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PubMed1999

Postoperative hypotension after carotid angioplasty and stenting: report of three cases

OBJECTIVE AND IMPORTANCE: Hemodynamic instability after carotid angioplasty and stenting is not well recognized. We report three patients who developed sustained hypotension in the postoperative period after successful carotid angioplasty and stent placement for internal carotid artery stenosis in the carotid sinus region. CLINICAL PRESENTATION: In two patients, hypotension was initially induced by inflation of the angioplasty balloon. The third patient developed hypotension after completion of the procedure. In all cases, the hypotension persisted for 18 to 33 hours after the procedure. During the postoperative period, two of these patients also developed sinus bradycardia, which, in one patient, was further complicated by a third-degree atrioventricular block. INTERVENTION: The hypotension was successfully treated by intravenous vasopressors or inotropic agents. No permanent neurological or cardiac sequelae were observed. CONCLUSION: Sustained hypotension with or without bradycardia may develop after carotid angioplasty and stent placement, presumably as a result of carotid sinus dysfunction. During the postoperative period, patients should be monitored in settings suited to expeditious management of cardiovascular emergencies.

Journal Article↗
PubMed2026

Sustainable dietary recommendations for the Spanish population.

BACKGROUND/OBJECTIVES: The 2030 Agenda for Sustainable Development highlights the urgent need for a profound transformation in food production and consumption to enhance both sustainability and human health. The aim of this study is to provide both the general population and food system stakeholders with the most comprehensive and current information available on healthy and sustainable dietary patterns, in the form of culturally adapted food-based guidelines. METHODS: We performed a systematic review of the scientific evidence published since 2019 on the association between main food groups consumption and the risk of developing chronic diseases and premature mortality to update the information provided by the Dietary Guidelines for Americans 2020-2025, which summarized previous evidence. With this information, we updated the servings recommended in the former dietary guidelines for Spain. Then, we considered the recommendations of the EAT-Lancet Commission for healthy diets within planetary boundaries, specific dietary habits and food production in Spain, and adjusted the servings per each group to consider these characteristics. RESULTS: A minimum intake of 5 servings of vegetables and fruits per day is recommended, which may be distributed in at least 3 servings of vegetables per day, and 2-3 servings of fruits per day. Cereal consumption is set at 3-6 servings per day, adjusted to individual energy needs and prioritizing whole grains, no more than 4 servings per day are advised in cases of caloric restriction. Plant-based foods are recommended as the primary protein source, with legumes incorporated into at least one main daily meal and consumed at a frequency of at least 4 servings per week, ideally up to daily. Nut consumption should reach at least 3 servings per week, up to one serving per day, choosing those without added salt, fats or sugar. The remaining protein portions may include fish (≥3 servings/week, prioritizing oily fish and low-impact species), eggs (up to 4/week), dairy (up to 3/day, with low-sugar and low-salt options), and meat (up to 3/week, emphasizing poultry and rabbit, and minimizing processed meats). Daily consumption of olive oil at main meals is recommended. CONCLUSIONS: The proposed Sustainable Dietary Recommendations can help improve the health and well-being of the Spanish population, while reducing the environmental impact.

Humans↗
PubMed1991

Acute hypokalemia and inducibility of ventricular tachyarrhythmia in a nonischemic canine model.

Inducibility of sustained ventricular tachycardia (VT) and ventricular fibrillation (VF) by programmed ventricular stimulation following acute hypokalemia was studied in 21 anesthetized dogs free of inducible ventricular tachyarrhythmias at baseline. The control mean serum potassium concentration of 3.65 mEq/L was decreased to 2.14 mEq/L by insulin and furosemide administration. Inducibility of arrhythmias was also assessed following isoproterenol infusion before and after induction of hypokalemia. None of the animals developed sustained VT. Only one animal developed VF following hypokalemia (p greater than 0.05). Two normokalemic animals and five hypokalemic animals developed VF following isoproterenol infusion; this difference was not significant (p greater than 0.05). In this study, hypokalemia did not predispose to the development of a substrate necessary for the genesis and maintenance of VT. The inducibility of VF following hypokalemia was not significantly enhanced and appears to be related to the "aggressive" stimulation protocol.

Acute Disease↗
PubMedDate not supplied

Health care in Africa--which way?

This article gives a personal view of the health situation in a typical country in the South. Uganda is a country which is well endowed with natural resources, as are many countries in the South, but is plagued by poverty, conflict, endemic infectious diseases and, more recently, disease due to HIV. The article argues for an integrated solution to appropriate health care, proposing that good health results from sustainable development. It focuses on constraints to development such as conflict, militarization, environmental degradation, lack of community action, and inappropriate policies by both developing world governments and members of the international arena. All of these play a role in the achievement of sustainable equity world-wide.

Adolescent↗
PubMed2003

The way ahead--the new technology in an old society.

Biotechnology is one of the most important scientific and technological revolutions of the last century and has greatly benefited various aspects of human life. The potentials are enormous and many breakthroughs have already been achieved in the area of healthcare, food, agricultural products and environmental production. The developments in this important area provide immediate benefits to mankind and offer environmentally friendly technologies for sustainable development. The Department of Biotechnology, Government of India, set up in 1986, has played an important catalytic role in promoting this revolutionary field. Research and development, technology validation and demonstration, technology transfer, human resource development, setting up of Centers of Excellence and promoting industry-academia interactions have been some of the major achievements during the last 15 years. A unique feature of this Department is the strong interaction with scientists and institutes across the country to promote biotechnology research and development efforts for commercialization and also to benefit the rural population for socio-economic development. A large number of research institutes/universities and organizations across the country have been supported in the areas of agriculture, healthcare, environment and industry. In addition, basic research has also been an important thrust area. In order to ensure that the benefits of biotechnology reach the masses at large, a very stringent biosafety mechanism has been adopted. India is a country rich in biodiversity with two hot spots and has a strong base of expertise available in nearly all fields--thus biotechnology could flourish leading to a Bioindustrial Revolution. We are today poised to be the leaders in this field in the 21st Century.

Agriculture↗
PubMed2006

Inhaled corticosteroid prevents the thickening of airway smooth muscle in murine model of chronic asthma.

Airway smooth muscle growth contributes to the mechanism of airway hyperresponsiveness (AHR) in asthma. Although current steroid use demonstrates anti-inflammatory activity, there is little reported on the action of corticosteroid on smooth muscle of the asthmatic airway. The present study investigated the effect of inhaled corticosteroid on the thickening of airway smooth muscle in bronchial asthma. We developed a mouse model of airway remodeling including smooth muscle thickening in which ovalbumin (OVA)-sensitized female BALB/c-mice were repeatedly exposed to intranasal OVA administration twice a week for 3 months. Mice were treated intranasally with fluticasone during the OVA challenge. Mice chronically exposed to OVA developed sustained eosinophilic airway inflammation compared with control mice. In addition, the mice chronically exposed to OVA developed features of airway remodeling, including thickening of the peribronchial smooth muscle layer. Intranasal administration of fluticasone inhibited the development of eosinophilic inflammation, and importantly, thickening of the smooth muscle layer. Moreover, intranasal fluticasone treatment reduced the transforming growth factor (TGF)-beta 1 level in bronchoalveolar lavage fluid and regulated active TGF-beta 1 signaling with a reduction in the expression of phospho-Smad2/3 and the concomitant up-regulation of Smad7 in lung tissue sections. These results suggest that intranasal administration of fluticasone can modulate the remodeling of airway smooth muscle via regulation of TGF-beta 1 production and active TGF-beta 1 signaling.

Administration, Intranasal↗
PubMed1992

Potential markers of heavy training in highly trained distance runners.

Markers of a heavy increase in training were examined in ten highly trained distance runners (mean(s.d.) age 29.8(1.7) years, maximal oxygen intake 65.3 ml kg-1 min-1, personal best 10-km time 31 min 4 s) who undertook a deliberate 38% increment of training over a 3-week period. Their running performance did not improve, and six of the ten subjects developed sustained fatigue, suggesting that training was excessive, although the full clinical picture of overtraining did not develop. The Profile of Mood States was the best single marker of disturbed function, indicating increased fatigue and decreased vigour. There were no useful changes of resting heart rate or perceived exertion during submaximal running, sleep was undisturbed, and there were no orthopaedic injuries. Two subjects developed rhinoviral infections following the heavy training, and a third complained of symptoms that were diagnosed 2 weeks later as exercise-induced asthma. The increase of serum cortisol normally induced by 30 min of submaximal exercise was no longer seen when the same acute exercise was performed after heavy training. Resting lymphocyte proliferation tended to increase in response to phytohaematoglutinin (PHA) and concanavalin A (Con A), the ratio of helper to suppressor cells (H/S) decreased, and pokeweed mitogen induced smaller increases in IgG and IgM synthesis. Whereas before heavy training, PHA-stimulated lymphocyte proliferation was unchanged by 30 min of acute submaximal exercise, after 3 weeks of heavy training the same bout of exercise caused an 18% suppression of proliferation. Likewise, heavy training brought about a decrease of T-lymphocytes in response to acute submaximal exercise, but an abolition of the acute exercise-induced decrease in the H/S ratio. The previously observed exercise-induced decrease of IgG synthesis did not occur when the same acute bout of exercise was performed after heavy training. We conclude that such minor and transient changes of immune function may possibly be a warning that training is becoming excessive, but they have only a limited significance for overall immune function.

Adult↗
PubMed2003

Immunostimulatory DNA inhibits transforming growth factor-beta expression and airway remodeling.

Immunostimulatory sequences of DNA (ISS) inhibit eosinophilic airway inflammation, Th2 responses, and airway hyperreactivity (AHR) in mouse models of acute ovalbumin (OVA)-induced airway inflammation. To determine whether ISS inhibits airway remodeling, we developed a mouse model of airway remodeling in which OVA-sensitized mice were repeatedly exposed to intranasal OVA administration for 1-6 mo. Mice chronically exposed to OVA developed sustained eosinophilic airway inflammation and sustained AHR to methacholine compared with control mice. In addition, the mice chronically exposed to OVA developed features of airway remodeling, including thickening of the peribronchial smooth muscle layer, peribronchial myofibroblast accumulation, expression of the profibrotic growth factor transforming growth factor-beta, and subepithelial collagen deposition (assessed by quantitation of the area of peribronchial trichrome staining using image analysis, and immunostaining with anti-collagen V antibodies). Administration of ISS systemically every other week significantly inhibited the development of AHR, eosinophilic inflammation, airway mucus production, and importantly, airway remodeling in mice chronically exposed to OVA for 3-6 mo. In addition, ISS significantly reduced bronchoalveolar lavage and lung levels of the profibrotic cytokine transforming growth factor-beta. These studies demonstrate that ISS prevents not only Th2-mediated airway inflammation in response to acute allergen challenge, but also airway remodeling associated with chronic allergen challenge.

Animals↗
PubMed1999

How much global ill health is attributable to environmental factors?

Over the years, estimates have been made of the portions of human mortality and morbidity that can be attributed to environmental factors. Frustratingly, however, even for a single category of disease such as cancer, these estimates have often varied widely. Here we attempt to explain why such efforts have come to such different results in the past and to provide guidance for doing such estimates more consistently in the future to avoid the most important pitfalls. We do so by carefully defining what we mean by the terms "environmental," "ill health," and "attributable." Finally, based on these recommendations, we attempt our own estimate, appropriately qualified according to the many remaining uncertainties. Our estimate is that 25-33% of the global burden of disease can be attributed to environmental risk factors. Children under 5 years of age seem to bear the largest environmental burden, and the portion of disease due to environmental risks seems to decrease with economic development. A summary of these estimates first appeared in the 1997 report, "Health and Environment in Sustainable Development," which was the World Health Organization's contribution to the 5-year anniversary of the Rio Earth Summit. A full explanation of how these estimates were made is first presented here. We end with a call for a program of "strategic epidemiology," which would be designed to fill important gaps in the understanding of major environmental health risks in important population groups worldwide.

Causality↗
PubMed2001

Spermine mediates inward rectification in potassium channels of turtle retinal Müller cells.

Retinal Müller cells are highly permeable to potassium as a consequence of their intrinsic membrane properties. Therefore these cells are able to play an important role in maintaining potassium homeostasis in the vertebrate retina during light-induced neuronal activity. Polyamines and other factors present in Müller cells have the potential to modulate the rectifying properties of potassium channels and alter the Müller cells capacity to siphon potassium from the extracellular space. In this study, the properties of potassium currents in turtle Müller cells were investigated using whole cell voltage-clamp recordings from isolated cells. Overall, the currents were inwardly rectifying. Depolarization elicited an outward current characterized by a fast transient that slowly recovered to a steady level along a double exponential time course. On hyperpolarization the evoked inward current was characterized by an instantaneous onset (or step) followed by a slowly developing sustained inward current. The kinetics of the time-dependent components (block of the transient outward current and slowly developing inward current) were dependent on holding potential and changes in the intracellular levels of magnesium ions and polyamines. In contrast, the instantaneous inward and the sustained outward currents were ohmic in character and remained relatively unaltered with changes in holding potential and concentration of applied spermine (0.5--2 mM). Our data suggest that cellular regulation in vivo of polyamine levels can differentially alter specific aspects of potassium siphoning by Müller cells in the turtle retina by modulating potassium channel function.

Animals↗
PubMedDate not supplied

Procainamide induced sustained monomorphic ventricular tachycardia in a patient with benign premature ventricular complexes.

A 59-year old female with history of benign ventricular ectopy who developed sustained monomorphic ventricular tachycardia (VT) during therapy with procainamide is reported. The tachycardia occurred 24 hours after institution of procainamide without any other evidence of drug toxicity or QT prolongation. When procainamide was withheld, VT resolved completely and no arrhythmia could be induced by programmed ventricular stimulation. When the patient was rechallenged with procainamide at therapeutic level, sustained monomorphic VT was initiated reproducibly by programmed ventricular stimulation. Without antiarrhythmic therapy, patient has been asymptomatic and free of recurrent VT after a follow-up of 9 months. This case: Demonstrates that procainamide may cause the first emergence of sustained monomorphic VT in a patient with no previous history of VT; and Emphasizes the utility of programmed ventricular stimulation in providing direct evidence for drug mediated exacerbation of the ventricular arrhythmia.

Bundle-Branch Block↗
PubMed1997

International HIV and AIDS prevention: Japan/United States collaboration.

As the epicenter of the HIV/AIDS pandemic shifts from Africa to Asia, Japan is becoming ever more aware of the importance of containing and preventing spread of the virus. International collaboration, particularly with the United States, is a logical approach because it allows utilization of expertise from countries in other stages of the pandemic, can prevent duplication of efforts, and complements efforts of the other countries. Further, both Japan and the United States can use their combined influence and prestige to encourage cooperation among all nations. In 1994, Japan established the Global Issues Initiative to extend cooperation to developing countries in the areas of population and AIDS control. It has disbursed more than $460 million (U.S.$) to promote active cooperation and stimulate international attention to the importance of addressing these health issues. Japan has established four main programs for international collaboration for control of HIV and AIDS, three operated by ministries and one by a Japanese nongovernmental organization. Japanese/United States collaboration is developing through the United States/Japan Cooperative Medical Sciences Program, the Common Agenda for Cooperation in Global Perspective, the Paris Summit, and the United Nations Joint Programme on AIDS. It is critical that Japan and the United States, as the two largest donors to international development, demonstrate, through their collaboration, ways to maximize the use of limited resources, reduce duplication, and promote sustainable development programs in which HIV prevention and AIDS care programs are systemically integrated.

Acquired Immunodeficiency Syndrome↗
PubMed2004

[Challenges facing Caribbean countries 10 years after the International Conference on Population and Development in Cairo, Egypt].

At the International Conference on Population and Development (ICPD) that was held in Cairo, Egypt, in 1994, participants acknowledged that population, economic growth, and sustainable development are concepts that are closely linked, and important strides were made in terms of increased recognition of sexual and reproductive rights. The Programme of Action ratified at that Conference was adopted as a platform for designing national and international policies in the areas of population and development for a period of twenty years. However, in Latin America and the Caribbean all types of obstacles-financial, institutional, and human-still stand in the way of attaining the goals of the Programme of Action, and some governments have established measures that undermine their people's exercise of sexual and reproductive rights. The Caribbean Subregional Meeting to Assess the Implementation of the Programme of Action of the International Conference on Population and Development 10 Years after its Adoption was held in Port of Spain, Trinidad and Tobago, in November of 2003. At the meeting, which was attended by representatives from 20 Caribbean countries and territories, a call was made for more rational use of available resources and for mobilization of additional funds for developing and implementing population and development programs and policies in the Caribbean. The meeting also saw the approval of the Caribbean Declaration, which lays out the challenges that should serve as the roadmap for taking actions to consolidate the progress achieved so far and come closer to attaining the goals established by the ICPD. In the Declaration, the countries and territories of the Caribbean asserted their commitment to continue legislative reforms at the national level while seeking to enforce these reforms in an effort to ensure implementation of the ICPD's Programme of Action and of the Caribbean Plan of Action for Population and Development that was adopted in 1996 by the Economic Community for Latin America and the Caribbean.

Caribbean Region↗
PubMed2000

Shrimp culture in Thailand: environmental impacts and social responses.

Black tiger shrimp (Penaeus monodon) is a major aquaculture commodity among Southeast Asian producers and remains a popular food export world-wide. Food brokers in Japan and the United States purchase huge quantities of these farmed shrimp and return significant foreign exchange earnings to developing nations like Thailand, a major producer and exporter since the early 1990s. However, coastal areas cannot sustain intensive shrimp farm production and local growers often end up in debt. Can the needs of farm communities around the world be suitably met when they join into a corporate-managed and export-oriented food system? What are the sustainable benefits and eventual costs to susceptible localities? The shrimp industry in Thailand reveals the difficult terrain to cross and powerful obstacles to overcome if authentic sustainable development is to be realized.

Journal Article↗
PubMed2002

[Basic theory and research method of urban forest ecology].

With the development of world economy and the increment of urban population, the urban environment problem hinders the urban sustainable development. Now, more and more people realized the importance of urban forests in improving the quality of urban ecology. Therefore, a new subject, urban forest ecology, and correlative new concept frame in the field formed. The theoretic foundation of urban forest ecology derived from the mutual combination of theory relating to forest ecology, landscape ecology, landscape architecture ecology and anthrop-ecology. People survey the development of city from the view of ecosystem, and regard the environment, a colony of human, animals and plants, as main factors of the system. The paper introduces systematically the urban forest ecology as follows: 1) the basic concept of urban forest ecology; 2) the meaning of urban forest ecology; 3) the basic principle and theoretic base of urban forest ecology; 4) the research method of urban forest ecology; 5) the developmental expectation of urban forest ecology.

City Planning↗
PubMed2003

[On planning methods of sustainable eco-environmental management in mining areas].

Studies on the theory and methodology of ecological planning could provide material guide and technical support for sustainable development in mining areas. As one of the most important section of ecological planning in mining areas, sustainable eco-environmental managing planning run through the whole producing course. On the basis of sustainable eco-environmental construction and management, the framework of eco-environmental management system of mining areas was established in this paper. The material methods for confirming the indexes of eco-environmental management, recognizing the factory of eco-environment and making the decision of eco-environmental managing project were also provided.

Ecology↗
PubMed1993

Sustained indomethacin and ranitidine with intermittent continuous infusion interleukin-2 in advanced malignant melanoma: a phase II study.

Experimental work has shown that, during the development of tumours, host macrophages are triggered to produce high levels of prostaglandin E2 which inactivates natural killer cells and suppresses lymphokine activated killer cell development. Sustained, uninterrupted indomethacin treatment, when combined with interleukin-2 (IL-2), can totally eradicate experimental metastases. Most trials utilizing high dose IL-2 employ indomethacin and ranitidine in order to alleviate or prevent IL-2 toxicity, but only administer these medications concurrently with IL-2 therapy. A Phase II trial was conducted in patients with advanced melanoma. Patients received 50-75 mg indomethacin three times daily and 150 mg ranitidine twice daily, starting at least 1 week prior to IL-2 and continuing until intolerance or disease progression. Continuous venous infusion IL-2 was administered for three courses, each consisting of 5 days of treatment at 18 x 10(6) iu/m2/day for the first course with escalation of dose for the subsequent courses if toxicity allowed. Twenty-one patients were eligible to receive all components of therapy. Three patients achieved an objective response (one complete and two partial), giving a response rate of 14%. However, two of these objective responses (one complete and one partial) were achieved on indomethacin and ranitidine alone, prior to the commencement of IL-2 therapy. In this study, indomethacin and ranitidine, without IL-2, have been shown to have antitumour activity in advanced melanoma; continuous infusion IL-2 appeared to add little to the response seen with these two agents.

Adult↗
PubMed2003

Industrial applications using BASF eco-efficiency analysis: perspectives on green engineering principles.

Life without chemicals would be inconceivable, but the potential risks and impacts to the environment associated with chemical production and chemical products are viewed critically. Eco-efficiency analysis considers the economic and life cycle environmental effects of a product or process, giving these equal weighting. The major elements of the environmental assessment include primary energy use, raw materials utilization, emissions to all media, toxicity, safety risk, and land use. The relevance of each environmental category and also for the economic versus the environmental impacts is evaluated using national emissions and economic data. The eco-efficiency analysis method of BASF is briefly presented, and results from three applications to chemical processes and products are summarized. Through these applications, the eco-efficiency analyses mostly confirm the 12 Principles listed in Anastas and Zimmerman (Environ. Sci. Technol. 2003, 37(5), 94A), with the exception that, in one application, production systems based on bio-based feedstocks were not the most eco-efficient as compared to those based on fossil resources. Over 180 eco-efficiency analyses have been conducted at BASF, and their results have been used to support strategic decision-making, marketing, research and development, and communication with external parties. Eco-efficiency analysis, as one important strategy and success factor in sustainable development, will continue to be a very strong operational tool at BASF.

Chemical Industry↗