Effects of 24-week prebiotic intervention on self-reported upper respiratory symptoms, gastrointestinal symptoms, and markers of immunity in elite rugby union players.

OBJECTIVES: Elite rugby union players face numerous physiological and psychological stressors which can increase upper respiratory and gastrointestinal illness risk, and in turn can compromise training and competitive performance. This study aimed to investigate the effect of daily prebiotic supplementation on upper respiratory symptoms, gastrointestinal symptoms, and markers of immune function in elite rugby union players. METHODS: Thirty-three elite rugby union players were randomly assigned to consume a prebiotic (2.8 g/day galactooligosaccharide) or placebo (2.8 g/day maltodextrin), daily for 168 days under double-blind conditions. Participants completed daily and weekly questionnaires for self-reported upper respiratory and gastrointestinal symptoms respectively. Blood and saliva samples were collected at 0, 84, and 168 days for assessment of plasma TNF-α and CRP, and saliva IgA respectively. RESULTS: The prebiotic group experienced a 2-day reduction in upper respiratory symptom duration (P = 0.045). Gastrointestinal symptom severity and incidence were lower in the prebiotic group compared to the placebo group (P < 0.001, P = 0.041) respectively. Salivary immunoglobulin A secretion rate was 42% greater in the prebiotic group compared to the placebo group at day 168 (P = 0.004), no differences in CRP and TNF-α were found (P > 0.05). CONCLUSION: A 168-day dietary prebiotic intervention reduced the duration of upper respiratory symptoms and reduced the incidence and severity of gastrointestinal symptoms in elite rugby union players. These findings suggest that seasonal prebiotic interventions may be beneficial for reducing illness in elite rugby union players, improving their availability to train and compete.Key pointsElite athletes are susceptible to upper respiratory symptoms and gastrointestinal symptoms which may impact upon training availability and competition performance.For the first time, this study shows that a dietary prebiotic intervention can reduce the duration of upper respiratory symptoms by 2 days in elite rugby union players.Dietary prebiotic supplementation can improve the incidence and severity of gastrointestinal symptoms experienced by elite rugby union players.Prebiotic supplementation was able to increase salivary IgA secretion after 168 days.These findings can inform practice suggesting that seasonal prebiotic use has the potential to modulate immune function and reduce illness in elite rugby union, which may improve a player's availability to train and compete.The mechanisms by which prebiotics reduce URS and GIS require further research exploration.

Reproducibility of the bronchoconstrictive response to eucapnic voluntary hyperpnoea.

BACKGROUND: Eucapnic voluntary hyperpnoea (EVH) is considered an effective bronchoprovocation challenge for identifying exercise-induced bronchoconstriction (EIB). However, the reproducibility of the hyperpnoea-induced bronchoconstriction (HIB) response elicited by EVH remains unknown and was therefore the focus of this study. METHODS: Two cohorts of 16 physically active males (each cohort comprised 8 controls and 8 with physician diagnosis of asthma) participated in two studies of the short- and long-term reproducibility of the bronchoconstrictive response to an EVH test with dry air. EVH was performed on days 0, 7, 14, and 21 (short-term study), and 0, 35, and 70 (long-term study). HIB was diagnosed by a ≥10% fall in forced expiratory volume in 1 s (FEV1) after EVH. RESULTS: On day 0 of the short-term study, FEV1 fell by 2 ± 1% (P < 0.05) and 27 ± 18% (P < 0.01) from pre-to post-EVH in control and HIB-positive groups respectively. The post-EVH fall in FEV1 did not differ across the short-term study test days. In the HIB-positive group, the day-to-day coefficient of variation, reproducibility, and smallest meaningful change for the fall in FEV1 were 12%, 328 mL, and 164 mL, respectively. On day 0 of the long-term study, FEV1 fell by 2 ± 2% and 25 ± 18% (P < 0.01) after EVH in control and HIB-positive groups respectively. The post-EVH fall in FEV1 did not differ across the long-term study test days. In the HIB-positive group, the day-to-day coefficient of variation, reproducibility, and smallest meaningful change for the fall in FEV1 were 10%, 196 mL, and 98 mL respectively. CONCLUSION: The EVH test elicits a reproducible bronchoconstrictive response in physically active males with physician diagnosed asthma. These data thus support the clinical utility of the EVH test for EIB screening and monitoring.

Modifying the surface charge of pathogen-sized microspheres for studying pathogen transport in groundwater.

Consuming pathogen-contaminated groundwater has caused many waterborne disease worldwide. Microspheres are often used as pathogen surrogates because they can be made similar to pathogens in terms of their sizes, buoyant densities, and shapes. Laboratory studies have, however, shown that the surface charges of microspheres are very different from those of pathogens of comparable sizes, and that their attenuation and transport behaviors differ significantly to those of the pathogens mimicked. Thus, for microspheres to be better surrogates, their surface charges need to be modified. We have demonstrated that the surface charge of a microorganism can be closely mimicked by microspheres covalently coated with a protein that has a similar pHPZC to the microorganism. Using MS2 bacteriophage to test our concept, 20 nm carboxylated microspheres were covalently coated with casein. Zeta potentials as a function of pH were determined for purified MS2, casein, and uncoated and coated microspheres. The uncoated microspheres were significantly more negatively charged than MS2. The coated microspheres displayed zeta potentials and a pHPZC value similar to MS2. The modified surface charge on the microspheres was stable for at least 4 mo. Using the concept developed from this study, surrogates for many specific pathogens of concern can be developed, and the results can be corrected with pathogen die-off determined independently in the laboratory. Protein-coated microspheres could provide a new and alternative approach to investigate pathogen transport in groundwater. Future research is required to validate the surrogates' resemblances to pathogens in terms of their attenuation and transport behaviors in groundwater.

Comparison of particle size spectrum determination from images made using manual and automated image analysis.

A digital processing method is described for determining the size spectra of sub-micron particles in natural water from transmission electron microscopy images of particles collected by ultracentrifugation, and is compared with traditional manual counting and size measurement methods. The processing method is based on the use of the MatLab Image Processing toolbox. The manual method was found to underestimate the population of particles smaller than 40 nm equivalent radius, primarily because of a "fatigue factor" in counting the very large numbers of particles in this size range. By contrast, the manual method produced higher particle counts of particles >50 nm radius, primarily because manual counters tend to group together particles as aggregates that digital processing indicates are not contiguous. The digitally-produced size spectrum for a river water sample was found to closely follow a power-series law down to the smallest particle size.

Adsorption of divalent copper, zinc, cadmium and lead ions from aqueous solution by waste tea and coffee adsorbents.

The adsorption of the divalent cations of Cu, Zn, Cd and Pb by tea leaves and coffee grounds from aqueous solutions is described. Both adsorbents exhibited strong affinity for these ions which could be described by a simple single-site equilibrium model. For coffee, the order of increasing adsorption equilibrium constant K was Cu < Pb < Zn < Cd, while for tea the opposite order was observed indicating that the adsorption sites on each adsorbent have a different chemical nature. Adsorption decreased at low pH < 4 through competition with H+ for adsorption sites, and for all metals except Cu, at high pH > 10, probably because of anion formation in the case of Zn2+ and also increased leaching of metal-binding soluble materials. The effect of metal ion concentration on the adsorptive equilibria indicated a threshold concentration above which overall adsorption became limited by saturation of the adsorption sites. Competition between two metal ions for the same sites was not observed with Cu(II) and Pb(II), however Zn(II) reacted competitively with Cd(II) binding sites on both tea and coffee. If fresh coffee or tea adsorbents were used, the fraction of metal ion taken up by the adsorbent was diminished by the competitive effects of soluble metal-binding ligands released by the tea or coffee. Experiments with coffee showed that roasting temperature controls the formation of metal ion adsorption sites for this adsorbent.

Global iron connections between desert dust, ocean biogeochemistry, and climate.

The environmental conditions of Earth, including the climate, are determined by physical, chemical, biological, and human interactions that transform and transport materials and energy. This is the "Earth system": a highly complex entity characterized by multiple nonlinear responses and thresholds, with linkages between disparate components. One important part of this system is the iron cycle, in which iron-containing soil dust is transported from land through the atmosphere to the oceans, affecting ocean biogeochemistry and hence having feedback effects on climate and dust production. Here we review the key components of this cycle, identifying critical uncertainties and priorities for future research.

Removal of copper and copper-binding organic ligands during potable water treatment.

The concentrations and chemical speciation of copper before and after potable water treatment have been examined using 3 techniques: a copper ion-selective electrode (Cu-ISE), chemiluminescence (CL) and anodic stripping voltammetry (ASV), together with water quality parameters colour, turbidity and dissolved organic carbon (DOC). As expected, only a small fraction of colour (6.6-11%), turbidity (6.7-14%) and DOC (20%) remained after treatment. The removal of Cu and Cu-binding natural organic matter (NOM) was more variable but still significant: 17-64% of total dissolved Cu and 19-61% of Cu-binding NOM (as determined by ASV) remained after treatment. Labile Cu levels, as measured by CL, were 0-23% after treatment. The Cu-ISE titrations showed significant Cu-binding in raw water in the concentration range 10(-7) to 10(-6) mol l(-1) Cu2+, but very little binding after treatment. The results indicate that conventional water treatment has a significant effect on both total Cu levels and Cu-binding NOM, with implications for Cu2+ speciation and bio-availability, particularly in reticulation systems containing copper pipes.

Activated eosinophils upregulate the metastasis suppressor molecule E-cadherin on prostate tumor cells.

Cell adhesion molecules (CAMs) play an important role in cancer metastasis by facilitating attachment to vascular endothelia, invasion and spread into secondary tissue sites. We have shown that activated eosinophils (EosA) inhibited the growth of prostate cancer (Pca) cells in vitro. In the present study, we examined the ability of EosA 24 hr conditioned supernatants (EosAcs) to modulate the expression of ICAM-1, VCAM-1, ELAM-1, E-cadherin and N-cadherin expression on human Pca cell lines, Du-145 and PC-3 by flow cytometry. TNF-alpha, IL-10 and IL-12 were also evaluated. ICAM-1, expressed on PC-3 and DU 145 cells, was enhanced by TNF-alpha and IL-10. ELAM-1 was present on DU 145 cells but absent on PC-3. TNF-alpha and IL-10 enhanced ELAM-1 on DU 145, but EosA 24 hr supematants failed to do so. All three cytokines, namely IL-10, IL-12 and TNF-alpha-induced ELAM-1 on PC-3 tumor cells. Although VCAM-1 was absent on DU 145 and PC-3 cells, it was expressed on DU-145 cells after exposure to EosA: tumor cell co-cultures, and was expressed on PC-3 following exposure to IL-10 and IL-12. N-cadherin and E-cadherin were both expressed on DU-145. While N-cadherin was expressed on PC-3 cells, E-cadherin was not. N-cadherin was enhanced on DU-145 and PC-3 cells following exposure to EosA co-culture and upregulated on PC-3 by IL-10 and EosA 24 hr supernatants, but decreased by IL-12. E-cadherin was up-regulated on DU 145 cells following co-culture with EosA and was induced on PC-3 by IL-10 and IL-12, but not by EosA co-culture and 24 hr supematants. In conclusion, inflammatory and non-inflammatory cytokines modulate CAM expression on Pca cells; EosA and EosA 24 hr supernatants also exerted modulatory activity of CAM expression. Most significantly, the metastasis suppressor molecule, E-cadherin was enhanced on DU 145 cells by EosA and induced on PC-3 by IL-10 and IL-12 both of which are produced by EosA. This suggests potential use of these cytokines in immunotherapeutic strategies for prostate cancer and its metastasis.

Eosinophils in a tri-cell multicellular tumor spheroid (MTS)/endothelium complex.

Eosinophils have been found in infiltrates of many different cancers. It is still unclear as to whether they are passive bystanders in the cellular milieu or active cellular agents in host responses. Thus their harmful or helpful nature remains equivocal. We have developed an in vitro tri-cell model of eosinophils, MCF-7 breast tumor cell spheroids and HUVEC endothelial cells to examine the binding and association of eosinophils with both the tumor and the endothelia and the ensuing action of the tumor. Eosinophils bound very rapidly to the tumor spheroid and remained tightly bound throughout the 24 hr culture period. Histological staining of the tri-cell complex revealed highly granulated eosinophils as well as large amounts of degranulated protein diffused throughout the spheroid. IL-5 treatment of eosinophil: MTS complexes resulted in destruction of the tumor cells, particularly those which had grown out from the spheroid onto the endothelial cells. Eosinophils, pretreated with IL-5 before interaction with the tumor or endothelial cells, bound aggressively to the endothelial cells, thereby preventing tumor attachment. This eosinophil tri-cell tumor model system mimics clinical observations with regards to binding to epithelial and endothelial cells, dispersal of granular proteins throughout the tumor and also tumor destruction. Because it closely mirrors in vivo cellular interactions, it allows one to study more closely the mechanism(s) of eosinophil killing, the modulation of eosinophil activity and the testing of therapeutic interventions. The accommodation of the model to tumor invasion, using metastatic tumor cells and extracellular matrices such as matrigel, will help to elucidate a role for eosinophils (and their mediators) in cancer invasion and metastasis.

Effect of diets rich in oleic acid, stearic acid and linoleic acid on postprandial haemostatic factors in young healthy men.

The aim of the present study was to investigate the effects of stearic acid-, oleic acid- and linoleic acid-rich meals on postprandial haemostasis in young healthy volunteers whose background diets had been controlled for 14 d in a residential study. Six healthy male volunteers were assigned randomly to consume diets rich in stearic acid, oleic acid or linoleic acid for 14 d. On day 15, plasma lipids and haematological variables were measured in the fasted state, and 3 and 7 h (factor VII and prothrombin activation peptide fragments, 1 and 2 only) after consumption of a test meal. Test meals provided 40 % of the subjects' daily energy requirement, with 41 % of the energy provided as fat, 17 % energy as protein and 42 % energy as carbohydrate. The mean fat content of the meal was 45 (sd 5) g. Significant alterations from fasted values were observed for activated factor VII after 7 h), factor VII antigen after 7 h), prothrombin activation peptide fragments 1 and 2 after 7 h) and plasminogen activator inhibitor type 1 activity after 3 h) after consumption of each of the three meals. No significant differences were observed in haemostatic values (factor VII coagulant activity, factor VII antigen, tissue plasminogen activator activity prothrombin activation peptide fragment and plasminogen activator inhibitor type-1) with regard to diet except for activated factor VII at 3 h; values were higher after the oleic acid- and linoleic acid-rich meals than after the stearic acid-rich meal After consumption of each of the three meals, chylomicrons contained proportionately more palmitic acid than the lipids ingested. The present study shows that there are demonstrable changes in postprandial haemostasis when young healthy volunteers with controlled dietary backgrounds are challenged with a physiological fat load. These changes are independent of the fatty acid composition of the test meals.

Cyclic gmp is a measure of physiologic stress.

This study was undertaken to determine whether patients who were critically ill evidenced elevated levels of blood cyclic guanosine monophosphate (cGMP). Cyclic guanosine monophosphate levels correlated with severity of illness as measured by the APACHE II severity of illness scoring system (p < 0.01). Cyclic guanosine monophosphate also correlated with the level of carboxyhemoglobin (HbCO) (p < 0.001). The correlation between cGMP and creatinine was p < 0.0001. Patients with end-stage disease (renal or liver) tended to have elevated levels of cGMP (p < 0.0001). We conclude that the induction of these two molecules may be linked in patients with increasing severity of illness.

Effects of smoking and abstention from smoking on fibrinogen synthesis in humans.

Cigarette smoking and hyperfibrinogenaemia are both significant risk factors for the development of cardiovascular disease. Two studies are described here which aimed to establish the metabolic mechanism responsible for the raised plasma fibrinogen concentration observed in smokers. Chronic smokers had a significantly elevated absolute rate of fibrinogen synthesis (ASR) compared with non-smokers (22.7 +/- 1.3 mg/kg per day versus 16.0 +/- 1.3 mg/kg per day; means +/- S.E.M., P < 0.01), with plasma levels of fibrinogen significantly correlated with fibrinogen synthesis (r = 0.65, P = 0.04). Unlike fibrinogen, plasma albumin concentrations were lower in smokers than in non-smokers (45 +/- 0.4 versus 47 +/- 0.7 g/l, P < 0.05), but there was no difference in rates of albumin synthesis between the two groups. Two weeks cessation from smoking by previously chronic smokers was associated with a rapid and marked fall in plasma fibrinogen concentration (from 3.06 +/- 0.11 g/l to 2.49 +/- 0.14 g/l, P < 0.001), and a significant reduction in ASR (a 33% reduction, from 24.1 +/- 1.7 to 16.1 +/- 1.0 mg/kg per day, P < 0.001). These studies suggest a primary role for increased synthesis in producing the hyperfibrinogenaemia associated with smoking. Moreover, abstention from smoking for a period of only 2 weeks induces a significant decrease in the rate of fibrinogen synthesis by the liver, with a concomitant reduction in the plasma fibrinogen concentration.

Methyl mercury bioaccumulation in long-finned eels, Anguilla dieffenbachii, from three rivers in Otago, New Zealand.

This research focuses on mercury (Hg) bioaccumulation in New Zealand long-tinned eels (Anguilla dieffenbachii) from the aquatic environment. Total Hg (HgT) and methyl mercury (MeHg) concentrations were determined in muscle tissue from eels living in three South Island rivers dominated respectively by urban, native bush and agricultural land-uses. Most of the Hg in eels was MeHg (> 84%) and the MeHg concentrations increased linearly with both length and eel age for a given river habitat. The annual growth rates for eels from the urban and agricultural streams were greater than for eels from the native bush stream. The average MeHg accumulation rate was significantly higher for the eels in the agricultural stream compared with either the urban or native bush catchments. These results are probably due to a combination of factors and further investigations in the lower food web are necessary to elucidate the exact mechanisms of MeHg bioaccumulation in these creatures.

A residential study comparing the effects of diets rich in stearic acid, oleic acid, and linoleic acid on fasting blood lipids, hemostatic variables and platelets in young healthy men.

Dietary fat is known to influence the variables of blood coagulation and fibrinolysis associated with vascular disease. However, the role of fat content and/or fat composition of the diet in this regard is still not well understood. In the present study, we investigated the effects of three isoenergic diets of differing fat composition in nine healthy young men in a strictly controlled residential study. Subjects consumed the three experimental diets for periods of 2 weeks each, separated by a washout period of at least 5 weeks in a randomized crossover design. The diets provided 38% of total energy intake as fat, 45% as carbohydrate, and 17% as protein, and differed only with respect to the fatty acid composition (stearic acid-rich diet: 34.1% stearic acid, 36.6% oleic acid; oleic acid-rich diet: 65.8% oleic acid; linoleic acid-rich diet: 36.5% linoleic acid, 38% oleic acid). Blood samples were collected at the beginning and at the end of each dietary period from fasted subjects for determination of factor VII coagulant activity (FVIIc), activated factor VII (FVIIa), factor VII antigen (FVIIag), tissue plasminogen activator (tPA) activity, plasminogen activator inhibitor type 1 (PAI-1) activity, fibrinogen, prothrombin fragment 1+2 (F(1+2)), and plasma lipids. There were no significant differences between diets in fasting plasma concentrations of FVIIc, FVIIa, FVIIag, fibrinogen, F(1+2), PAI-1 activity, and tPA activity. Plasma concentrations of lipids (high density lipoproteins, low density lipoproteins, triacylglycerols, and total cholesterol) were also unaffected. Although there were no changes in platelet aggregation response and membrane fluidity observed in any of the diets, increased anti-aggregatory prostaglandin E(1) binding to platelet membranes was observed only in the case of linoleic acid-rich diet. In conclusion, diets with very different fatty acid compositions, at 38% of energy as fat intake, did not significantly influence blood coagulation, fibrinolysis, or blood lipids in the fasting state in young healthy men.

The effects of structurally defined triglycerides of differing fatty acid composition on postprandial haemostasis in young, healthy men.

The aim of this study was to investigate whether a number of key haemostatic factors were altered when healthy young individuals were challenged with a fat load of physiological size contained within a meal composed of normal ingredients and whether this response was modified when the fatty acid composition of the meal was altered radically. Eight healthy male volunteers each randomly consumed four meals which were identical in terms of gross nutritional content (41% of energy provided as fat, 17% as protein and 42% as carbohydrate) but which differed in fatty acid composition. To reduce the possible influence of fatty acid position within the triglyceride molecule on lipid absorption and subsequent metabolic effects, the structural integrity of 91% of fat (test triglycerides such as 1,3 distearoyl-2-oleoyl glycerol (S-O-S), trioleine (O-O-O), and 1,3 dilinoleoyl-2-oleoyl glycerol, (L-O-L)) in the meals was controlled so that the principal fatty acid in the sn-2 position was oleic acid (18:1n-9). Meals rich in either a test triglyceride or a control oil provided 44+/-6 g of fat. No significant alterations from fasted values of elevated plasma factor VII coagulant activity (FVIIc) or F1 + 2 were observed. FVIIA varied significantly over the postprandial time course; however, when expressed as a percentage of the fasting value, the FVIIa responses to O-O-O and L-O-L differed significantly but this was not evident when the absolute values were analysed. Similarly, no difference in plasma fibrinopeptide A (FPA) concentrations were evident. After all four meals, chylomicron contained proportionately more palmitic acid and generally less oleic acid than the ingested lipids. This study clearly demonstrates that postprandial haemostatic responses of young healthy individuals to a physiological fat load are minimal, (irrespective of triglyceride structure).

Depression in community-dwelling elders. Overcoming treatment obstacles with new antidepressants.

Although depression is the most common psychiatric disorder among older adults, it continues to be misdiagnosed and undertreated in this population for a variety of reasons. The authors present an overview of the efficacy and side effects of antidepressant medications, pointing out advantages of new drugs that are especially important in older patients.

Pharmaceutical care for home-dwelling elderly persons: a determination of need and program description.

To determine the need for pharmaceutical care services within a community-based, case management program for elders, an assessment of medication, health, and functional status was completed by a pharmacist on 49 home-dwelling older adults. The goal of this assessment was to support the need for pharmacists as members of multidisciplinary teams that provide comprehensive, in-home care for elderly persons. Pharmacists can identify drug misadventures that have the potential to lead to loss of independent living status, hospital admissions, and death. This article describes this program and the results of the assessment that supported the decision to include a pharmacist on the multidisciplinary team.

Acute epiglottitis in a gravid 19-year-old.

We report a case of adult onset epiglottitis needing emergent tracheal intubation in a parturient at 11 weeks gestational age.

Pharmaceutical care applied to the hospice setting: a cancer pain model.

A review of the concept of pharmaceutical care applied to the hospice setting with emphasis on the management of cancer pain. Traditionally pharmacists involved in hospice care have acted in a distributive function and as an information resource. The advantages of having a hospice pharmacist practicing pharmaceutical care are many and include enhanced patient quality of care through monitoring patient outcomes, establishing drug therapy protocols, enhanced patient compliance through patient education, better pain and symptom control, and staff education. Monitoring therapeutic outcomes starts with chart reviews to collect all relevant information and attending patient care conferences to obtain information concerning the patient's condition. Once this is done, a patient-specific drug-related problem list is formulated, and from this list, desired therapeutic outcomes and alternatives are established to monitor therapy and to insure the drug is producing the desired effect. Pharmaceutical care fits well with the concept of hospice care, which has as its primary purpose maintaining the quality of life in the terminal patient. There is no portion of caring for the terminally ill patient that is more important than the management of pain. As a result of implementing the concept of pharmaceutical care in the hospice setting for cancer patients, pain can be managed in an effective and compassionate way. By monitoring treatments and eliminating medication-induced problems, the pharmacist becomes a valuable member of the health care team in the management of terminally ill patients. This in turn increases the quality of care as well as the quality of life for the hospice patient.

Pharmacist-managed intravenous to oral step-down program.

In an effort to provide cost-effective pharmaceutical care at a 650-bed community hospital, a pharmacist-managed intravenous to oral step-down program was developed and implemented. As part of this program, satellite pharmacists review daily the charts of patients receiving 1 or more of 10 targeted drugs given intravenously. Based on a predetermined set of criteria and their clinical judgment, pharmacists recommend that physicians switch to the oral formulation of the targeted drugs if appropriate. This program has been in place for 7 months, during which time 223 recommendations were made. Of these recommendations, 190 were accepted and implemented, resulting in a cost savings of $21,596.00. When annualized, the expected savings is $37,000.00 or nearly the salary of one full-time pharmacist. This program has been well accepted by physicians and pharmacists. It appears to be having a positive impact on physician awareness of using oral medications when appropriate.