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PubMed2004

The diagnosis of Echinococcus granulosus in dogs.

The problem of diagnosing Echinococcus granulosus in dogs has still only been partially resolved, even after the advent of biotechnology. The eggs of taeniid Cestoda are extremely similar, and thus identification by microscopic examination of the faeces is risky and non-specific. For this reason, Echinococcus granulosus was traditionally diagnosed in dogs ante mortem after an arecoline hydrobromate purge. The faeces were examined macro and microscopically to establish if the adult tapeworm or its proglottids were present. Although this method is 100% specific, it is bio-hazardous and time-consuming, requires trained personnel, and its sensitivity varies. In the 1990s copro-antigens were discovered and characterised. These are released by the adult worm in the faeces. This made it possible to use enzyme-linked immune-adsorbent assay (ELISA) for in vitam diagnosis of Echinococcus granulosus. In recent years several PCR protocols have been published on the identification of Echinococcus granulosus DNA from eggs or from adult parasites and new ways of diagnosing this cestode have been developed.

Animals↗
PubMed1998

Exercise, immune function and HIV infection.

The implications of HIV infection for exercise and sport are reviewed. HIV infection leads to impairment in a number of key elements of immune function, most obviously a progressive decline in the numbers of CD4+ T helper/inducer lymphocytes. Nevertheless, patients with early through moderately advanced HIV-1 infection can engage in moderate sport and exercise without risk to themselves or other participants; the resulting gains of aerobic power and muscle strength are similar to those observed in healthy individuals of comparable initial fitness. In fully developed AIDS, the ability to exercise may be compromised by deteriorations in cardiorespiratory and neuromuscular function. Given the impairment of resting immune function, the potential immunosuppression from very intensive bouts of competitive exercise must be avoided. Review of all published papers to date provides a relatively limited data base. During a bout of moderate physical activity, HIV seropositive individuals apparently have an impaired ability to mobilize neutrophils, NK and LAK cells into the circulation. Nevertheless, programmes of moderate training can be sustained without any large change in CD4+ count or CD4+/CD8+ ratio. In some studies, training has also attenuated psychological stress, possibly for this reason checking the anticipated fall in CD4+ count. However, further large-scale randomized and long-term studies of HIV are needed, comparing the therapeutic value of exercise alone with that of psychotherapy or a combined programme of exercise and psychotherapy.

CD4-Positive T-Lymphocytes↗
PubMed1994

Tuberculin reactivity after newborn BCG immunization in mono- and dizygotic twins.

SETTING: Studies showing significantly higher concordance of tuberculosis among monozygotic twins than dizygotic twins have provided support for genetically determined susceptibility to tuberculosis. OBJECTIVE: We wished to explore whether the development of delayed type hypersensitivity to tuberculin after newborn BCG immunization of twins suggested genetic regulation of the response to BCG in humans. DESIGN: Our study population consisted of 17 monozygotic twin pairs, 18 dizygotic twin pairs, and 64 single infants 3-34 months of age from Santiago, Chile. All had a BCG scar and were tuberculin tested by one trained nurse. RESULTS: The mean birth weight of both groups of twins was significantly lower than that of singletons and the percentage of individuals who failed to respond to tuberculin was approximately twice as high in twins as in singletons. After adjustment for birth weight and age by regression analysis, it was found that the distribution of tuberculin reactivity in both monozygotic and dizygotic twins was not significantly different from that of singletons. Both twin pair correlations is adjusted tuberculin reactivity were significantly greater than zero (P < 0.01) and led to a heritability estimate of 0.28. However, the monozygotic twin correlation was not significantly larger than the dizygotic twin correlation so that heritability is poorly estimated. CONCLUSION: These results are consistent with a genetic regulation of the response to newborn BCG immunization in humans by a mechanism capable of producing similar responses in identical and nonidentical twins alike.

BCG Vaccine↗
PubMed2006

[Effect of self-foot reflexology massage on depression, stress responses and immune functions of middle aged women].

PURPOSE: This study was aimed to identify the effects of a self-foot reflexology massage on depression, stress responses and functions of the immune system of middle-aged women. METHOD: This study was a one group pretest-posttest experimental design and the data was collected from August 1st, 2004 to May 31st, 2005. The subjects consisted of 46 middle-aged women (40 - 64 years) who were recruited from the Community Health Center in Busan city. Subjects were not treated for 4 weeks, subsequently they were trained in self foot reflexology massage for 2 weeks, and then they did their own daily for 6 weeks (2 days at the research center, 5 days at home). The outcome variables were measured 4 times, at baseline, pre training, after training, and after the intervention. The collected data was analyzed using repeated measure ANOVA by the SPSS/WIN program. RESULT: There was a statistically significant difference in depression, perceived stress, systolic blood pressure, natural-killer cells and Ig G. However, there was not a statistically significant difference in diastolic blood pressure, pulse or serum cortisol. CONCLUSION: These results suggest that a self-foot reflexology massage could be utilized as an effective nursing intervention to reduce depression and stress responses, and to strengthen immune systems in middle-aged women.

Adult↗
PubMed1974

Administration and evaluation of rural health services. I. A tetanus control program in Haiti.

Tetanus has been a public health problem of major importance in rural Haiti. Energetic preventive measures by a rural Haitian hospital were successful in controlling the problem only after immunization services were made easily available to the entire population served by the hospital. This was accomplished by a program which carried the services to the market places and villages of the region. The program developed several new categories of auxiliary personnel who were recruited locally and trained on the job. These personnel were utilized in a program which incorporated preparatory publicity, timing, handling of large crowds in open surroundings, education, record keeping, follow-up and evulation as well as the technical matters concerning the giving of injections. The program sharply reduced the number of admissions to the hospital for the treatment of tetanus. Evaluated on the basis of hospitalizations avverted the program cost only 1/9 the value of the 50,000 hospital days of care for the tetanus cases it prevented.

Adolescent↗
PubMed2001

Lipopolysaccharide induces memory-processing deficits in day-old chicks.

Recent evidence has demonstrated that immune activation can result in cognitive deficits due to the actions of the proinflammatory cytokines. These series of studies examined the effects of peripheral administration of lipopolysaccharide (LPS) on the memory processes of day-old chicks trained on a single-trial passive-avoidance task. LPS impaired performance in a dose- and time-dependent manner. Maximal impairment was produced by a dose of 2.5-mg/kg LPS administered 60 min prior to training. Retention tests revealed that deficits in memory processing appeared between 10 and 20 min posttraining. These results demonstrate an inhibitory effect of LPS on memory processing at the transition point from short-term memory to intermediate-term memory.

Animals↗
PubMed1980

Needlestick and puncture wounds: definition of the problem.

During 1979, all hospital personnel who were victims of needlestick or puncture wounds completed an incident questionnaire so that the epidemiology of these events could be determined. The attack rate varied from a high of 20 to a low of 0.8 incident/100 employee years worked (mean 7.5) for different employee groups. Personal carelessness accounted for 55% of the 81 incidents, whereas 35% of the involved personnel were innocent victims. Needles were responsible for 58% of the incidents. Screening for hepatitis B surface antigen (HBsAg) revealed no positive patient or employee associated with needlestick or puncture wounds. Only 2 of 45 employees were hepatitis B surface antibody (anti-HBs) positive. Hepatitis B immune globulin (HBIG) was recommended for 4 employees, immune serum globulin (ISG) for 13, and no globulin for 65. The estimated cost of this surveillance program and globulin therapy was $60 per incident. This data is being used as the basis for in-service training of high-risk personnel in order to decrease the number of incidents.

Cross Infection↗
PubMed2002

Unconscious amygdalar fear conditioning in a subset of chronic fatigue syndrome patients.

Here, a novel hypothesis for chronic fatigue syndrome (CFS) is proposed. CFS may be a neurophysiological disorder focussing on the amygdala. During a 'traumatic' neurological event often involving acute psychological stress combined with a viral infection or other chemical or physiological stressor, a conditioned network or 'cell assembly' may be created in the amygdala. The unconscious amygdala may become conditioned to be chronically sensitised to negative symptoms arising from the body. Negative signals from the viscera or physiological, chemical and dietary stressors, become conditioned stimuli and the conditioned response is a chronic sympathetic outpouring from the amygdala via various brain pathways including the hypothalamus. This cell assembly then produces the CFS vicious circle, where an unconscious negative reaction to symptoms causes immune reactivation/dysfunction, chronic sympathetic stimulation, leading to sympathetic dysfunction, mental and physical exhaustion, and a host of other distressing symptoms and secondary complications. And these are exactly the symptoms that the amygdala and associated limbic structures are trained to monitor and respond to, perpetuating a vicious circle. Recovery from CFS may involve projections from the medial prefrontal cortex to the amygdala, to control the amygdala's expressions. I shall firstly discuss predisposing, precipitating, and perpetuating factors involved in the possible etiology of chronic fatigue syndrome (CFS), followed by the patient's experience of the illness. Finally, I shall look at a suggested explanation for the symptoms of CFS.

Amygdala↗
PubMed1995

Characteristics of frequent pediatric emergency department users.

The purpose of this study was to examine the medical and demographic characteristics of patients who frequently seek emergency care at a pediatric emergency department (ED). Registration information of ED visits during the study period from 11/1/87 to 5/31/92 (4.6 years) was stored in a data base. Patients with 10 or more ED visits during this study period were considered to be "frequent" ED users. Outpatient and inpatient medical records of these patients were manually reviewed. Demographics, chronic conditions, and the acute conditions for each ED visit were coded and analyzed. During the study period, there were 79,049 ED patient visits under 21 years of age. Of the patients born after 1970, there were 47,451 visits by patients seen one or two times, 25,883 visits by patients seen three to nine times, and 5178 visits by 357 patients seen in the ED ten times or more. Ninety-nine patients were seen more than 15 times, 39 patients were seen more than 20 times, 17 patients were seen more than 25 times, and 10 patients were seen more than 30 times. Two hundred sixty-five of the 357 frequent ED users (74%) had chronic disease conditions. Two hundred and twenty-three of them had good functional status, 25 had mild or moderate impairment in carrying out activities of daily living, and 17 had severe impairment of function. The most common chronic medical conditions were recurrent wheezing (226), neurologic conditions (33), gastrointestinal conditions (13), cardiac conditions (12), and endocrine conditions (9). The other 92 were assessed as healthy children. Patients' immunization status were up to date as of the last ED visit during the study period in 329 patients (92%). Pediatricians were the primary care providers in 339 patients (95%). Medical insurance status of patients follows: private insurance (38%), military (0.3%), Medicaid or state assistance (60%), and no insurance (1.4%). Polynesian ethnic groups were over-represented in the cohort of frequent ED users. We conclude that cultural differences appeared to be an important factor associated with frequent ED use by healthy persons. Medical care resources as measured by immunizations, insurance, and identification of a primary care physician did not appear to be deficient in this cohort of frequent ED users. Since recurrent wheezing is a dominant chronic condition among frequent ED users, pediatric emergency medicine training programs may consider the inclusion of the chronic management of wheezing in their curriculum.

Acute Disease↗
PubMed1988

Electrical safety during electrophysiological testing.

This report describes the inadvertent induction of non-sustained atrial and ventricular arrhythmias due to the malfunction of a programmable cardiac stimulator. The malfunction occurred when line power resumed after a brief municipal power outage ("blackout") during an invasive electrophysiological study. The stimulator spontaneously delivered very high frequency pulses through the electrode catheter to the myocardium which resulted in atrial and ventricular arrhythmias. During bench testing, the stimulator delivered a continuous train of high frequency output pulses (greater than or equal to 1 mA) when line voltage resumed normal level after it had dropped below 65 VAC. Electrical safety during electrophysiological testing requires a stimulator design which is immune to altered operating conditions, and which shuts down if abnormal operating or output conditions are detected.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Bangladesh specialists call for more maternal, child care.

Some 28,000 Bangladesh mothers die during childbirth each year and 375,000 become debilitated, according to a statement from the Obstetrical and Gynecological Society of Bangladesh which held its first international conference in Dhaka in December. 1992. Almost 300,000 babies do not survive childbirth, the society said recently. The society calculates that, of the 4 million births in Bangladesh each year, around 600,000 require clinic or hospital facilities and 200,000 require cesarean section. At present hospitals account for barely 40,000 deliveries and around 25,000 cesarean sections are carried out each year. Bangladesh not only lacks hospital beds, equipment, and nurses but also needs 1000 more specialists in obstetrics and gynecology, the society's statement said. The society called for a National Council on Maternal and Child Health, headed by the prime minister. The council should be supported by a technical committee and Maternal and Child Health should be a full directorate in the Ministry of Health and Family Welfare. The society recommended setting minimum standards for health education, nutrition, and treatment of anemia, immunization, screening for high-risk pregnancies, safe delivery, referral, transport, neonatal and postpartum care, infant care, and treatment of unsafe abortion. Collaboration with non governmental organizations should be the basis for providing more facilities and equipment, training more staff, and ensuring adequate transport to hospital, the society said.

Asia↗
PubMed1994

Approaches to HIV and AIDS. Review of CFPC initiatives.

The College of Family Physicians of Canada offers education on acquired immune deficiency syndrome to family physicians across Canada. This article outlines the growth and development of this education project and describes some innovative approaches to AIDS education. In the program, family doctors teach family doctors and tailor training to suit the needs of different communities.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Chronic exercise enhances in vivo and in vitro cytotoxic mechanisms of natural immunity in mice.

This study investigated the influence of 9 wk of chronic exercise on natural cytotoxicity in male C3H mice. Both in vivo cytotoxicity (pulmonary vasculature) and in vitro cytotoxicity (spleen) were determined for voluntary (wheel running; n = 30) and forced (treadmill running, 15 m/min, 30 min/day; n = 30) exercise protocols. A sedentary control group (n = 30) and a treadmill control group (5 m/min, 5 min/day; n = 30) were also included. After 9 wk of chronic exercise, submaximal exercise O2 uptake was reduced in the wheel-running group relative to that in sedentary or treadmill-trained mice. Maximal citrate synthase activity of soleus muscle was higher in treadmill-trained group compared with that in sedentary or wheel-running mice. Chronic exercise consistently reduced percent retention of CIRAS 3 tumor cells in the lungs of treadmill- (15.3 +/- 1.4) and wheel- (17.9 +/- 1.4) trained mice below that of sedentary (29.5 +/- 2.7) and treadmill control (25.8 +/- 1.8) groups (P < 0.001). Injection of anti-asialo GM1 (ASGM1) antibody increased tumor cell retention in the lungs for all groups but did not alter the differences between activity conditions. In vitro cytotoxicity was enhanced in treadmill- and wheel-trained mice relative to that in sedentary controls but was not elevated in the treadmill control group. Anti-ASGM1 injection eliminated in vitro cytotoxicity for all groups. Chronic exercise slightly increased the frequency of ASGM1-positive splenocytes in treadmill-trained mice only. These results indicate that chronic exercise enhances natural cytotoxic mechanisms in vivo and in vitro and that this enhancement is present for both forced and voluntary exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1979

The impact of training traditional birth attendants on the utilisation of maternal health services.

The impact of training traditional birth attendants (TBAs) on the utilisation of maternal health services at a rural health training centre in India has been studied. Records of the utilisation of the services for two periods of six months each (one before training and one after) have been analysed. A marked improvement in the registration of antenatal cases at an earlier date in pregnancy has been observed. The average number of visits to antenatal clinics, the immunisation against tetanus, and the presence of trained personnel at the time of delivery all showed considerable improvement after the local TBAs had been trained and motivated. The differences observed in the two series were statistically significant.

Female↗
PubMed1996

The emerging role of glutamine as an indicator of exercise stress and overtraining.

Glutamine is an amino acid essential for many important homeostatic functions and for the optimal functioning of a number of tissues in the body, particularly the immune system and the gut. However, during various catabolic states, such as infection, surgery, trauma and acidosis, glutamine homeostasis is placed under stress, and glutamine reserves, particularly in the skeletal muscle, are depleted. With regard to glutamine metabolism, exercise stress may be viewed in a similar light to other catabolic stresses. Plasma glutamine responses to both prolonged and high intensity exercise are characterised by increased levels during exercise followed by significant decreases during the post-exercise recovery period, with several hours of recovery required for restoration of pre-exercise levels, depending on the intensity and duration of exercise. If recovery between exercise bouts is inadequate, the acute effects of exercise on plasma glutamine level may be cumulative, since overload training has been shown to result in low plasma glutamine levels requiring prolonged recovery. Athletes suffering from the overtraining syndrome (OTS) appear to maintain low plasma glutamine levels for months or years. All these observations have important implications for organ functions in these athletes, particularly with regard to the gut and the cells of the immune system, which may be adversely affected. In conclusion, if methodological issues are carefully considered, plasma glutamine level may be useful as an indicator of an overtrained state.

Animals↗
PubMed1995

National Immunization Coverage Survey Saudi Arabia, 1991.

A nationwide survey was carried-out aiming at determination of immunization coverage level against the six killer diseases of childhood (tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis, and measles). Variations between geographical zones, urban-rural settings, age, education and mother's employment, father's education, and child's birth order were studied. The standard WHO cluster technique was used. The sample (1102 children) was restricted to Saudi children 1-2 years old. Interviewers were exposed to training and methods of calibration, and involved in a pilot survey. Nationally, the survey showed very high coverage levels, BCG was the highest (99 per cent), measles was the lowest (90 per cent), whereas the three doses of DPT (diphtheria, pertussis and tetanus) and TOPV (trivalent oral polio vaccine) were in between (98, 96 and 94 per cent, respectively). There was no marked differences between urban-rural settings. The western zone showed the lowest coverage by all vaccines. The national coverage by the six vaccines reached 86 per cent correctly immunized (according to WHO standards), 14 per cent partially immunized and 1 per cent non-immunized. Immunization coverage was higher for children to younger mothers. The non-immunized group belonged exclusively to illiterate mothers (1 per cent). Children to mothers with basic education showed the highest coverage (88 per cent). Birth order had negative effect on coverage. Nationally, 88 per cent of children had immunization certificate while 12 per cent had not. The eastern and central zones had the highest percentages of children with certificates (92 and 91 per cent, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Order↗
PubMed2000

Effects of traditional classroom and distance continuing education: a theory-driven evaluation of a vaccine-preventable diseases course.

OBJECTIVES: This study evaluated the effects of a major federal immunization continuing education course, delivered in both traditional classroom and satellite broadcast versions, on public health professionals' knowledge, agreement, self-efficacy, and adherence in practice to recommendations. METHODS: The study used a comparative time series design to determine whether the course influenced participants' knowledge, agreement, self-efficacy, and adherence in practice to general and polio-specific recommendations as measured immediately and 3 months after the course. It also compared the effects of the classroom and satellite broadcast versions and used path analysis to show how the outcomes were related to one another. RESULTS: Both versions significantly improved knowledge, agreement, self-efficacy, and adherence. Knowledge and agreement were significant predictors of self-efficacy, which directly predicted adherence. Vaccine availability and supportive clinic policies were also important adherence predictors. CONCLUSIONS: A well-designed training update can change provider knowledge, agreement, self-efficacy, and adherence. Traditional classroom and distance training can have comparable effects. The findings support incorporation of distance learning in national public health training, if the distance learning is used wisely in relation to training needs, goals, and practice contexts.

Analysis of Variance↗