Effects of body temperature on post-anoxic oxidative stress from the perspective of postnatal physiological adaptive processes in rats.

It is well known that decrease in body temperature provides protection to newborns subjected to anoxia/ischemia. We hypothesized that the normal body temperature of 33°C in neonatal rats (4°C below normal body temperature in adults) is in fact a preadaptation to protect CNS from anoxia and further reductions as well as elevations in temperature may be counterproductive. Our experiments aimed to examine the effect of changes in body temperature on oxidative stress development in newborn rats exposed to anoxia. Two-day-old Wistar rats were divided into 4 temperature groups: i. hypothermic at body temperature of 31°C, ii. maintaining physiological neonatal body temperature of 33°C, iii. forced to maintain hyperthermic temperature of 37°C, and i.v. forced to maintain hyperthermic temperature of 39°C. The temperature was controlled starting 15 minutes before and afterword during 10 minutes of anoxia as well as for 2 hours post-anoxia. Cerebral concentrations of lipid peroxidation products malondialdehyde (MDA) and conjugated dienes (CD) and the activities of antioxidant enzymes had been determined post mortem: immediately after anoxia was finished and 3, 7, and 14 days later. There were no post-anoxic changes in the concentration of MDA, CD and in antioxidant enzymes activity in newborn rats kept at their physiological body temperature of 33°C. In contrast, perinatal anoxia at body temperature elevated to 37°C or 39°C as well as under hypothermic conditions (31°C) intensified post-anoxic oxidative stress and depleted the antioxidant pool. Overall, these findings suggest that elevated body temperature (hyperthermia or fever), as well as exceeding cooling beyond the physiological level of body temperature of newborn rats, may extend perinatal anoxia-induced brain lesions. Our findings provide new insights into the role of body temperature in anoxic insult in vivo.

Outbreak of hepatitis A infection associated with the consumption of frozen berries, Ireland, 2013--linked to an international outbreak.

In May 2013, a European alert was issued regarding a hepatitis A virus (HAV) outbreak in Italy. In June 2013, HAV subgenotype IA with an identical sequence was identified in Ireland in three cases who had not travelled to Italy. The investigation consisted of descriptive epidemiology, a case-control study, microbiological testing of human and food specimens, molecular typing of positive specimens and food traceback. We identified 21 outbreak cases (14 confirmed primary cases) with symptom onset between 31 January and 11 October 2013. For the case-control study, we recruited 11 confirmed primary cases and 42 matched controls. Cases were more likely than controls to have eaten berry cheesecake (matched odds ratio (mOR): 12; 95% confidence interval (CI): 1.3-114), whole frozen berries (mOR: 9.5; 95% CI: 1.0-89), yoghurt containing frozen berries (mOR: 6.6, 95% CI: 1.2-37) or raw celery (mOR: 4; 95% CI: 1.2-16). Among cases, 91% had consumed at least one of four products containing frozen berries (mOR: 12; 95% CI: 1.5-94). Sixteen food samples tested were all negative for HAV. As products containing frozen berries were implicated in the outbreak, the public were advised to heat-treat frozen berries before consumption.

Influenza vaccine effectiveness estimates in Europe in a season with three influenza type/subtypes circulating: the I-MOVE multicentre case-control study, influenza season 2012/13.

In the fifth season of Influenza Monitoring Vaccine Effectiveness in Europe (I-MOVE), we undertook a multicentre case-control study (MCCS) in seven European Union (EU) Member States to measure 2012/13 influenza vaccine effectiveness against medically attended influenza-like illness (ILI) laboratory confirmed as influenza. The season was characterised by substantial co-circulation of influenza B, A(H1N1)pdm09 and A(H3N2) viruses. Practitioners systematically selected ILI patients to swab ≤7 days of symptom onset. We compared influenza-positive by type/subtype to influenza-negative patients among those who met the EU ILI case definition. We conducted a complete case analysis using logistic regression with study as fixed effect and calculated adjusted vaccine effectiveness (AVE), controlling for potential confounders (age, sex, symptom onset week and presence of chronic conditions). We calculated AVE by type/subtype. Study sites sent 7,954 ILI/acute respiratory infection records for analysis. After applying exclusion criteria, we included 4,627 ILI patients in the analysis of VE against influenza B (1,937 cases), 3,516 for A(H1N1)pdm09 (1,068 cases) and 3,340 for influenza A(H3N2) (730 cases). AVE was 49.3% (95% confidence interval (CI): 32.4 to 62.0) against influenza B, 50.4% (95% CI: 28.4 to 65.6) against A(H1N1)pdm09 and 42.2% (95% CI: 14.9 to 60.7) against A(H3N2). Our results suggest an overall low to moderate AVE against influenza B, A(H1N1)pdm09 and A(H3N2), between 42 and 50%. In this season with many co-circulating viruses, the high sample size enabled stratified AVE by type/subtype. The low estimates indicate seasonal influenza vaccines should be improved to achieve acceptable protection levels.

Antibacterial prescriptions for acute gastrointestinal infections: uncovering the iceberg.

A prospective survey was conducted in patients admitted to 11 randomly selected general practices and eight hospitals located in six provinces of Poland. For each patient meeting the international acute gastrointestinal infection (AGI) case definition criteria, information was collected on healthcare resources used. Antibacterial drug consumption was assessed using defined daily doses (DDD) and extrapolated to the national level using results from a parallel study of AGI incidence in the community. Additionally, a logistic multivariable model was fitted assessing determinants of antibacterial drug administration. Valid questionnaires were collected from 385 general practitioner (GP) consultations and 504 hospital admissions. Antibacterials for systemic use were prescribed during 60 (16%) GP consultations and 179 (36%) hospital admissions. The estimated societal AGI-related consumption of antibacterials amounted to 5·48 million DDD (95% uncertainty interval 1·56-14·12 million DDD). Antibacterial prescription was associated with work in large practices [adjusted odds ratio (aOR) 3·16] and hospital wards (aOR 2·87), compared to small general practices, referral for microbiological testing (aOR 2·88), presence of fever (aOR 2·50), presence of mucus or blood in stool (aOR 1·94), age >65 years vs. <5 years (aOR 1·88), and rural vs. urban residence (aOR 1·53). Despite the fact that antibacterials were prescribed to a minority of consulted AGI patients, their consumption in society was not negligible due to the high prevalence of AGI symptoms. Prescription of antibacterial drugs should be restricted to cases with specific indications, preferably following microbiological investigation of AGI aetiology. To achieve this, clear national recommendations should be widely disseminated to physicians, and included in medical training curricula.

Virus detection in questing ticks is not a sensitive indicator for risk assessment of tick-borne encephalitis in humans.

Tick-borne encephalitis virus (TBEV) is the most important tick-transmitted arbovirus causing human disease in Europe, but information on its endemic occurrence varies between countries because of differences in surveillance systems. Objective data are necessary to ascertain the disease risk for vaccination recommendations and other public health interventions. In two independent, separately planned projects, we used real-time RT-PCR to detect TBE virus in questing ticks. In Poland, 32 sampling sites were selected in 10 administrative districts located in regions where sporadic TBE cases were reported. In Germany, 18 sampling sites were selected in two districts located in a region with high TBE incidence. Altogether, >16,000 ticks were tested by real-time RT-PCR, with no sample testing positive for TBEV. A systematic search for published studies on TBEV prevalence in ticks in Poland and Germany also suggested that testing large numbers of collected ticks could not consistently assure virus detection in known endemic foci. Although assignment of results to administrative regions is essential for TBE risk mapping, this was possible in only 10 (investigating 22,417 ticks) of 15 published studies (>50,000 ticks) identified. We conclude that the collection and screening of ticks by real-time RT-PCR cannot be recommended for assessment of human TBE risk. Alternative methods of environmental TBEV monitoring should be considered, such as serological monitoring of rodents or other wildlife.

Did public health travel advice reach EURO 2012 football fans? A social network survey.

We posted a survey on the Union of European Football Associations (UEFA)'s EURO 2012 Facebook profile to evaluate whether public health travel advice, specifically on the importance of measles vaccination,reached fans attending EURO 2012. Responses suggested that these messages were missed by 77% of fans. Social networks could serve as innovative platforms to conduct surveys, enabling rapid access to target populations at low cost and could be of use during upcoming mass gatherings such as the Olympics.

Incidence of self-reported acute gastrointestinal infections in the community in Poland: a population-based study.

A retrospective cross-sectional survey of self-reported acute gastrointestinal infection (AGI) incidence in the community was performed in Poland, from December 2008 to November 2009. The aim of the study was to estimate the magnitude and distribution of self-reported AGI, in order to calibrate the routine AGI surveillance system in Poland. The study population were randomly selected residents of all Polish regions, having a fixed telephone line. An equal number of telephone interviews were collected each month, requesting the interviewee to identify gastrointestinal symptoms that had occurred in the previous 4 weeks. The international AGI case definition was used. In total 3583 complete interviews were obtained. The compliance ratio was 26%. Of 3583 respondents, 240 (6.7%) individuals fulfilled the AGI case definition. The annualized incidence of acute gastroenteritis was 0.9/person-year (95% confidence interval 0.8-1.0). Comparison of the obtained annual AGI estimate (33.3 million infections) with the number of cases reported to national surveillance during the corresponding period (73 512), yielded an underreporting factor of 453 cases occurring in the community for each reported case. Of the 240 AGI cases, 30.4% consulted a general practitioner, and 4.6% were admitted to hospital. Samples for microbiological confirmation were collected from four (1.6%) cases. This first population-based study in eastern Europe has confirmed that AGI places a high burden on Polish society, which is underestimated by national surveillance data. Efforts are necessary to improve AGI reporting and diagnostic practices in order to increase the effectiveness of the Polish surveillance system in detecting threats related to new AGI pathogens, new routes of transmission or the potential for international spread.

Surveillance of aseptic central nervous system infections in Poland: is it meeting its objectives?

In Poland, a surveillance system capturing generic information on both diagnosed and undiagnosed aseptic central nervous system infections (ACI) has been in operation since 1966. This study evaluates to what extent the ACI surveillance is able to meet its objectives to monitor ACI trends and to detect signals of public health importance such as enteroviral outbreaks, tick-borne encephalitis (TBE) endemic foci, poliovirus appearance or emergence of new neurotropic viruses. Between 2004 and 2008, aetiology was established for 17% of ACI cases. Of the 1,994 reported ACI cases, 232 (11.6%) were diagnosed with TBE virus, 46 (2.3%) with enterovirus, 35 (1.8%) with herpesvirus, and 32 (1.6%) had other viral causes such as Epstein Barr virus or adenovirus. The system's performance varied between the provinces, with the frequency of suspected ACI cases referred for viral aetiology investigation in 2008 ranging from 1.98 to 285.4 samples per million inhabitants. The sensitivity of physicians' reporting, estimated as the proportion of hospitalised ACI cases reported to the surveillance system, was 48% nationally, with vast regional differences (range 30­91%). To conclude, the ACI surveillance system in Poland does currently not meet its objectives, due to limited availability of aetiological diagnosis and microbiological confirmation and to regional differences in reporting sensitivity.

Mass immunisation campaign in a Roma settled community created an opportunity to estimate its size and measles vaccination uptake, Poland, 2009.

During a mass immunisation campaign following an outbreak of measles in a Roma community settled in the town of Pulawy, Poland, we performed an estimation of the size of this Roma population and an assessment of its vaccination uptake. We obtained a list of Roma residing in Pulawy from the local municipality and estimated using a simple capture-recapture formula that Pulawy had 377 Roma residents (43% under 20 years old), which was 27% more than the 295 registered at the municipality. During the vaccination campaign, demographic information was recorded that could be linked to information from the municipality list as well as to prior immunisation status. Among the people whose data were recorded during the vaccination campaign, 14% were not registered at the primary healthcare centres, and were therefore deprived of access to healthcare. Among 102 screened subjects under the age of 20 years, 51% were vaccinated according to schedule. Vaccine uptake for the first dose of measles-containing vaccine was 56% (54/96) and for the second dose 37% (18/49). The present study indicates the need to get a better demographic overview of Roma communities living in Poland and to understand the barriers limiting their access to healthcare and social services. Organisation of catch-up immunisations of this vulnerable population is necessary.

Spotlight on measles 2010: An epidemiological overview of measles outbreaks in Poland in relation to the measles elimination goal.

The objective of this study was to describe transmission chains of measles observed in Poland during 2008-2009. A decade ago, the incidence of measles in Poland declined and approached one case per million inhabitants one of the World Health Organization's criteria for measles elimination. Following a period of very few reported measles cases (2003 to 2005), an increase in incidence was observed in 2006. Since then, the incidence has constantly exceeded one case per million inhabitants. Of 214 measles cases reported in 2008 and 2009 in Poland, 164 (77%) were linked to 19 distinct outbreaks, with 79% of cases belonging to the Roma ethnic group. Outbreaks in the non-Roma Polish population had different dynamics compared to those in the Roma population. On average, measles outbreaks in Roma communities involved 10 individuals, seven of whom were unvaccinated, while outbreaks in the non-Roma Polish population involved five individuals, half of whom were incompletely vaccinated. The majority of outbreaks in Roma communities were related to importation of virus from the United Kingdom. In six outbreaks, the epidemiologic investigation was confirmed by identification of genotype D4 closely related to measles viruses detected in the United Kingdom and Germany. Our data indicate that Poland is approaching measles elimination, but measles virus circulation is still sustained in a vulnerable population. More efforts are needed to integrate the Roma ethnic group into the Polish healthcare system and innovative measures to reach vulnerable groups should be explored.

Spotlight on measles 2010: A measles outbreak in a Roma population in Pulawy, eastern Poland, June to August 2009.

We describe a local indigenous outbreak of measles in a susceptible Roma community, which occurred in Pulawy, a town of 50,000 citizens in the Lubelskie province (eastern Poland) during summer 2009. From 22 June to 30 August 2009, 32 measles cases were reported, and additionally nine possible cases were actively identified. A mass immunisation campaign was organised to stop measles transmission in the Roma community. Active surveillance of rash-febrile illnesses allowed documentation of the impact of mass immunisation in preventing further measles spread in the Roma community, and the surrounding population of Pulawy.

Stress-induced behaviour in adult and old rats: effects of neonatal asphyxia, body temperature and chelation of iron.

Perinatal asphyxia in mammals leads to iron accumulation in the brain, which results in delayed neurobehavioural disturbances, including impaired learning and abnormal alertness over their entire life span. The aim of this investigation was to verify our hypothesis that newborn rats, showing reduced normal body temperature, are protected against neurotoxicity of the asphyxia up to senescence. Alertness was studied in adult and old male Wistar rats after exposure to critical neonatal anoxia: (i) at physiological neonatal body temperature of 33 degrees C, (ii) at body temperature elevated to 37 degrees C, or (iii) at body temperature elevated to 39 degrees C (the thermal conditions remained unchanged both during anoxia and for 2 h postanoxia). To elucidate the effect of iron-dependent postanoxic oxidative damage to the brain, half of the group (iii) was injected with deferoxamine, a chelator of iron. Postanoxic behavioural disturbances were recorded in open-field, elevated plus-maze, and sudden silence tests when the rats reached the age of 12 and 24 months. Open-field stress-induced motor activity was reduced in rats subjected to neonatal anoxia under hyperthermic conditions. In contrast, these rats were hyperactive in the plus-maze test. Both the plus-maze and sudden silence tests show reduced alertness of these rats to external stimuli signalling potential dangers. The behavioural disturbances were prevented by body temperature of 33 degrees C and by administration of deferoxamine.

Seasonal changes in cryoprotectants concentrations in Helix pomatia snails.

Terrestrial snails are often exposed to freezing. Therefore, we investigated seasonal shifts in hemolymph concentrations of cryoprotectants such as glycerol and glucose. We also investigated whether summer acclimation to cold and short-day photoperiod induced synthesis of cryoprotectants in Helix pomatia snails. Concentrations of the both cryoprotectants were elevated in winter and reduced in summer. These changes, however, were not correlated with shifts in liver glycogen content. Summer acclimation to cold (5 degrees C) and short-day photoperiod evoked a selective increase in glycerol concentration. In conclusion, glycerol may play a role in adaptation of the snails to winter cold and glucose is rather unlikely to provide the cryoprotection.

Iron body status of rats chronically exposed to cadmium and ethanol.

AIMS: The present study was performed to assess the effect of simultaneous long-term exposure to cadmium (Cd) and ethanol on iron (Fe) status of male Wistar rats. METHODS: The animals received drinking water containing 50 mg of Cd/l and/or 10% (w/v) ethanol for 12 weeks. Fe and Cd concentrations in serum (blood), certain tissues, urine and feces were determined by atomic absorption spectrometry. The total pool of Fe was calculated as a sum of its content in liver, spleen, kidneys, heart and brain. Fe bioavailability was evaluated based on its apparent absorption. RESULTS: The daily Cd intake ranged from 3.17 to 4.28 mg/kg (Cd group) and from 2.41 to 3.17 mg/kg (Cd + ethanol group); ethanol consumption ranged from 47.5 to 86.9 g/kg/24 h (ethanol group) and from 47.3 to 63.4 g/kg/24 h (Cd + ethanol group). Exposure to Cd or/and ethanol caused serious disturbances in Fe metabolism, as indicated by Fe body depletion. Both substances, applied alone and in combination, reduced the apparent Fe absorption and decreased its total pool in certain organs, and urinary excretion. However, the Cd- and ethanol-induced changes in the tissue Fe concentrations were different. Cd exposure decreased the concentration of Fe in serum, liver, spleen and femur, whereas ethanol decreased it in the spleen. In rats co-exposed to Cd and ethanol, decreased serum, spleen and brain Fe concentrations were all observed. CONCLUSIONS: The changes in Fe status in rats co-exposed to Cd and ethanol can be explained by the independent action of the two substances, leading to a decrease in Fe bioavailability, or by their interactions, which involves a modifying effect of ethanol on Cd turnover. The results allow the conclusion that ethanol may increase Cd accumulation, making the organism more susceptible to Fe depletion. Alcoholics thus may be at increased risk of disorders in Fe body status.

Effect of temperature on postanoxic, potentially neurotoxic changes of plasma pH and free iron level in newborn rats.

In asphyxiated newborns, iron, released from heme and ferritin and deposited in the brain, contributes to neurodegeneration. Because hypothermia provides neuroprotection, newborn mammals, showing reduced body temperature, might avoid iron-mediated neurotoxicity. However, hypothermia leads to acidosis, which induces hyperferremia. Therefore, we decided to study the effects of body temperature on plasma pH and iron levels in newborn rats exposed to a critical anoxia. Rectal temperature was kept at 33 degrees C (typical of neonates), reduced by 2 degrees C, or elevated to a level typical of healthy (37 degrees C) or febrile (39 degrees C) adults. Arterial blood samples were collected at 0, 10, 20, 30, and 120 min postanoxia. Control samples were obtained from normoxic, temperature-matched neonates. Anoxia tolerance time decreased progressively at rectal temperatures exceeding 33 degrees C. Neither pH nor plasma iron were significantly affected by anoxia at 33 degrees C. Although hypothermia (31 degrees C) resulted in acidosis in normoxic rats, both pH and iron levels were hardly influenced by anoxia. However, acidosis and hyperferremia, proportional to body temperature, developed at 37 and 39 degrees C. In conclusion, reduced body temperature is likely to protect asphyxiated newborns against iron-mediated brain injury.

The effect of zinc supply on cadmium-induced changes in the tibia of rats.

It has been determined that zinc supplementation (240 microg Zn/ml) during (for 12 weeks) or after (for 2 weeks) cadmium exposure (50 microg Cd/ml for 12 weeks) can prevent the accumulation and toxic action of Cd in the tibia of rats. The exposure to Cd led to disturbances in bone metabolism reflected by changes in the chemical composition of bone and decreased bone mineral density (osteomalacian changes). The Zn supply in conditions of Cd intoxication completely prevented the Cd-induced increase in percentage of water content and decrease in tibia ash weight, ash weight/dry weight, non-org. comp./org. comp., Zn content and concentration. Moreover, Zn partly protected from the decrease in Ca concentration and content, percentage of non-organic components content, Ca/wet weight, Ca/ash weight and Ca/dry weight. Zn administered after Cd exposure partly, but not completely, protected from Cd-induced decrease in percentage of non-organic components content, Ca/wet weight as well as Ca content and concentration. This protective effect on bone was most evident when Zn was administered during Cd exposure. But Zn, independently of the manner of its administration, did not prevent Cd accumulation in the tibia. Our results suggest that Zn supply in conditions of simultaneous exposure can prevent Cd-induced bone loss to some extent, and used after Cd treatment can give therapeutic benefits.

[Influence of thermal processing and storage on the content of nitrates and nitrites in chosen vegetables from the Podlasie province]. / Ocena wplywu obróbki termicznej i przechowywania na zawartosc azotanów i azotynów w wybranych warzywach województwa podlaskiego.

The dangerous for health nitrate and nitrite can penetrate with food human organism for this reason in study the influence of thermal processing and storage on the level of these compounds in the vegetables was determined. The content of nitrates and nitrites was determined in such vegetables as carrot, parsley-root, celery and potatoes growing by farmers in the Podlasie province. Nitrates and nitrites were assessed in fresh and boiled vegetables as well as in the stock and in carrot juice. These compounds were also determined after storage of vegetables at +4 degrees C for 2 weeks and at -15 degrees C for 1 and 3 months. Nitrates and nitrites concentrations were assayed colorimetrically by the Griess method modified to food investigation. Boiling reduced nitrate content in the vegetables. Considerable part (about 50%) of these compounds passed into stock during boiling. Storage of these vegetables at +4 degrees C resulted in slight lowering of nitrate content in carrot and parsley-root and marked elevation in celery. Cold storage of vegetables through 1 and 3 months had no important influence on nitrate content. Boiling decreased the content of nitrites similarly as nitrates. Storage of the vegetables at +4 degrees C through 2 weeks led to an increase in nitrite content in carrot and parsley-root while in celery the content of nitrites was reduced. Storage of vegetables at -15 degrees C resulted in lowering content of nitrite. The study revealed that the vegetable-roots (carrot, parsley and celery) and potatoes cultivated in the Podlasie province as well as in the other provinces were excessively contaminated by nitrates and nitrites. Moreover, it has been shown that thermal processing such as boiling considerably reduced the content of nitrates and nitrites in these vegetables while freezing changed mainly nitrite content.

Effect of short-term ethanol administration on cadmium retention and bioelement metabolism in rats continuously exposed to cadmium.

The present study was performed to assess the effect of short-term ethanol administration on cadmium retention and accumulation as well as on bioelement metabolism (zinc, copper, calcium, and magnesium) in rats exposed to an aqueous solution of cadmium chloride for 8 weeks. Intoxication with cadmium led to accumulation of this toxic metal, particularly in the liver and kidney, which was linked to metallothionein synthesis as well as to a disturbance in the metabolism of zinc, copper, and calcium. These effects were dependent on the level of exposure. The administration of ethanol in the final phase of cadmium treatment increased cadmium retention and accumulation in the body with simultaneous elevation in liver and kidney metallothionein concentration. Ethanol alone or with cadmium caused or intensified the cadmium-induced changes in metabolism of zinc and copper. Calcium metabolism disturbed by cadmium was not influenced by ethanol. Neither agents had any effect on magnesium metabolism. We conclude that even short-term ethanol consumption in conditions of exposure to cadmium can increase this heavy metal body burden and lead to more serious disturbances in metabolism of important elements such as zinc and copper. Cadmium- and ethanol-induced changes in the homeostasis of these microelements are probably connected with the ability of both xenobiotics to cause metallothionein induction.

[Nitric oxide in pathology of hypoxia--ally or enemy]. / Tlenek azotu w patologii niedotlenienia--sojusznik czy wróg.

Nitric oxide (NO) has been found to play an important role as a signal molecule in many parts of the organism. However, under certain conditions, like hypoxia or ischemia, it acts as a cytotoxic effector molecule. It appears paradoxical that NO on the one hand acts as a physiological intercellular messenger and on the other can have damaging effects to cells. To make things even more complicated cytoprotective properties of NO are also described. Whether NO is useful or harmful depends on the rate and location of its production.