In children aged 2–59 months (n = 859), the nurses were able to classify, using the modified chart, the presenting illness in >99% of children and found more than one classification in 70%. For the children with pneumonia, diarrhoea, dengue shock syndrome, severe DHF and severe disease requiring urgent admission, the nurse's classification was >60% sensitive and >85% specific compared with that of the paediatrician. For the nurse's classification of DHF the specificity was 50–55% for the children <5 years and in children with definitive dengue serology. Alterations in the DHF algorithm improved specificity at the expense of sensitivity.Conclusion  Using the IMCI chart, nurses classified appropriately many of the major clinical problems in sick children <5 years in southern Vietnam. However, further modifications will be required in the fever section, particularly for dengue. The impact of using the IMCI chart in peripheral health stations remains to be evaluated.
Prevalence of Opisthorchis viverrini infection and incidence of cholangiocarcinoma in Khon Kaen, Northeast Thailand
Authors: Sriamporn S. , Pisani P. , Pipitgool V. , Suwanrungruang K. , Kamsa‐ard S. , Parkin D. M. 
Published: April 2004

SummaryLiver cancer is the most common cancer in Khon Kaen, Northeast Thailand, because of the high incidence of cholangiocarcinoma (CHCA). Opisthorchis viverrini (OV), a liver fluke, is endemic in the area, and has been evaluated as a cause of CHCA by International Agency for Research on Cancer. Residents of 20 districts in the province were invited to attend a mobile screening programme between 1990 and 2001. Of 24 723 participants, 18 393 aged 35–69 years were tested for OV infection, by examining stools for the presence of eggs. Prevalence of infection in each district was estimated from the sample of the population who had been tested. The incidence of liver cancer in 1990–2001 was obtained for each district from the cancer registry. The average crude prevalence of OV infection in the sample subjects was 24.5%, ranging from 2.1% to 70.8% in different districts. Truncated age‐standardized incidence of CHCA at ages >35 years varied threefold between districts, from 93.8 to 317.6 per 100 000 person‐years. After adjustment for age group, sex and period of sampling, there was a positive association between prevalence of OV infection and incidence of CHCA at the population level. Associations between CHCA and active OV infection in individuals have become hard to demonstrate, because of effective anti‐OV treatment. The relationship may, however, be clear in comparisons between populations, which, for infectious diseases, take into account the contextual effects of group exposure in determining individual outcome. The cancer registry is an appropriate tool for disease monitoring in small areas.
Quality of sexually transmitted infections services for female sex workers in Abidjan, Côte d'Ivoire
Authors: Vuylsteke B. , Traore M. , Mah‐Bi G. , Konan Y. , Ghys P. , Diarra J. , Laga M. 
Published: April 2004

SummaryObjectives  To assess the quality of sexually transmitted infections (STI) care in health care facilities in Abidjan attended by female sex workers.Methods  A cross‐sectional study was conducted in June 2000 in the 29 health care facilities and 10 pharmacies, which were reported as points of first encounter for STI care by female sex workers in a previous study on health seeking behaviour. Evaluation components included: (1) checklists of equipment and STI drugs in the facilities; (2) interviews with health care providers and pharmacists; (3) direct observation of the provider/client interaction; (4) exit interviews with women attending with STI or genital problems.Results  Private health care facilities were more expensive, had fewer clients, and had less equipment and medical staff than public facilities, with the exception of the special female sex worker clinic. A total of 60 health care providers and 29 pharmacists were interviewed. There was no difference in their scoring on syndromic approach case studies, with the exception of the nurse assistants, who scored less. Overall scores for correct treatment were lowest for the pharmacists. We observed 513 provider–client interactions, of which 161 related to STIs or genital problems in women. Questions about recent sexual contacts were asked in only 20% and preventive messages were given in only 9% of the cases with STI/genital problems. Of 161 clients interviewed, 44% complained about a long waiting time, and 39% thought the health care provider had adequately explained the problem to them.Conclusions  The opportunity for improvement of STI case management in health care facilities in Abidjan where female sex workers go for STI care is enormous. Public and private health care facilities should be made more accessible for sex workers, and their services should be upgraded to better respond to the sexual health needs of high risk women.
Short communication: Misleading microscopy in amoebiasis
Authors: Kebede Amha , Verweij Jaco J. , Petros Beyene , Polderman Anton M. 
Published: April 2004

SummaryHigh prevalences of intestinal amoebiasis are commonly reported by microscopy in Ethiopia. In order to confirm the actual occurrence of Entamoeba histolytica we collected 108 stool specimens from different hospitals & health centers from patients in whom haematophagous trophozoites were believed to be found. We detected only a single E. histolytica case while 77 (71.3%) were E. dispar and the remaining 30 samples were negative for both species by real‐time PCR based on the small subunit ribosomal RNA gene sequence of E. histolytica and E. dispar. The tradition of microscopy in a routine diagnostic set‐up appears unsatisfactory to reliably differentiate rbc‐engulfing amoeba from non‐invasive amoeba in wet smears.
Maternal perceptions of acute respiratory infections in children under 5 in rural South Africa
Authors: Kauchali Shuaib , Rollins Nigel , Bland Ruth , Van den Broeck Jan ,   on behalf of the Child Health Group
Published: April 2004

SummaryObjectives  To assess maternal ability to recognize respiratory distress and to identify local beliefs and practices around respiratory infections in rural KwaZulu/Natal, South Africa.Methods  A descriptive study: 15 knowledgeable mothers were shown a video of 10 children with respiratory distress and four normal children. Mothers were asked to describe perceived types, signs, symptoms, causes of and actions taken for each child. Sensitivity and specificity were calculated for maternal recognition of respiratory distress (chest indrawing, fast breathing) shown on the video. A focus group discussion with six mothers was held to corroborate and refine individually reported local concepts.Findings  Maternal recognition of respiratory distress was good (sensitivity 91.3%, 95% CI: 86.8–95.8%; specificity 95%, 95%CI: 89.5–100%), with little variation between mothers (kappa = 0.704). Mothers described 12 ‘local types of respiratory illness’, each with its own name and its own well‐defined set of signs and symptoms. They were classifiable into five causative categories: supernatural, natural, tuberculosis, cold weather and unknown, indicating that perceptions of causation differed greatly from biomedical concepts. For illnesses of perceived supernatural causation, mothers were reluctant to seek medical care and antibiotics were deemed inappropriate. Traditional remedies were preferred instead.Conclusion  Knowledge of local vocabulary and concepts about respiratory infections is essential to design strategies for health care workers to communicate with mothers about respiratory disease, so that mothers will seek timely medical care, provide continued safe, supportive home care and comply with antibiotic treatment.
Relationship between age, molecular markers, and response to sulphadoxine–pyrimethamine treatment in Kampala, Uganda
Authors: Staedke Sarah G. , Sendagire Hakim , Lamola Steven , Kamya Moses R. , Dorsey Grant , Rosenthal Philip J. 
Published: April 2004

SummarySulphadoxine/pyrimethamine (SP) has become the first‐line treatment of uncomplicated malaria in a number of African countries. Molecular surveillance of resistance‐mediating mutations in Plasmodium falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) has been proposed as a means of predicting SP treatment outcomes, but optimal methods of surveillance in different populations have not been well established. To investigate the relationship between molecular markers of SP resistance, host immunity, and response to therapy, we evaluated the association between the presence of five key dhfr and dhps mutations at enrollment and clinical outcome in children and adults treated with SP for uncomplicated malaria in Kampala, Uganda. Clinical treatment failure was 11% at 14 days, increasing to 30% at 28 days, after excluding new infections. Outcomes varied markedly based on the number of dhfr and dhps mutations and on the age of treated subjects. All infections with less than two dhfr/dhps mutations were successfully treated. Treatment failure associated with any two, three, or four dhfr/dhps mutations occurred in nine of 24 (38%) children up to 5 years, but not in older patients (0/20). In the presence of all five mutations, treatment failure occurred equally in children aged 5 years or younger [7/16 (44%)] and in older patients [8/16 (50%)]. Our results showed that age, a surrogate marker of antimalarial immunity, had a major impact on the relationship between polymorphisms in SP target enzymes and treatment outcomes. The use of molecular markers of SP resistance to predict treatment failure rates should take age into account.
Implementation of intermittent preventive treatment with sulphadoxine–pyrimethamine for control of malaria in pregnancy in Kisumu, western Kenya
Authors: van Eijk Anna M. , Ayisi John G. , ter Kuile Feiko O. , Slutsker L. , Otieno Juliana A. , Misore Ambrose O. , Odondi J. O. , Rosen Daniel H. , Kager Piet A. , Steketee Rick W. , Nahlen Bernard L. 
Published: April 2004

SummaryObjective In 1998, the Kenyan Ministry of Health introduced intermittent preventive treatment (IPT) with sulphadoxine–pyrimethamine (SP), one treatment dose in the second trimester (16–27 weeks) and one treatment dose between 28 and 34 weeks of gestational age, for the control of malaria in pregnancy. We evaluated the coverage and determinants of receipt of IPT after its introduction in the Provincial Hospital in Kisumu, western Kenya.Methods Information on the use of IPT in pregnancy was collected from women who attended the antenatal clinic (ANC) and delivered in the same hospital. In exit interviews, we assessed patterns of IPT use in the ANC.Results Of 1498 women who delivered between June 1999 and June 2000, 23.7%, 43.4% and 32.9% received ≥2, 1 or no dose of SP, respectively. Late first ANC attendance was the most important factor contributing to incomplete IPT; 45% of the women started attending ANC in the third trimester. More women received at least one tetanus toxoid immunization than at least one dose of IPT (94%vs. 67%, P < 0.05). In exit interviews, 74% correctly associated IPT with treatment of malaria; however, knowledge on the need for the second dose was poor. Three per cent of the administrations were given despite contraindications. The agreement between gestational age by date of last menstrual period and by palpation was low (κ = 0.1).Conclusions Education of pregnant women and ANC staff to increase earlier attendance for ANC has the potential to substantially increase the proportion of women receiving two doses of IPT with SP.