Seagrass habitat in Tarawa Lagoon, Kiribati: Service benefits and links to national priority issues.

This paper presents a review around seagrass habitat in Tarawa Lagoon, Kiribati and explores the links between seagrass occurrence and the national priority issues of climate change, urban development, human health, nearshore fisheries, threatened species, ocean policy, research capacity and awareness. The contribution of healthy seagrass habitats to many aspects of these national issues is often overlooked and there is need to establish the knowledge gaps and priority actions that can enable mitigation of issues that impact on valuable seagrass resources and their management. Research data on seagrass habitats in Kiribati, and the wider Pacific Island region, is limited and this hinders informed decisions at local, national and regional levels. We present a comprehensive review on seagrass within a national context to aid prioritisation and uptake of information for resource owners, and wider stakeholders, in Kiribati while acknowledging local expertise. The paper highlights data and knowledge gaps that if addressed, will provide information useful to Kiribati nationals, communities and government stakeholders. Recommendations for actions that fill these gaps and build understanding of seagrass resources in Kiribati are provided.

The effects of thrombin on adenyl cyclase activity and a membrane protein from human platelets.

Washed human platelets were incubated with 0.1-1.0 U/ml human thrombin and the effects on adenyl cyclase activity and on a platelet membrane protein (designated thrombin-sensitive protein) were studied. Adenyl cyclase activity was decreased 70-90% when intact platelets were incubated with thrombin. The T(1/2) for loss of adenyl cyclase activity was less than 15 sec at 1 U/ml thrombin. There was no decrease of adenyl cyclase activity when sonicated platelets or isolated membranes were incubated with these concentrations of thrombin. Loss of adenyl cyclase activity was relatively specific since the activities of other platelet membrane enzymes were unaffected by thrombin. Prior incubation of platelets with dibutyryl cyclic adenosine monophosphate (AMP), prostaglandin E(1), or theophylline protected adenyl cyclase from inhibition by thrombin. Incubation of intact but not disrupted platelets with thrombin resulted in the release of thrombin-sensitive protein from the platelet membrane. The rapid release of this protein (T(1/2) < 15 sec) at low concentrations of thrombin suggested that removal of thrombin-sensitive protein from the platelet membrane is an integral part of the platelet release reaction. This hypothesis is supported by the parallel effects of thrombin on adenyl cyclase activity and thrombin-sensitive protein release in the presence of dibutyryl cyclic AMP, prostaglandin E(1), and theophylline at varying concentrations of thrombin.

Non-Hodgkin's lymphoma of the stomach: a prospective pilot study of surgery plus chemotherapy in early and advanced disease.

A prospective pilot study of 23 patients with non-Hodgkin's lymphoma involving the stomach was undertaken to assess the efficacy of surgical resection followed by chemotherapy with adjuvant cyclical cyclophosphamide, vincristine, and prednisolone (CVP) in early stage disease, and cyclical cyclophosphamide, vincristine, prednisolone, and doxorubicin (CHOP) in advanced disease. One of 18 evaluable patients died postoperatively; 17 of 18 completed therapy and are alive and disease-free at a median follow-up of 41 months after surgery (range, 5 to 111 months), including four patients with stage IV disease who remain in complete remission 19 to 47 months after surgery. There was one postoperative death, giving an actuarial survival rate of 94% in the study group. Three of five inoperable patients were treated with CHOP, with two achieving complete remission. Two untreated patients died. Overall actuarial disease-free survival was 82.6%. Surgical resection plus chemotherapy is capable of producing long-term remission and cure in both localized and advanced non-Hodgkin's lymphoma of the stomach. Intensive supportive care plus chemotherapy may salvage a proportion of patients with inoperable tumors.

An observational study of public and private general practitioner consultations in the Republic of Ireland.

BACKGROUND: The reasons why patients visit their general practitioner (GP) is vital information for fund holders and policy makers. GP consultations in the Republic of Ireland are either paid by the patient on a fee-per-service basis (private patients) or by the state [general medical service (GMS) card holders], and information related to primary care consultations is limited. OBJECTIVES: The aim of this study was to conduct an observational study of GMS and private consultations within general practice in Ireland. DESIGN: This is a cross-sectional study of general practitioner consultations. METHODS: GPs within existing Continued Medical Education (CME) groups were invited to participate. Participating GPs gathered data on 100 consecutive consultations between September 2008 and April 2010. RESULTS: There were 16,899 consultations recorded; 53.8 % (9,095) were GMS patients. Patients ≥65 years accounted for 23.69 % of consultations (n = 3,822). Respiratory illnesses accounted for the highest proportion of consultations (3,886, 23.0 %), followed by routine check-ups (15.4 %). GMS patients were more likely to consult for a repeat prescription (OR = 4.04, 95 % CI 2.93-5.57) and were also more likely to consult to review their treatment (OR = 2.33, 95 % CI 1.68-3.22) compared to private patients. CONCLUSION: This study displays the consultation behaviour of patients in Ireland. It suggests that inequalities may exist in access to primary care services in ROI; however, more research is required to examine this further. There is insufficient information available on primary healthcare utilisation. Key issues such as the lack of unique patient identifiers and the lack of extractable data from GP practices in ROI need to be addressed.

Familial hairy cell leukemia.

A mother and son are reported who both developed hairy cell leukemia. The mother aged 74 presented with pancytopenia and responded well to splenectomy. Four years later her son aged 48 presented with pancytopenia; splenectomy was less effective but he improved after treatment with interferon-alpha. Histological examination of the splenic tissue in both cases showed changes characteristic of hairy cell leukemia. This is the third report of this rare disease occurring in family members.

Oxytocin augmentation of labor and perinatal outcome in nulliparas.

Recent pharmacologic observations in vivo suggest the use of a lower starting dose (0.5-0.1 mU/minute) of oxytocin and a longer interval between dose augmentations (30-60 minutes) than previously advocated. In this study, a high-dose oxytocin protocol was used to augment nonprogressive labor in normal nulliparous women. The rate of oxytocin infusion started at 6 mU/minute and was increased by 6 mU/minute every 15 minutes to a maximum dose of 40 mU/minute. Charts were reviewed of 1080 nulliparous women for whom the principles of active management of labor were followed and delivery occurred between March 1, 1986 and December 31, 1988. Four hundred fifty-six who required oxytocin augmentation in labor were compared with 624 who did not receive oxytocin. There were no statistically significant differences in birth asphyxia or perinatal morbidity.

Hybrid biphenotypic acute leukemia with extreme hypodiploidy.

A patient diagnosed as having acute lymphoblastic leukemia (L2) relapsed 4 months later and was found to have morphologic and immunologic evidence of a biphenotypic hybrid acute leukemia. Chromosome analysis at relapse showed two abnormal clones, one with marked hypodiploidy and the other with exactly double the hypodiploid clone. It is considered that this is an example of a hybrid lymphoblastic/nonlymphoblastic leukemia with unique karyotype.

Observations on dopamine receptor antagonists and gastric ulceration associated with experimental anorexia cachexia.

Gastric ulceration is frequently reported to occur in tumour-bearing animals and man, even when such tumours are not associated with organs of digestion. That central and peripheral dopamine (DA) containing neurones may be relevant to this phenomenon, is supported by the fact that the DA receptor antagonists domperidone (0.1 and 0.05 mg/kg) and pimozide (0.1 mg/kg) were observed to prevent gastric ulceration commonly reported in rats bearing the Walker 256 carcinosarcoma. Daily administration of these drugs prevented the formation of ulcers similar to those observed in vehicle-treated animals. These results demonstrate that DA neurone function is important in the formation of gastric ulcers in tumour-bearing animals and suggest that such compounds may be useful in cancer management.

Evaluating the effectiveness of a commercial portable air purifier in homes with wood burning stoves: a preliminary study.

Wood burning for residential heating is prevalent in the Rocky Mountain regions of the United States. Studies have shown that wood stoves can be a significant source of PM(2.5) within homes. In this study, the effectiveness of an electrostatic filter portable air purifier was evaluated (1) in a home where a wood stove was the sole heat source and (2) in a home where a wood stove was used as a supplemental heat source. Particle count concentrations in six particle sizes and particle mass concentrations in two particle sizes were measured for ten 12-hour purifier on and ten purifier off trials in each home. Particle count concentrations were reduced by 61-85 percent. Similar reductions were observed in particle mass concentrations. These findings, although limited to one season, suggest that a portable air purifier may effectively reduce indoor particulate matter concentrations associated with wood combustion during home heating.

A thrombin-sensitive protein of human platelet membranes.

The action of thrombin on intact human platelets has been studied with the aid of polyacrylamide gel electrophoresis in sodium dodecylsulfate. A single major membrane protein band with a molecular weight of 190,000 disappears after thrombin treatment, while a new membrane protein with a molecular weight of 107,000 appears. This may represent hydrolysis of the thrombin-sensitive protein. When platelets are disrupted or when the thrombin-sensitive protein is solubilized from membranes prior to thrombin treatment, no hydrolysis occurs. The effect of thrombin on the platelet membrane protein is complete within 2 min which suggests that hydrolysis of this membrane protein may trigger the physiological effects of thrombin on platelets.

A variant chromosomal translocation found in a series of 24 patients with Philadelphia positive chronic granulocytic leukaemia.

The bone marrow chromosomes of 24 patients with Philadelphia positive (Ph 1) chronic granulocytic leukaemia (CGL) were studied using banding techniques. In 23 patients, the Ph(1) had been produced by the standard translocation between chromosomes 9 and 22, but in the remaining patient, the Ph(1) chromosome had been formed by a translocation between chromosomes 16 and 22. Clinical and haematological details of this patient are reported.

Thrombocytopenia and carcinoma.

The cases of two patients suffering from carcinoma of the lung and severe thrombocytopenia are described. The thrombocytopenia was probably due to an immune mechanism and not to marrow replacement by carcinoma or consumption coagulopathy. It is suggested that patients in the older age group presenting with thrombocytopenia may have occult carcinoma.

Active management of labor and operative delivery in nulliparous women.

There has been a fourfold increase in cesarean births in Canada in the last 20 years. The two main indications are dystocia and repeat cesarean section. Of all primary cesarean sections, about half are due to dystocia. This is largely confined to nulliparous women. Work from Ireland suggests that a policy of active management of labor may reduce dystocia. This involves a uniform policy of amniotomy once a diagnosis of labor is established, followed by oxytocin augmentation if labor is nonprogressive (less than 1 cm/hr). From October 1, 1985, to December 31, 1986, this policy was carried out on 552 consecutive normal nulliparous women in spontaneous labor at greater than or equal to 37 weeks' gestation with a single fetus in vertex presentation with no fetal distress. These results were compared with a control group of 533 similar nulliparous women delivered between January 1, 1984 and March 31, 1985. The cesarean section rate dropped to 4.3% from 13% (p less than 0.005) and the forceps delivery rate dropped to 19.4% from 29% (p less than 0.005). The duration of labor greater than 12 hours dropped to 7% from 20% (p less than 0.005). There was no increase in fetal morbidity or mortality.