[The lung microbiota. Review]. / Le microbiote pulmonaire.

In the last 20years, culture-independent DNA-based techniques ("shotgun sequencing") demonstrated that complex microbial communities reside on most epithelial surfaces, including the lower airways. Until the amniotic sac ruptures, a fetus is considered to be essentially sterile. Many factors affect the composition of the lung microbiota: inheritance, mode of delivery, diet, and age-related changes in adults. It interacts with the digestive and oropharyngeal microbiotas. Animal models show that these interactions play a role in innate pulmonary immunity and modulation of the inflammatory response. The microbial composition of the airway microbiota differs between healthy children and those with chronic lung disease. The advances in the comprehension of microbiome changes have resulted in new approaches concerning the microbiota for treatment and prevention of disease.

Effects of oral exposure to mining waste on in vivo dopamine release from rat striatum.

Several single components of mining waste (arsenic, manganese, lead, cadmium) to which humans are exposed at the mining area of Villa de la Paz, Mexico, are known to provoke alterations of striatal dopaminergic parameters. In this study we used an animal model to examine neurochemical changes resulting from exposure to a metal mixture. We used microdialysis to compare in vivo dopamine release from adult rats subchronically exposed to a mining waste by oral route with those from a control group and from a sodium arsenite group (25 mg/kg/day). We found that arsenic and manganese do accumulate in rat brain after 2 weeks of oral exposure. The mining waste group showed significantly decreased basal levels of dihydroxyphenylacetic acid (DOPAC; 66.7 +/- 7.53 pg/ microl) when compared to a control group (113.7 +/- 14.3 pg/ microl). Although basal dopamine release rates were comparable among groups, when the system was challenged with a long-standing depolarization through high-potassium perfusion, animals exposed to mining waste were not able to sustain an increased dopamine release in response to depolarization (mining waste group 5.5 +/- 0.5 pg/ microl versus control group 21.7 +/- 5.8 pg/ microl). Also, DOPAC and homovanillic acid levels were significantly lower in exposed animals than in controls during stimulation with high potassium. The arsenite group showed a similar tendency to that from the mining waste group. In vivo microdialysis provides relevant data about the effects of a chemical mixture. Our results indicate that this mining waste may represent a health risk for the exposed population.

Detection of Cysticercus cellulosae antigens in cerebrospinal fluid by dot enzyme-linked immunosorbent assay (Dot-ELISA) and standard ELISA.

The dot enzyme-linked immunoassay and standard enzyme-linked immunoassay were used to detect Cysticercus cellulosae antigens in cerebrospinal fluid of patients suffering with neurocysticercosis. Using the dot enzyme-linked immunoassay, 10 of 17 patients (59%) were positive at a reciprocal titer of 128 (range 128-1,024). In the standard assay, 13 of 17 (77%) were positive (range 128-512). Specificity was 100% in both assays using 48 cerebrospinal fluids from patients with various central nervous system infections. The quantification of antigens in cerebrospinal fluid using standard assay and photometric readings showed a range of 17 to 138 ng/ml. The results indicate that both assays are sensitive, specific, and economical for the diagnosis of neurocysticercosis.

Treatment of neurocysticercosis with flubendazole.

Thirteen patients with neurocysticercosis were studied and treated with flubendazole. Diagnostic procedures included computerized tomography (CT) and enzyme-linked immunosorbent assay. In 12 cases treatment with the drug led to clinical improvement. CT showed that some cysts regressed in size, and in two patients they disappeared. The treatment also lowered the antibody levels. The drug was well tolerated and no allergic reaction or other side effects were observed.

Pre-exposure to the first dental treatment.

The present study attempts to verify the relative efficacy of two forms of pre-exposure which are identical in content and parallel in mode of exposure (in vivo or videotape). These two forms of pre-exposure were given to 38 children, aged four to six years old, before their first dental visit. The results showed that all groups manifested relatively little negative behavior while seeing the dentist. The theoretical and methodological implications of this study are discussed.

The effects of sodium arsenite exposure on behavioral parameters in the rat.

Arsenic is a metalloid widely present in the environment. It is found in well water, soil, and air, and is also released from mining residues and industrial debris, among other anthropogenic sources. It has been previously reported that the content of catecholamines in striatum, hippocampus, and other cerebral regions changes in mice and rats exposed to arsenic. Few studies have examined behavioral alterations after intoxication with arsenic, and both increased and decreased locomotor activity, as well as learning deficits, have been described. In order to characterize the behavioral alterations induced by arsenic exposure, we exposed adult male Sprague-Dawley rats to 5, 10, and 20 mg/kg of arsenic by intragastric route for 2 or 4 weeks. Exposed rats showed reduced locomotor activity, which returned to control levels at the end of the intoxication period. We also found an increase in the number of errors in an egocentric task, alterations in monoamine content in midbrain and cortex, and increases in arsenic brain concentration, which were related to time of the exposure but not dose. These results indicate that short-term arsenic exposure induces neural and behavioral changes that may reflect a neurotoxic effect, and that these alterations are correlated to dose, time of exposure, and experimental conditions.

Effects of arsenite on central monoamines and plasmatic levels of adrenocorticotropic hormone (ACTH) in mice.

We studied the effects of chronic arsenic exposure on brain monoamines and plasma levels of adrenocorticotropic hormone (ACTH) of mice. After weaning, mice received arsenic (0, 20, 40, 60 or 100 ppm) in drinking water over a period of 9 weeks. Monoamine content was quantified in different brain regions, arsenic was quantified in brain tissue and ACTH levels in plasma. Brain arsenic concentrations up to 200 ng/g showed a significant correlation with exposure levels and produced slight modifications in regional monoamine levels. ACTH plasma levels were significantly associated with norepinephrine (NE) concentrations in the medulla and pons, but not with hypothalamic NE levels. ACTH levels were significantly higher in the group exposed to 20 ppm. Dopamine showed significant dose-related decreases in the hypothalamus. These results show that chronic sodium arsenite exposure produces changes in central monoamines, which are not associated on a dose-dependent basis with major alterations in plasma ACTH.

Methylmercury increases glutamate extracellular levels in frontal cortex of awake rats.

A current hypothesis about methylmercury (MeHg) neurotoxicity proposes that neuronal damage is due to excitotoxicity following glutamate uptake alterations in the astrocyte. By sampling from a microdialysis probe implanted in the frontal cortex of adult Wistar rats, we measured the effects of acute exposure to either 10 or 100 microM MeHg through the microdialysis probe, on glutamate extracellular levels in 15 awake animals. After baseline measurements, the perfusion of MeHg during 90 min induced immediate and significant elevations in extracellular glutamate at 10 microM (9.8-fold, P<.001) and at 100 microM (2.4-fold, P=.001). This in vivo demonstration of increments of extracellular glutamate supports the hypothesis that dysfunction of glutamate neurotransmission plays a key role in MeHg-induced neural damage.

Behavioral effects of exposure to endosulfan and methyl parathion in adult rats.

Endosulfan (ES) and methyl parathion (MP) are widely used in Latin America, and simultaneous exposure to both products is documented. This exposure may have effects on the nervous system because their targets include the GABAergic and cholinergic systems, which are main modulators of neuronal excitability in the cortex and hippocampus. We tested whether low-level, repeated exposure of adult rats to commercial formulations containing ES and MP disrupts spatial learning in the water maze. Five groups of eight animals received subcutaneously appropriate dilutions of the commercial formulations to yield the following treatments during 10 days: saline, 25 mg/kg ES, 2 mg/kg MP (MP(2)), 25 mg/kg ES plus 1 mg/kg MP (ES+MP(1)) and 25 mg/kg ES plus 2 mg/kg MP (ES+MP(2)). In addition, markers of neurological function, renal and hepatic damage were explored as potential consequences of exposure. In the absence of overt toxicity, the groups exposed to the ES plus MP showed significantly longer escape latencies, higher number of failures to reach the platform and more time in the periphery of the tank than the control and single-exposed groups. This finding shows that commercial formulations of ES and MP have marginal effects when administered individually but can produce behavioral alterations when given in combination.

Acute toxicity of boric acid and boron tissue residues after chronic exposure in broiler chickens.

The acute oral mean lethal dose of boric acid in 1-day-old chickens was found to be 2.95 +/- 0.35 g/kg of body weight, which classifies this product as only slightly toxic to chickens. One-day-old broiler chicks were housed in floor pens in which litter had been treated with 0, 0.9, 3.6, or 7.2 kg of boric acid per 9.9 m2 of floor space. Boron residue levels in brain, kidney, liver, and white muscle were not statistically elevated following a 15-day exposure period. Boron residue levels in the same types of tissue were not significantly elevated in chicks fed 500 ppm or 1250 ppm boric acid in feed ad libitum for 3 weeks; however, residues were significantly higher in chicks fed 2500 ppm or 5000 ppm boric acid. These data indicate that broilers grown on boric acid-treated litter do not consume enough boric acid to cause elevated boron levels in tissues.

Experimental exposure of broiler chickens to boric acid to assess clinical signs and lesions of toxicosis.

One-day-old broiler chicks were housed on litter treated with 0, 0.9, 3.6, or 7.2 kg of boric acid per 9.3 m2 of floor space. After 15 days, average body weights were 340.7 g, 278.1 g, and 213.2 g for chickens exposed to 0, 3.6, and 7.2 kg boric acid/9.3 m2, respectively (P < or = 0.05). Feed conversion was 1.68 and 2.29 in chickens exposed to 0 and 7.2 kg boric acid/9.3 m2 (P < or = 0.05). In a second experiment, after birds ingested feed treated with 2500 and 5000 ppm of boric acid for 2 weeks, body weights were 254.8 g and 149.6 g, respectively. The chickens in the control group weighed an average of 285.0 g (P < or = 0.05). The 5000 ppm treatment group had a feed conversion of 1.70, vs. 1.45 in the controls (P < or = 0.05). A dose-related feathering abnormality was evident in treated chickens. No significant histopathologic changes were observed. Livability, weight gain, and feed conversion were not adversely affected in broilers as a result of exposure to litter treated with boric acid at recommended levels of 0.4-0.9 kg/9.3 m2.

Effectiveness of soft laser treatment in periodontal surgery.

The aim of this study was to determine the analgesic, anti-inflammatory and healing effects of soft-laser treatment in a double-blind crossover study of periodontal post-surgical patients. For each patient, mucogingival procedures were required on contralateral sides of the mouth for similar problems. Twenty-eight patients had a total of 28 pairs of surgical procedures performed. Prior to surgery, a complete examination was carried out, scaling and root planing were performed, and oral hygiene instructions were given. Following surgery on both sides of the mouth, one site was lased and a placebo procedure was carried out on the other site. The patients evaluated pain three times a day for one week (modified McGill pain scale). An inflammatory index (Loe and Silness Index) was ascertained at days 7 and 14 for both sides of the mouth. A healing score (Landry, Turnbull, Howley Index) was evaluated at days 7 and 14. For both surgical procedures, the assessments were carried out in the same manner. Univariate and multivariate analyses of variance were performed for all parameters. The results showed no significant differences in the gingival index, healing index and pain reduction when the soft laser treatment was compared to the placebo operation. These results suggest that soft laser (As-Ga and He-Ne) treatments may not be a useful adjunct after certain periodontal surgical procedures.

Lead exposure in the city of Arar, Saudi Arabia.

In follow-up to a case of lead encephalopathy, high prevalences of lead exposure (23%) and iron deficiency (60%) were found in children who lived in Arar, Saudi Arabia. Environmental factors had minor effects on the blood lead concentrations of these children. We concluded that traditional cosmetics and remedies were the major sources of lead exposure in this Arar population.

Living in limbo: the low-level brain-injured patient and the patient's family.

One hallmark of severe traumatic brain injury (TBI) is a loss of consciousness followed by varying states of consciousness. Estimates suggest that 30-40% of individuals who survive severe TBI will stay in low-level or reduced states of consciousness for prolonged periods. The state of coma is relatively easy to diagnose; however, differential diagnosis of other states of reduced consciousness have proven to be much more difficult, precipitating a number of problems related to prognosis, treatment, and rehabilitation. Accurate diagnosis is critical in determining the prognosis for persons with severe TBI because it has significant implications for the patient, family, clinician, and payer. Studies have shown that prognosis directly influences numbers and types of treatments recommended. Often, families find themselves being forced to make critical decisions with little knowledge and a great deal of uncertainty. Understanding reduced states of consciousness and facilitating accurate evaluation of such states allow neuroscience nurses to help families effectively cope during this difficult time.

Brain attack: correlative anatomy.

Approximately 500,000 people suffer a new or recurrent brain attack each year. Despite advanced treatments, stroke continues to be the third leading cause of death in the United States. Survivors of stroke experience many different clinical problems and neurological deficits. Individual symptomatology varies according to specific vessel involvement and the location of brain tissue infarction or hemorrhage. Understanding basic cerebral anatomy provides a foundation for the neuroscience nurse to plan effective nursing care for the victim of brain attack.

Traumatic brain injury: a family experience.

Traumatic brain injury (TBI), sometimes referred to as a silent epidemic, affects thousands of people each year. A head injury not only affects the patient, but the entire family system as well. Families experience a myriad of needs during this time of crisis. With the immediate focus on the patient's physical or cognitive state, the family's needs may go unnoticed or unrecognized. It is imperative health care professionals understand the emotional impact on family needs, and the unique grieving patterns which influence their ability to cope with this situation. Caregivers are advised to assess, formulate and implement a plan of care for the family as well as the patient. Since families play such an integral role in the patient's recovery process, it is crucial to recognize the scope of the TBI experience and provide care within the context of the individual family system.

Bicycle safety programs: targeting injury prevention through education.

Children especially are prone to bicycle injuries, many of which are preventable. Data from an assessment of pediatric bicycle-related injuries at a major Southeastern Tennessee trauma center were used to support the need for a public awareness program about children's bicycle safety. Results of the assessment are reviewed and program planning, implementation, and evaluation are described.

King's theory: a critique of the critiques.

This article describes Imogene M. King's conceptual framework and theory of goal attainment. The critiques of various nursing scholars reflect a misunderstanding of the intent of the theory and conceptual framework. Major areas of concern of the critics include cultural limitations, patient competence, and lack of specific guidelines to work within the nursing process. These critiques are discussed and examples supporting the use of King's work in practice are presented.

Better oral health for infants and toddlers: a community based program.

Effective partnerships between health professional educational institutions and social service community programs can result in improved health outcomes for the people of the community being served. Such partnerships also may contribute considerably to student maturation into compassionate providers who have an appreciation for how an individual's health and quality of life may be affected by societal factors. A dental hygiene program at a private university and an Early Head Start Program joined in partnership to develop, and implement successfully, a project that was highly productive and of reciprocal benefit. With a focus on infant oral care in general, and early childhood caries in particular, dental hygiene students were able to provide much needed oral health services to 45 families with children enrolled in the Early Head Start Program, at multiple rural locations in Maine. In addition to meeting the needs of the Early Head Start Program, the project created a foundation for student exchange on the issues of dental caries in very young children, and the complexity of the factors contributing to them. Professional dental hygienists may choose to adopt all or portions of this innovative project when planning for the delivery of dental hygiene care to specialized populations in community-based settings.