Lung Health in the Solomon Islands: A Mixed Methods Study.

BACKGROUND AND OBJECTIVES: Despite a population of 600,000 people from 900 islands, there is little published data on the prevalence of lung disease in the Solomon Islands. We sought to 1) estimate the prevalence of obstructive lung disease (OLD) in Gizo, Solomon Islands, 2) identify risk factors for respiratory disease in this population and 3) review current management practices for respiratory disease through an audit of local emergency department (ED) presentations. METHODS: A two-part mixed methods study was performed between March and May 2019; the first was a population-based, cross-sectional study conducted in Gizo, Solomon Islands, with a random sample undergoing questionnaires and spirometry. The second was an audit of Gizo Hospital ED records to assess presentation numbers, diagnoses and outcomes. RESULTS: A total of 104 patients were randomly selected for spirometry. The mean age was 46.9 years. Current smoking rates were high (24.0% overall, 43.3% age < 40, 16.2% age ≥ 40) as was regular (>10h/week) exposure to indoor/enclosed wood fire ovens (51.5%). The prevalence of COPD was 3.2% overall. A further 9.7% of participants demonstrated significant bronchodilator responsiveness suggestive of possible asthma. Most patients seen in ED presented with a respiratory condition or fever/viral illness, but spirometry was not available. Only four outpatients were prescribed salbutamol and two patients inhaled corticosteroid. CONCLUSION: There appears to be a high burden of obstructive lung disease in the Solomon Islands with high smoking rates, indoor smoke exposure and bronchodilator responsiveness. Respiratory symptoms are common amongst hospital ED presentations; however, inhaled asthma treatments are infrequently prescribed to outpatients.

Apoptosis is a feature of TGF beta-induced cataract.

BACKGROUND: Studies in our laboratory have shown that transforming growth factor beta (TGF beta) induces rodent lens epithelial cells to undergo aberrant growth and differentiation that reproduces morphological and molecular features of human anterior subcapsular cataract and posterior capsule opacification. In addition, features of apoptosis have been described in some forms of human cataract. In the present study we investigated apoptotic changes induced by TGF beta in our rodent models. METHODS: Lens epithelial explants and whole lenses from rats were cultured with TGF beta. Morphological analysis and TUNEL were used to detect apoptotic changes. Transgenic mice expressing a self-activating form of human TGF beta 1 in the lens were included in the analysis. RESULTS: TGF beta-induced cell loss in epithelial explants coincided with increased numbers of pyknotic nuclei. Some of these nuclei were TUNEL-positive. Studies on lenses cultured with TGF beta and lenses from transgenic mice showed that the subcapsular plaques that developed contained pyknotic nuclei and that many of these were TUNEL-positive. DISCUSSION: This study shows that cells develop morphological and molecular features of apoptosis in TGF beta-induced cataract models. This confirms that apoptosis can be included as another TGF beta-induced cellular change that mimics events in human cataract.