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PubMed2004

The Living Organ Donor Network: a model registry for living kidney donors.

The South-Eastern Organ Procurement Foundation presents the first report on a programme to track donors through questionnaires completed at the time of donation, 3 months, 6 months, and yearly thereafter. Donors at participating centres were eligible for an insurance policy with a total benefit of 250,000 US dollars, covering accidental death related to donation, surgery, medical expenses of complications, and disability income. The four participating centres have registered 104 donors. Response rate to the questionnaires was 90.91%. The majority of the donors come from the immediate family (81.62%), either by blood or marriage. The majority of donors are employed full time, with income ranges similar to the national census. Donors rely on employer-provided vacation time and sick leave to recuperate, but the average donor required 12 days of unpaid leave before returning to work. Donors also experienced costs of transportation, lodging, and childcare. Anti-depressants were prescribed to 10.58% of donors, and 4.8% of donors reported they are treated for hypertension. Complications were reported by 37.5% of the donors, but only 7.6% of the complications were serious enough to require hospitalization or surgery. Donors reported higher complication rates than reported by the centres and experience financial burdens afterwards.

Employment↗
PubMed1983

Effects of working environment on the liver in 10 anaesthetists.

Drug-metabolising ability, i.e. antipyrine half-life, in anaesthetists was significantly slowed (23%) at the end of summer vacation (2-4 weeks), as compared to prevacation values. Despite changes in either direction, the antipyrine half-lives, including four determinations within a year and a half from the ten anaesthetists, were within normal limits. Liver enzymes (aspartate aminotransferase, alanine amino-transferase, alkaline phosphatase) were also normal. In one anaesthetist the test for anti-HBsAg was positive in 1980, while in the others HBsAg and anti-HBsAg were negative in 1980 and 1981. The inorganic fluoride concentrations of serum and urine (determined four times) were at normal levels. Only in one anaesthetist was there a transient, surprisingly high, serum concentration (7.9 mumol/l), apparently unrelated to work exposure.

Adult↗
PubMed1998

Sleep-wake rhythm of autistic children.

Using a sleep log for 28 days in the summer vacation, 89 autistic children living in a suburb of Tokyo were examined. Only one girl of 13 years showed a tendency of non-24 h sleep-wake syndrome. Most autistic children showed a large variation of total sleep time. Forty per cent of subjects showed 10% or more on coefficient of variation of total sleep time. In the retiring and rising time, many subjects tended to show late retiring and early rising.

Adolescent↗
PubMed1997

Regulation of quantal transmitter secretion by ATP and protein kinases at developing neuromuscular synapses.

The effects of endogenously released ATP on the maturation of developing neuromuscular synapses were investigated in Xenopus nerve-muscle co-cultures. The potentiating action of ATP (1 mM) on spontaneous acetylcholine release was inhibited by P2-purinoceptor antagonists suramin (0.3 mM) and reactive blue 2 (RB-2, 3 microM) in day 1 cultures. Bath application of suramin (10 microM) or RB-2 in day 1 cultures and prolonged treatment for 2 days dramatically decreased the amplitude of both spontaneous synaptic currents (SSCs) and evoked synaptic currents (ESCs) in the same cultures on day 3. Chronic treatment with 8-cyclopentyltheophylline (4 microM) or 6-cyano-2,3-dihydroxy-7-nitroquinoxaline (CNQX, 10 microM), P1-purinoceptor and glutamate receptor antagonists respectively, did not exert such an inhibitory effect. Chronic treatment with suramin or RB-2 for 2 days had no significant effect on the amplitude of either iontophoretic acetylcholine-induced whole-cell currents or single acetylcholine channel measurements in 3-day-old cultured myocytes. In addition, prolonged treatment for 2 days with various kinase inhibitors such as H-8 (10 microM), KN-62 (5 microM) and H-7 (10 microM) also decreased the amplitudes of both spontaneous and evoked synaptic currents in natural synapses, but not those of iontophoretic acetylcholine-induced currents. Furthermore, suramin and these protein kinase inhibitors also decreased the amplitude of spontaneous synaptic currents in manipulated synapses of 'vacated' nerve terminals. The results suggest that endogenously released ATP, acting in concert with various protein kinases, is involved in the maintenance and/or development of the quantum size of synaptic vesicles at embryonic neuromuscular synapses.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗
PubMed2006

Post-embryonic remodelling of neurocranial elements: a comparative study of normal versus abnormal eye migration in a flatfish, the Atlantic halibut.

The process of eye migration in bilaterally symmetrical flatfish larvae starts with asymmetrical growth of the dorsomedial parts of the ethmoid plate together with the frontal bones, structures initially found in a symmetrical position between the eyes. The movement of these structures in the future ocular direction exerts a stretch on the fibroblasts in the connective tissue found between the moving structures and the eye that is to migrate. Secondarily, a dense cell population of fibroblasts ventral to the eye starts to proliferate, possibly cued by the pulling forces exerted by the eye. The increased growth ventral to the eye pushes the eye dorsally. Osteoblasts are deposited in the dense cell layer, forming the dermal part of the lateral ethmoid, and at full eye migration this will cover the area vacated by the migrated eye. When the migrating eye catches up with the previous migrated dermal bones, the frontals, these bones will be remodelled to accommodate the eye. Our findings suggest that a combination of extremely localized signals and more distant factors may impinge upon the outcome of the tissue remodelling. Early normal asymmetry of signalling factors may cascade on a series of events.

Acid Phosphatase↗
PubMed1982

Body weight, exercise and menstrual status among ballet dancers in training.

A prospective study of the menstrual pattern and weight changes was made in the first year of training of 29 new female entrants to a professional ballet school. Seventy-nine per cent of the student girls had menstrual disturbances at entry: primary amenorrhoea, four; secondary amenorrhoea, 11; irregular menses, eight. The incidence of secondary amenorrhoea increase substantially by the end of the year (20), but was not associated with any significant change in body weight. Only three students menstruated regularly during the year. Menstrual regularity improved during periods of injury and long vacation and it appears that deterioration of the menstrual pattern during dancing periods was related to strenuous physical exercise rather than to any change in body weight.

Adolescent↗
PubMed1990

Aromatic L-amino acid decarboxylase is modulated by D1 dopamine receptors in rat retina.

Aromatic L-amino acid decarboxylase (AAAD) activity of rat retina increases when animals are placed in a lighted environment from the dark. The increase of activity can be inhibited by administering the selective dopamine D1 receptor agonist SKF 38393, but not the selective D2 agonist quinpirole, or apomorphine. Conversely, in the dark, enzyme activity can be enhanced by administering the selective D1 antagonist SCH 23390 or haloperidol, but not the selective D2 antagonist (-)-sulpiride. Furthermore, in animals exposed to room light for 3 h, the D1 agonist SKF 38393 reduced retinal AAAD activity, and this effect was prevented by prior administration of SCH 23390. In contrast, quinpirole had little or no effect when administered to animals in the light. Kinetic analysis indicated that the apparent Vmax for the enzyme increases with little change in the apparent Km for the substrate 3,4-dihydroxyphenylalanine or the cofactor pyridoxal-5'-phosphate. We suggest that dopamine released in the dark tonically occupies D1 receptors and suppresses AAAD activity. When the room light is turned on, D1 receptors are vacated and selective D1 agonists can either prevent the rise of AAAD or reverse light-enhanced AAAD activity.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗
PubMed2004

Benign summer light eruption and polymorphic light eruption: genetic and functional studies suggest that a revised nomenclature is required.

New research indicates that polymorphic light eruption (PLE) is an autoimmune disease against an ultraviolet radiation-induced cutaneous antigen. PLE may even confer some protection against skin cancer later in life. This new information demands a reassessment of the precise nature and nomenclature of PLE. Benign summer light eruption (BSLE) (lucite estivale bénigne) is the name used in continental Europe, and particularly France, to describe a clinically short-lived, itchy, papular eruption particularly affecting young women after several hours of sunbathing at the beginning of summer or on sunny vacations. Clinically more prolonged forms of solar eruption, starting early in spring and persisting for long periods, have been known in France as polymorphic light eruption (PLE) (lucite polymorphe) ('European PLE'). Investigative studies, however, now suggest that BSLE and some cases of 'European PLE' are part of the same spectrum. In the Anglo-Saxon literature, they are lumped together as PLE ('Anglo-Saxon PLE'). The other cases of 'European PLE', which do not fall within the compass of 'Anglo-Saxon PLE', are, in the Anglo-Saxon literature, classified as either actinic prurigo (AP) (a genetically determined, prolonged, excoriated form of Anglo-Saxon PLE), or chronic actinic dermatitis (CAD) (a sunlight-induced eczema precisely resembling allergic contact dermatitis, apparently to an ultraviolet radiation-induced antigen). It is therefore proposed that: i. the European term BSLE be dropped and that these patients be reclassified within the spectrum of (Anglo-Saxon) PLE, ii. the European use of the term PLE ('European PLE') be discontinued, iii. those previously diagnosed as having 'European PLE' be reclassified as (Anglo-Saxon) PLE, AP or CAD, as appropriate. The benefits of such a change in nomenclature would be twofold, firstly a uniformity of terminology and secondly, and more importantly, terminology would then correlate better with our recently improved understanding of the pathogenesis of these disorders.

Journal Article↗
PubMed1987

Psychological, social, and health consequences of caring for a relative with senile dementia.

While providing home care for a family member with senile dementia is clearly extremely stressful, there has been little controlled research assessing the specific effects of this stress on caregiver psychological, social, and health functioning. To address this question, 44 primary caregivers of senile dementia patients and 44 matched controls completed a series of questionnaires and interview assessments. Caregivers reported significantly higher levels of depression and negative affect toward their relatives, and lower overall life satisfaction than controls. Caregivers also had significant impairment of their social activities, including visits with friends, vacations, and church attendance when compared with controls. Caregivers expressed less satisfaction with their social networks than did controls, but the groups did not differ in objective size of social network or number of network contacts. Caregivers reported poorer health, more prescription medication use, and higher utilization of health care than controls. Results clearly indicate the serious and wide-ranging effects of the stress of caregiving, and reinforce the importance of providing comprehensive services for caregiving families.

Aged↗
PubMed1985

Invasion and early development of Sarcocystis muris (Apicomplexa, Sarcocystidae) in tissue cultures.

Ultrastructural observations on the invasion and early development of merozoites (bradyzoites) of Sarcocystis muris in Madin-Darby canine kidney (MDCK) cells are presented. Invading merozoites cause the host cell plasmalemma to invaginate; they form a membrane junction (moving junction) and move into the host cell where they are enclosed in a primary parasitophorous vacuole (PV). Within 30-45 min after becoming intracellular, merozoites begin to vacate the newly established primary PV and move, forming a new membrane junction, into a secondary PV. Simultaneously with the movement of the parasite, the contents of dense granules in the apical part of the merozoites are shed by exocytosis into the lumen of the developing secondary PV. A lamella of the endoplasmic reticulum of the host cell becomes attached to the PV membrane, forming a PV limited by three host cell membranes.

Animals↗
PubMed1984

Caries inhibition of a dentifrice containing 0.78% sodium monofluorophosphate in a silica base.

The purpose of this double blind clinical trial was to determine the anticaries activity of a dentifrice containing 0.78% sodium monofluorophosphate in a silica gel abrasive base compared with a placebo under conditions of supervised brushing. 1154 schoolchildren, ages 9-12, were recruited in a non-fluoridated semi-rural area of northeastern Connecticut. Subjects were stratified according to school, grade and sex, and then randomly divided into two groups. Each school day, children brushed their teeth for 1 min under supervision by project personnel. Weekend and vacation usage was ad libitum. Caries examinations and radiographic readings were performed by the same examiner (J.R.). After 12 months, the 996 subjects examined showed that the group using the test dentifrice had significantly (less than 0.05) lower DMFT (25.0%) and DMFS (19.1%) increments than the group using the placebo. After 24 months the 876 subjects examined showed that the test group continued to have significantly lower DMFT (24.5%) and DMFS (24.7%) increments than the placebo group. Surface protection after 24 months ranged from 22.1% for occlusal to 37.1% for interproximal surfaces.

Child↗
PubMed1975

Nickel allergy and hand eczema.

A clinical study was performed in 66 female patients with hand eczema and contact allergy to nickel. They were drawn from a basic material of 165 patients with nickel allergy in which hand eczema occurred in 86 cases (52%). The hand eczema started at an average age of 32 years and it had been preceded by a metal hypersensitivity for an average of 6 years. The eczema was found to be chronic with a mean duration up to the time of examination of 8 years. It was associated with secondary eruptions in half of the cases. The hand eczema showed a low degree of relevance with regard to dependance of occupation or vacation, as well as to exacerbation of the dermatitis after a direct contact with nickel-coated objects. The clinical examination disclosed in 77% a pompholyx, i.e. a symmetric vesicular eruption mainly located on the palms and volar aspects of fingers, and sides of fingers. The eczema often showed a periodic activity, with about 15 annual eruptions in the pompholyx cases. It is concluded that simple external contact with the metal can hardly explain the most common clinical pattern of the hand eczema in nickel allergy.

Adolescent↗
PubMed1992

Contact dermatitis from telefax paper.

A nonatopic female secretary developed hand dermatitis after 1 year of full-time work with telefax paper. Her dermatitis improved on sick leave and vacation and relapsed at work. Patch testing showed allergic reactions to several fragrances, balsam of Peru, colophony and neomycin. In 3 patch test sessions, her own telefax papers gave a doubtful reaction which persisted for 4 days, but it could not be determined whether the reactions were allergic or irritant. The colophony content of the telefax paper was about 1%, and it was possible that colophony in the telefax paper was responsible for the weak path test reactions. Accordingly, the contact dermatitis would have been allergic. The patient has now been relocated, does not handle telefax paper, and is symptomless. We concluded that our patient had an occupational hand contact dermatitis induced by telefax paper and possibly caused by colophony allergy.

Dermatitis, Allergic Contact↗
PubMed1995

Traumatic dental injuries at the Accident and Emergency Department of Singapore General Hospital.

The purpose of this retrospective study was to determine the occurrence and the type of after office-hours traumatic dental injuries managed by the Dental Unit of the Accident and Emergency Department at the Singapore General Hospital. During a 2-year period (from August 1990 to July 1992), 461 trauma patients (314 males, 147 females) sustained injuries to 968 teeth. The distribution in different races of Chinese: Malay: Indian: others was 7.3: 1.3: 0.9: 0.5. The predominant age groups were 2-3 years, 3-4 years and 17-18 years; 71.3% of the teeth sustained luxation type injuries, the remaining 28.7% had fractures, 45.3% of the cohort had concomitant soft tissues injuries, while 13.7% had associated facial bone fractures. Teenager traumas were more common during school vacations. It is concluded that thorough standardized documentation is imperative to obtain baseline information on dental trauma. This could facilitate future preventive measures, education and research.

Adolescent↗
PubMed1995

Epidemiologic Observations on Diarrhea Developing in U.S. and Mexican Students Living in Guadalajara, Mexico.

Background: A previous study suggested that U.S. students who lived in Mexico for 1 year had a risk of diarrhea intermediate between the rate for newly arrived U.S. students and Mexican students; however, the study was not controlled for changes of risky behavior over time. Methods: An analysis of acute diarrhea occurring among U.S. and Mexican student groups living in Guadalajara, Mexico was conducted to explore the association of diarrhea developing during selected 28-day periods with length of residence, season, and risk factors such as locations of food consumption, consumption of tap water, unsafe ice, alcohol, and antibiotics. Results: Compared to U.S. and Mexican student groups, newly arrived U.S. college students in July had the highest rate of diarrhea (55%), highest enteropathogen isolation rate (46%), and most consumption of alcohol and antibiotics; they also ate most frequently at restaurants and in Mexican family homes. Compared to a 34% rate of diarrhea among newly arrived U.S. medical students in August, the rate was only 6% among established medical students in January. This drop in attack rate was attended by less tap water and unsafe ice consumption by established students in January compared to the habits of newly arrived students in January or August when risky behavior was otherwise similar among these groups. The role of tap water and unsafe ice in the acquisition of wintertime diarrhea is further supported by the relatively high 29% rate of diarrhea among U.S. medical students newly arrived in January, who also consumed more tap water and ice than established students in January. Enterotoxigenic E. coli disease was observed only during the summer months; whereas, Campylobacter jejuni disease and disease associated with no detected pathogen were more common in winter. Conclusions: These data imply that wintertime diarrhea in Guadalajara is more likely than summertime diarrhea to be waterborne and to be caused by agents such as viruses or previously unrecognized enteropathogens that were not assessed in this study. Among Mexican students who had the highest frequency of tap water consumption and eating from vendors, the low rates of diarrhea in summer (3%) and winter (5%) imply that they enjoy a substantial degree of immunity. Further study will be necessary to understand the role that immunity (or its loss during summer vacation back in the United States) might play in additionally accounting for observed differences in attack rates between newly arrived students and those who had lived for a period of time in Mexico. (J Travel Med 2:6-10, 1995)

Journal Article↗
PubMed1995

Risk Behavior for Travelers' Diarrhea Among Finnish Travelers.

Background: Contaminated food and drink are the primary sources of traveler's diarrhea (TD). Identification of the characteristics that make a traveler more prone to TD is needed to improve prevention and therapy of this illness. Methods: We evaluated, by questionnaire, the association of dietary errors with TD among 933 adult Finnish tourists vacationing in Morocco. A stool specimen was obtained from patients in the group that developed TD at the onset of the diarrheal episode, and from all participants in the study on their return to Finland. Results: Only 5% of the 933 subjects who responded to the questionnaire, and who gave a stool sample, had adhered strictly to generally accepted recommendations. About 45% made five or more dietary errors during the trip; of these, 75% consumed raw vegetables, 65% salads, 33% puddings, 32% mayonnaise or other cold dressings, 31% consumed food bought from street vendors, 29% consumed cold meat, 18% cold sandwiches, 4% drank tap water, and 2% consumed raw meat. The age of the subjects did not correlate with the number of dietary errors. Subjects who had been abroad during the preceding 12 months committed more dietary errors than those who had not (mean 3.9 versus 4.5; p <.001). Also, subjects who spent 2 weeks in Morocco committed more dietary errors than those who spent only 1 week (mean 4.0 versus 4.8; p <.001). However, no association between TD and the number of dietary errors was observed. Differences with respect to eating habits were not observed between subjects, with or without TD or with or without an identified pathogen in stool specimens. There was no correlation between eating habits and the presence, or absence, of a specific pathogen in the stool sample; this is with the exception of Campylobacter spp: subjects with this pathogen consumed steak tartar or salad more often than did other subjects. Conclusions: Etiologic agents are so ubiquitous in this high-risk area that instructions to avoid certain foodstuffs commonly thought to be contaminated may be to some extent without value. Moreover, dietary self restraint proved to be impossible in the real situation. (J Travel Med 2:77-84, 1995)

Journal Article↗
PubMed1995

A Family Case Report of Schistosoma haematobium Infection in Italian Travelers.

Schistosoma haematobium infection is endemic in 53 countries and is confined to Africa and the Middle East.1,2,3 It is estimated that about 90 million persons are infected and that at least 180 million persons are exposed to the risk of infection.1 Fortunately, the morbidity caused by S. haematobium infection is probably low, even though it is still difficult to define and evaluate this morbidity with any precision. S. haematobium infection is not a significant cause of death in most endemic areas.1,2 In fact, this particular parasitic infection is mild and often without symptoms. In some cases, the only clinically relevant symptom is recurrent, painless hematuria.2 Among people living in endemic areas, almost all children are infected by the parasite and, in some cases, complications develop, such as chronic renal infection, bladder abnormalities, and carcinoma.2 The seriousness of the disease is related to the rate of infection, since the active disease is more frequently detected among children aged 5-15 years.1,3,4 In developing countries, strategies for the control and prevention of the increasing diffusion of the S. haematobium infection are mainly aimed at the following: (1) education of the population to avoid contamination of fresh water with urine, possibly containing viable eggs of the parasite; (2) education to avoid bathing in or contact with, contaminated water; (3) control of irrigation systems and snails; and (4) use of noninvasive diagnostic techniques and treatment of infected subjects.2,3 In industrialized countries, S. haematobium infection is a rare, imported disease. In most cases, it exhibits only mild symptoms related to the urinary tract. The disease is often frequently unsuspected and misdiagnosed. In fact, S. haematobium infection is usually suspected only in patients immigrating from endemic areas and suffering from urinary tract symptoms, whereas correct diagnosis is often delayed in most cases of infected patients returning from a visit to an endemic area with similar symptoms. In addition, only a few laboratories can perform the correct diagnostic procedures. One such procedure is urine filtration, which can detect the presence and determine the number of S. haematobium eggs in urine samples obtained from infected subjects. In Italy, the number of reported cases of S. haematobium infection has increased in recent years. The increase is due to the increasing presence of immigrants from endemic African countries (unpublished data). The aim of this work was to describe the case report of an Italian family, which was infected by S. haematobium while vacationing in Malawi, and to emphasize that, in addition to immigrants from endemic areas, this parasitic infection should be suspected in patients who travel to these areas and who return, suffering from urinary tract symptoms.

Journal Article↗
PubMed1998

Diarrhea in returning Austrian tourists: epidemiology, etiology, and cost-analyses.

BACKGROUND: Between 1995 and 1997, stool samples of 322 Austrian tourists returning from abroad with diarrhea were examined for bacteria, parasites and viruses. METHODS: Epidemiologic data were collected from information furnished by physicians and hospitals and from questionnaires. Moreover, testing expenses and additional cost for treated cases were evaluated. RESULTS: In 97 of 322 patients examined (30%), one or more pathogens were detected in the stool. Bacteria were found in 38 patients (39%), parasites in 33 patients (34%) and viruses in 26 patients (27%). In 6 patients, mixed infections with parasites and viruses were detected and in 5 patients with bacteria and viruses. Among bacteria, Campylobacter jejuni was most frequent; among parasitic infections, Giardia lamblia. Significant correlations were established between the country of destination, age, travel style and length of stay. Forty-four percent of all patients visited Asia (including Turkey), 27% Africa, 18% Latin America, and only 10% southern Europe. The group between 20 and 29 years of age was most frequently affected (p<.001), the group between 0 and 19 years of age least. Fifty-seven percent stayed in a hotel without frequent changes of location; 43% undertook a trekking trip; and of those, 75% belonged to the group aged between 20 and 39. In terms of the correlation between travel style and pathogen, it was found that 74% of patients with bacterial infections stayed in a hotel (avg. 57.9%; p<.05) whereas 64% of all patients with parasitic infections undertook a trekking trip (avg. 42%; p<.001). Thirty-six percent of all patients with parasitic infections spent their vacation in India (avg. 13%; p<.001). The length of stay of patients with bacterial infections was shorter than average (72% spent between 1 and 2 weeks abroad, avg. 49.8%). Patients with parasitic infections spent significantly more time abroad than average (42% more than 2 months; avg. 17.7%; p<.001). Average cost of specific antimicrobial therapy was U.S.$31 whereas the average cost of identifying a patient needing such treatment was almost U.S.$580. CONCLUSION: Optimal detection rate and cost reduction for the diagnosis require precise history, adequate collection of samples using adequate transport media, and rapid transfer to the laboratory.

Adolescent↗