CTLA4 Autoimmunity-Associated Genotype Contributes to Severe Pulmonary Tuberculosis in an African Population

The gene of Cytotoxic T Lymphocyte-associated Antigen 4 (CTLA4), a negative regulator of T lymphocytes, contains a single-nucleotide polymorphism (SNP) at position +6230A->G (ct60A->G), which has been found associated with several autoimmune diseases and appears to reduce T-cell inhibitory activity. In Ghana, West Africa, we compared the frequencies of CTLA4 +6230 A/G and 6 haplotype-tagging SNPs in 2010 smear-positive, HIV-negative patients with pulmonary tuberculosis (TB) and 2346 controls matched for age, gender and ethnicity. We found no difference in allele frequencies between cases and controls. However, +6230A and a distinct CTLA4 haplotype and a diplotype comprising the +6230A allele were significantly less frequent among cases with large opacities in chest radiographs compared to those with small ones (P_{corrected [cor]} = 0.002, P_cor = 0.00045, P = 0.0005, respectively). This finding suggests that an increased T-cell activity associated with the CTLA4 +6230G allele contributes to pathology rather than to protection in pulmonary TB.     

Cadmium-substituted skeletal troponin C metal binding investigations and sequence assignment of the cadmium-113 resonances

The binding of cadmium to the calcium binding subunit of skeletal troponin (STnC) has been reinvestigated using direct binding methods and fluorescent derivatives. These data provide straightforward explanations of the observed titration behavior in the 113Cd NMR (Ellis, P.D., Strang, P., and Potter, J.D. (1984) J. Biol. Chem. 259, 10348-10356). Further, fluorescent derivatives of skeletal troponin C provide an excellent means of establishing a sequence assignment for the resonances observed in the 113Cd NMR. The results of these experiments demonstrate that sites I and II, the Ca2+ regulatory sites, can be assigned to resonances at -108.5 and -101.5 ppm, respectively. Sites III and IV, the structural sites, are assigned to resonances -112.8 and -106.8 ppm, respectively. These data are discussed in terms of recent structural findings and speculations.     

Contemporary gastroenteritis of infancy: clinical features and prehospital management.

In a prospective survey carried out over 12 months 447 children aged under 2 years were admitted to the Manchester Regional Infectious Diseases Unit for treatment of gastroenteritis. Comparison of the children with those in a survey 15 years previously in the same unit showed that the illness was milder than in the earlier series, with no deaths and with lower incidences of hypernatraemia (1%), uraemia (8%), and dehydration (14%). These improved findings occurred despite several deficiencies of care in the prehospital phase of the illness, particularly poor compliance with the widely recommended guidelines for fluid and dietary management in infantile gastroenteritis.     

KILLER WHALE ATTACKS ON MINKE WHALES: PREY CAPTURE AND ANTIPREDATOR TACTICS

We describe nine incidents of predation or attempted predation of minke whales ( Balaenoptera acutorostrata ) by mammal-hunting "transient" killer whales ( Orcinus orca ) in coastal waters of British Columbia, Washington, and southeastern Alaska. Pursuits of minke whales were characterized by prolonged chases on a straight heading at velocities of 15–30 km/h. In four of the nine cases the adultsized minke whale gradually outdistanced the killer whales, which abandoned the high-speed pursuit after 0.5–1 h. In one case the minke beached itself and died. Four attacks were successful. In one instance a subadult minke was killed in open water following a chase. In two cases the fleeing minke entered a confined bay and was killed by the killer whales. One adult minke was taken after apparently attempting to seek cover beside a large sailboat. Minke whales made no attempt to physically defend themselves and were killed by repeated ramming or by asphyxiation. Although killer whales are capable of sprinting speeds greater than those of minke whales, it appears that adult minkes can maintain higher sustained speeds and evade capture if sufficient space for an extended escape trajectory is available. Successful predation of minke whales in coastal waters is rare compared to pinnipeds and small cetaceans, the main prey of transient killer whales.     

Efficacy and safety of insulin glulisine in patients with type 1 diabetes.

Insulin glulisine (glulisine), a human insulin analogue with a rapid-acting time-action profile, has been developed to fulfil the mealtime (bolus) insulin requirement in patients with diabetes. The aim of this multinational, multi-centre, controlled, open-label, randomized, parallel-group study was to compare the efficacy and safety of insulin glulisine (glulisine) to that of insulin lispro (lispro) in adults diagnosed with Type 1 diabetes. Of the 683 patients randomized, 672 received treatment (339 patients received glulisine, 333 patients received lispro). Over the 26-week study, a similar reduction in mean HbA1c occurred in both groups (adjusted mean change from baseline -0.14% in both groups). The basal insulin dose was relatively unchanged from baseline in the glulisine group but increased in the lispro group (glulisine: 0.12 IU vs. lispro: 1.82 IU; p = 0.0001). As a consequence, total daily insulin dose decreased in the glulisine group but increased in the lispro group (glulisine: -0.86 IU vs. lispro: 1.01 IU; p = 0.0123). There was no relevant difference between the two groups in the reporting of symptomatic hypoglycaemia (overall, nocturnal and severe). This study demonstrates that glulisine provides equivalent glycaemic control to lispro. The clinical relevance of any difference in total daily insulin dose remains to be established.     

Climate Change Influences on Environmental and Human Health Chemical Standards

Regulatory agencies use many chemical standards to help protect human health and the environment. Some of these standards could potentially be adversely influenced by climate change, so it is important to scope the likelihood of such changes, and develop a plan for addressing them. A review of the literature showed that many complex interactions could occur between climate change factors, chemicals, and receptors. However, the way in which chemical standards are currently set is already likely to take into account predicted climate changes in temperate regions, at least implicitly. In contrast, compliance monitoring to ensure that chemical standards are not breached may be compromised if climate change leads to more variability in measured parameters, with a consequent reduction in the statistical power of monitoring programs.