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Assessment of training effects on activity levels of alveolar macrophage in matured rats using chemiluminescent technique.

Chemiluminescence responses have been used for the evaluation of phagocyte function. In this study, to evaluate effects of training started after maturation on pulmonary immunity, the activity levels of rat alveolar macrophages (AMs) were assessed as reactive oxygen species (ROS) generating capacity, measured by lucigenin- and luminol-dependent chemiluminescence, using a parallel luminometer. One group of male Wistar rats started training at 11 weeks old and another group at 17 weeks old. The experimental period was 12 weeks, and about half of the rats were sacrificed after 6 weeks. The forced and voluntary exercises affect the mean levels of body weights and cell populations in the bronchoalveolar lavage fluid in younger animals; however, the voluntary exercise group in younger animals seemed to adapt after 12 weeks. By contrast, chemiluminescence responses in older rats observed after 6 weeks suggest that AMs are primed, and the maximum releasing activities of ROS are reduced. These changes in AM activity may be caused by the exercise and separation stresses and the rats may adapt to those stressors after 12 weeks. The chemiluminescent technique is thought to be useful to evaluate the changes of AM activity.

Acridines↗

[Does public access to defibrillators have a chance in Germany?--On the US model, legal considerations and justification].

PURPOSE: The introduction of public access to defibrillation via automated external defibrillators makes it possible to reduce the incidence of sudden cardiac arrest cases. Since they may expect civil and criminal liability after negligence causing damage, many German potential First Responders might hesitate to use an AED. METHODS: After we demonstrate the medical reasons and compare the legal situation of Public Access Defibrillation between the USA and Germany we analyse a possible hesitation of German First Responders. RESULTS: More than 30 states of the USA provide immunity from civil liability after a public access defibrillation followed by damage due to negligence. However, only an AED-trained US-First Responder is granted immunity from civil liability. In Germany there is no immunity from civil and criminal liability in case of public access defibrillation with damage caused by negligence. CONCLUSION: German law will not decrease any possible hesitation by First Responders. For a successful system of public access defibrillation, revision of the legal situation is mandatory.

Cardiopulmonary Resuscitation↗

New aspects for the role of physical training in the management of patients with chronic heart failure.

Recent experimental and clinical data have shown that physical training is an important therapeutic intervention in the management of patients with chronic heart failure (CHF), improving central hemodynamics and attenuating peripheral abnormalities (endothelial dysfunction and skeletal myopathy) characterizing the progression of the syndrome. Additionally, physical training seems to beneficially modulate peripheral immune responses of CHF expressed by elevated circulating proinflammatory cytokines, soluble cellular adhesion molecules and soluble apoptosis signaling molecules, resulting in improvement in exercise capacity of CHF patients. This article summarizes current knowledge about the beneficial role of physical training in CHF, as well as about traditional and novel mechanisms contributing to the physical training-induced improvement in clinical performance of CHF patients.

Chronic Disease↗

Overtraining, excessive exercise, and altered immunity: is this a T helper-1 versus T helper-2 lymphocyte response?

Overtraining syndrome (OTS) occurs where an athlete is training vigorously, yet performance deteriorates. One sign of OTS is suppressed immune function, with an increased incidence of upper respiratory tract infection (URTI). An increased incidence of URTIs is also associated with high volume/intensity training, as well as with excessive exercise (EE), such as a marathon, manifesting between 3-72 hours post-race. Presently, there is no encompassing theory to explain EE and altered immune competence. Recently, it has been conclusively established that T helper lymphocytes (T(H)), a crucial aspect of immune function, represent two distinct functional subsets: T(H)1 and T(H)2 lymphocytes. T(H)1 lymphocytes are associated with cell-mediated immunity (CMI) and the killing of intracellular pathogens, while T(H)2 lymphocytes are associated with humoral immunity and antibody production. When T(H)-precursor cells are activated, the balance is tipped in favour of one or the other. Furthermore, the most appropriate means of determining the T(H)-subset, is by the prevailing cytokine 'pattern'. This paper hypothesises that exercise-related immunosuppression is due to tissue trauma sustained during intense exercise, producing cytokines, which drive the development of a T(H)2 lymphocyte profile. A T(H)2 cell response results in simultaneous suppression of CMI, rendering the athlete susceptible to infection. Additionally, increased levels of circulating stress hormones (cortisol and catecholamines), as well as prostaglandin E(2), support up-regulation of T(H)2 lymphocytes. Marathon-related data are presented to support this hypothesis. It is concluded that an increased incidence of illness associated with OTS and in response to EE is not due to immunosuppression per se, but rather to an altered focus of immune function, with an up-regulation of humoral immunity and suppression of CMI.

Disease Susceptibility↗

The impacts of the "Immune of Life" for teens module application on the coping behaviors and mental health of early adolescents.

This quasi-experimental research is the subsequent part of the Health Promotion for Early Adolescents Project, which focuses on the training of schoolteachers in using the module Immune of Life for Teens, which was developed in 1999, for evaluating its impact. The module consists of a manual and a VDO cassette display of a story of a teenager who has difficulty adjusting to life changes. The program aimed at improving the coping skills and psychological health or mental health of junior high school students. Schoolteachers from 13 schools participated nationwide as part of an experimental group and received training in the use of the module in their schools with students in Grades 7-9. The control group was composed of 3 schools that did not apply the module. Each school performed the pretest and posttest 1 month after the module's application. The total number of the students in the study was 1,580. There were 445 students in the control group, 474 in the experimental I group (intensive training) group, and 661 in the experimental II group (nonintensive group). The instruments used to evaluate impact were the following: (1) Young Adult Coping Orientation for Problem Experiences, which was developed by Patterson, McCubbin, and Grochowski in 1983, and the (2) Thai Mental Health Questionnaire, a 70-item self-administered questionnaire developed by Pattrayuwat in 1999 to assess mental health status. The findings reveal that both experimental groups had better coping behaviors than the control group when using pretest scores as covariates (experimental I group: F = 9.425, p < .01; experimental II group: F = 22.446, p < .001) 1 month after the module was implemented. They also show that both experimental groups had better mental health than the control group when using pretest scores as covariates (experimental I group: F = 6.034, p < .05; experimental II group: F = 6.596, p < .001) 1 month after the module was implemented. The study confirmed the impact of the Immune of Life for Teens module on better coping behaviors and better mental health status among the subjects after it was implemented by their teachers. Thus, for further use of the module, intensive training for schoolteachers is recommended for the health promotion of early adolescents.

Adaptation, Psychological↗

Exercise, aging and immune function.

Aging leads to a diminution of resting immune function, increasing the risk of infection, tumor development and auto-immune diseases. The production of interleukin-2 is decreased, sometimes with a decrease of total T cell count, and often with changes in T cell subsets and proliferative responses to mitogens. However, natural killer cell activity remains unchanged. In theory, moderate exercise should help to reverse the adverse effects of aging upon the immune system. However, there have been relatively few studies comparing the immune responses of young and older individuals to acute exercise and to training. A single bout of moderate exercise seems to be well tolerated by the elderly. The NK cell response is much as in younger individuals, but perhaps because of a low initial proliferative capacity, older subjects show less stimulation of lymphocyte proliferation by moderate activity and less suppression with exhausting exercise. Perhaps because resting immune function is less than in the young, moderate training programs seem to stimulate immune function to a greater extent than in young subjects. The proliferative response of the T cells is enhanced in elderly rodents whereas in young animals it is suppressed. Moreover, the resting NK cell activity of elderly human subjects seems to be increased by training. Nevertheless, the therapeutic use of exercise must be cautious in the elderly, since aging also enhances susceptibility to over-training.

Aging↗

Survey of local immunisation training in England--the case for setting national standards.

In June 2003 a questionnaire on immunisation training was sent to the 302 primary care trusts (PCTs) in England to ascertain the frequency and content of immunisation training being offered to healthcare professionals. Fifty-four per cent of the 227 trusts (75%) who replied were concerned about their ability to deliver an immunisation programme. Contributing factors included the lack of a designated training lead, shortage of specialist input, available time, and funding. Of PCTs, 33/219 (15%) were not providing immunisation training sessions for practice nurses, 28/219 (13%) for health visitors, and 30/219 (14%) for school nurses; 67/219 (31%) had no sessions organised for general practitioners. Most 138/175 (79%) PCTs would welcome the introduction of some national minimum standards for immunisation training to assist them in setting up and maintaining a programme, and allocating sufficient resources to it.

England↗

Keeping up-to-date on immunizations: a framework and review for pharmacists.

OBJECTIVE: To provide a framework for keeping current in the immunizations field; an update on changes in adult and pediatric vaccine delivery since 2003; and an update on new immunization guidelines, new approved vaccines, and changes in uses for current vaccines. DATA SOURCES: Published guidelines identified from the Centers for Disease Control National Immunization Program Web site. In addition, published articles were identified through Medline (January 2003-November 2005) using specific vaccine names as search terms. Additional sources were identified from the bibliographies of retrieved articles. STUDY SELECTION: By the authors. DATA EXTRACTION: By the authors. DATA SYNTHESIS: To implement the immunization services now permitted under law in 44 states, many pharmacists receive initial training through the American Pharmacists Association Pharmacy-Based Immunization Delivery CERTIFICATE PROGRAM. To remain up-to-date in this field, pharmacists can apply the process described in this article, which includes regular monitoring of the Web site and publications of the Centers for Disease Control and Prevention and participation in one or more listservs. Specific information is presented on new vaccines marketed in the United States since 2003 along with updates on standards for adult and adolescent immunizations and changes in guidelines during this time frame. CONCLUSION: As increasingly committed health professionals in the immunizations field, pharmacists are responsible for keeping updated on the constantly changing recommendations for vaccines and related products. By incorporating the recent information presented in this article and applying the process described for tracking changes in this field, pharmacists can fulfill their emerging vaccine-related roles on the health care team.

Adolescent↗

Theoretical considerations of the role of antigen structure in B cell activation.

Thymus-independent antigens generally are polymeric molecules with repeating arrays of antigenic determinants. Immunological studies of the activity of haptenated thymus-independent antigens have shown that small changes in hapten density can transform a polymeric antigen from nonimmunogenic to immunogenic, and from immunogenic to tolerogenic. In this paper we compute the equilibrium configuration of a linear flexible, haptenated polymer absorbed to a B cell surface, and correlate configurational features of the molecule with its immunological functioning. A polymeric molecule bound to a cell generally will not lie entirely on the surface; rather there will be sections that form loops extending into solution, separated by tightly bound sections, or trains. Trains link antibody receptors on the B cell surface in a fashion that restricts their mobility. Thus trains cause restrictive cross-linking. Our computations show that there is a critical hapten density below which the polymer does not bind to the surface. At hapten densities slightly above the critical density, the polymer binds weakly to the surface with a configuration dominated by a few, rather long loops. These loops cross-link receptors, but do so without bringing the cross-linked receptors into close proximity and without substantially restricting their motion. Long loops thus cause unrestrictive cross-linking. As the hapten density increases, the average loop length decreases and the average train length increases. Thus cross-linking becomes restrictive. In this density range, immune stimulation is observed. At high hapten densities long trains form, separated by few, very short loops and almost all receptors are cross-linked. Consequently cross-linking may be overly restrictive, freezing receptors into place and generating an abundance of cross-linking or other signals that induce a state of immunological tolerance.

Antigens↗

[Expanded vaccination program. Training model for community medicine].

The expanded programme on immunization (E.P.I.) is a very concrete example of community health programme. In so far, it uses various methods which the medical personnel should be taught a better way: the epidemiological method, health planning, health management. The E.P.I. provides a great deal of actual conditions well-suited to the preparing of either tutorials or self-training modules within various fields such as epidemiological surveys with estimate or evaluation purposes, planning for a prevention strategy, supply management. Aiming at the enlargement to community health and with a much more participative pedagogical spirit, the author points out the importance of making the educators aware of unequalled capabilities of training provided by the E.P.I.

Communicable Disease Control↗

Exercise and the immune response.

A growing number of reports have become available which implicate infectious disease with reduced performance in athletes. The immune system consists of both nonspecific and specific components geared to control infections. Adaptive immunity functions through both antibody-mediated and cell-mediated compartments to establish and maintain long term immunity to infectious agents. Evidence is accumulating to support the view that physical exercise can lead to modification of the cells of the immune system. However, studies have often not been well designed to control exercise protocols when examining the effects of exercise on the immune system. Large numbers of peripheral blood lymphocytes are mobilised with exercise and in vitro tests indicate that temporarily these cells may not be capable of responding normally to mitogens. These reactions appear to be influenced by hormones to some degree and there are reports that the cells of the immune system are extremely active biochemically and may depend on products from muscles to maintain their activity. Specific populations within the circulating leucocyte pool vary significantly with exercise and there is some evidence that the T4/T8 lymphocyte ratio may become significantly reduced. This reduction in ratio may be related to the variable responses to T and B cell mitogens recorded in vitro which overall suggests that a temporary immune suppression may exist following certain training or performance schedules. It is argued that this may lead to a temporary susceptibility to infection and could result from overtraining.

Antibody Formation↗

[Physical training of patients with rheumatoid arthritis].

The training methods given to patients with rheumatoid arthritis (RA) are reviewed. Recent studies indicate that patients with moderately active RA may tolerate physical training. Treatment with isometric training and rest-therapy have less beneficial effects than dynamic training with strength and aërobic condition training. Two training studies have shown that patients with moderate active RA show decreased disease activity after training when compared to the control groups. The explanation of this is not clear, but an immune modulation or hormonal stimulation induced by the training might be the cause, but further research is needed, as training-induced improvement of the physical ability and disease activity is important.

Arthritis, Rheumatoid↗

[Neural network classification of people with chronic, nonspecific lung diseases using immunologic parameters of the blood and activity of metabolic enzymes in lymphocytes].

Informatic importance of blood immunological parameters and activities of lymphocyte metabolic enzymes was investigated in patients with chronic non-specific lung diseases (CNLD) in remission by neural-network classifier. There insignificant increase of immunoregulatory index, absence of variations in indices of humoral immunity, but decrease oxidoreductase activities controlling of bioenergetic processes were detected in immunocompetent cells of patients with CNLD. It was assumed that disturbance of the metabolic state of lymphocytes defined weak functional activation of immunocompetent cells, as well as the development of immunodeficiency and chronicity of diseases. Basing on analysis of lymphocytic NAD(P)-dependent dehydrogenases, neural-network classifier divided all patients with CNLD into two groups distinguishing by the level of intracellular metabolism and the type of immune reactions. This result and complete training on the basis of immunological parameters reflect higher informatic importance of metabolic indices of lymphocytes in diagnosis of immunodeficiency.

Antibody Formation↗

Immune response to two hours of rowing in elite female rowers.

The influence of carbohydrate (C) versus placebo (P) beverage consumption on the immune and hormonal responses to normal rowing training sessions was measured in 15 elite female rowers residing at the U.S. Olympic Training Center. In a randomized, counterbalanced design, the athletes received C or P beverages (double-blind) before, during, and after two 2-hour bouts of rowing (one day apart). Blood samples were collected before, and 5-10 minutes and 1.5 hours after rowing. Metabolic measures indicated that training was performed at moderate intensities, with some high intensity intervals interspersed throughout the sessions (mean oxygen uptake of 2,307+/-169 m x min(-1), 57% of VO2max). Glucose and insulin were significantly lower after two hours of rowing with ingestion of P compared to C. The patterns of change in cortisol, growth hormone, epinephrine, and norepinephrine did not differ between C and P rowing trials. Blood neutrophil cell counts and the neutrophililymphocyte ratio were significantly higher following P versus C rowing sessions. The patterns of change in blood lymphocyte and lymphocyte subset counts, and lymphocyte proliferative responses did not differ between P and C trials, except for a slight difference in NK cell counts and activity. In summary, minimal changes in blood hormonal and immune measures were found following two-hour bouts of training in elite female rowers. Carbohydrate compared to placebo ingestion attenuated the moderate rise in blood neutrophil counts, but had slight or no effects on other immune parameters.

Adult↗

The menstrual cycle and its effect on the immune status of female endurance runners.

Twenty highly trained, eumenorrhoeic female endurance runners were studied over three consecutive menstrual cycles. Average training distance per week, total years training and mood states were recorded throughout the three cycles. Salivary progesterone and menstrual cycle diaries were recorded over the first two cycles to identify luteal phase onset and the presence of any menstrual irregularities. Saliva samples were collected daily over the third cycle for analysis of immunoglobulin A (IgA) concentration and secretion and saliva flow rate. Two-way analysis of variance (ANOVA) revealed no significant differences in mood states across the phases of the menstrual cycle (P > 0.05). Training logs indicated that training did not alter throughout the 3 month study. One-way ANOVA revealed no significant differences in IgA concentration (P = 0.92), secretion rate (P = 0.84) or saliva flow rate (P = 0.95) across the phases of the menstrual cycle. Pearson's product-moment correlation revealed no relationship between IgA concentration and progesterone between the phases of the cycle (r = 0.39). We conclude that, in ovulatory female endurance runners whose physical and emotional stress are stable, IgA concentration is not significantly affected by fluctuations in progesterone during the menstrual cycle.

Adult↗

[Manpower in Madagascar and training: evaluation of vaccination coverage by cluster sampling in a rural Malagasy environment].

To assess the immunization coverage, a cluster sampling survey in Malagasy rural areas has been carried out at the occasion of an in-service training in Expanded Programme on Immunization (E.P.I.) organized for 15 Health Medical Inspectors. Leading results are: 17% of children have received B.C.G. immunization. 15% have received D.T.C. 4% have received oral poliomyelitis immunization.

Birth Rate↗

The elicitation of carboxylesterase activity in antibodies by reactive immunization with labile organophosphorus antigens: a role for flexibility.

For the creation of powerfully catalytic antibodies, the technique of reactive immunization solves the problem inherent in immunization with transition-state analogs (TSAs), namely, that many interesting target reactions are multistep reactions, with multiple transition states, and thus in general, no single analog can adequately simulate all the transition states along the reaction path. In contrast, immunization with chemically reactive antigens such as phosphonylating agents, which phosphonylate B-cells during the immune response, produces antibodies that have been "trained" to recognize, bind, and stabilize all the actual transition states involved in the phosphonylation reaction. Therefore, catalytic antibodies have been selected by the immune system on the basis of their capacity to stabilize any number of transition states that occur during the target reaction. Somewhat surprisingly, phosphonolysis catalysts generated in this way commonly also catalyze esterolysis reactions. Esterolysis reactions should pass through transition states with a roughly tetrahedral disposition of ligands about a central carbon atom, while phosphonolysis reactions should pass through transition states with a roughly trigonal-bipyramidal disposition of ligands about a central phosphorus atom. These two divergent transition-state geometries suggest that the same active site should have difficulty recognizing and stabilizing both kinds of transition state. The observations thus indicate a puzzling form of "cross-reactivity" toward transition states. A possible explanation arises from evidence that at least some nucleophilic displacements at phosphorus do not pass through a trigonal-bipyramidal adduct, with a bond-formation transition state preceding it and a bond-fission transition state succeeding it. Instead a single transition state is traversed in which both bond-formation and bond-fission occur simultaneously. Such a concerted-reaction transition state should have two weak, partial bonds to phosphorus, one for formation of the nucleophile-P bond and one for fission of the P-leaving group bond. In a stepwise reaction through an intermediate, only one bond is partial and weak in each of the two transition states. The concerted-reaction transition state, with two weak bonds to phosphorus, may be more easily compressed, expanded, and otherwise distorted because of the lower force constants associated with partial bonds; particularly distortions of angles involving the two partial bonds should require relatively low energies. This may lend a high level of flexibility to phosphonolysis transition states, allowing them to be accommodated within an active site (or a range of active sites) with strong catalytic stabilization. Included among these active sites may be a majority that can also stabilize esterolysis transition states. Indeed many of the target esterolysis reactions studied to date may occur through a single concerted-reaction transition state rather than through separate transition states before and after a tetrahedral intermediate. Thus, the esterolysis transition states may also be highly flexible. Finally, flexibility present in germline antibodies may be specifically preserved in reactive immunization. The high flexibility of both kinds of ligands and of the antibody combining site may then account for the catalytic "cross-reactivity" of these antibodies.

Antibodies, Catalytic↗