Conformal Coating of Stem Cell-Derived Islets for β Cell Replacement in Type 1 Diabetes

The scarcity of donors and need for immunosuppression limit pancreatic islet transplantation to a few patients with labile type 1 diabetes. Transplantation of encapsulated stem cell-derived islets (SC islets) might extend the applicability of islet transplantation to a larger cohort of patients. Transplantation of conformal-coated islets into a confined well-vascularized site allows long-term diabetes reversal in fully MHC-mismatched diabetic mice without immunosuppression. Here, we demonstrated that human SC islets reaggregated from cryopreserved cells display glucose-stimulated insulin secretion in vitro. Importantly, we showed that conformally coated SC islets displayed comparable in vitro function with unencapsulated SC islets, with conformal coating permitting physiological insulin secretion. Transplantation of SC islets into the gonadal fat pad of diabetic NOD-scid mice revealed that both unencapsulated and conformal-coated SC islets could reverse diabetes and maintain human-level euglycemia for more than 80 days. Overall, these results provide support for further evaluation of safety and efficacy of conformal-coated SC islets in larger species.

Persistent organic pollutant patterns in grey seals (Halichoerus grypus)

The aim of this paper is to examine the patterns of polychlorinated biphenyls (PCB) in the grey seals (Halichoerus grypus) from the Baltic, Northeast and Eastern England, and the St. Lawrence Estuary (Canada). In fact, the feeding habits of the ringed seal (Phoca hispida) include ingestion of major quantities of benthic crustaceans that might cause observed differences obtained in PCBs, whereas the grey seal feed mainly on fish. The profile (percent in mixture) of polychlorinated biphenyls (PCB) 101, 118, 138, 153, and 180, and the total of their concentrations in mg/kg lipid in grey seals from the Baltic, from Northeast and Eastern England, and from the St. Lawrence estuary (Canada), were examined by principal component analysis (PCA). When considering the possible effects of consuming seafood by the grey seal, it is necessary to characterize populations and individuals according to the amounts they consume, since populations in different parts of the world are likely to show big differences in their consumption of seafood. The patterns differ between juveniles and adult animals, but the gender of adults and geography do not appear to play a role.

Toward a redefinition of psychiatric emergency

OBJECTIVE

To compare three methods for rating legitimate use of psychiatric emergency services (PES) in order to develop criteria that can differentiate appropriate from inappropriate PES service requests.

METHOD

Ratings of PES visits by treating physicians and ratings of the same visits made during review of medical records.

STUDY DESIGN

Two previously used methods of identifying justified PES service use were compared with the treating physician's rating of the same: (1) hospitalization as visit outcome and (2) retrospective chart ratings of visit characteristics using traditional medico-surgical criteria for "emergent" illness episodes.

DATA EXTRACTION METHODS

Data were extracted through use of a physician questionnaire, and medical and administrative record review.

PRINCIPAL FINDINGS

Agreement between the methods ranged from 47.1 percent to 74.1 percent. A total of 21.7 percent of visits were rated as true health "emergencies" by the traditional definition, while 70.4 percent of visits were rated as "necessary" by treating physicians, and 21.0 percent resulted in hospitalization. Acuteness of behavioral dyscontrol and imminent dangerousness at the time of the visit were common characteristics of appropriate use by most combinations of the three methods of rating visits.

CONCLUSIONS

The rating systems employed in similar recent studies produce widely varying percentages of visits so classified. However, it does appear likely that a minimum of 25-30 percent of visits are nonemergent and could be triaged to other, less costly treatment providers. Proposed criteria by which to identify "legitimate" psychiatric emergency room treatment requests includes only patient presentations with (a) acute behavioral dyscontrol or (b) imminent dangerousness to self or others.

The nature of help-seeking during psychiatric emergency service visits by a patient and an accompanying adult

Utilization rates for urban psychiatric emergency services remain high, and the decision to seek care in this setting is poorly understood. Three hundred individuals accompanying patients to a psychiatric emergency service were interviewed about their help seeking and choice of treatment setting. Twenty-three of the interviewees (7.7 percent) were caregivers accompanying patients with severe and persistent mental illness. They were significantly more likely than other interviewees to know the difference between psychiatric emergency services and services offered by other outpatient providers. More than half reported that the patient they accompanied was intermittently noncompliant, which required visiting either a walk-in service during a moment when the patient was cooperative or a facility equipped to provide involuntary treatment.

[Comparative study of 2 common tests for lupus anticoagulant determination: critical analysis of the results observed in 21 patients]

The Schleider and/or the Exner test have been found positive in twenty-one patients; five of these patients suffered of systemic lupus erythematosus (SLE). The Quick time and the activated partial thromboplastin time are normal in 52% of the cases. 40% have a minor haemorrhagic diathesis, without other significant clotting defect and 30% have thrombo-embolic complications. The Schleider index is more often strongly positive (greater than 2) in these two groups. 58% have an anemia, 25% a mild thrombocytopenia not deep enough to explain an haemorrhagic tendency (from 90.000 to 140.000/mm3). Several auto-immune tests are frequently positive even without SLE. The Schleider test is positive in 86% of the cases and appears a little more useful for the diagnosis than the Exner test, which has a 71% positivity.

[Comparative study of the value of Schistosoma mansoni and Schistosoma haematobium antigens in the indirect immunofluorescent reaction applied to the diagnosis of rectal S. intercalatum bilharziasis]

A comparative study of the value of antigenic sections of S. mansoni and S. haematobium in indirect immunofluorescence applied to the diagnosis of S. intercalatum rectal bilharziosis (in 66 cases) shows that far better results are obtained with S. haematobium antigen (83,3 0/0 positive reactions with higher titers dilution) than with S. mansoni (33,3 0/0 positive reactions).

[Changes in fluorescent antibodies in experimental bilharziasis with S. mansoni and S. haematobium in mice. Comparison of the results obtained using homologous and heterologous antigens]

Fluorescent antischistosomiasis antibodies appear earlier in mice infected by 150/200 cercariae than in those who only received 20. The use of a homologous antigen in mice infected by S. mansoni or S. haematobium allows earlier and more important responses. The infections by S. haematobium seem to determinate in mice a more important immune responsiveness. Is it a specific parasitic manifestation (S. mansoni being better adapted to rodents?).