Stable Isotope Composition of Fatty Acids in Organisms of Different Trophic Levels in the Yenisei River

We studied four-link food chain, periphytic microalgae and water moss (producers), trichopteran larvae (consumers I), gammarids (omnivorous – consumers II) and Siberian grayling (consumers III) at a littoral site of the Yenisei River on the basis of three years monthly sampling. Analysis of bulk carbon stable isotopes and compound specific isotope analysis of fatty acids (FA) were done. As found, there was a gradual depletion in 13C contents of fatty acids, including essential FA upward the food chain. In all the trophic levels a parabolic dependence of δ13C values of fatty acids on their degree of unsaturation/chain length occurred, with 18:2n-6 and 18:3n-3 in its lowest point. The pattern in the δ13C differences between individual fatty acids was quite similar to that reported in literature for marine pelagic food webs. Hypotheses on isotope fractionation were suggested to explain the findings

Cardiac resynchronization therapy; the importance of evaluating cardiac metabolism

Cardiac Dysfunction and Arrhythmia

Evidence of scar tissue: contra-indication to cardiac resynchronization therapy?

Ventricular Dysfunction & Heart Failur

Towards a Dutch national vaccination programme for the 21st century

A view is presented on the future vaccination policy in the Netherlands. The report addresses the following four subjects. (i) Improvement of the current national vaccination programme (RVP). Maintaining and improving the quality of the RVP requires efforts related to efficacy, safety and adverse effects, vaccination schemes, (re)vaccination of elderly people and the eradication of polio. (ii) Possible inclusion in the RVP of available vaccines or vaccines probably available before 2010. Twelve candidate vaccines were analysed with respect to disease-burden, cost-efectiveness and feasibility of inclusion in the current vaccination programme. The analysis resulted in the identification of vaccines deemed suitable and less suitable for incorporation in the RVP with a number of recommendations for further action. (iii) Vaccines in a stage of early development and possibly available between 2010 and 2020. Some of these vaccines (five) may be relevant for the Dutch public health. Progress in these fields should be monitored. In addition, active participation with respect to combination vaccines and alternative application routes (to parenteral immunisation) is paramount. (iv) Activities important for maintaining a successful RVP were identified.Er wordt een visie gepresenteerd voor een toekomstig vaccinatiebeleid in Nederland. De volgende vier onderwerpen worden komen aan de orde. (i) Verbetering van het huidige rijksvaccinatieprogramma (RVP). Handhaving en verbetering van de kwaliteit van het RVP vergt inspanning m.b.t. effectiviteit, veiligheid en bijwerkingen, vaccinatieschema's, (her)vaccinatie van ouderen en de uitroeiing van polio. (ii) Mogelijke opname in het RVP van nieuwe vaccins of vaccins die waarschijnlijk voor 2010 beschikbaar zijn. Twaalf kandidaat vaccins werden geanalyseerd m.b.t. voorkombare ziektelast, kosteneffectiviteit en haalbaarheid van inpassing in het RVP. Op basis van de analyse werden de vaccins beoordeeld als geschikt of minder geschikt voor opname in het RVP. Daarnaast werden voorstellen voor actie geformuleerd. (iii) Vaccins in een vroeg stadium van ontwikkeling en mogelijk beschikbaar tussen 2010 en 2020. Vijf vaccins uit deze groep lijken relevant voor de Nederlandse volksgezondheid. De voortgang op dit terrein moet gevolgd worden. Actieve participatie m.b.t. combinatievaccins en andere dan parenterale toedieningsvormen is van belang. (iv) Activiteiten van belang voor handhaving van een succesvol RVP

Taking a hard look at the pathogenesis of childhood HIV-associated nephropathy

Childhood human immunodeficiency virus-associated nephropathy (HIVAN) is defined by the presence of proteinuria associated with mesangial hyperplasia and/or global-focal segmental glomerulosclerosis, in combination with the microcystic transformation of renal tubules. This review discusses the pathogenesis of childhood HIVAN and explores how the current pathological paradigm for HIVAN in adults can be applied to children. The Human Immunodeficiency virus-1 (HIV-1) induces renal epithelial injury in African American children with a genetic susceptibility to develop HIVAN. The mechanism is not well understood, since renal epithelial cells harvested from children with HIVAN do not appear to be productively infected. Children with HIVAN show a renal up-regulation of heparan sulphate proteoglycans and a recruitment of circulating heparin-binding growth factors, chemokines, and mononuclear cells. Macrophages appear to establish a renal HIV-reservoir and transfer viral particles to renal epithelial cells. All of these changes seem to trigger an aberrant and persistent renal epithelial proliferative response. The paradigm that viral products produced by infected renal epithelial cells per se induce the proliferation of these cells is not supported by data available in children with HIVAN. More research is needed to elucidate how HIV-1 induces renal epithelial injury and proliferation in HIV-infected children