Comparison of glucose tolerance in renal transplant recipients and hemodialysis patients

BACKGROUND: Impaired glucose tolerance is a risk factor for atherosclerosis in hemodialysis patients and renal transplant recipients. METHODS: To check the relationship of impaired glucose tolerance with the other atherosclerotic risk factors, fasting blood sugar and the standard two hour glucose tolerance test, serum tryglyceride, serum cholesterol, cyclosporine through level (in renal tranpslant recipients) and hemoglobin A1C were measured in 55 stable renal transplant recipients, 55 hemodialysis patients and 55 healthy controls with similar demographic characteristics. Patients with diabetes mellitus and propranolol consumers were excluded. The mean age and female to male ratio were 39 +/- 7 years and 23/22, respectively. RESULTS: Four of the renal transplant recipients and twelve of the hemodialysis patients had impaired glucose tolerance. Significant linear correlation was observed with body mass index and IGT only in hemodialysis patients (r = 0.4, p = 0.05). Glucose tolerance also had a significant correlation with triglyceride levels (217.2 +/- 55 mg/dl in hemodialysis patients vs. 214.3 +/- 13 mg/dl in renal transplant recipients and 100.2 +/- 18 mg/dl in control groups, p = 0.001). The glucose tolerance had significant relationship with higher serum cholesterol levels only in the renal transplant recipients (269.7 +/- 54 in renal transplant recipients vs. 199.2 +/- 36.6 mg/dl in hemodialysis and 190.5 +/- 34 mg/dl in control groups, p = 0.0001). In the renal transplant recipients, a linear correlation was observed with glucose tolerance and both the serum cyclosporine level (r = 0.9, p = 0.001) and the hemoglobin A1C concentration (6.2 +/- 0.9 g/dl). The later correlation was also observed in the hemodialysis patients (6.4 +/- 0.7 g/dl; r = 67, p = 0.001). CONCLUSIONS: We conclude that although fasting blood sugar is normal in non-diabetic renal transplant and hemodialysis patients, impaired glucose tolerance could be associated with the other atherosclerotic risk factors

Regulation of mammary gland branching morphogenesis by the extracellular matrix and its remodeling enzymes.

A considerable body of research indicates that mammary gland branching morphogenesis is dependent, in part, on the extracellular matrix (ECM), ECM-receptors, such as integrins and other ECM receptors, and ECM-degrading enzymes, including matrix metalloproteinases (MMPs) and their inhibitors, tissue inhibitors of metalloproteinases (TIMPs). There is some evidence that these ECM cues affect one or more of the following processes: cell survival, polarity, proliferation, differentiation, adhesion, and migration. Both three-dimensional culture models and genetic manipulations of the mouse mammary gland have been used to study the signaling pathways that affect these processes. However, the precise mechanisms of ECM-directed mammary morphogenesis are not well understood. Mammary morphogenesis involves epithelial 'invasion' of adipose tissue, a process akin to invasion by breast cancer cells, although the former is a highly regulated developmental process. How these morphogenic pathways are integrated in the normal gland and how they become dysregulated and subverted in the progression of breast cancer also remain largely unanswered questions

Assessment of organoleptic postmortem inspection techniques for bovine offal

Objective: To evaluate organoleptic postmortem inspec-tion techniques for bovine livers and kidneys. Study design: At Australian export abattoirs, bovine liver and kidneys are assessed and graded by qualified meat inspectors during normal operations. Over a 12-month period at a large abattoir in eastern Australia during 1997 and 1998, a sample of these organs was reassessed independently using a range of pathological and microbiological methods. Agreement between routine inspection and independent assessment was evaluated using methods of inter-rater agreement. Results: A total of 944 livers and 1374 kidneys were included in the study. All of these organs had been classified during routine inspection. The authors examined 363 livers and 329 kidneys both grossly and histologically, including 36 livers and 14 kidneys that were also subjected to microbiological examination. All other organs were only examined grossly. There was only a moderate level of agreement between the routine and independent assessment methods. For livers, the percentage agreement was 80.2%, McNemar's test of symmetry 55.2 (3 degrees of freedom, P < 0.001) and kappa 0.63. For kidneys, the percentage agreement was 67.8%, McNemar's test of symmetry 9.9 (1df, P = 0.002) and kappa 0.35. Conclusions: The results reinforce concerns from a number of authors about organoleptic postmortem inspection. Risk assessment methodologies offer the opportunity to modify inspection techniques in a manner that is most relevant to current public health concerns

Plasmodium falciparum genetic variation of var2csa in the Democratic Republic of the Congo

Background: The Democratic Republic of the Congo (DRC) bears a high burden of malaria, which is exacerbated in pregnant women. The VAR2CSA protein plays a crucial role in pregnancy-associated malaria (PAM), and hence quantifying diversity at the var2csa locus in the DRC is important in understanding the basic epidemiology of PAM, and in developing a robust vaccine against PAM. Methods: Samples were taken from the 2013–14 Demographic and Health Survey conducted in the DRC, focusing on children under 5 years of age. A short subregion of the var2csa gene was sequenced in 115 spatial clusters, giving country-wide estimates of sequence polymorphism and spatial population structure. Results: Results indicate that var2csa is highly polymorphic, and that diversity is being maintained through balancing selection, however, there is no clear signal of phylogenetic or geographic structure to this diversity. Linear modelling demonstrates that the number of var2csa variants in a cluster correlates directly with cluster prevalence, but not with other epidemiological factors such as urbanicity. Conclusions: Results suggest that the DRC fts within the global pattern of high var2csa diversity and little genetic diferentiation between regions. A broad multivalent VAR2CSA vaccine candidate could beneft from targeting stable regions and common variants to address the substantial genetic diversity

Call to Action: Promoting Domestic and Global Tobacco Control by Ratifying the Framework Convention on Tobacco Control in the United States

Tim K. Mackey and colleagues outline why the United States should ratify the Framework Convention on Tobacco Control (FCTC). Please see later in the article for the Editors' Summar