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PubMed1994

[Role of malnutrition on immunity].

Although the relationship between starvation and reduced resistance to infection has been suggested by historical accounts of famines and pestilence and by recent epidemiologic studies, the concept of nutritional deficiency causing impairment of immunocompetence is relatively recent. In PEM (protein-energy malnutrition), most of the host defence mechanisms are breached, especially manifested in reduced cell-mediated immunity. One plausible reason is the reduction in mature fully differentiated T lymphocytes. Recent immunological methods made it possible to analyze its precise mechanism and process in detail. Naturally occurring states of malnutrition are difficult to interpret largely because deficiencies usually involve multiple dietary factors. It is obvious that single nutrients can only be analyzed in defined and controlled animal experiments. Role of micronutrients such as zinc, iron, and vitamins, specific amino acids such as arginine, glutamine, and fat on immunological responses have been paid attention on their specific actions and some of them have been investigated in humans as well.

Antibody Formation↗
PubMed1976

Nutritional situation in the world.

The paper describes the international nutrition problem, with references to previous crisis in the world. It is stated that the present situation cannot be compared to the historical famines in the past. The causes and magnitude of the problem are quite different. The information available on the nutritional situation in the world at present is scanty, erratic and contradictory. The criteria used for such evaluation is not uniform, and this is the reason of the differences in the estimation of the magnitude of the problem. According to the analysis of 101 surveys conducted in 59 developing countries during the last 10 years, in which more than 260,000 children below 5 years were examined the percentage of cases of severe forms of malnutrition was of 2.3% and of moderate forms of 18.8%. However there are some areas where severe forms represent 10 or 20% of children examined. Taking only the most representative surveys (25 out of 59) a rough estimation of the total number of malnoursihed children in developing countries gives the figure of 10 millions of severe forms and 90 millions of moderate forms. The paper makes references to mortality trends in developing countries compared with the trends observed in developed countries. It is the view of the author that the recent dramatic decline on mortality in developing countries is due more to public health action, particularly the existence of new drugs, than to any significant improvement in the standard of living, including nutrition. A distinction is made on the differences between the biological needs of nutrients and the social satisfaction produced by food intake. In fact the biological needs are much less than the average consumption of the affluent society. It is suggested that in order to raise the standards of nutrition in developing countries it would perhaps be necessary to moderate the excessive consumption among other things, of proteins of animal origin in developed countries. Finally the author strongly recommend to intensify the action on nutrition at international, national and family level.

Africa↗
PubMed1993

Trends in demographic change.

The paper reviews changes in fertility and mortality in Asia, Africa and Latin America which have taken place during the last 40 years. In the Far East and in Latin America dramatic falls in fertility have occurred, but in the Indian sub-continent reductions in birth rates have been much more sluggish, while in sub-Saharan Africa the evidence suggests that fertility was rising rather than falling, though a few countries, notably Kenya, Zimbabwe, Botswana, Swaziland and Senegal, now appear to have turned the corner. Despite famines and other disasters in Africa and elsewhere, there is as yet no evidence that mortality has risen in any countries of the 'Third World'; indeed both child and adult mortality have continued to decline--a trend which is attributed to the expansion of primary health care, improved education, and better understanding of how to keep children alive.

Africa↗
PubMed1993

Disease threats in Somalia.

During this time of war and famine in Somalia, disease threats are encyclopedic both for Somalis and visitors. Malnutrition will amplify the magnitude and severity of endemic tropical infectious diseases. Necessary crowding around life-saving food distribution centers could turn focal infectious disease outbreaks into large epidemics.

Diarrhea↗
PubMed1995

A critical review of a personal series of 1000 gastroplasties.

INTRODUCTION: In a world suffering from famine, it is paradoxical to find in Belgium and in most Western countries a marked tendency to obesity. A recent study has revealed that one Belgian out of five is overweight. The literature has provided evidence that behaviour modification or dietary therapy do not result in long term weight loss for severe obese. As a result, more and more obese people are treated by surgery and we present here our personal experience of bariatric surgery during the last eight years. All the surgical procedures have been performed by a single surgeon as part of a multidisciplinary approach that also involves internists, dieticians, psychiatrists and basic scientists.

Adolescent↗
PubMed1995

Afghanistan tragedy: public health and human suffering.

Dedicated to two young volunteers killed in a landmine clearing accident, this story of Afghanistan is just one among thousands of others that never leave its borders. To understand Afghanistan is to come to terms with the religious, racial and cultural faultlines that divide it. A 3 month medical placement provided insights rather than answers. An indomitable people through famine, war, firce winters and foreign intrusion, the Afghanis are set to continue their struggle into succeeding generations.

Afghanistan↗
PubMed1996

The indirect association of lactation with subsequent perimenopausal body weight.

OBJECTIVE: We aimed to estimate the relationship of prior breastfeeding to perimenopausal body mass index (BMI) (kg/m2). While most long-term studies of women's body weight after reproductive experience have found a negative relationship between lactation and body weight, most short-term studies found either no impact of lactation on body weight, or decelerated postpartum weight loss among breastfeeding women. DESIGN: We performed a retrospective cohort study. SETTING: The study was done in The Netherlands between 1987 and 1990. SUBJECTS: The 1067 singleton females who were born around the time of the Dutch famine (1 August 1944 through 15 April 1946) at The University of Amsterdam Teaching Hospital were all traced and accounted for. This analysis refers to the 671 who were interviewed and for whom all data elements were available. ANALYSIS: We related parity and number of children breastfed at least 1 week to BMI at age 45 and at the time of marriage, both calculated from respondents: recall of weight and height, by linear multiple regression analysis, adjusting for potentially confounding variables. RESULTS: Among parous women, each additional live birth was associated with a BMI increase of 0.69 kg/m2 (CI = 0.24 to 1.13, P = 0.003), and for each additional child breastfed, the BMI was lower by 0.41 kg m2 (CI = -0.77 to -0.04, P = 0.03) at age 45. However, BMI before any reproductive experience was 0.39 kg/m2 greater (CI = 0.08 to 0.71, P = 0.01) with each additional subsequent birth, and for each additional infant breastfed, 0.34 kg/m2 lower (CI = - 0.60 to - 0.09, P = 0.008). CONCLUSIONS: The negative relationship of prior breastfeeding to perimenopausal weight was probably not causally related to breastfeeding, since the relationship was present before any reproductive experience. The results could also arisen in part because of biased recall of weight; however, the relationship of parity to perimenopausal BMI was far less attenuated by adjusting for prior BMI than was the association with breastfeeding, lending support to an indirect association of breast- feeding with later BMI.

Bias↗
PubMed1996

[Changes in eating habits and disease symptoms in the 16th and 17th centuries].

The Renaissance period in Europe saw many dietary changes due to imports of new ingredients from the Far East as well as from newly discovered Central and South America. Maize and potatoes rapidly conquered European markets and because of their easier cultivation and higher calorie content, displaced grains such as wheat and rye. Drinking habits too changed, when tea, coffee and chocolate were introduced, first as strengthening medicines, later as 'delicatessen' in the aristocratic British and French cafés. These new foods and beverages may have helped diminish the periods of famine typical of Medieval and Early Renaissance times. In the 16th and 17th century, new diseases were described that were directly related to dietary intake. Ergotism and scurvy, particularly, sometimes decimated whole populations in rural areas or at sea. It was not until the 18th century that scientific research elucidated the cause of such diseases and helped us to understand the importance of a balanced diet.

Beverages↗
PubMed1996

Early nutritional origins of hypertension: a hypothesis still lacking support.

PURPOSE: It has been hypothesized that limitations in 'a baby's nourishment before birth', as reflected in reductions in birthweight and other newborn anthropometric measurements, are associated with subsequent elevations in blood pressure. We assess this hypothesis in light of four causal criteria commonly used by epidemiologists: specificity, consistency, strength and biological coherence. We also examine aspects of the methodology used in studies of this hypothesis. METHODOLOGIC PROBLEMS: Two major data sources for testing the hypothesis in Hertfordshire and Preston are flawed by very high attrition. The practice of testing this hypothesis by controlling for adult weight in the analysis overstates the benefit that might accrue from interventions to increase birthweight. CAUSAL CRITERIA: Studies used to support the hypothesis examine a wide variety of exposures and outcomes, without prespecification of which associations are expected. The inverse relationship of birthweight to blood pressure is found inconsistently and, when present, is not strong. Potential confounding variables, especially social class, have not generally been taken into account. Evidence from human nutrition studies, especially of famine exposure and pregnancy nutrition supplementation, are not supportive of the proposition that in industrialized countries variations in the birthweight of the population closely reflect pregnancy nutrition. CONCLUSION: When examined critically, the evidence thus far provided does not support the hypothesis that prenatal nutrition is a major determinant of adult blood pressure.

Fetus↗
PubMed1997

The development of a MUAC-for-height reference, including a comparison to other nutritional status screening indicators.

Mid-upper-arm circumference (MUAC) based on a single cut-off value for all the children less than 5 years of age has been used for many years as an alternative nutritional status index for children during famines or refugee crises, and as an additional screening tool in nonemergencies. However, it has recently been questioned whether MUAC is age- and sex-independent. After reviewing the scientific evidence underlying the use and interpretation of MUAC, a WHO Expert Committee recommended a new MUAC-for-age reference for under-5-year-olds. In some settings, however, it is difficult to assess a child's age and in such circumstances MUAC-for-height may be a good alternative. The height-based QUAC stick is a simple means of adjusting MUAC cut-offs according to height, and the MUAC-for-height reference and the construction and use of the QUAC stick are described in this article. Described also is the use of the receiver operating characteristic (ROC) curve method to evaluate the performance of MUAC, MUAC-for-age, and MUAC-for-height in screening malnourished children.

Age Factors↗
PubMed1998

Uses of mushrooms by Finns and Karelians.

Finns have adopted two traditions of mushroom use: one, the old Roman tradition, came through France and Sweden to the educated, mostly Swedish speaking people of southwest Finland; the other came from the east via Karelia and was adopted by ordinary country folk. This eastern tradition is still maintained among the Karelinas living in Tver government in Russia. Even the use of Amanita muscaria for killing flies is still utilized there. The western tradition favoured chanterelles and Boletus edulis, the eastern acrid milk caps, the Lactarius species. During the famines in the 1860's and after the World War II the government authorities tried to promote the use of wild mushrooms, but the real impulse to a more versatile mushroom use was initiated after the war when 400,000 evacuees from that part of Karelia conquered by the Soviet Union were resettled among farming families all over Finland. In 1969 the National Board of Forestry began to train mushroom advisors, a programme which still continues. In 1981 Finland passed a statute on edible mushrooms and drew up a list of commercial species. Even today the largest percentage of marketed mushrooms comes from Eastern Finland and the Lactarius tivialis species sells best. Gyromitra esculenta, the false morel is considered a delicacy. Today picking mushrooms is a passionate hobby for many Finns.

Basidiomycota↗
PubMed1998

The dentition of Abraham's people. Why Abraham left Mesopotamia.

Ancient Mesopotamia (southern Iraq) in 2000 B.C. was the home of the biblical figure Abraham and his people. An analysis of skeletal material from cemeteries in the ancient cities of Ur (birthplace of Abraham) and Kish shows a homogeneous, short-lived population that suffered severe dental attrition (95 percent of inhabitants), periodontal disease (42 percent) and caries (two percent). Many oral congenital and neoplastic lesions were noted Skeletal (dental) evidence indicates the population suffered from extensive disease and nutritional deficiency. Of special note was a possible case of endodontic treatment. The people of Abraham had modern dentition but relatively poor dental health. It is probable that Abraham, if in truth he existed, left Mesopotamia because of the threat of famine, as evidenced by biblical record, geologic strata and dental analysis.

Adult↗
PubMed1998

Diseases in European historical populations and their effects on individuals and society.

Traditionally, populations are considered "historical" when first written evidences appear. Cultural development with all it's features--agricultural innovations and as a consequence--population growth, social specialisation and stratification, and finally--urbanisation trigger new environmental conditions, among them also in epidemiological situation, that have the feedback effects on the population and the individual. At this time only qualitative evaluations on many of questions can be presented. This paper is an attempt to synthesize available data on the following specific topics related to Medieval/Early Modern European population welfare: nutritional intake, malnutrition and famine; great epidemics and their consequences; spreading of specific infectious diseases (tuberculosis, syphilis, leprosy), which also had a great social resonance in those times, professional diseases. Considerations on their impact on demographical situation (life expectancy, birth rate), life quality and physical development and body build of an individual are also presented. Finally, possibilities for directional selection and impact on modern genetic diversity in Europe are discussed.

Communicable Diseases↗
PubMed2006

Induction of transforming growth factor-beta 1 on dentine pulp cells in different culture patterns.

Recent studies have documented that TGF-beta1 takes part in dental pulp tissue repair. Moreover, dental pulp cells have the potential to differentiate into odontoblast-like cells and produce reparative dentine in this process. However, the molecular mechanisms and potential interactions between TGF-beta1 and dental pulp cells are not clear due to the complexity of the pulp/dentine microenvironment. In this study, we investigated the induction of TGF-beta1 on the dental pulp cells in cell culture, tissue culture and three-dimensional culture patterns. These results demonstrated that TGF-beta1 significantly increased the proliferation of cells and activity of ALPase. Dental pulp cells cultured in the presence of TGF-beta1 formed mineralization nodules. In the organ culture, dental pulp cells treated with TGF-beta1 differentiated into odontoblast-like cells and formed a pulp-dentinal complex; and TGF-beta1 significantly induced synthesis of dentine relative proteins DSPP, DMP-1. The dental pulp cells share some characteristics of the odontoblast, such as a parallel arrangement with columnar form and a unilateral cell process. Together, these data indicate that TGF-beta1 can make dental pulp cells differentiated into odontoblast-like cells and form the pulp-dentinal complex. Moreover, these results suggest that TGF-beta1 is an important regulatory factor in odontoblast differentiation during tooth development and pulp repair.

Bone Matrix↗
PubMed2002

Differential effects of 4-aminoquinoline-containing antimalarial drugs on hemoglobin digestion in Plasmodium falciparum-infected erythrocytes.

Several reports suggest that the antimalarial mode of action of quinoline drugs may differ in their mechanistic details. The malaria parasite Plasmodium falciparum was treated in culture with chloroquine, amodiaquine, quinine and mefloquine in a dose- and time-dependent fashion. After removal of the drug, the viability of the parasites and their hemoglobin content were determined. Whereas in the presence of chloroquine and amodiaquine, there was a correlation between parasite killing and accumulation of hemoglobin, with quinine and mefloquine parasite killing was not associated with the accumulation of hemoglobin. Mefloquine inhibited the chloroquine-dependent accumulation of hemoglobin. It is suggested that whereas chloroquine and amodiaquine inhibit the digestion of hemoglobin, mefloquine and possibly quinine inhibit the ingestion of host cell hemoglobin by interfering with the ingestion process. These results may explain the demonstrable antagonism between chloroquine and mefloquine and their antipodal sensitivity to these drugs.

Animals↗
PubMed1998

Inhibition of glutathione-dependent degradation of heme by chloroquine and amodiaquine as a possible basis for their antimalarial mode of action.

We propose here a new and detailed model for the antimalarial action of chloroquine (CQ), based on the its ability to inhibit degradation of heme by glutathione. Heme, which is toxic to the malaria parasite, is formed when the intraerythrocytic malaria parasite ingests and digests inside its food vacuole its host cell cytosol, which consists mainly of hemoglobin. The parasite protects itself against the toxicity of heme by polymerizing some of it to insoluble hemozoin (HZ). We show here that in Plasmodium falciparum at the trophozoite stage only ca. 30% of the heme is converted into hemozoin. We suggest that nonpolymerized heme exits the food vacuole and is subsequently degraded by glutathione, as has been shown before for uninfected erythrocytes. Marginal amounts of free heme could be detected in the membrane fraction of infected cells but nowhere else. It is well established that CQ and amodiaquine (AQ) accumulate in the parasite's food vacuole and inhibit heme polymerization, thereby increasing its efflux out of the food vacuole. We found that these drugs competitively inhibit the degradation of heme by glutathione, thus allowing heme to accumulate in membranes. Incubation of intact infected cells with CQ and AQ results in a marked increase in membrane-associated heme in a dose- and time-dependent manner, and a relationship exists between membrane heme levels and the extent of parasite killing. Heme has been shown to disrupt the barrier properties of membranes and to upset ion homeostasis in CQ-treated malaria-infected cells. In agreement with the predictions of our model, increasing the cellular levels of glutathione leads to increased resistance to CQ, whereas decreasing them results in enhanced sensitivity to the drug. These results insinuate a novel mechanism of drug resistance.

Amodiaquine↗