Lack of impact of cytotoxic T-lymphocyte antigen 4 gene exon 1 polymorphism on susceptibility to or clinical course of egyptian childhood immune thrombocytopenic purpura.

Dysfunctional T-lymphocyte immunity plays an important role in the pathophysiology of immune thrombocytopenic purpura (ITP). Cytotoxic T-lymphocyte antigen 4 (CTLA-4)-a surface marker expressed on T regulatory cells and activated T lymphocytes-is a negative modulator of T-cell responses. Polymorphisms of the CTLA-4 may alter the level of antigen expression and hence may influence immune regulation. The study aimed to evaluate the possible contribution of CTLA-4 exon 1 49 A>G polymorphism to the pathogenesis of ITP and its relation to age of disease onset, clinical course, and response to therapy. Genotyping of CTLA-4 exon 1 49 A>G was performed in 100 pediatric patients with ITP and 259 healthy individuals by polymerase chain reaction-restricted fragment length polymorphism. No significant differences existed in genotype or allele distributions between patients and controls for the studied polymorphism. Comparable genotypes and allele frequencies were obtained between the 2 groups after their stratification by age of disease onset, clinical course, or response to therapy. In conclusion, CTLA-4 exon 1 49 A>G polymorphism is not associated with susceptibility to ITP in the Egyptian population; neither it affects the clinical picture of the disease.

Meibomian gland dysfunction and ocular discomfort in video display terminal workers.

PURPOSE: Meibomian gland dysfunction (MGD) is one of the most common ocular disorders encountered in clinical practice. The clinical manifestations of MGD are related to the changes in the tear film and ocular surface with symptoms of ocular discomfort. In recent years, many surveys have evaluated symptoms associated with the use of Video Display Terminals (VDT), and VDT use is recognized as a risk factor for eye discomfort. The aim of the present study was to determine if the presence of MGD contributes to the signs and symptoms of ocular discomfort during the use of VDT. METHODS: In course of a routine health surveillance programme, a group of 70 subjects fulfilled the inclusion criteria and responded to a questionnaire about symptoms of ocular discomfort. The following ocular tests were performed: tear break-up time, fluorescein corneal stain, and basal tear secretion test. RESULTS: A total of 52 subjects out of 70 (74.3%) had MGD. A statistically significant correlation between the symptoms of ocular discomfort and hours spent on VDT work was observed in the total population (r=0.358; P=0.002; 95% CI 0.13-0.54) and in the group of subjects with MGD (r=0.365; P=0.009; 95% CI 0.103-0.58). Such correlation was not shown in subjects without MGD. CONCLUSIONS: The high prevalence of MGD among the subjects with symptoms of ocular discomfort suggests that this diagnosis should be considered when occupational health practitioners encounter ocular complaints among VDT operators. It appears that MGD can contribute to the development of ocular discomfort in VDT operators.

Prevalence of aflatoxins in blood and urine of Egyptian infants with protein-energy malnutrition.

The aim of the present work was to study the presence of aflatoxins in blood and urine of infants with protein-energy malnutrition (PEM). The study was conducted on 60 infants, 30 with kwashiorkor and 30 with marasmus, with 10 age-matched healthy infants studied as a control group. Complete blood count, liver function tests, and determination of the level of aflatoxins (B1, B2, G1, G2, M1, M2, G2a, B3, GM1, P, and aflatoxicol R0) in blood and urine were carried out in all studied infants. Serum aflatoxins were detected in more infants with kwashiorkor (80%) than in those with marasmus (46.7%). The mean serum levels of total aflatoxins, AFB1, AFG1, and AFB2a, were significantly higher in infants with kwashiorkor (p <.001). Aflatoxin B1 (AFB1) was the most commonly detected type. The prevalence of aflatoxin excretion in the urine of infants with kwashiorkor was 80%, a higher value than that in infants with marasmus (46.7%). The mean urinary concentration of total aflatoxins followed the same pattern of distribution (p < .052). There were no significant differences between groups in the mean urinary concentrations of AFB1, AFG1, AFB2a, AFM1, and AFG2a. Aflatoxins were not detected in any of the serum or urine samples of the control group. Aflatoxins are highly prevalent in this study population and show a high degree of correlation with severe PEM.

Upper extremity pain seen with fly-casting technique: a survey of fly-casting instructors.

OBJECTIVE: To identify the prevalence of upper extremity pain symptoms in fly-casting instructors and examine the association between pain and casting style and equipment. METHODS: We used a cross-sectional survey of a randomly selected group of 577 fly-casting instructor mailing-list members and recorded equipment; casting styles; pain symptoms; and Disability of the Arm, Shoulder, and Hand inventory. We used univariate statistical tests to examine the associations between pain and casters' equipment and styles. RESULTS: In 292 usable surveys, pain was reported in the shoulder (50%), elbow (39%), and wrist (36%) of those surveyed and was characterized as moderate-to-severe by 25% of all respondents. Overhead casting was associated with less frequent wrist and elbow pain than was sidearm or elliptical casting. Respondents who used multiple casting styles had significantly less elbow pain than did single-style casters (7% vs 38% overhead, P = .04: 45% sidearm, P = .02; 71% elliptical, P = .003). Pain was significantly more frequent in those who cast with a haul (75% vs 33%, P = .04), used shooting heads (79% vs 66%, P = .04), or added weight to sinking flies (78% vs 60%, P = .01). Moderate-to-severe pain was more frequent in fishers of heavy saltwater fish. CONCLUSIONS: Upper extremity pain was frequent, but not often severe, in this group of fly-casting instructors. Increased weight on the line and "haul" technique appeared to increase pain symptoms. Modifications in casting style and equipment may help in avoiding or reducing pain.

Is there an association between athletic amenorrhea and endothelial cell dysfunction?

PURPOSE: To test the hypothesis that young females with athletic amenorrhea and oligomenorrhea show signs of early cardiovascular disease manifested by decreased endothelium-dependent dilation of the brachial artery. METHODS: Ten women with athletic amenorrhea (mean +/- SE, age 21.9 +/- 1.2 yr), 11 with oligomenorrhea (age 20.8 +/- 1.1 yr), and 11 age-matched controls (age 20.2 +/- 1.1 yr) were studied. Study subjects were amenorrheic an average of 2.3 (range 0.6-5) yr and oligomenorrheic an average of 6.2 yr. All ran a minimum of 25 miles.wk. They were nonpregnant and free of metabolic disease. Brachial artery flow-mediated dilation (endothelium-dependent) was measured with a noninvasive ultrasound technique in each group. RESULTS: Endothelium-dependent brachial artery dilation was reduced in the amenorrheic group (1.08 +/- 0.91%) compared with oligomenorrheic (6.44 +/- 1.3%; P< 0.05) and eumenorrheic (6.38 +/- 1.4%; P< 0.05) groups. CONCLUSION: Athletic amenorrhea is associated with reduced endothelium-dependent dilation of the brachial artery. This may predispose to accelerated development of cardiovascular disease.

Does oral creatine supplementation improve strength? A meta-analysis.

OBJECTIVES: Oral creatine is the most widely used nutritional supplement among athletes. Our purpose was to investigate whether creatine supplementation increases maximal strength and power in healthy adults. STUDY DESIGN: Meta-analysis of existing literature. DATA SOURCES: We searched MEDLINE (1966-2000) and the Cochrane Controlled Trials Register (through June 2001) to locate relevant articles. We reviewed conference proceedings and bibliographies of identified studies. An expert in the field was contacted for sources of unpublished data. Randomized or matched placebo controlled trials comparing creatine supplementation with placebo in healthy adults were considered. OUTCOMES MEASURED: Presupplementation and postsupplementation change in maximal weight lifted, cycle ergometry sprint peak power, and isokinetic dynamometer peak torque were measured. RESULTS: Sixteen studies were identified for inclusion. The summary difference in maximum weight lifted was 6.85 kg (95% confidence interval [CI], 5.24-8.47) greater after creatine than placebo for bench press and 9.76 kg (95% CI, 3.37-16.15) greater for squats; there was no difference for arm curls. In 7 of 10 studies evaluating maximal weight lifted, subjects were young men (younger than 36 years) engaged in resistance training. There was no difference in cycle ergometer or isokinetic dynamometer performance. CONCLUSIONS: Oral creatine supplementation combined with resistance training increases maximal weight lifted in young men. There is no evidence for improved performance in older individuals or women or for other types of strength and power exercises. Also, the safety of creatine remains unproven. Therefore, until these issues are addressed, its use cannot be universally recommended.

Sperm storage in the oviduct of the internal fertilizing frog Ascaphus truei.

This study provides the first descriptions of sperm storage at the tissue and cellular levels in a female frog or toad. Oviducal anatomy was studied by light and electron microscopy in Ascaphus truei from north coastal California. Ascaphus truei is one of the few species of anurans in which fertilization is internal. Unlike other anurans with internal fertilization, however, mating in A. truei consists of a unique combination of amplectic and copulatory mechanisms that we term "copulexus." Posterior to a short, aglandular infundibular region, the oviduct possesses: 1) a proximal, convoluted ampullary region where intrinsic tubular glands secrete gelatinous envelopes around eggs; 2) a middle ovisac region where fertilization occurs; and 3) a distal oviducal sinus formed by medial junction of the ovisacs. Sperm storage tubules (SSTs) occur in the anterior portions of the ovisacs and consist of simple tubular glands. SSTs and the rest of the oviducal lining stain positively with the periodic acid-Schiff's procedure for neutral carbohydrates and this reaction is especially intense in reproductively active females. Sperm were found in the SSTs of gravid females as well as some nonvitellogenic females. The sperm are in orderly bundles in the SSTs, and although occasionally sperm nuclei were embedded in the epithelium, no evidence for spermiophagy was found. Oviducal sperm storage in A. truei is homoplastic, with closest structural similarities to squamate reptiles. Oviduct/sperm design constraints appear to limit the options for expression of features associated with oviducal sperm storage.