Multi-Domain Interventions for Dementia Prevention - A Systematic Review

OBJECTIVES

There is a growing incidence of cognitive decline and dementia associated with the ageing population. Lifestyle factors such as diet, physical activity, and cognitive activities may individually or collectively be undertaken to increase one's odds of preventing cognitive decline and future dementia. This study will examine whether clinical trials using multidomain lifestyle intervention can significantly decrease the risk of cognitive decline and therefore dementia.

DESIGN, SETTING AND PARTICIPANTS

This systematic literature review of multidomain lifestyle interventions for the prevention of cognitive decline and dementia followed the PRISMA guidelines. Clinical trials involving multidomain intervention (i.e., diet and physical activity, or without cognitive training) in older adults (≥ 49 years old) at higher risk of dementia were identified through 5 electronic databases (EMBASE, MEDLINE, CINAHL, Cochrane, and Scopus). A comprehensive search was performed to identify and retrieve publications until 15 November 2022. Trials were published in English.

RESULTS

The included studies (n=15) assessed change in cognition in response to a multidomain lifestyle intervention. However, the cognitive outcome measures used in these studies were heterogeneous. Despite this heterogeneity, two thirds of the studies showed improvement in cognition following a multidomain intervention (n=10 with a total of 9,439 participants). However, five studies reported no improvement in cognition following the multidomain intervention. The most common form of dietary intervention included higher amount of fruit and vegetable intake; whole-grain cereal products instead of refined; low fat options in milk and meat products; and limiting sucrose intake to less than 50 g/day. Most clinical trial studies were powered to examining the effects of multidomain interventions in cognition but were not designed to test the contribution of individual domains (i.e., dietary changes, increased physical activity, or increased cognitive stimulation alone).

CONCLUSION

This systematic review aimed to determine the effect of multimodal lifestyle interventions on cognitive outcomes in older adults at risk of dementia. We found that participants with conditions that may increase the risk of dementia, (e.g., hypertension, cardiovascular fragility) do benefit from multi-modal lifestyle changes including diet, physical activity, and cognitive training. Two thirds of studies using multidomain lifestyle interventions showed improvements in cognitive function. Trials with a focus on cognitive training, dietary improvement, and physical activity may prevent or delay cognitive decline in older adults including those at risk of developing dementia. Future studies should consider longer follow-up periods and adequate power to be able to examine the effects of each lifestyle component in the context of multimodal interventions.

Inhibition of the NorA efflux pump of Staphylococcus aureus by synthetic riparins

AIM

The goal of this study was to increase knowledge about the antimicrobial activity of some synthetic Riparin-derived compounds, alone or in combination with fluoroquinolone antibiotics, against a strain of Staphylococcus aureus resistant to fluoroquinolone by way of overexpression of the NorA efflux pump.

METHODS AND RESULTS

Microdilution tests showed that Riparins A and B did not show any significant antibacterial activity against Staph. aureus strains. On the other hand, the intrinsic antibacterial activity increased with increasing lipophilicity of the compounds, in the following order: Riparin-D (MIC 256 μg ml^-1 ; Log P 2·95) < Riparin-C (MIC 102 μg ml^-1 ; Log P 3·22) < Riparin-E (MIC 16 μg ml^-1 ; Log P 3·57). The addition of all riparins to growth media at subinhibitory concentrations caused an increase in the antibacterial activity of antibiotics against the NorA-overexpressing test strain. Riparin-B, which has two methoxyl groups at the phenethyl moiety, showed the best modulatory effect.

CONCLUSIONS

Riparin-E is a good anti-staphylococci agent, while Riparin-B functions as a NorA efflux pump inhibitor.

SIGNIFICANCE AND IMPACT OF THE STUDY

Our data suggest the possibility of using Riparin-B in combination with norfloxacin or ciprofloxacin for therapy of infections caused by multi-drug resistant Staph. aureus.

Desmodus rotundus (Mammalia: Chiroptera) on the southern coast of Rio de Janeiro state, Brazil

Since the 1990s, attacks by hematophagous bats on humans and domestic animals have been reported both on the continent and on the islands on the southern coast of Rio de Janeiro state. The density of vampire bats was investigated based on percentage of captures during control of Desmodus rotundus samplings and during bat diversity research. In the present work, 203 individuals of D. rotundus were captured from 1993 to 2009, which corresponds to 11.88% of all bat captures carried out for species control in local villages and 1.58% of all captures in faunistic inventories. The density of D. rotundus is high even on the recently occupied islands where domestic animals have been introduced. It is probable that this species dispersed from the continent to the islands due to the introduction of domestic animals.

Efficiency of sulphur in garlic extract and non-sulphur homeopathy in the control of the cattle tick Rhipicephalus (Boophilus) microplus

The objective of the present work was to evaluate the efficacy of a non-sulphur-based homeopathic preparation and a sulphur-containing natural product derived from Allium sativum (Linnaeus) against infestation by the cattle tick Rhipicephalus (Boophilus) microplus (Canestrini) (Acari: Ixodidae). A total of 24 crossbred calves (7 : 8 Holstein : Zebu), aged 6-8 months and maintained in individual stables under tick-free conditions, were divided into three groups. Group 1 (control group) received no treatment; Group 2 was treated with 0.01 g/day of the homeopathic preparation Fator C&MC(®), and Group 3 was treated with 20 g/day of Enxofre-Allium sativum(®). After adaptation to the diet for 1 month, each calf was subjected to artificial infestation with 8000 R. (B.) microplus larvae (aged 7-14 days) twice per week over a 5-month period. Numbers of engorged females were recorded every 14 days and samples of freely released engorged females were collected at 14-day intervals commencing 3 months after the start of the experiment. The engorged females were weighed, incubated for 15 days under biochemical oxygen demand conditions at 27 ± 1 °C and relative humidity >85%, and the weights of the egg masses produced were recorded. Other biological parameters, including reproduction estimate, reduction in oviposition and efficiency of treatment, were determined. A significant reduction in the number of engorged females was detected on animals treated with Enxofre-Allium sativum(®) (Group 3) in comparison with the other two groups. The overall efficiency of the treatment with the sulphur-containing product was 64%, whereas that of the homeopathic preparation was 26%. Under the experimental conditions established, Enxofre-Allium sativum(®) can reduce the intensity of the R. (B.) microplus infestation.

Cysteine-rich peptides (CRPs) mediate diverse aspects of cell-cell communication in plant reproduction and development

Cell-cell communication in plants is essential for the correct co-ordination of reproduction, growth, and development. Studies to dissect this mode of communication have previously focussed primarily on the action of plant hormones as mediators of intercellular signalling. In animals, peptide signalling is a well-documented intercellular communication system, however, relatively little is known about this system in plants. In recent years, numerous reports have emerged about small, secreted peptides controlling different aspects of plant reproduction. Interestingly, most of these peptides are cysteine-rich, and there is convincing evidence suggesting multiple roles for related cysteine-rich peptides (CRPs) as signalling factors in developmental patterning as well as during plant pathogen responses and symbiosis. In this review, we discuss how CRPs are emerging as key signalling factors in regulating multiple aspects of vegetative growth and reproductive development in plants.

Colony size, sex ratio and cohabitation in roosts of Phyllostomus hastatus (Pallas) (Chiroptera: Phyllostomidae)

Phyllostomus hastatus bat is species broadly distributed over the Neotropical region, which uses as diurnal roosts caves, hollow trees, palm leaves and human buildings. Thirteen diurnal roosts of P. hastatus were analysed from 1990 to 2009 in several localities of Rio de Janeiro State, regarding environment (rural, urban or protected area), type of roost (hollow tree, basement or roof), sex ratio and cohabitation. A nocturnal roost was also analysed. Sex ratio of P. hastatus varied considerably among roosts what may be explained by the fact this species can roost alone, in couples, in harems or in groups of bachelor males. Phyllostomus hastatus was observed in cohabitation with three other species: Molossus rufus, Molossus molossus and Myotis nigricans. Due to the frequency of cohabitation observed between P. hastatus and species of the genus Molossus, one or more advantages for the members of this association may be expected. The simultaneous usage of a feeding roost by a group of bachelor males is unknown information in the literature, and may suggest that this kind of group may interact with each other even when away from their diurnal roosts.

Bat diversity of Ilha da Marambaia, Southern Rio de Janeiro State, Brazil (Chiroptera, Mammalia)

Few sites have been well sampled for bats, and samplings in islands are even scarcer. Therefore, the objectives of the present study were: (1) to list the bat species of Ilha da Marambaia; (2) to compare richness, abundance and biomass of bat guilds found there; (3) to analyse abundance patterns of bat species; and (4) to compare richness, abundance and composition of the bat fauna among different kinds of environment. To capture bats we used mist nets set in five different environments, totalising 3559.2 net-hours, during 37 nights between October 2006 and August 2008. A total of 1,133 captures were accomplished, comprising 34 species from five families. The most abundant species was Molossus molossus. Frugivorous bats exhibited higher richness, abundance and biomass if compared to other guilds. Most species (N = 22) exhibited abundances between 1 to 10% of all captures. Sixteen species were restricted to just one of the environments sampled. The high richness may be attributed to sampling carried out in several environments, and to the capture of insectivorous species over water bodies.

Retinoblastoma makes its mark on imprinting in plants

Imprinting in flowering plants and mammals causes monoallelic expression of parental alleles, but how is this achieved? New evidence in plants implicates the retinoblastoma pathway in establishing imprints during gametogenesis.

Soil and vegetation carbon stocks in Brazilian Western Amazonia: relationships and ecological implications for natural landscapes

The relationships between soils attributes, soil carbon stocks and vegetation carbon stocks are poorly know in Amazonia, even at regional scale. In this paper, we used the large and reliable soil database from Western Amazonia obtained from the RADAMBRASIL project and recent estimates of vegetation biomass to investigate some environmental relationships, quantifying C stocks of intact ecosystem in Western Amazonia. The results allowed separating the western Amazonia into 6 sectors, called pedo-zones: Roraima, Rio Negro Basin, Tertiary Plateaux of the Amazon, Javari-Juruá-Purus lowland, Acre Basin and Rondonia uplands. The highest C stock for the whole soil is observed in the Acre and in the Rio Negro sectors. In the former, this is due to the high nutrient status and high clay activity, whereas in the latter, it is attributed to a downward carbon movement attributed to widespread podzolization and arenization, forming spodic horizons. The youthful nature of shallow soils of the Javari-Juruá-Purus lowlands, associated with high Al, results in a high phytomass C/soil C ratio. A similar trend was observed for the shallow soils from the Roraima and Rondonia highlands. A consistent east-west decline in biomass carbon in the Rio Negro Basin sector is associated with increasing rainfall and higher sand amounts. It is related to lesser C protection and greater C loss of sandy soils, subjected to active chemical leaching and widespread podzolization. Also, these soils possess lower cation exchangeable capacity and lower water retention capacity. Zones where deeply weathered Latosols dominate have a overall pattern of high C sequestration, and greater than the shallower soils from the upper Amazon, west of Madeira and Negro rivers. This was attributed to deeper incorporation of carbon in these clayey and highly pedo-bioturbated soils. The results highlight the urgent need for refining soil data at an appropriate scale for C stocks calculations purposes in Amazonia. There is a risk of misinterpreting C stocks in Amazonia when such great pedological variability is not taken into account.

When genomes collide: aberrant seed development following maize interploidy crosses

BACKGROUND AND AIMS

The results of wide- or interploidy crosses in angiosperms are unpredictable and often lead to seed abortion. The consequences of reciprocal interploidy crosses have been explored in maize in detail, focusing on alterations to tissue domains in the maize endosperm, and changes in endosperm-specific gene expression.

METHODS

Following reciprocal interploidy crosses between diploid and tetraploid maize lines, development of endosperm domains was studied using GUS reporter lines, and gene expression in resulting kernels was investigated using semi-quantitative RT-PCR on endosperms isolated at different stages of development.

KEY RESULTS

Reciprocal interploidy crosses result in very small, largely infertile seeds with defective endosperms. Seeds with maternal genomic excess are smaller than those with paternal genomic excess, their endosperms cellularize earlier and they accumulate significant quantities of starch. Endosperms from the reciprocal cross undergo an extended period of cell proliferation, and accumulate little starch. Analysis of reporter lines and gene expression studies confirm that functional domains of the endosperm are severely disrupted, and are modified differently according to the direction of the interploidy cross.

CONCLUSIONS

Interploidy crosses affect factors which regulate the balance between cell proliferation and cell differentiation within the endosperm. In particular, unbalanced crosses in maize affect transfer cell differentiation, and lead to the temporal deregulation of the ontogenic programme of endosperm development.

Abscisic acid and stress signals induce Viviparous1 expression in seed and vegetative tissues of maize

Viviparous1 (Vp1) encodes a B3 domain-containing transcription factor that is a key regulator of seed maturation in maize (Zea mays). However, the mechanisms of Vp1 regulation are not well understood. To examine physiological factors that may regulate Vp1 expression, transcript levels were monitored in maturing embryos placed in culture under different conditions. Expression of Vp1 decreased after culture in hormone-free medium, but was induced by salinity or osmotic stress. Application of exogenous abscisic acid (ABA) also induced transcript levels within 1 h in a dose-dependent manner. The Vp1 promoter fused to beta-glucuronidase or green fluorescent protein reproduced the endogenous Vp1 expression patterns in transgenic maize plants and also revealed previously unknown expression domains of Vp1. The Vp1 promoter is active in the embryo and aleurone cells of developing seeds and, upon drought stress, was also found in phloem cells of vegetative tissues, including cobs, leaves, and stems. Sequence analysis of the Vp1 promoter identified a potential ABA-responsive complex, consisting of an ACGT-containing ABA response element (ABRE) and a coupling element 1-like motif. Electrophoretic mobility shift assay confirmed that the ABRE and putative coupling element 1 components specifically bound proteins in embryo nuclear protein extracts. Treatment of embryos in hormone-free Murashige and Skoog medium blocked the ABRE-protein interaction, whereas exogenous ABA or mannitol treatment restored this interaction. Our data support a model for a VP1-dependent positive feedback mechanism regulating Vp1 expression during seed maturation.

empty pericarp4 encodes a mitochondrion-targeted pentatricopeptide repeat protein necessary for seed development and plant growth in maize

The pentatricopeptide repeat (PPR) family represents one of the largest gene families in plants, with >440 members annotated in Arabidopsis thaliana. PPR proteins are thought to have a major role in the regulation of posttranscriptional processes in organelles. Recent studies have shown that Arabidopsis PPR proteins play an essential, nonredundant role during embryogenesis. Here, we demonstrate that mutations in empty pericarp4 (emp4), a maize (Zea mays) PPR-encoding gene, confer a seed-lethal phenotype. Mutant endosperms are severely impaired, with highly irregular differentiation of transfer cells in the nutrient-importing basal endosperm. Analysis of homozygous mutant plants generated from embryo-rescue experiments indicated that emp4 also affects general plant growth. The emp4-1 mutation was identified in an active Mutator (Mu) population, and cosegregation analysis revealed that it arose from a Mu3 element insertion. Evidence of emp4 molecular cloning was provided by the isolation of four additional emp4 alleles obtained by a reverse genetics approach. emp4 encodes a novel type of PPR protein of 614 amino acids. EMP4 contains nine 35-amino acid PPR motifs and an N-terminal mitochondrion-targeted sequence peptide, which was confirmed by a translational EMP4-green fluorescent protein fusion that localized to mitochondria. Molecular analyses further suggest that EMP4 is necessary to regulate the correct expression of a small subset of mitochondrial transcripts in the endosperm.

Maternal gametophytic baseless1 is required for development of the central cell and early endosperm patterning in maize (Zea mays)

In angiosperms, double fertilization of an egg cell and a central cell with two sperm cells results in the formation of a seed containing a diploid embryo and a triploid endosperm. The extent to which the embryo sac controls postfertilization events in the seed is unknown. The novel gametophytic maternal-effect maize mutation, baseless1 (bsl1) affects central cell development within the embryo sac, frequently by altering the position of the two polar nuclei. Despite this irregularity, fertilization is as efficient as in wild type. The spatial expression of basal endosperm-specific transcripts is altered in free-nuclear and cellular mutant endosperms. At later stages of seed development, bsl1 predominantly affects development of the basal endosperm transfer layer (BETL). When bsl1/+ diploid plants were pollinated by wild-type tetraploid plants, the BETL abnormalities observed in bsl1/bsl1/+/+ tetraploid endosperms were diverse and of variable severity. Moreover, the frequency of kernels with severely perturbed BETL development correlated with the percentage of severely affected bsl1 central cells. Therefore, BSL1 is likely required in the central cell before fertilization for correct BETL patterning to occur. These findings provide new genetic evidence that a maternal gametophytic component is necessary for correct endosperm patterning.

Epigenetic asymmetry of imprinted genes in plant gametes

Plant imprinted genes show parent-of-origin expression in seed endosperm, but little is known about the nature of parental imprints in gametes before fertilization. We show here that single differentially methylated regions (DMRs) correlate with allele-specific expression of two maternally expressed genes in the seed and that one DMR is differentially methylated between gametes. Thus, plants seem to have developed similar strategies as mammals to epigenetically mark imprinted genes.

Construction and screening of subtracted cDNA libraries from limited populations of plant cells: a comparative analysis of gene expression between maize egg cells and central cells

The analysis of cell type-specific gene expression is an essential step in understanding certain biological processes during plant development, such as differentiation. Although methods for isolating specific cell types have been established, the application of cDNA subtraction to small populations of isolated cell types for direct identification of specific or differentially expressed transcripts has not yet been reported. As a first step in the identification of genes expressed differentially between maize egg cells and central cells, we have manually isolated these types of cell, and applied a suppression-subtractive hybridization (SSH) strategy. After microarray screening of 1030 cDNAs obtained from the subtracted libraries, we identified 340 differentially expressed clones. Of these, 142 were sequenced, which resulted in the identification of 62 individual cDNAs. The expression patterns of 20 cDNAs were validated by quantitative RT-PCR, through which we identified five transcripts with cell type-specific expression. The specific localization of some of these transcripts was also confirmed by in situ hybridization on embryo sac sections. Taken together, our data demonstrate the effectiveness of our approach in identifying differentially expressed and cell type-specific transcripts of relatively low abundance. This was also confirmed by the identification of previously reported egg cell- and central cell-specific genes in our screen. Importantly, from our analysis we identified a significant number of novel sequences not present in other embryo sac or, indeed, in other plant expressed sequence tag (EST) databases. Thus, in combination with standard EST sequencing and microarray hybridization strategies, our approach of differentially screening subtracted cDNAs will add substantially to the expression information in spatially highly resolved transcriptome analyses.

Isolation and characterization of a polymorphic stigma-specific class III peroxidase gene from Senecio squalidus L. (Asteraceae)

A novel stigma-specific class III peroxidase gene, SSP (Stigma-Specific Peroxidase), has been isolated from the self-incompatible daisy Senecio squalidus L. (Asteraceae). Expression of SSP in flower buds is developmentally regulated, with maximal levels of expression coinciding with anthesis, when stigmas are most receptive to pollen and when self-incompatibility is fully developed. In situ hybridization revealed SSP expression to be localized exclusively to the specialized secretory epidermal cells (papillae) of the stigma, which receive and discriminate pollen. SSP is therefore the first tissue-specific and cell-specific peroxidase gene identified in a plant. SSP belongs to a distinct clade of class III plant peroxidases that possess two introns, instead of the more normal situation of three conserved introns. The deduced amino acid sequence of SSP revealed a 27 amino acid signal peptide, suggesting that the SSP protein is secreted to the cell wall of the stigmatic papillae. In-gel peroxidase activity assays showed that SSP has relatively low peroxidase activity compared to other, as yet uncharacterized, peroxidases present in stigmatic extracts. Six SSP alleles have been cloned from different lines of S. squalidus carrying a range of self-incompatibility (S)-alleles but there was no consistent association between the presence of a particular SSP allele and S-genotype indicating that SSP is not the female determinant of SSI in S. squalidus. Nevertheless, the precise expression of SSP in stigmatic papillae suggests that it may have a more general function in pollen-stigma interactions, or alternatively in protection of stigmas from pathogen attack. Extensive database screens have identified homologues of SSP in other plant species, but available expression data for these genes indicates that none are flower-specific, suggesting that SSP represents a new functional type of class III peroxidase specific to the stigma. We discuss the possible function(s) of S. squalidus SSP in pollen-stigma interactions and in protection of stigmas from pathogen attack.

maternally expressed gene1 Is a novel maize endosperm transfer cell-specific gene with a maternal parent-of-origin pattern of expression

Growth of the maize (Zea mays) endosperm is tightly regulated by maternal zygotic and sporophytic genes, some of which are subject to a parent-of-origin effect. We report here a novel gene, maternally expressed gene1 (meg1), which shows a maternal parent-of-origin expression pattern during early stages of endosperm development but biallelic expression at later stages. Interestingly, a stable reporter fusion containing the meg1 promoter exhibits a similar pattern of expression. meg1 is exclusively expressed in the basal transfer region of the endosperm. Further, we show that the putatively processed MEG1 protein is glycosylated and subsequently localized to the labyrinthine ingrowths of the transfer cell walls. Hence, the discovery of a parent-of-origin gene expressed solely in the basal transfer region opens the door to epigenetic mechanisms operating in the endosperm to regulate certain aspects of nutrient trafficking from the maternal tissue into the developing seed.

The globby1-1 (glo1-1) mutation disrupts nuclear and cell division in the developing maize seed causing alterations in endosperm cell fate and tissue differentiation

Cereal endosperm tissues account for most of the world's calorific intake, yet the regulation of monocot seed development remains poorly understood. The maize endosperm originates with a series of free-nuclear divisions, followed by cellularisation and subsequent formation of a range of functional cellular domains. We describe the isolation and characterisation of a mutation that induces aberrant globular embryo and endosperm morphology, globby1-1 (glo1-1). Our data indicate that glo1-1 plays a role in nuclear division and cytokinesis in the developing seed. Pattern formation in the embryo is severely impaired with development arresting at premature stages, while in the endosperm, the effects of the glo1-1 mutation are manifest at the free-nuclear or syncytial stage. During cellularisation, and at later stages of development, aberrant cell division and localised domains of cell proliferation are apparent in glo1-1 endosperms. As a consequence, cell fate acquisition and subsequent differentiation of endosperm tissues are affected to varying degrees of severity. To date, it has been hypothesised that BETL cell fate is specified in the syncytium and that cell files subsequently develop in response to a gradient of signal(s) derived from the maternal pedicel region. Based on our findings, however, we propose that specification of BETL cells is an irreversible event that occurs within a narrow window of syncytial development, and that BETL cell identity is subsequently inherited in a lineage-dependent manner. Additionally, our data suggest that acquisition of aleurone cell fate does not solely rely upon signalling from the maternal surrounding tissue to the periphery of the endosperm, as previously thought, but that other factor(s) present within the endosperm are involved.

Imprinting in the endosperm: a possible role in preventing wide hybridization

Reproductive isolation is considered to play a key part in evolution, and plants and animals have developed a range of strategies that minimize gene flow between species. In plants, these strategies involve either pre-zygotic barriers, such as differences in floral structure and pollen-stigma recognition, or post-zygotic barriers, which are less well understood and affect aspects of seed development ranging from fertilization to maturation. In most angiosperms, a double fertilization event gives rise to a zygote and the endosperm: a triploid tissue with an unequal parental genomic contribution, which, like the placenta of mammals, provides reserves to the developing embryo. Interestingly, many aspects of endosperm development, again like the placenta, are regulated by a range of epigenetic mechanisms that are globally termed imprinting. Imprinted genes are characterized by their uniparental expression, the other parental allele being silenced. Normal development of the endosperm thus requires a highly specific balance of gene expression, from either the maternal or paternal genomes. Any alteration of this balance resulting from changes in allelic copy number, sequence or epigenetic imprints can cause endosperm failure and eventual seed abortion. In its widest sense, the endosperm thus serves as an accurate 'sensor' of compatibility between parents. A first step in understanding this important, yet complex system must clearly be the isolation and characterization of as wide a range as possible of imprinted genes.

Voltage-clamp: a useful approach to study in vitro duodenal iron transport in the mouse

The mechanism(s) controlling iron absorption remain(s) uncertain despite the progress in the identification of genes selectively expressed in the duodenum. The availability of experimental models of iron absorption is critical to the clarification of such mechanism(s). In the present study, a simple method for studying in vitro iron absorption in mouse duodenum is described. Short circuit current, open circuit potentials and epithelial conductances were measured in mouse duodenal segments. Also, unidirectional 55Fe fluxes at different pH conditions were measured in mice with varying iron status. The findings reinforce evidence for an adaptive response of the iron absorptive process according to the body iron status. Significant differences are demonstrated between iron fluxes measured in normal and parenterally iron loaded mice and at acidic compared to neutral pH environment. Also, a significant difference was observed between transepithelial potential measured in duodenum from iron-loaded compared to untreated mice. Advances in the understanding of the mechanism(s) of iron absorption can be brought by the application of voltage-clamp techniques to the electrophysiologic study of iron overload mouse models.

Iron compounds after erythrophagocytosis: chemical characterization and immunomodulatory effects

In humans, the lymphomyeloid system has a fundamental role on iron metabolism promoting its recycling due to a continuous removal of effete red blood cells. Additionally, one of the most intriguing aspects of metalloporphyrins in biology is their effect on the immune system. However, the process of erythrocyte catabolism is still poorly understood and needs further research. In the present study, we attempt to investigate the nature and the possible physiologic role of Fe compounds released after erythrophagocytosis during the removal of red blood cells. Monocyte erythrophagocytosis in vitro experiments were done to characterize chemically the Fe compounds present inside the cells and in the culture supernatants. We tested the probable immunomodulatory functions of erythrophagocytosis products over lymphocyte cultures activated in vitro with T mitogens (alpha-CD3). Data obtained from atomic absorption spectroscopy confirmed the presence of Fe in the culture supernatants of monocyte cultures after erythrophagocytosis. Also, high-spin haem complexes derived from erythrocyte catabolism were detected by electron paramagnetic electronic resonance. Finally, in vitro activated lymphocyte proliferation experiments indicate the co-mitogenic properties of monocyte culture supernatants after red blood cells phagocytosis. Thus, the results of the present work provide evidence that culture monocyte supernatants after in vitro erythrophagocytosis contain Fe (III) high-spin haem complexes and show lymphocyte proliferation co-stimulatory properties.

Practical points in the management of the hospitalized epileptic patient

This article briefly discusses the etiology and pathophysiology of epilepsy. Therapeutic management and nursing considerations of the hospitalized epileptic patient are the primary focus.

[Clinical significance, epidemiology and microbiology of coagulase-negative staphylococcal nosocomial bacteremia at a teaching hospital]

Coagulase-negative staphylococci (CNS) are an important cause of nosocomial bacteremia and they are frequently considered as contaminants of blood-cultures. From October 1990 to September 1992, 300 positive blood-cultures for CNS at the Hospital São Paulo were studied and 141 CNS bacteremias were characterized as nosocomial bacteremias. Clinical and microbiological criteria were defined to differentiate between true CNS bacteremia and contaminated cultures. Only 20.6% of the CNS nosocomial bacteremia were considered as true bacteremia. Most of the CNS true nosocomial bacteremia were detected among newborns admitted to the neonatal intensive care unit; the presence of intravascular catheter and parenteral nutrition were significant findings. We did not detect significant difference between true nosocomial bacteremia and contaminated cultures regarding to resistance to oxacillin and SLIME production. The clinical criteria and the positivity of the blood-cultures up to 48 hours after incubation, utilized in our definitions, were useful parameters to characterize the CNS true nosocomial bacteremia.