Preschool children's consumption of drinks: implications for dental health.

Objective: To examine drinking patterns in pre-school children and their relationship to percentage of energy intake from non-milk extrinsic sugars.

Design: Secondary analysis of data from the national diet and nutrition survey (NDNS) relating to the dietary intakes of a representative sample of pre-school children in the UK.

Subjects: 1,675 children aged 1.

Early nonspecific immune responses and immunity to blood-stage nonlethal Plasmodium yoelii malaria.

The early role of natural killer cells and gamma delta T cells in the development of protective immunity to the blood stage of nonlethal Plasmodium yoelii infection was studied. Splenic cytokine levels were measured 24 h after infection of natural killer cell-depleted immunodeficient and littermate mice or transiently T-cell-depleted normal mice. Splenic gamma interferon levels were significantly increased above background in immunodeficient and littermate mice 24 h after infection.

Levonorgestrel-releasing (20 microgram/day) intrauterine systems (Mirena) compared with other methods of reversible contraceptives.

Objective: To assess the relative contraceptive effectiveness, tolerability and acceptability of the levonorgestrel-releasing (20 microg per day) intrauterine system (LNG-20) compared with reversible contraceptive methods in women of reproductive age.

Design: A systematic review and meta-analysis of randomised controlled trials.

Identification: Studies were identified through seven databases, and by contacting investigators and organisations working in the contraceptive field.

Influence of arm positioning on tomographic thallium-201 myocardial perfusion imaging and the effect of attenuation correction.

Lateral attenuation in single-photon emission tomography (SPET) myocardial perfusion imaging (MPI) has been attributed to the left arm if it is held by the patient's side during data acquisition. As a result MPI data are conventionally acquired with the arms held above the head. The aims of this study were to determine the effect of imaging arms down on reconstructed tomographic images depicting regional myocardial thallium-201 distribution and to assess whether attenuation-corrected (AC) myocardial perfusion images acquired arms down could replace uncorrected (NC) images acquired arms up for routine clinical service.

The beta-subunit of the hepatocyte growth factor/scatter factor (HGF/SF) receptor phosphorylates and associates with CrkII: expression of CrkII enhances HGF/SF-induced mitogenesis.

CrkII, a 40 kDa adaptor possessing a Src homology (SH)2 domain followed by two SH3 domains, although not endowed with catalytic activity, participates in intracellular signalling, presumably by activating the Ras pathway. CrkII was found to be phosphorylated in response to hepatocyte growth factor/scatter factor (HGF/SF) and to associate with the beta-subunit of the HGF receptor (MET). CrkII associated with p(145betaMET) via its SH2 domain.

PI3-kinase inhibition: a target for drug development?

The phosphoinositide 3-kinases (PI3-kinases) are a ubiquitously expressed enzyme family that, through the generation of phospholipid second messengers, play a key role in the regulation of many cellular processes. These include motility, proliferation and survival, and carbohydrate metabolism. Members of the PI3-kinase family and related kinases, their mechanism of activation and the cellular events that they influence are described in this review.

Immunopathology of cerebral malaria: morphological evidence of parasite sequestration in murine brain microvasculature.

A murine model that closely resembles human cerebral malaria is presented, in which characteristic features of parasite sequestration and inflammation in the brain are clearly demonstrable. "Young" (BALB/c x C57BL/6)F(1) mice infected with Plasmodium berghei (ANKA) developed typical neurological symptoms 7 to 8 days later and then died, although their parasitemias were below 20%. Older animals were less susceptible.

Social determinants of von willebrand factor: the Whitehall II study.

Data from the Whitehall II Study and others have demonstrated a role for the metabolic syndrome and fibrinogen underlying the association between social position and coronary heart disease. In this study, we examined the role of an additional hemostatic factor and marker of endothelial dysfunction, von Willebrand factor (vWF). Four thousand five hundred and forty-eight men and 1837 women were examined in the third phase of the study, which took place between 1991 and 1993.

Fluid compartments of the embryonic environment.

The exocoelomic cavity was probably the last remaining physiological body fluid cavity to be explored in the human embryo. Its unique anatomical position has enabled us to study the protein metabolism of the early placenta and secondary yolk sac and to explore materno-embryonic transfer pathways. The exocoelomic cavity forms inside the extraembryonic mesoderm alongside the placental chorionic plate and is now believed to be an important transfer interface and a reservoir of nutrients for the embryo.

New labour and Britain's National Health Service: an overview of current reforms.

Britain's National Health Service (NHS) has been the subject of unprecedented market reforms, which have failed to solve its problems. The New Labour government elected in 1997 has halted the drive toward the marketization of health care and replaced cost with quality as the central concern of NHS administration and policy. Major changes are occurring in the regulation of professional activity, with profound implications for the medical profession and the health service.

Long-term effect of prospective detection of high genetic risk on couples' reproductive life: data for thalassaemia.

Prospective risk detection with availability of prenatal diagnosis is the best service currently available for couples at high genetic risk Here we describe the long term effect of this service on the reproductive life of 102 couples at risk of thalassaemia, whose risk was detected prospectively by carrier screening, who made use of prenatal diagnosis, and where the woman is now over 40. Overall outcome for couples is described in terms of number of favourable versus unfavourable pregnancy outcomes. (A favourable pregnancy outcome = unaffected livebirth, or affected livebirth resulting from informed parental choice.

Variation in the PPARalpha gene is associated with altered function in vitro and plasma lipid concentrations in Type II diabetic subjects.

Aims/hypothesis: Peroxisome proliferator activated receptor alpha (PPARalpha) regulates genes involved in lipid metabolism, haemostasis and inflammation, in response to fatty acids and fibrates, making it a candidate gene for risk of dyslipidaemia, atherosclerosis and coronary artery disease. Plasma non-esterified fatty acids are increased in subjects with Type II (non-insulin-dependent) diabetes mellitus, suggesting that PPARalpha could link Type II diabetes and dyslipidaemia, and affect response to fibrates. This has been investigated in association studies in healthy and diabetic subjects and in vitro studies.

Angiotensin II is mitogenic for human lung fibroblasts via activation of the type 1 receptor.

The expression of renin-angiotensin system components and the elevation of angiotensin-converting enzyme (ACE) in a number of fibrotic lung diseases suggests angiotensin II (AII) could play a role in the pathogenesis of pulmonary fibrosis. However, the effect of AII on lung fibroblasts has not previously been assessed and the mechanisms by which AII induces cell proliferation in mesenchymal cells are not fully understood. We have examined the ability of AII to stimulate fetal and adult human lung fibroblast proliferation in vitro.

BCL10 gene mutation in lymphoma.

BCL10 is directly involved in t(1;14)(p22;q32) of mucosa-associated lymphoid tissue (MALT) lymphoma. Wild-type BCL10 promoted apoptosis and suppressed malignant transformation in vitro, whereas truncated mutants lost the pro-apoptotic activity and exhibited gain of function enhancement of transformation. We studied 220 lymphomas for genomic BCL10 mutation by polymerase chain reaction-single-strand conformational polymorphism and DNA sequencing.

Social determinants of health: from observation to policy.

Differences in the health of individuals reflect inherent features of the societies in which they live. The way a society organizes itself and delivers wellbeing to its members are major determinants of health. Social, economic and political factors have an important influence on health and longevity.

Reasons for accepting or declining to participate in randomized clinical trials for cancer therapy.

This paper reports on the reasons why patients agreed to or declined entry into randomized trials of cancer following discussions conducted by clinicians in both District General and University Hospitals. Two hundred and four patients completed a 16-item questionnaire following the consultation, of these 112 (55%) were women with breast cancer. Overall results showed that 147 (72.

The development of the stria vascularis in the human foetus.

The development of the stria vascularis in the human cochlea was studied in step sections of 81 human foetal temporal bones. The stria vascularis primordium can be identified as a ridge of epithelial cells on the lateral wall of the cochlear duct. The first signs of differentiation appear at the 11th week, but it is not until the 17th-18th week that the typical trilaminar structure is observed.

Hormone replacement therapy and breast cancer.

The concern that postmenopausal hormone replacement therapy (HRT) may cause cancer of the breast has lead to an enormous volume of research in epidemiology, endocrinology and tumour cell biology. The epidemiology has become extremely sophisticated because the anticipated effect is small and there are several confounding factors. The consensus today is that long-term HRT (>10 years) is associated with an increase in the risk of breast cancer which, on average, is equivalent to delaying menopause for the same period of time that the patient is on treatment.

Comparing health inequality in men and women: prospective study of mortality 1986-96.

Objectives: To study prospectively the differences in health inequality in men and women from 1986-96 using the Office for National Statistics' longitudinal study and new socioeconomic classification. To assess the relative importance of social class (based on employment characteristics) and social position according to the general social advantage of the household to mortality risk in men and women.

Design: Prospective study.

Decreased expression of FcgammaRIII (CD16) by gammadelta T cells in patients with rheumatoid arthritis.

Some gammadelta T cells express a receptor for the Fc portion of immunoglobulin G (FcgammaRIII - CD16). The relevance of this Fc receptor to gammadelta T-cell function is at present unclear. Our previous studies have shown that gammadelta T cells express activation markers in patients with rheumatoid arthritis (RA).

Advances in the management of tuberculosis: clinical trials and beyond.

Modern short-course treatment for tuberculosis is highly effective and cost-effective, yet the disease remains a leading cause of suffering and death. The problem has been exacerbated in recent years by the human immunodeficiency virus (HIV) pandemic and the increasing prevalence of multidrug-resistant tuberculosis. Improvements in diagnosis, vaccination, chemoprophylaxis, and therapy are thus urgently needed.

In-vivo and in-vitro nutrient-gene interactions.

Association studies of gene variants and response to dietary challenges represent one way of investigating gene-nutrient interactions. Several studies reported in the present review concentrate on evaluating variation at the apolipoprotein AI-CIII-AIV and apolipoprotein E gene loci, as well as the fatty acid binding protein gene. In addition, the effect of nutrients can be directly evaluated at the level of gene expression, and reports of in-vitro studies of control of fatty acid and triglycerides synthesis are discussed in the present review.

The process of outpatient referral and care: the experiences and views of patients, their general practitioners, and specialists.

Background: The primary care system in the United Kingdom, involving the general practitioner (GP) as gatekeeper to further services, has helped to keep health care costs down. Despite this, unexplained variation in referral rates and increasing health care costs have led to the search for methods of improving efficiency. There is relatively little recent descriptive data on the processes of care at the primary-secondary care interface.