Protection against allergic airway inflammation during the chronic and acute phases of Trichinella spiralis infection

BACKGROUND

Modulation of the host immune response by helminths has been reported to be essential for parasite survival and also to benefit the host by suppressing inflammatory diseases such as allergies. We have previously shown that excretory-secretory products of Trichinella spiralis muscle larvae have immunomodulatory properties and induce in vitro the expansion of CD4(+) CD25(+) FOXP3(+) Treg cells in a TGF-β-dependent manner.

OBJECTIVE

We aimed at determining the effect of the acute (intestinal) and the chronic (muscle) phase of T. spiralis infection on experimental allergic airway inflammation (EAAI) to Ovalbumin (OVA) and the involvement of Treg cells.

METHODS

The chronic phase was established before OVA-sensitization/challenge and the acute phase at two-time points, before and after OVA-sensitization. Mice were infected with 400 T. spiralis larvae and after euthanasia different pathological features of EAAI were measured. Adoptive transfer of CD4(+) T cells from Trichinella infected mice to OVA sensitized/challenged recipients was also performed.

RESULTS

We found that the chronic as well as the acute phase of Trichinella infection suppress EAAI as indicated by reduction in airway inflammation, OVA-specific IgE levels in sera, Th2-cytokine production and eosinophils in bronchoalveolar lavage. This protective effect was found to be stronger during the chronic phase and to be associated with increased numbers of splenic CD4(+) CD25(+) FOXP3(+) Treg cells with suppressive activity. Adoptive transfer of splenic CD4(+) T cells from chronically infected mice with elevated numbers of Treg cells resulted in partial protection against EAAI.

CONCLUSIONS AND CLINICAL RELEVANCE

These results demonstrate that the protective effect of T. spiralis on EAAI increases as infection progresses from the acute to the chronic phase. Here, Treg cells may play an essential role in the suppression of EAAI. Elucidating the mechanisms and molecular helminth structures responsible for this regulatory process is relevant to develop alternative tools for preventing or treating allergic asthma.

Promoting the self-regulation of clinical reasoning skills in nursing students

Aim:

The purpose of this paper is to describe the research surrounding the theories and models the authors united to describe the essential components of clinical reasoning in nursing practice education. The research was conducted with nursing students in health care settings through the application of teaching and learning strategies with the Self-Regulated Learning Model (SRL) and the Outcome-Present-State-Test (OPT) Model of Reflective Clinical Reasoning. Standardized nursing languages provided the content and clinical vocabulary for the clinical reasoning task.

Materials and Methods:

This descriptive study described the application of the OPT model of clinical reasoning, use of nursing language content, and reflective journals based on the SRL model with 66 undergraduate nursing students over an 8 month period of time. The study tested the idea that self-regulation of clinical reasoning skills can be developed using self-regulation theory and the OPT model.

Results:

This research supports a framework for effective teaching and learning methods to promote and document learner progress in mastering clinical reasoning skills. Self-regulated Learning strategies coupled with the OPT model suggest benefits of self-observation and self-monitoring during clinical reasoning activities, and pinpoints where guidance is needed for the development of cognitive and metacognitive awareness.

Recommendations and Conclusions:

Thinking and reasoning about the complexities of patient care needs requires attention to the content, processes and outcomes that make a nursing care difference. These principles and concepts are valuable to clinical decision making for nurses globally as they deal with local, regional, national and international health care issues.

[A case of liver abscesses in a bull]

During a farm visit a breeding bull was presented with signs of anorexia, somnolence, and loss of condition. These signs were chronic and slowly progressive. Clinical examination revealed an enlarged liver and subsequent ultrasonography revealed multiple abscesses in the liver. This was confirmed during post-mortem examination. Ultrasonography, proved to be of great diagnostic value, especially because it is a quick and non-invasive procedure.

A new direction for cognitive development in nursing to prepare the practitioners of the future

The quest to improve metacognitive control of critical thinking abilities has gained increasing importance throughout the world during the past thirty years. Self-regulated learning, a concept within the construct of critical thinking, is currently receiving much attention from educational theorists. A self-regulated individual requires a dependable experiential knowledge base, uses cognitive critical thinking strategies in a reflective manner, and is affected by social and cultural influences. One purpose of this article is to review the significant legacy of cognitive research in nursing. The research is categorized according to the concepts of the self-regulation learning model; metacognitive self-regulation (critical thinking, information processing), behavioral self-regulation (reflective practice) and environmental self-regulation (social interaction, clinical context). Another purpose of the article is to explore some self-regulated learning techniques that could be used to improve metacognitive control of critical thinking abilities in practice situations. Nursing leaders in service and education should consider a new approach for cognitive development in practice, since the result could be outcomes that are more closely aligned with mandates of governing bodies, growth of the discipline and patient welfare.

Studies on the pH value of abomasal contents in dairy cows during the first 3 weeks after calving

The pH value of the abomasal contents in adult cattle is normally constant and has a value of 2. Abomasal contents with pH values of 5.5 and higher could give rise to bacterial fermentation with subsequent gas production. The accumulation of gas is thought to form a key event in the pathogenesis of abomasal displacement. The aim of the present study was to determine the pH values of abomasal contents of dairy cows in the first 3 weeks after calving. The pH of the abomasal contents was, over several days. higher than the pH value of the abomasal juice in mid-lactation cows. The highest pH values were measured on day 14 after calving, thereafter the pH declined. Possible explanations for the rise in the pH value of the abomasal contents are discussed.

[Congenital white muscle disease in a Belgian blue calf]

In this case report about white muscle disease (WMD) in a Belgian Blue herd, the disease is described both as an individual and as a herd problem. Aetiology, diagnosis, and therapy of WMD are discussed. WMD is a disease of animals with muscle damage due to the presence of free radicals. Unsaturated fatty acids in the cell membrane are transformed into a radical form in a chain reaction: a fatty acid next to the fatty acid radical can be transformed into another free radical. In healthy animal the chain reaction is stopped by anti-oxidants such as vitamin E and glutathione peroxidase. WMD can occur when more free radicals are produced than the available anti-oxidants can deal with. The disease occurs in calves, lambs, and foals.

Comparison of information obtained from a Usenet newsgroup and from drug information centers

Responses to drug information questions posted on the Internet Usenet pharmacy newsgroup sci.med. pharmacy were compared for accuracy with responses from drug information centers (DICs). Twenty-five questions were randomly selected from the past five years' continuing-education sections of the Annals of Pharmacotherapy, and possible answers were determined on the basis of corresponding articles. The questions were randomly submitted to sci.med.pharmacy from various e-mail accounts over a 10-week period. The same questions were submitted by telephone to randomly selected DICs. The correctness of responses was judged by a panel of four pharmacists. The questions received 31 responses from sci.med. pharmacy and 38 from the DICs. The responses from sci.med.pharmacy received 38 (31%) judgments of correct and the responses from the DICs, 85 (56%). A significantly smaller proportion of drug information responses from the Usenet newsgroup sci.med.pharmacy were judged as being accurate compared with responses from DICs.

The Use of a Homeless Shelter as a Clinical Rotation for Nursing Students

Homeless persons are a population at risk in the community with health problems which nursing can impact. They are a heterogeneous group from all levels of society with a variety of acute and chronic health problems. Senior nursing students learn the theories and causative factors of becoming homeless as well as the resources available to them in this southeastern city. The students are also introduced to the mechanisms by which homeless persons interact with the present healthcare system. The clinical experience is described as it occurs in this inner city location. Learning activities include health assessments, treatments, education, and referrals. The value of this experience to the student is that it promotes independence, self-direction, and priority setting. The advantages and disadvantages of this clinical experience for senior nursing students and their clients are discussed.

Planning nursing education for the 21st century

In looking towards the 21st century, the faculty at the Presbyterian Hospital School of Nursing, along with the Presbyterian Health Services Corporation and Queen's College, adopted a 1-2-1 programme. The process of developing a new nursing curriculum is presented as the task force proceeded from the philosophy and goals to conceptual framework and curriculum objectives. After discussions with nurse administrators and educators, extensive literature reviews and brainstorming sessions, concepts and subconcepts were chosen to form a philosophy. The metaparadigm of nursing and other related concepts were then organized into a conceptual framework. Ongoing communication and feedback from the faculty ensured group ownership of all documents. The eclectic organizational scheme was a good fit for a large faculty with differing beliefs and values about a nursing curriculum. The process of developing a future orientated nursing curriculum has been exciting, challenging and rewarding. The faculty is committed to the new philosophy, goals and conceptual framework and believe that the 1-2-1 programme will educate future practitioners who are prepared to meet the challenges and changes in health care for the 21st century.

Aneurysm of the cranial mesenteric artery in a cow

An exploratory laparotomy of a four-year-old red Holstein cow with signs of abdominal discomfort revealed a painful pulsating mass in the cranial part of the abdomen. The cow died suddenly. A post mortem examination showed that a ruptured aneurysm of the cranial mesenteric artery had been the cause of death.

Stressors and coping strategies of patients with automatic implantable cardioverter defibrillators

This study investigated the stressors of and coping strategies used by patients living with the automatic implantable cardioverter defibrillator. A descriptive study of stress perceptions and coping strategies was conducted with quantitative and qualitative methods. The Lazarus stress and coping paradigm was used as a theoretic framework. Interviews of 20 subjects revealed a mixture of problem-focused and emotion-focused coping strategies in the physical, psychologic, and social areas. The optimistic coping style facilitated coping best. Nursing implications include fostering the use of mixed coping strategies, including optimism, in living with this device.

Effects of experimental duodenal occlusion on electrical activity of the proximal duodenum in cattle

An electromyographic study of the proximal duodenum in cattle is presented. Changes of motility patterns were studied after induced mechanical obstruction of the descending duodenum in five healthy cows. Special attention was paid to the ratio of antegrade and retrograde motility. Induced duodenal obstruction of which the duration was at most 48 hours, resulted in abrupt disorganisation of the migrating myoelectric complexes; the phases of regular spiking activity disappeared completely or reappeared in a disorganised pattern, and the phases of irregular spiking activity consisted of repetitive groups of spike bursts with prolonged duration and increased propagation velocity. Retrograde peristaltic contractions in the proximal duodenum were observed. Relief of obstruction resulted in a rapid reorganisation of the cyclic pattern of the migrating myoelectric complexes, which indicates normalisation of intestinal activity.

[Pseudotuberculosis in goats also in the Netherlands. A literature review]

Pseudotuberculosis or caseous lymphadenitis in goats is marked by superficial abscesses and was recently observed in the Netherlands. The literature on this disease is reviewed, concerning the incidence, aetiology, pathogenesis, symptoms, diagnosis, therapy and preventive measures. The damage which the disease could cause to goat husbandry in the Netherlands, is discussed. Although the losses from death and diminished production will probably be small, treatment is time-consuming and requires much labour. The greatest damage will possibly consist in the fact that breeders will not be able to sell their animals when caseous lymphadenitis occurs in their herd. Particularly, the export of breeding stock could be menaced by this disease.

Secondary indigestion as a cause of functional pyloric stenosis in the cow

In 23 cows suffering from a secondary indigestion, in most cases with septicaemia, the syndrome of functional pyloric stenosis or vagal indigestion developed. The signs were anorexia, ruminal distension with fluid material, abomasal reflux into the ruminoreticulum, dehydration, hypochloraemic, hypokalaemic metabolic alkalosis and uraemia. These signs often disappeared after treatment of both the primary causative disease and the secondary indigestion. The importance of recognising this condition is emphasised, because the serious signs of the secondary indigestion may dominate the causative disease. The prognosis depends upon the causative disease and is not necessarily bad.

Reticulo-omasal stenosis in the cow: differential diagnosis with respect to pyloric stenosis

In the complex called vagal indigestion two main types of stenosis can be distinguished, pyloric stenosis and stenosis between the reticulum and omasum or reticulo-omasal stenosis. Laboratory examinations of blood and rumen fluid were carried out in 10 cows with reticulo-omasal stenosis. The results are discussed with respect to the differential diagnoses of pyloric stenosis. In the cows with reticulo-omasal stenosis no metabolic alkalosis occurred and consequently dehydration and uraemia did not develop. For the clinician valuable points of difference were a more prolonged and chronic course and, on physical examination, the absence of serious circulatory disturbances and the absence of an ammoniacal-uraemic odour in the expired air. The clinical picture of reticulo-omasal stenosis strongly resembles a syndrome described as failure of omasal transport.

[The roll-and-suture technic as a treatment method in left-sided abomasal displacement in cattle: an acceptable alternative?]

The roll-and-suture technique was introduced as a rapid, easy and cheap method of surgical correction of left-sided abomasal displacement in cattle. It is questionable however, whether satisfactory reposition and fixation are achieved in every case using this technique. The present authors studied the roll-and-suture technique in four animals affected with left-sided abomasal displacement. In addition, five cases treated by this method in general practice were investigated. In view of the results obtained, attention is drawn to possible intra- and postoperative complications. It is concluded that the roll-and-suture technique should be rejected from the point of view of surgical treatment as it is not known which abdominal structures are being sutured. Although there may be ethical reservations in regard to the roll-and-suture technique, this method may therefore be acceptable from the economic point of view.

[Results of treatment by rotation in left-sided abomasal displacement (author's transl)]

The results are given of the treatment of thirty cows with left-sided abomasal displacement by rotation, followed by intravenous injection of hypertonic sodium chloride solution and a calcium borogluconate solution. In addition, ammonium chloride was administered orally for a few days. The rations of the animals were gradually restored to normal levels. The purpose was to examine whether recurrences following rotation could be prevented by supplementary measures. Of these thirty animals, five did not respond to treatment because of complications that would otherwise not have reacted favourably to any form of treatment either. Correction of the abomasal displacement was successful in more than 90 per cent (23 animals) of the remaining five cows. However, abomasal displacement recurred in sixteen of these twenty-three animals (70%). Of these fourteen cows, two animals developed an abomasal torsion. It is concluded that the supplementary measures adopted will not prevent recurrences.

[Disseminated intravascular coagulation in colitis X. Coincidence or part of the syndrome? (author's transl)]

The course run by the disease is described in a horse which showed the symptom complex of colitis X following treatment with oxytetracycline. Disseminated intravascular coagulation was also observed in this horse. The possibility of disseminated intravascular coagulation being part of colitis X is discussed.

[Indigestion in cattle due to partial or total obstruction of the gastrointestinal tract (author's transl)]

The clinical picture and the results of examination and treatment in a cow with "posterior stenosis" are reported. The metabolic effects resulting from obstruction of the gastrointestinal tract and reflux of the contents of the abomasum are then discussed. The classification into "anterior" and "posterior" stenosis is of importance in the differential diagnosis. The most common cause is local peritonitis originating from traumatic reticulitis or abomasal ulcer. Treatment of "posterior stenosis" is mainly directed to removing the cause, though restoring water and salt metabolism and the acid-base equilibrium also are of major importance.

[Oesophagotracheal fistula in a calf. Report of a case (author's transl)]

The case of a nine-month-old Dutch-Friesian heifer calf with an oesophagotracheal fistula which probably was congenital, is reported. The fistula passed obliquely from the caudodorsal to the cranioventral region, from the ventral portion of the oesophagus to the dorsal part of the trachea, into which it opened at a point one cm. cranial to the eparterial bronchus. The animal had been affected with bloat at birth and had had difficulty in drinking as a young calf. It did not show any clinical symptoms during the grazing period. It was not until the animal was housed at an age of nine months that bloat recurred as a result of inflation of the rumen by the fistula.