Solar Radiation and Vitamin D: Mitigating Environmental Factors in Autoimmune Disease

This paper looks at the environmental role of vitamin D and solar radiation as risk reduction factors in autoimmune disease. Five diseases are considered: multiple sclerosis, type 1 diabetes, rheumatoid arthritis, autoimmune disease of the thyroid, and inflammatory bowel disease. Clinical relevant studies and factors that may indicate evidence that autoimmune disease is a vitamin D-sensitive disease are presented. Studies that have resulted in prevention or amelioration of some autoimmune disease are discussed. An example of the utility of supplementing vitamin D in an unusual autoimmune disease, idiopathic thrombocytic purpura, is presented

The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health?

This review looks at the role of an alkaline diet in health. Pubmed was searched looking for articles on pH, potential renal acid loads, bone health, muscle, growth hormone, back pain, vitamin D and chemotherapy. Many books written in the lay literature on the alkaline diet were also reviewed and evaluated in light of the published medical literature. There may be some value in considering an alkaline diet in reducing morbidity and mortality from chronic diseases and further studies are warranted in this area of medicine

Kardiorespiratorische Effekte von automatischer Tubuskompensation während Airway Pressure Release Ventilation bei Patienten mit akutem Lungenversagen

Hintergrund: Spontane Atembemühungen während einer Drucknachlassbeatmung (APRV) werden nicht von der Beatmungsmaschine unterstützt und müssen den artifiziellen Atemwegswiderstand (Ret) des Tubus überwinden. Die automatische Atemwegskompensation (ATC) unterstützt jeden spontanen Atemzug durch Erhöhung des Atemwegdrucks (Paw) in der Inspiration und Erniedrigung von (Paw) in der Exspiration. Untersucht wurde, ob APRV mit ATC bei Patienten mit akutem Lungenversagen (ALI) und erhöhter Gefahr eines weiteren Alveolarkollaps die inspiratorischen Bemühungen reduziert, ohne dabei die kardiale Funktion, das endexspiratorische Lungenvolumen (EELV) oder den alveolaren Gasaustausch zu erniedrigen. Methodik: Anhand eines computergesteuerten mechanischen Lungenmodells wurden mittels eines Pneumotachographen Paw und Trachealdruck (Ptr) aufgenommen. Offline wurde daraus, über die root-mean-square (RMS) Analyse des Ptr, die Regelgüte der Atmungunterstützung des Beatmungsgerätes (Evita 4) untersucht. Die Tiermessungen an 7 intubierten, narkotisierten und beatmeten Schweinen beinhalteten zusätzlich die Aufnahme des Ösophagusdruckes (Pes) mit dessen Hilfe eine Formel für die Berechnung von Ptr validiert wurde. Dritter Tel war ein Kollektiv aus 14 beatmeten Patienten auf einer Intensivstation. Spirometrische Messungen umfassten die Aufnahme von Paw, Pes und abdominellen bzw. muskulären Drucks (Pmus) mit dessen Hilfe die Atemarbeit (WOB) über das pressure time product (PTPdi) erechnet wurde. EELV wurde über die Stickstoffauswaschmethode bestimmt. Ergebnisse: Die PtrRMS Werte erreichten bei keinem Tubus oder Trachealkanüle den Vergleichswert einer Messung ohne Tubus. Vor allem die vollständige Kompensation von kleinen Tubusdurchmessern war nicht möglich. Der Unterschied zwischen gemessenem und berechneten Ptr betrug unter APRV 0,34 ± 0,06 und mit ATC Modus 0,41 ± 0,09 cm H2O. Die Druckunterstützung erfolgte durchschnittlich 166± 19ms verzögert. Die Patientenmessungen ergaben, dass ATC den dPaw von 7.7±1.9 to 11.3±3.1 cm H2O (mean SD, pZusammenfassung: Die Modellmessungen zeigten, dass die Regelgüte der Tubuskompensation des Ventilators nicht optimal funktioniert. Die Validierung der Ptr Berechnungsfomel konnte mit den Tiermessungen erfolgreich nachgewiesen werden. Es zeigte sich erstmals eine Zeitverzögerung der Druckunterstützung. Die Atemarbeit der untersuchten Patienten konnte durch ATC deutlich gesenkt und die EELV erhöht werden, ohne dass es zu Veränderungen der kardiorespiratorischen Funktion kam. Bemerkenswert war die Tatsache, dass eine intermittierende Senkung des Paw keine Bildung von Atelektasen provozierte. Trotzdem zeiget sich eine nihct ideale Zeitverzögerung der Unterstützung.Cariovascular effects of automatic tube compensation during airway pressure release ventilation on patients with acute lunge injuryBackground: Spontaneous breaths during airway pressure release ventilation (APRV) are unsupported and have to overcome the load imposed by the resistance of the artificial airway (Ret). Automatic tube compensation (ATC) provides ventilatory assistance for each spontaneous breath by increasing airway pressure (Paw) during inspiration and lowering Paw during expiration thereby compensating for Ret. We studied, if APRV with ATC reduces the inspiratory effort without compromising cardiovascular function, end-expiratory lung volume (EELV), and gas exchange in patients with acute lung injury (ALI) at risk for further alveolar collapse. Methods: Mea14 patients with ALI were breathing spontaneously during APRV with or without ATC in random order. Airway (Paw), esophageal, and abdominal pressure and gas flow were continuously measured, and tracheal pressure (Ptr) was estimated. Trans-diaphragmatic pressure time product (PTPdi) was calculated as an index of inspiratory muscle load. Multi-breath nitrogen washout maneuvers were used to determine EELV. The validity of the Ptr calculation was investigated in 7 healthy ventilated pigs. Results: ATC during APRV increased DPaw from 7.7±1.9 to 11.3±3.1 cm H2O (mean±SD, pConclusion: In the studied patients with ALI ventilated with APRV, ATC markedly unloaded the inspiratory muscle load and increased alveolar ventilation without compromising cardiorespiratory function. Apparently, transient lowering of Paw during expiration with ATC did not promote alveolar collapse in our patients with ALI

Biochemical and functional properties of indigenous Australian herbal infusions

The phytochemical profile, organic acid content, minerals, various antioxidant assays and consumers acceptability of indigenous Australian herbal infusions namely gulban (Melaleuca citrolens), anise myrtle (Syzygium anisatum), and lemon myrtle (Backhousia citriodora) were compared with a commercial green tea (Camellia sinensis). Total phenolic content and catechin derivatives were higher in green tea as compared to indigenous herbal infusions (P < 0.05). Phytochemical profiles showed high levels of caffeine in green tea, but, it was not found in herbal infusions (P < 0.05). Australian indigenous herbal infusions were a good source of calcium and magnesium compared to green tea (P < 0.05). Oxalic acid was higher in green tea, whereas gulban and anise myrtle infusions were rich in citric acid (P < 0.05). Antioxidant activities of green tea and gulban herbal infusions were comparable (P ≥ 0.05). Overall liking scores were higher for herbal infusions compared to green tea (P < 0.05). Indigenous Australian herbal infusions particularly gulban has a potential to become a successful commercial herbal beverage

Vitamin D Status of Clinical Practice Populations at Higher Latitudes: Analysis and Applications

Background: Inadequate levels of vitamin D (VTD) throughout the life cycle from the fetal stage to adulthood have been correlated with elevated risk for assorted health afflictions. The purpose of this study was to ascertain VTD status and associated determinants in three clinical practice populationsliving in Edmonton, Alberta, Canada -a locale with latitude of 53°30\u27N, wheresun exposure from October through March is often inadequate to generate sufficient vitamin D. Methods: To determine VTD status, 1,433 patients from three independent medical offices in Edmonton had levels drawn for 25(OH)D as part of their medical assessment between Jun 2001 and Mar 2007. The relationship between demographic data and lifestyle parameters with VTD status was explored. 25(OH)D levels were categorized as follows: (1) Deficient

Spatial and temporal patterns of pore water chemistry in the inter-tidal zone of a high energy beach

Submarine groundwater discharge (SGD) is a ubiquitous source of meteoric fresh groundwater and recirculating seawater to the coastal ocean. Due to the hidden distribution of SGD, as well as the hydraulic- and stratigraphy-driven spatial and temporal heterogeneities, one of the biggest challenges to date is the correct assessment of SGD-driven constituent fluxes. Here, we present results from a 3-dimensional seasonal sampling campaign of a shallow subterranean estuary in a high-energy, meso-tidal beach, Spiekeroog Island, Northern Germany. We determined beach topography and analyzed physico-chemical and biogeochemical parameters such as salinity, temperature, dissolved oxygen, Fe(II) and dissolved organic matter fluorescence (FDOM). Overall, the highest gradients in pore water chemistry were found in the cross-shore direction. In particular, a strong physico-chemical differentiation between the tidal high water and low water line was found and reflected relatively stable in- and exfiltrating conditions in these areas. Contrastingly, in between, the pore water compositions in the existing foreshore ridge and runnel system were very heterogeneous on a spatial and temporal scale. The reasons for this observation may be the strong morphological changes that occur throughout the entire year, which affect the exact locations and heights of the ridge and runnel structures and associated flow paths. Further, seasonal changes in temperature and inland hydraulic head, and the associated effect on microbial mediated redox reactions likely overprint these patterns. In the long-shore direction the pore water chemistry varied less than the along the cross-shore direction. Variation in long-shore direction was probably occurring due to topography changes of the ridge-runnel structure and a physical heterogeneity of the sediment, which produced non-uniform groundwater flow conditions. We conclude that on meso-tidal high energy beaches, the rapidly changing beach morphology produces zones with different approximations to steady-state conditions. Therefore, we suggest that zone-specific endmember sampling is the optimal strategy to reduce uncertainties of SGD-driven constituent fluxes

Control of Tungiasis through Intermittent Application of a Plant-Based Repellent: An Intervention Study in a Resource-Poor Community in Brazil

Tungiasis is a parasitic skin disease caused by the female sand flea Tunga penetrans. The disease is frequent in resource-poor communities in South America and sub-Saharan Africa and affects the poorest of the poor. Sand flea disease is associated with a considerable morbidity and may lead to tetanus in non-vaccinated individuals. The degree of morbidity depends on the intensity of infestation, i.e., the number of embedded sand fleas a person has. Since tungiasis is a zoonosis involving a host of animal reservoirs, and because an effective treatment is not at hand, in resource-poor settings elimination is not feasible. Preventing morbidity to develop is therefore the only means to protect exposed individuals from sand flea disease. Similar to other arthropods, sand fleas can be repelled before they penetrate into the skin. In this study we show that the intermittent application of a plant-based repellent, of which the major component is coconut oil, reduces the intensity of infestation dramatically during the whole transmission season and prevents tungiasis-associated morbidity from developing. The prevention can be performed at the household level by the affected individuals themselves with minimal input from the health sector

Controlling Tungiasis in an Impoverished Community: An Intervention Study

Tungiasis is a disease caused by the sand flea Tunga penetrans, a parasite prevalent in many impoverished communities in developing countries. The female sand flea penetrates into the skin of animals and humans where it grows rapidly in size, feeds on the host's blood, produces eggs which are expelled into the environment, and eventually dies in situ. The lesions become frequently superinfected and the infestation is associated with considerable morbidity. Clearly, tungiasis is a neglected disease of neglected populations. We investigated the impact of a package of intervention measures targeted against on-host and off-host stages of T. penetrans in a fishing community in Northeast Brazil. These measures decreased disease occurrence only temporarily, but had a sustained effect on the intensity of the infestation. Since infestation intensity and morbidity are correlated, presumably the intervention also lowered tungiasis-associated morbidity. Control measures similar to the ones used in this study may help to effectively control tungiasis in impoverished communities

Effect of n-3 fatty acids on immune function in broiler chickens

There is interest in the enrichment of poultry meat with long-chain n-3 polyunsaturated fatty acids in order to increase the consumption of these fatty acids by humans. However, there is concern that high levels of n-3 polyunsaturated fatty acids may have detrimental effects on immune function in chickens. The effect of feeding increasing levels of fish oil (FO) on immune function was investigated in broiler chickens. Three-week-old broilers were fed 1 of 4 wheat-soybean basal diets that contained 0, 30, 50, or 60 g/kg of FO until slaughter. At slaughter, samples of blood, bursa of Fabricius, spleen, and thymus were collected from each bird. A range of immune parameters, including immune tissue weight, immuno-phenotyping, phagocytosis, and cell proliferation, were assessed. The pattern of fatty acid incorporation reflected the fatty acid composition of the diet. The FO did not affect the weight of the spleen, but it did increase thymus weight when fed at 50 g/kg (P < 0.001). Fish oil also lowered bursal weights when fed at 50 or 60 g/kg (P < 0.001). There was no significant effect of FO on immune cell phenotypes in the spleen, thymus, bursa, or blood. Feeding 60 g/kg of FO significantly decreased the percentage of monocytes engaged in phagocytosis, but it increased their mean fluorescence intensity relative to that of broilers fed 50 g/kg of FO. Lymphocyte proliferation was significantly decreased after feeding broiler chickens diets rich in FO when expressed as division index or proliferation index, although there was no significant effect of FO on the percentage of divided cells. In conclusion, dietary n-3 polyunsaturated fatty acids decrease phagocytosis and lymphocyte proliferation in broiler chickens, highlighting the need for the poultry industry to consider the health status of poultry when poultry meat is being enriched with FO