Context Matters for Food Security: Multi-Sited Evidence of Shared Cultural Models of Food Consumption.

Anthropologists have long emphasized the social significance of foods and the contexts in which they are consumed. Expanding on this idea, we define the context of consumption as the non-eating behaviors that surround eating, such as the manner of food preparation, food sharing, and dietary patterns. In this study, we used cultural consensus analysis to assess whether there exist consistently shared, normative ideas about preferable context of food consumption in three diverse research sites: urban Ethiopia, rural Brazil, and rural Haiti. Our analysis demonstrates that in all three communities, there are distinct sets of behaviors that people identified as non-preferable because they reliably associate them with poverty and food insecurity, and behaviors that people identify as preferable because they reliably associate them with wealth and food security. Across the settings, there was little variation in agreement about behaviors across household composition, age, gender, and food security status. These findings suggest that people do indeed share culturally specific ideas about the context in which foods should be prepared and consumed, beyond the actual content of one's diet. Exploring these cultural models elucidates the social consequences of food insecurity, enabling researchers to better examine the relationship between food insecurity, social context, and well-being.

Serial observations of angiotensin-converting enzyme and pulmonary function in sarcoidosis.

Fifty-six measurements of angiotensin-converting enzyme (ACE) level, diffusing capacity (DLCO), and total lung capacity (TLC) were made in 18 sarcoid patients with a maximum of 25 months of follow-up observation. During spontaneous or corticosteroid-induced changes in disease activity, there was a significant inverse correlation between changes in ACE level and changes in DLCO and between changes in ACE level and changes in TLC. These observations suggest that ACE measurement may be a useful adjunct to pulmonary function tests to follow the course of sarcoidosis and to monitor the effects of corticosteroid therapy on the lung.

Selection of patients with hemoptysis for fiberoptic bronchoscopy.

One hundred ten hospitalized patients with hemoptysis were reviewed to identify factors that would characterize those with malignancy and to evaluate the usefulness of fiberoptic bronchoscopy (FB) in the diagnosis of hemoptysis. Seventy patients underwent FB. This procedure was diagnostic in 22/28 (79 percent) of the carcinoma patients and in 26/42 (62 percent) of the patients with a nonmalignant cause of hemoptysis. The following three characteristics indicate a high probability of malignancy: 1) age greater than 40 years, 2) any abnormality on the chest roentgenogram, 3) hemoptysis lasting greater than one week. If any of these factors are present, FB should be done. Other factors to be considered include presence of anemia, weight loss, persistent cough, long smoking history and risk of bronchoscopic complications.

Effects of lipopolysaccharide on human endothelial cells in culture.

Lipopolysaccharide (LPS) in concentrations up to 10 micrograms/ml did not induce detectable direct cytotoxicity in human umbilical vein, pulmonary artery, or pulmonary vein endothelial cells. By contrast, significant cytotoxicity was observed in bovine aortic endothelial cells exposed to LPS 0.01 micrograms/ml. Transmission electron microscopy of human umbilical vein cells exposed to LPS 10 micrograms/ml for 4 days revealed no significant ultrastructural abnormalities compared to control cells. Whereas human umbilical vein endothelial cell cytotoxicity was observed when neutrophils were stimulated with phorbol myristate acetate, LPS-stimulated neutrophils did not induce significant cytotoxicity even in the presence of fresh human serum as a complement source. Moreover, human umbilical vein endothelial cell factor VIII-antigen and fibronectin release, angiotensin-converting enzyme activity, and PGI2 release were unaffected by a 24-hour exposure to LPS. Cytotoxicity, however, was produced when human umbilical vein endothelial cells were coincubated with LPS and cycloheximide. The proliferation of human umbilical vein endothelial cells was also inhibited after prolonged, continuous exposure to LPS 10 micrograms/ml. We conclude that LPS with or without complement or neutrophils does not induce significant human endothelial cell lysis or detachment. Moreover, brief exposure to LPS has minimal, direct effect on several functions of human endothelial cells in vitro.

Modification of soft drinks with xanthan gum to minimise erosion: a study in situ.

OBJECTIVE: To compare the erosive effect of a new blackcurrant/calcium drink with xanthan gum, on enamel in situ, with a low erosive product, a conventional fruit beverage and water. DESIGN: The study was single centre, randomised, single blind, 4 treatment crossover design. SETTING: This study, conducted in 2000, employed volunteers working at the Bristol Dental Hospital, UK. SUBJECTS, MATERIALS AND METHODS: 16 subjects (>or=18 years) wore two enamel samples in a removable acrylic appliance. The drinks tested were (A) New blackcurrant/calcium/gum drink (test product), (B) Original blackcurrant/calcium drink, (C) Conventional blackcurrant drink (positive control) and (D) Water (negative control), for 15 day study periods. Drinking was supervised, with 250 ml imbibed four times/day between 9.00am-5.00pm. Profile measurements of specimens were made at baseline, 5, 10 and 15 days. MAIN OUTCOME MEASURES: Paired t-tests compared erosion by surfometry with selected pairs of formulations. RESULTS: Of 16 screened subjects (3 male, 13 female), mean age 34.2 years, 1 subject failed to complete the study. A caused significantly less enamel loss than C, with no statistically significant differences from B at any time points measured. Of 43 treatment emergent adverse events, none were considered related to the study formulations. CONCLUSIONS: A retained low erosive properties similar to B, with additional benefits of taste flexibility and beverage stability.

Increased proportion of active sheep erythrocyte rosette-forming lymphocytes and plasma rosette enhancement in sarcoidosis.

We examined blood lymphocyte subpopulations in 20 patients with sarcoidosis, 37 patients with other diseases, and 51 normal subjects. The B-lymphocytes were identified by the presence of surface immunoglobulin or B-lymphocyte-associated antigen. Lymphocytes were also centrifuged with sheep erythrocytes for 5 min at room temperature at 200 g, and rosette formation was assayed immediately (active E-rosette-forming T-lymphocytes) or after 60-min incubation at 4 degrees C (total T-lymphocytes). The B-lymphocytes counts did not differ among the groups. The proportions of total E-rosette-forming T-lymphocytes and active E-rosette-forming T-lymphocytes were increased in the sarcoid patients, whereas absolute counts of both types of E-rosette-forming T-lymphocytes were not different from control counts. Active E-rosette-forming T-lymphocytes showed an inverse correlation with serum concentration of angiotensin-1-converting enzyme, a probable indicator of the disease activity. Incubation of normal lymphocytes with sarcoid plasma increased the proportion of active E-rosette-forming T-lymphocytes. This plasma rosette enhancement was correlated with the number of active E-rosette-forming T-lymphocytes in the blood from which the plasma was separated. These results suggest that a factor in sarcoid plasma affects the number of active E-rosette-forming T-lymphocytes and that high numbers of these cells are associated with disease stability.

A practical procedure for measuring functional residual capacity during mechanical ventilation with or without PEEP.

The measurement of functional residual capacity (FRC) in patients receiving mechanical ventilation may provide valuable data in the assessment and management of acute respiratory failure. Previous descriptions of apparatus and techniques for FRC measurement have either been inapplicable to patients receiving positive end-expiratory pressure (PEEP), or insufficiently detailed to allow convenient duplication in the clinical setting. The authors describe a helium rebreathing method for bedside determination of FRC which can be performed during ventilation with PEEP and which is applicable in patients with prolonged equilibration times. The method is both reproducible in patients (variation from mean FRC: +/- 2.2%) and accurate (coefficient of variation from in vitro FRC of 3000 ml: +/- 1.7%). The apparatus and assembly are described in detail and require only components which are readily available commercially, so that they may be applicable to clinical use in a general hospital.

Effect of positive end-expiratory pressure on right and left ventricular function in patients with the adult respiratory distress syndrome.

The predominant mechanism of the cardiac output reduction associated with positive end-expiratory pressure (PEEP) is unclear. Reported possibilities include decreased systemic venous return, increased pulmonary vascular resistance, or change in ventricular contractility. We investigated this question by studying 9 patients with the adult respiratory distress syndrome (ARDS) during PEEP application. We used an equilibrium radionuclide angiography method modified for improved right ventricular imaging to evaluate changes in left and right ventricular volume and contractility. Thermodilution cardiac output and stroke volume progressively declined (27 and 33% mean decrease, respectively) with increasing increments of PEEP. Right and left ventricular end diastolic counts, reflecting volume, also progressively diminished as PEEP increased (38 and 27% mean decrease in RV and LV counts, respectively; p less than 0.001 for both ventricles). A slight upward trend in ejection fraction was found for both ventricles. These findings support the concept that during PEEP application the reduction in cardiac output is due to biventricular reduction in blood volume. This biventricular volume reduction is compatible with either preload reduction to both ventricles because of impeded venous return or to change in ventricular configuration caused by external compression of both ventricles.

Association of complement activation and elevated plasma-C5a with adult respiratory distress syndrome. Pathophysiological relevance and possible prognostic value.

Clinical and experimental observations suggest that aggregation of polymorphonuclear granulocytes (PMN) in response to activated complement (C) might contribute to the genesis of the adult respiratory distress syndrome (ARDS), aggregating PMN causing pulmonary dysfunction by becoming lodged in the lung as leucoemboli. PMN-aggregating activity can be detected in C-activated plasma and reflects C5a levels. In 61 patients at risk for ARDS a strong and highly significant correlation was found between the presence of PMN-aggregating activity in the plasma and the development of ARDS; this correlation was also significant when patients with sepsis were excluded from analysis. In patients followed prospectively detection of elevated C5a seemed to be a useful predictor of ARDS. Since corticosteroids have been shown to inhibit PMN aggregation both in vitro and in vivo, the evidence for a role for PMN aggregation in the genesis of ARDS supports the use of corticosteroids in this disorder.

Modified chronic lung lymph fistula in goats via thoracic duct.

Pure lung lymph has previously been obtained in awake sheep and goats via a cannula placed in an efferent duct of the caudal mediastinal lymph node (CMN). We describe a modification in goats wherein a segment of the thoracic duct collecting pulmonary efferents is isolated and cannulated. Lymph purity and responses to elevation of pulmonary microvascular pressure are illustrated and are found to be comparable to data obtained from a series of animals prepared by standard CMN cannulation. We have adopted the alternative procedure whenever, at cannulation may be complicated. When used in combination with the CMN approach, the overall rate of successful cannulation has increased from 50% to about 80%.

Distribution of ventilation and perfusion during positive end-expiratory pressure in the adult respiratory distress syndrome.

The response of respiratory gas exchange to incremental increases in positive end-expiratory pressure (PEEP) was studied in patients with the adult respiratory distress syndrome (ARDS). Fifty total changes in PEEP were studied in 19 PEEP trials performed in 16 patients. The initial patterns of ventilation-perfusion distribution as measured by the multiple inert gas elimination technique showed a large shunt flow (32 +/- 14% of total cardiac output), which was accompanied in half of the patients by perfusion to a region of low ventilation-perfusion ratio (VA/Q ratio less than 0.1). In 17 PEEP trials, there was an improvement in PaO2 (increase in PaO2 greater than 10 mmHg over control value) with at least one level of PEEP tested. In the 38 PEEP increments in these trials where PaO2 did improve, there was either a reduction in shunt alone, a reduction in ventilation-perfusion regions alone, or a redistribution in blood flow from shunt to regions of low or normal ventilation-perfusion ratio. In the increments where no increase was observed in PaO2, this reduction in blood flow to shunt or low VA/Q regions did not occur. In some instances, there was an increase in ventilation to unperfused alveoli and evidence of high ventilation-perfusion ratio (VA/Q greater than 10) as the level of PEEP increased. Because patients had an adequate pulmonary artery wedge pressure at the start of the PEEP trial (mean wedge pressure, 12.8 +/- 1.5 mmHg) improvements in oxygenation could usually be attained with only mild decreases in cardiac output.

The visual appearance and somatic cell count of mammary secretions collected from primigravid heifers during gestation and early postpartum.

Mammary secretions, obtained before and after calving, were examined for visual appearance, SCC, and bacteriology as part of a larger study determining the prevalence of IMI in 1588 primigravid heifers. Appearance of secretions was categorized into five groups: thin and watery, honey-like, serumy, milky, or thickened colostrum. Precalving secretions were further characterized as low viscosity (thin and watery, serumy, or milky) or high viscosity (honey-like and thickened colostrum). Postcalving secretions were further characterized as normal (milky, thickened colostrum) or abnormal (thin and watery, serumy, or honey-like). Infected precalving quarters (81%) had low viscosity secretions. Quarters that were uninfected precalving (75%) had high viscosity secretions. Greater than 90% of all postcalving milk samples appeared to be normal, regardless of geographic location, season, or bacterial infection status. Only 77% of the samples from quarters infected with contagious and noncontagious mastitis pathogens had normal appearance. Precalving SCC from bacteriologically negative quarters were lower than SCC from infected quarters. Similarly, postcalving SCC were lower from the bacteriologically negative quarters than from the infected quarters. Infected quarters had higher mean SCC than the uninfected quarters during both pre- and postcalving periods.

Antimicrobial susceptibility of microorganisms isolated from the mammary glands of dairy heifers.

Minimum inhibitory concentrations were determined with 1494 microorganisms isolated from the mammary glands of dairy heifers. The antimicrobial agents tested were penicillin, cloxacillin, cephapirin, ceftiofur, novobiocin, enrofloxacin, erythromycin, and pirlimycin. All minimum inhibitory concentrations were expressed as micrograms per milliliter. The isolates tested included 135 Staphylococcus aureus, 1222 Staphylococcus sp., 42 Streptococcus sp., 15 Enterococcus sp., 60 enteric species, and 20 miscellaneous organisms. The minimum inhibitory concentrations for 90% of isolates for the various antimicrobial agents with Staph. aureus were as follows: penicillin, .13; cloxacillin, .5; cephapirin, .5; ceftiofur, 1; novobiocin, .5; enrofloxacin, .5; erythromycin, .5, and pirlimycin, .5. In comparison, the minimum inhibitory concentrations for 90% of isolates for the Staphylococcus sp. were 1, 1, .5, 1, .5, .5, 1, and .5 for penicillin, cloxacillin, cephapirin, ceftiofur, novobiocin, enrofloxacin, erythromycin, and pirlimycin, respectively. The minimum inhibitory concentrations for 90% of isolates for the Streptococcus sp. were 2, 32, 2, 2, 8, 1, 64, and 32 for the respective antimicrobial agents; the minimum inhibitory concentrations for 90% of isolates were 4, 64, 32, 64, 4, 1, 4, and 4 for the enterococci. Against the Gram-negative enteric bacilli, only ceftiofur and enrofloxacin were active; minimum inhibitory concentrations for 90% of isolates were 1 microgram/ml for ceftiofur and .25 microgram/ml for enrofloxacin. Results indicated that the majority of staphylococcal strains were susceptible to the antimicrobial agents tested but that antimicrobial susceptibility varied for Streptococcus sp. Compounds currently available in intramammary infusion products demonstrated poor activity against the enteric organisms.