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The measurement of extravascular lung water is a relatively new technology which has not yet been well validated as a clinically useful tool. We studied its utility in patients undergoing pulmonary endarterectomy as they frequently suffer reperfusion lung injury and associated oedematous lungs. Such patients are therefore ideal for evaluating this new monitor. We performed a prospective observational cohort study during which extravascular lung water index measurements were taken before and immediately after surgery and postoperatively in intensive care. Data were analysed for 57 patients; 21 patients (37%) experienced severe reperfusion lung injury. The first extravascular lung water index measurement after cardiopulmonary bypass failed to predict severe reperfusion lung injury, area under the receiver operating characteristic curve 0.59 (95%CI 0.44-0.74). On intensive care, extravascular lung water index correlated most strongly at 36 h, area under the receiver operating characteristic curve 0.90 (95%CI 0.80-1.00). Peri-operative extravascular lung water index is not a useful measure to predict severe reperfusion lung injury after pulmonary endarterectomy, however, it does allow monitoring and measurement during the postoperative period. This study implies that extravascular lung water index can be used to directly assess pulmonary fluid overload and that monitoring patients by measuring extravascular lung water index during their intensive care stay is useful and correlates with their clinical course. This may allow directed, pre-empted therapy to attenuate the effects and improve patient outcomes and should prompt further studies. [ABSTRACT FROM AUTHOR]

Genetic and pharmacological studies indicate that casein kinase 1 epsilon ( Csnk1e) contributes to psychostimulant, opioid, and ethanol motivated behaviors. We previously used pharmacological inhibition to demonstrate that Csnk1e negatively regulates the locomotor stimulant properties of opioids and psychostimulants. Here, we tested the hypothesis that Csnk1e negatively regulates opioid and psychostimulant reward using genetic inhibition and the conditioned place preference assay in Csnk1e knockout mice. Similar to pharmacological inhibition, Csnk1e knockout mice showed enhanced opioid-induced locomotor activity with the mu opioid receptor agonist fentanyl (0.2 mg/kg i.p.) as well as enhanced sensitivity to low-dose fentanyl reward (0.05 mg/kg). Interestingly, female knockout mice also showed a markedly greater escalation in consumption of sweetened palatable food - a behavioral pattern consistent with binge eating that also depends on mu opioid receptor activation. No difference was observed in fentanyl analgesia in the 52.5°C hot plate assay (0-0.4 mg/kg), naloxone conditioned place aversion (4 mg/kg), or methamphetamine conditioned place preference (0-4 mg/kg). To identify molecular adaptations associated with increased drug and food behaviors in knockout mice, we completed transcriptome analysis via mRNA sequencing of the striatum. Enrichment analysis identified terms associated with myelination and axon guidance and pathway analysis identified a differentially expressed gene set predicted to be regulated by the Wnt signaling transcription factor, Tcf7l2. To summarize, Csnk1e deletion increased mu opioid receptor-dependent behaviors, supporting previous studies indicating an endogenous negative regulatory role of Csnk1e in opioid behavior. [ABSTRACT FROM AUTHOR]

Objective: To compare the sensitivity of high-risk human papillomavirus (hrHPV) and genotype detection in self-collected urine samples in the morning (U1), and later on (U2), brush-based self-samples (SS), and clinician-taken smears (CTS) for detecting cervical intraepithelial neoplasia grade 2+ (CIN2+) in a colposcopic referral population.Design: Cross-sectional single-centre study.Setting: A colposcopy clinic in Spain.Population: A cohort of 113 women referred for colposcopy after an abnormal Pap smear.Methods: Women undergoing colposcopy with biopsy for abnormal Pap smears were sent a device (Colli-Pee™, Novosanis, Wijnegem, Belgium) to collect U1 on the morning of colposcopy. U2, CTS, and SS (Evalyn brush™, Rovers Medical Devices B.V., Oss, the Netherlands) were also analysed. All samples were tested for HPV DNA using the analytically sensitive SPF10-DEIA-LiPA25 assay and the clinically validated GP5+/6+-EIA-LMNX.Main Outcome Measures: Histologically confirmed CIN2+ and hrHPV positivity for 14 high-risk HPV types.Results: Samples from 91 patients were analysed. All CIN3 cases (n = 6) tested positive for hrHPV in CTS, SS, U1, and U2 with both HPV assays. Sensitivity for CIN2+ with the SPF10 system was 100, 100, 95, and 100%, respectively. With the GP5+/6+ assay, sensitivity was 95% in all sample types. The sensitivities and specificities for both tests on each of the sample types did not significantly differ. There was 10-14% discordance on hrHPV genotype.Conclusions: CIN2+ detection using HPV testing of U1 shows a sensitivity similar to that of CTS or brush-based SS, and is convenient. There was substantial to almost excellent agreement between all samples on genotype with both hrHPV assays. There was no advantage in testing U1 compared with U2 samples.Tweetable Abstract: Similar CIN2+ sensitivity for HPV testing in first-void urine, physician-taken smear and brush-based self-sample. [ABSTRACT FROM AUTHOR]

Background: In the Alzheimer's disease sequencing project (ADSP) whole exome dataset, only the well‐known TREM2.pR47H variant shows genome‐wide significance by conventional single variant analysis. To identify novel AD genes related to TREM2, we used gene‐based polygenic score analysis (PGSA) to evaluate an immune, temporal cortical co‐expression network with 229 genes including TREM2. Method: The most recent whole exome variant call files from the ADSP (NG00067.v7) were subjected to stringent quality control. Post‐QC samples were divided into discovery (4174 samples sequenced at Broad), test (3299 samples sequenced at WashU), and follow‐up (2273 samples sequenced at Baylor) sets. The pruned variants (r2 < 0.2) with a minor allele count over 20 in each gene were analyzed by Broad/WashU PGSA thereby obtaining P‐values (gPbr.wa) for each gene in WashU samples. To assess significance in independent Baylor samples, cumulative Broad/Baylor PGSA was performed using a novel approach in which variants were stratified by both gene (gPbr.wa) and variant (Broad.P). Result: After excluding TREM2, the five variants with gPbr.wa ≤ 0.08 and Broad.P ≤ 0.03 showed significant association in Broad/Baylor PGSA. One of these variants showed no evidence of association with AD in the combined dataset. Polygenic scores for the other four variants, which were in three genes, showed significant association in Baylor samples, and significant, essentially identical association in WashU samples. Polygenic scores for nine additional variants in these genes (0.03> Broad.P ≤ 0.13) also showed significant, essentially identical association in Baylor and WashU samples. The association of these 13 variants with AD was driven primarily by six deleterious, protein‐altering variants with minor allele frequencies less than 1%, but the other 7 variants also contributed. Conclusion: Using gene‐based polygenic score analysis to analyze an immune co‐expression network, we identify three novel immune genes with actionable nonsynonymous and stopgain variants that show significant, replicable association with AD in the most recent release of the ADSP whole exome dataset. [ABSTRACT FROM AUTHOR]

Point-of-care testing is becoming increasingly relevant to the practice of anaesthesia and critical care medicine, especially in terms of minimisation of sample volumes and decreased time to decision making. We performed a prospective observational study to evaluate a novel, in-line blood gas analysis device against a conventional benchtop model, and assessed it while placing the enrolled patients under extreme physiological conditions, specifically deep hypothermic circulatory arrest. Eight patients were studied, and had between seven and 11 samples analysed for seven variables (pH, pCO2 , pO2 , HCO3 (-) , base excess [BE], K(+) and haematocrit [Hct]), using the device during the process of cooling to 20 °C on cardiopulmonary bypass, and subsequent rewarming to normothermia. After Passing-Bablok analysis, the variables were evaluated for bias, limits of agreement and percentage error at above and below 30 °C. Of the measured variables, only pH (percentage error 2.4%) and potassium (19.8%) demonstrated acceptable (< 30%) percentage error over the full range of temperatures measured. Carbon dioxide, when stratified by temperature, was acceptable (< 30 °C percentage error 24.6%, > 30 °C percentage error 9.9%), but the overall percentage error of the dataset (45.8%) was excessively high. Bicarbonate and haematocrit both had an acceptable percentage error above 30 °C (25.2% and 18.5%, respectively), but similar to carbon dioxide, percentage error for the full range of temperatures exceeded 30%. These data differ from previous work examining this device, and highlights the difference between derived measures using different apparatuses when exposed to extreme physiological conditions. [ABSTRACT FROM AUTHOR]

Objective To study colposcopic performance in diagnosing high-grade cervical intraepithelial neoplasia or cervical cancer ( CIN2+ and CIN3+) using colposcopic characteristics and high-risk human papillomavirus (hr HPV) genotyping. Design Cross-sectional multicentre study. Setting Two colposcopy clinics in The Netherlands and Spain. Population Six hundred and ten women aged 17 years and older referred for colposcopy because of abnormal cytology. Methods A cervical smear was obtained. Colposcopists identified the worst lesion, graded their impression and scored the colposcopic characteristics of the lesions. Up to four biopsies were collected, including one biopsy from visually normal tissue. Main outcome measures CIN2+ and CIN3+, positive for HPV16 or other high-risk HPV types (non-16 hr HPV-positive). Results The mean age in HPV16-positive CIN2+ women was 35.1 years compared with 39.1 years in women with other hr HPV types ( P = 0.002). Sensitivity for colposcopy to detect CIN2+ was 87.9% (95% CI 83.2-91.5), using colposcopic cut-off of 'any abnormality'. The remaining CIN2+ were found by a biopsy from visually normal tissue or endocervical curettage ( ECC). Detection of CIN2+ by lesion-targeted biopsies was not different between HPV16-positive women [119/135; 88.1% (95% CI 81.2-92.9)] and non-16 hr HPV-positive women [100/115; 87.0% (95% CI 79.1-92.3); P = 0.776]. In multivariate analysis, 'acetowhitening' [odds ratio ( OR) 1.91, 95% CI 1.56-3.17], 'time of appearance' ( OR 1.95, 95% CI 1.21-3.15) and 'lesion >25% of visible cervix' ( OR 2.25, 95% CI 1.44-3.51) were associated with CIN2+. Conclusions In this population following European screening practice, HPV16-related CIN2+ lesions were detected at younger age and showed similar colposcopic impression as non-16 hr HPV high-grade lesions. There was no relationship between any of the colposcopic characteristics and HPV16 status. [ABSTRACT FROM AUTHOR]

Activated sludge foaming caused by filamentous microorganisms is a major wastewater treatment plant operating problem. This paper presents the results of an investigation of the role of dispersed nocardioforms in activated sludge foaming. Dispersed nocardioforms had a greater propensity for foaming than floc-bound nocardioforms. The mode of effluent withdrawal from an aeration basin plays a major role in determining the relative proportion of dispersed and floc-bound nocardioforms in the activated sludge. Reactors with "trapping" features (sub-surface mixed liquor withdrawal) had significantly higher dispersed nocardioform populations than reactors with "non-trapping" features (surface mixed liquor withdrawal). High dispersed nocardioform filament concentrations were correlated with a high propensity for foaming. Cationic polymer and poly-aluminum chloride reduced foaming by flocculating dispersed nocardioforms, thereby converting them to floc-bound nocardioforms. Low non-ionic surfactant concentrations changed the relative proportions of dispersed and floc-bound nocardioforms by deflocculating floc-bound filaments and converting them to the dispersed growth form. This could act as a trigger for initiating the rapid-onset nocardioform foaming events observed at activated sludge plants. [ABSTRACT FROM AUTHOR]

The unprecedented brilliance achieved by third-generation synchrotron sources and the availability of improved optics have opened up new opportunities for the study of materials at the micrometre and nanometre scale. Focusing the synchrotron radiation to smaller and smaller beams is having a huge impact on a wide research area at synchrotrons. The key to the exploitation of the improved sources is the development of novel optics that deliver narrow beams without loss of brilliance and coherence. Several types of synchrotron focusing optics are successfully fabricated using advanced miniaturization techniques. Kinoform refractive lenses are being developed for hard X-ray beamlines, and the first test results at Diamond are discussed in this paper. [ABSTRACT FROM AUTHOR]

Objective To investigate the prevalence of Echinococcus granulosus in wild dogs (dingos and dingo–domestic dog hybrids) living in and around human habitation on Fraser Island and in townships of the Maroochy Shire, on Queensland's Sunshine Coast, Australia. Design Wild dogs were humanely killed on Fraser Island and in the Maroochy Shire because they were deemed a potential danger to the public. Their intestines were collected and the contents examined for intestinal parasites. Procedure Intestines were removed as soon after death as possible, packed in plastic bags and kept frozen until examination. The intestinal contents were washed, sieved and examined microscopically for the presence of helminths, which were identified and counted. Results Intestines from 108 wild dogs, 7 foxes and 18 Fraser Island dingoes were examined. Echinococcus granulosus was only present in the wild dogs from Maroochy Shire (46.3%) with worm burdens of between 30 and 104,000. Other helminths included Spirometra erinacei, Dipylidium caninum, Taenia spp., Ancylostoma caninum and Toxocara canis. Two specimens of a trematode ( Haplorchinae sp.) usually found infecting fish and seabirds were recovered from a Fraser Island dingo. Conclusion Dingoes on Fraser Island are not infected with E. granulosus and do not pose a hydatid disease public health risk to residents or visitors. However, wild dogs examined from the Maroochy Shire do present a potential hydatid disease public health risk. [ABSTRACT FROM AUTHOR]

Issue Addressed: There is evidence that many of the chronic lifestyle-related problems faced by Australia's Indigenous population are related to physical inactivity. However, little is known as to how to introduce physical activity programs that will be meaningful, relevant and acceptable to Australia's Indigenous people.Methods: Seventeen focus groups involving 96 Indigenous adult participants, explored the meaning of, the barriers to, and potential strategies for promoting physical activity among urban Indigenous Australians. Indigenous researchers moderated the groups and data were transcribed verbatim and analysed independently.Results: The relationship between physical activity and health was well understood by participants. Commonly reported activities undertaken by participants included walking, domestic chores and specific sports. Barriers to activity included being judged by others when in public spaces, cost and accessibility. Family engagement and group-based activities were strong motivators for participation.Conclusions: Attempts to increase physical activity among urban Indigenous Australians must engage the community from the outset, and focus on increased opportunities for family-orientated activities, and/or group walking programs; cost and safety must also be addressed. [ABSTRACT FROM AUTHOR]

Diverticulitis causes recurrent abdominal pain associated with increased mucosal expression of mucosal galanin and substance P (SP). We studied changes in mucosal and myenteric plexus neuropeptides in adult rats using a model of colonic inflammation, trinitrobenzenesulphonic acid colitis. We assessed the effects on the pan-neuronal markers protein gene product 9.5 (PGP9.5) and neurofilament protein, as well as specific neuropeptides at 1, 2, 3, 4, 6, 8, 10 and 14 weeks. Following the acute injury there was macroscopic resolution of inflammation but minor microscopic abnormalities persisted. Percent area stained of mucosal PGP9.5 fell initially but average levels on days 21 and 28 levels were significantly elevated ( P < 0.001), returning to normal by day 42. Percent area staining of PGP9.5 in the muscle rose immediately and remained significantly elevated at 70 days ( P < 0.001). SP, neuropeptide K and galanin followed a similar overall pattern. SP to PGP9.5 ratio was significantly increased in the muscle both acutely (days 1–28) and in the long term (days 70 and 98), whereas the galanin to PGP9.5 ratio was significantly increased in the mucosa throughout the study. Low-grade chronic inflammation after an acute initial insult causes a persistent increase in the expression of galanin in the mucosa and SP in muscle layer. [ABSTRACT FROM AUTHOR]

The response of multisensor capacitance probes (MCPs) to water content depends on multiple soil properties including temperature. The goal of this study was to evaluate a new temperature-dependent scaled frequency algorithm to correct for the temperature effect on the performance of MCPs. Plastic columns with MCPs and thermocouples in the middle were filled with air, deionized water, or quartz sand at different water contents (0.0, 0.02, 0.04, 0.06, 0.08, 0.12 and 0.38 m³m -3) and placed in a water bath with temperature varying between 5 and 45°C. Scaled frequency (SF) readings in saturated sand (0.38 m³ m-3) were negatively correlated with temperature. There were positive correlations observed, however, between isothermal SF readings and media temperature for air and unsaturated quartz sand. Temperature effects in the unsaturated sand decreased with increasing water content; observed SF for quartz sand at 0.0 and 0.12 m³ m-3 water contents increased 58 and 4%, respectively, when temperature increased from 5 to 45°C. A hysteretic temperature effect was observed in all tested media. A new temperature-dependent SF calibration methodology that we developed mitigated the increase in apparent water content caused by the use of the isothermal SF calibration equation. Our experimental data indicate that quartz sand temperature effects on apparent volumetric water content measured with MCPs can be mitigated using this new temperature-dependent SF methodology. [ABSTRACT FROM AUTHOR]

The article presents a discussion of a comparison of membrane bioreactor (MBR) and conventional-activated-sludge mixed liquor and biosolids characteristics. It was found that particle size distribution in the MBR system of the authors of the study was changed toward smaller particles. Significant differences in volatile solids destruction during aerobic and anaerobic digestion experiments were observed by the authors.

Background: Anti-tumour necrosis factor (anti-TNF) therapy has been an important development for the treatment of rheumatoid arthritis (RA) but the impact of its delivery on hospital resources in still emerging. Aims: We audited the effect of starting anti-TNF on the use of other anti-rheumatic therapies and hospital resources in a routine secondary care setting. Methods: A retrospective study of resource use before and after anti-TNF was conducted. Hospital records of 54 RA patients were studied and data taken from the time of commencing anti-TNF to 1 October 2004 and an equal time period prior to commencing anti-TNF. Identical data were collected for 54 controls not on anti-TNF. Relevant figures were extrapolated to per annum rates. Results were analysed using two-factor ANOVAs comparing the pre- versus post-anti-TNF period. Cases on intravenous (IV) versus subcutaneous (SC) anti-TNF were also compared in separate ANOVAs. Results: Mean duration of anti-TNF therapy was 17.04 months (range 3.60–42.36). Mean pre- and 3-months post-anti-TNF Disease Activity Scores (DAS28) were 6.93 and 3.88, respectively. Cases were more likely than controls to be on oral prednisolone pre- and post-anti-TNF. Methylprednisolone requirement, number of disease-modifying anti-rheumatic drugs (DMARDs), telephone helpline contacts and duration as an inpatient reduced significantly post-anti-TNF. Day case admissions increased but outpatient appointments decreased only in cases on IV anti-TNF. Conclusions: In a pragmatic setting, anti-TNF therapy led to reduced need for steroid injections and other DMARDs, as well as reductions in use of several hospital resources. Wider replication of these findings will be important for planning delivery. Copyright: © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Anaerobic and aerobic (AnA) and completely aerobic (CA) sequencing-batch reactors (SBRs) were used to investigate the suitability of the AnA process for treating phosphorus (P)-deficient wastewaters with highly variable influent chemical oxygen demand (COD) loading. Both SBRs were subjected to influent COD loading patterns (LPs) that simulated (1) daily COD loading fluctuations, (2) weekend shutdowns, and (3) long weekend or holiday shutdowns. During LP 1, the AnA SBR produced lower average effluent soluble phosphorus concentrations than CA SBR (0.4 vs. 1.0 mgP/L). A similar result was observed during LP 2, but effluent acetate was detected after the first high COD loading cycle of the weekday loading period. During LP 3, the volatile suspended solids content of both reactors dropped sharply, and the effluent quality of both SBRs deteriorated. Model predictions suggest that the AnA process is stable when treating LP 1, but eventually fails when treating LP 2. [ABSTRACT FROM AUTHOR]

To investigate the problem of children drowning in bath seats by examining case reports, by looking at the epidemiology of bath drowning in children under two years of age and by reviewing the literature.We describe two babies: one who drowned and one nearly drowned in the bath whilst in a bath seat. We examined the RoSPA/RLSS UK database of cases of children under two years drowning in the bath for the years 1989–2003. Cases are ascertained through a press cutting system. We conducted an all language literature search of original articles, references, textbooks and conference abstracts 1951– October 2004 in 11 standard databases.The two cases illustrate how parents can have a false sense of security with bath seats. We found six cases of babies under two years drowning in the UK associated with bath seats in the time period 1989–2003. They were all boys: five of the six were under one year of age. This compared with 47 children of similar age drowning in the bath not associated with a bath seat. The literature is sparse with only four papers since 1966.A baby drowning after being placed in a bath seats is a rare but definite cause of death. Bath seats appear to give a false sense of security (even if not encouraged by the manufacturers). It is unclear whether putting a baby in a bath seat represents an increased risk of drowning compared with a baby without a seat. Without knowing the numbers of mothers that use bath seats it is difficult to come to firm conclusions on the risks to babies. New research is needed to clarify this issue. Whether in a seat or not it is clear that the main risk to babies in the bath is being left unsupervised. [ABSTRACT FROM AUTHOR]

Allergic rhinitis is characterized by selective expansion of T cell subsets with a CD4+ phenotype. Recently, we identified a subpopulation of nonallergic rhinitis subjects with increased epithelial mast cell and eosinophil populations, suggestive of local mucosal allergy. Previously, T cell subsets have not been characterized in this subselection of nonallergic subjects and furthermore, their relationship to mast cell and basophil effector cells remain unidentified. To determine if a subpopulation of nonallergic subjects with idiopathic rhinitis (IR) have localized allergy confined to their nasal mucosa by comparing the T cell subsets and major histocompatibility complex (MHC) II expressing cells to persistent allergic rhinitis (PAR). Furthermore, the relationship between T cell subsets and mast cells/basophils was investigated. None of the symptomatic patients in this study were clinically allergen-challenged. Nasal turbinate mucosa was removed from patients with PAR, IR and normal controls. Morphometry was performed on immunostained sections for T cell subset populations including CD3+, CD4+, CD8+, CD25+, CD45RA+, CD45RO+, human leucocyte antigen (HLA) -DR α (MHC class II), mast cell tryptase and for basophils. Subjects with persistent allergic rhinitis differed to normal controls in showing significantly increased numbers of total (CD3+), activated (CD25+) and allergen-naïve (CD45RA+) T lymphocytes in their nasal mucosa ( P < 0.025). The naïve CD45RA+ memory T cells correlated to mucosal mast cells in PAR ( P = 0.03). IR patients differ to allergic subjects in showing significantly reduced numbers of epithelial HLA-DR α+ cells ( P = 0.007), but increased numbers of CD8+ lymphocytes ( P = 0.02). The CD8+ T cells correlated with mucosal mast cell numbers ( P = 0.02). In both rhinitis groups, basophils were present in very low numbers obviating the need for statistical analysis. PAR is characterized by increased numbers of CD3+, CD25+ and CD45RA+ T lymphocytes compared with normal mucosa. Allergic and nonallergic rhinitis groups can be separated by significant differences in the number of epithelial antigen presenting cells (APCs) (HLA-DR α+) and sub-epithelial activated (CD25+) T cells. Moreover, IR patients do not significantly differ to their allergic counterparts with respect to total (CD3+) and naïve (CD45RA+) T cell numbers, or numbers of epithelial activated (CD25+) lymphocytes. IR subjects show significantly increased numbers of CD8+ lymphocytes compared with control mucosa and although our findings suggest that the initiating inflammatory events may differ, both rhinitis groups show a similarity in pathology involving mucosal mast cells with an association to infiltrating T cells. [ABSTRACT FROM AUTHOR]

The Th2 immune response in the nasal mucosa of subjects with allergic rhinitis is mediated by allergen-specific IgE. Moreover, these subjects show positive responses for markers of systemic atopy, including allergen-specific skin sensitivity and raised serum IgE titres. In contrast, idiopathic rhinitis (IR) subjects with similar histological nasal mucosal features differ in being defined as non-allergic because they have negative atopic responses. We hypothesized that it is possible to have an allergic Th2 disease pathway localized in the nasal mucosa of ‘non-allergic’ rhinitis subjects despite an absence of atopic responses. The presence of house dust mite and grass pollen-specific IgE antibodies was investigated in non-atopic ( n=10) and atopic ( n=11) subjects with persistent rhinitis and compared to normal ( n=12) control subjects. Biotin-labelled allergen was used to localize specific allergen-binding antibodies in situ in sections of nasal mucosa. Grass pollen allergen binding was detected in the nasal mucosa of 3/10 non-atopic IR subjects but, in contrast, dust mite-specific antibodies were not detected. Specific antibodies were present in a total of 8/11 mucosal samples from the allergic group, but none was detected in normal control tissues. These findings support the concept of localized nasal allergy in ‘non-atopic’ rhinitis subjects. We propose the term ‘ entopy’ to define this phenomenon and believe that this concept has a wider implication for localized allergic responses in other mucosal sites. [ABSTRACT FROM AUTHOR]

Summary Background : Post-infectious irritable bowel syndrome is associated with increased serotonin-containing enterochromaffin cells and lymphocytes in rectal biopsies. Animal studies have suggested that steroids reduce the lymphocyte response and suppress some of the post-infectious changes in neuromuscular function. Aim : To evaluate whether steroids reduce the number of enterochromaffin cells and improve the symptoms of post-infectious irritable bowel syndrome. Methods : Twenty-nine patients with post-infectious irritable bowel syndrome underwent a randomized, double-blind, placebo-controlled trial of 3 weeks of oral prednisolone, 30 mg/day. Mucosal enterochromaffin cells, T lymphocytes and mast cells were assessed in rectal biopsies before and after treatment, and bowel symptoms were recorded in a daily diary. Results: Initial enterochromaffin cell counts were increased and correlated with initial lamina propria T-lymphocyte counts (r = 0.460, P = 0.014). Enterochromaffin cell counts did not change significantly after either prednisolone (- 0.8% ± 9.2%) or placebo (7.9% ± 7.9%) (P = 0.5). Although lamina propria T-lymphocyte counts decreased significantly after prednisolone (22.0% ± 5.6%, P = 0.003), but not after placebo (11.5% ± 8.6%, P = 0.1), this was not associated with any significant treatment-related improvement in abdominal pain, diarrhoea, frequency or urgency. Conclusions : Prednisolone does not appear to reduce the number of enterochromaffin cells or cause an improvement in symptoms in post-infectious irritable bowel syndrome. Other approaches to this persistent condition are indicated. [ABSTRACT FROM AUTHOR]

Abstract Aims To measure the prevalence of persistent glucose intolerance at 6–12 weeks postpartum in various ethnic groups to assess the value of targeted postpartum screening. Methods A retrospective study was performed using computerized databases from two large maternity units within one UK region. Both units used the same screening strategy for gestational diabetes mellitus (GDM) and the same postpartum follow-up at 6–12 weeks using a 75-g oral glucose tolerance test (OGTT). A total of 221 women with a diagnosis of GDM/impaired glucose tolerance (IGT) in the index pregnancy in addition to a completed postpartum 75-g OGTT were studied. Of these, 91 were Caucasian, 89 were of Indo-Asian (Asian) origin and 41 were of Afro-Caribbean origin. Results The study showed that 35% Indo-Asians had persistent postpartum glucose intolerance compared with 7% Caucasians and 5% Afro-Caribbeans (P < 0.003). Insulin requirement during pregnancy and a diagnosis of gestational diabetes prior to 20 weeks of pregnancy were predictive for persistent postpartum glucose intolerance amongst Indo-Asians. Conclusions The frequency of postpartum glucose intolerance among Indo-Asian women is significantly greater than among age-matched Caucasian and Afro-Caribbean women. We suggest that all Indo-Asian women with gestational diabetes should undergo postpartum screening for persistent glucose intolerance. However, in non-Asian women selective screening may be more cost effective. Diabet. Med. 20, 382–386 (2003). [ABSTRACT FROM AUTHOR]

Aims: Preinvasive endocervical glandular lesions, termed cervical glandular intraepithelial neoplasia, are increasing in incidence. The distinction of cervical glandular intraepithelial neoplasia from benign mimics, especially tubo-endometrial metaplasia, endometriosis and microglandular hyperplasia, can be difficult. This study investigates the value of immunohistochemical staining with MIB1, bcl2 and p16 in the distinction of cervical glandular intraepithelial neoplasia from these benign mimics. Methods and results: Immunohistochemical staining using the monoclonal antibodies MIB1, bcl2 and p16 was performed on cases of cervical glandular intraepithelial neoplasia (n =21), tubo-endometrial metaplasia (n =13), endometriosis (n =7) and microglandular hyperplasia (n =14). With tubo-endometrial metaplasia and microglandular hyperplasia staining with MIB1 was either negative or involved <10% of cells, while with cervical glandular intraepithelial neoplasia the majority of cases (86%) exhibited >10% positive cells. Two cases of endometriosis exhibited a MIB1 index of 10–30% while in the other cases <10% cells stained. With bcl2 the cells of microglandular hyperplasia were negative although there was staining of associated reserve cells in 43% of cases. All cases of tubo-endometrial metaplasia except one and all cases of endometriosis stained diffusely positive with bcl2. Cases of cervical glandular intraepithelial neoplasia were negative or exhibited focal staining. With p16 all cases of cervical glandular intraepithelial neoplasia exhibited diffuse strong positivity, generally involving 100% of cells, while all cases of microglandular hyperplasia were negative. Sixty-two percent of cases of tubo-endometrial metaplasia showed focal positivity, the remainder being negative. Cases of tubo-endometrial metaplasia were never diffusely positive with p16. In three cases of endometriosis there was staining of >50% of cells while the other cases were either focally positive or negative. Conclusions: A panel of antibodies, comprising MIB1, bcl2 and p16, is a useful adjunct to histology in distinguishing cervical glandular intraepithelial neoplasia from tubo-endometrial metaplasia, endometriosis and microglandular hyperplasia. Cases of cervical glandular intraepithelial neoplasia are diffusely positive for p16 and generally exhibit a high proliferation index with MIB1, while bcl2 is negative or, at most, focally positive. Tubo-endometrial metaplasia and endometriosis are characterized by strong diffuse positivity with bcl2 and a low proliferation index with MIB1 (although occasional cases of endometriosis show moderate proliferative activity). p16 is negative or exhibits focal positivity in tubo-endometrial metaplasia but in endometriosis there may be quite widespread positivity. Microglandular hyperplasia shows a low proliferation index with MIB1 and is negative for bcl2 and p16. [ABSTRACT FROM AUTHOR]

Background The pathophysiology of idiopathic rhinitis is unknown but the disease is classified as being non-allergic on the basis of negative serum IgE radioallergosorbent assay (RAST) and skin prick tests. In contrast, allergic rhinitis has a Th2 type inflammatory pathology mediated by IgE and mast cells. Objective To test the null hypothesis that there would be no difference in the cellular infiltrate for key Th2-associated inflammatory cells between allergic and idiopathic rhinitis. Methods We applied strict selection criteria in the recruitment of allergic and idiopathic rhinitis cases. In contrast to previous studies which used cytology or small biopsies, we studied all layers of the mucosa by using whole, full-thickness nasal turbinate specimens with an average length of 2.5 cm. Immunohistochemistry and in situ hybridization techniques were used to compare the distribution and cell populations of mast cells, IgE positive (IgE+) cells, eosinophils and plasma cells in perennial allergic (n = 11) and idiopathic (n = 17) rhinitis, and control nasal mucosal tissue (n = 9). Results Mast cells and IgE+ cells were significantly increased within the epithelium of allergic and idiopathic mucosa compared to normal mucosa (P < 0.05). More IgE+ cells were present in the allergic group compared to the idiopathic group with the majority of IgE+ cells being mast cells. Both rhinitic groups showed increased eosinophilia localized to the superficial submucosa compared to normal mucosa (P < 0.05). More plasma cells were present in the allergic rhinitic tissue. Conclusion Idiopathic and allergic rhinitic mucosa show similarities in their inflammatory infiltrate suggesting that both groups share a highly localized Th2, IgE-mediated cellular immunopathology. [ABSTRACT FROM AUTHOR]

As part of a prevalence and recognition study of 336 elderly attenders at GP surgeries, 65 with high depression scores (who had not been referred for specialist psychiatric services) were randomly allocated either to 9 months' treatment by a multidisciplinary community psychogeriatric team or to continued management by their GP. At follow-up, elderly men treated by the team had done better then those cared for by their GP, but this was not statistically significant. There was no difference in outcome for elderly women, nor for the group as a whole. It is suggested that white larger studies are awaited, elderly depressed men might profitably be referred to specialist services more often than at present. [ABSTRACT FROM AUTHOR]

The philosophy of nursing emphasizes the importance of holistic care delivered to an individual and their significant others through a shared understanding of the person. Dementia, however, strikes at the very nature of personhood, and carers are challenged to re-evaluate how care can be adjusted to help preserve dignity and independence during a very variable span of deteriorating mental function. This paper explores the impact of dementia on patients and carers through the meanings of self and body image which give individuality to each of us. It concludes by highlighting how recognition of this may assist carers to accommodate the necessary changes associated with the illness. [ABSTRACT FROM AUTHOR]

SUMMARY Pedogenesis involves reorganization of a soil's components and thus relocation of nutrients within the microfabric. This has particular relevance to P which, being relatively immobile, is needed within the immediate root environment. The spatial distribution of P and S in four profiles (haplaquepts, eutrochrept, ochraqalf) with well developed prismatic structure has been investigated at the 1 mm scale, by physical sampling of successive ped surface zones, and at the 1 μm scale by electron probe microanalysis. Results reveal distinct though variable patterns of concentration of P and S at ped surfaces (0.1-3 mm depth) in certain profile horizons; correlation with extractable Ca, Al & Fe proved obscure by macroanalysis, but microanalysis showed specific associations variously interpreted as detrital grains (apatite, monazite, etc.), organic debris or adsorbed phosphate. Such heterogeneity in distribution is mostly consistent with the microfabric seen in thin-section, although some remains cryptic. This is important since plant roots selectively sample the differentiated ped surfaces and not the bulk homogenized soil analysed in the routine assessment of nutrient availability. [ABSTRACT FROM AUTHOR]

Examines the issue of the incremental information content of the 10-K financial report from the aggregate perspective. Identification of time periods, sample and unexpected return-generating methods; Data analysis techniques used; Presentation of statistical results.

The present study examined the effect of varying dietary linoleate intake (0.01, 0.24, 2.4, 24, 80 or 160 g/kg diet) for 24 weeks on the distribution of triacylglycerol (TG) molecular species in rat epididymal adipose tissue. Adipose TG fractions were purified by thin-layer chromatography and separated into different molecular species by reversephase high-performance liquid chromatography. The identification of TG species was based on fatty acid composition, retention time and the theoretical carbon number. When the dietary 18∶2n−6 content was equal to or less than 24 g/kg, no significant amounts of n−6 fatty acids (mainly 18∶2n−6) were observed in adipose tissue TG despite the fact that the levels of 20∶4n−6 in liver phospholipids increased significantly. There were 12 major molecular species in adipose tissue when the dietary 18∶2n−6 content was less than 2.4 g/kg. When the diteary 18∶2n−6 content reached 24 g/kg, an additional six TG species containing one, two or three molecules of 18∶2n−6 were observed. The levels of TG molecules containign two or three 18∶2n−6 residues were further increased when the diet contained very large amounts of linoleic acid (160 g/kg). Conversely, those TG species containing only one 18∶2n−6 residue became less abundant. It is suggested that the accumulation of these linoleate-rich TG molecular species in adipose tissue, particularly di- and trilinoleoyl containing TG, is the result of an adequate or an excessive intake of linoleic acid. [ABSTRACT FROM AUTHOR]