Background. Cabin air on commercial aircraft is sometimes contaminated with hydraulic fluids, synthetic jet engine oils and combusted or pyrolized materials. The incidence of contaminated air events is hard to quantify as commercial aircraft do not have air quality monitoring systems on board. In the UK, around 350 aircrew have advised their union that they may be suffering physical and psychological ill health following exposure to contaminated air.Design. This paper presents a case series of 27 pilots referred for psychological assessment. The general aim of the assessment was to determine whether pilots show evidence of cognitive impairment and whether this relates to exposure history.Materials and method. All pilots underwent neuropsychological and adult mental health assessment, undertaken by 12 examiners, instructed to search for alternative explanations other than exposure to toxic fumes for any symptoms reported.Results. Pilots reported alarming cognitive failures at work such as being unable to retain or confusing numerical information from Air Traffic Control. Nine pilots were excluded from further analysis because they had a medical or psychiatric condition which might otherwise explain these difficulties. In the remaining 18 pilots, language, perceptual skills and general intellectual ability were preserved, but performance on tests of psychomotor speed, attention and executive functioning was below expected levels.Conclusions. The cognitive deficits identified in this cohort of pilots cannot be attributed to factors such as mood disorder or malingering. However, the evidence available in this study does not enable firm conclusions to be drawn regarding a causal link with contaminated air; the cohort of pilots was self‐selected and only crude indices of exposure were available. Further research is warranted given the scientific uncertainty regarding the health effects of inhalation of heated or pyrolized engine oil.
Purpose . To test whether plasma vitamin C levels, following oral doses in supplemented volunteers, are tightly controlled and subject to a maximum in the region of 220 mML 21 , as suggested by previous researchers for depleted subjects. To determine plasma levels following single, variable-sized doses of standard and liposomal formulations of vitamin C and compare the effects of the different formulations. To determine whether plasma levels above ,280 mML 21 , which have selectively killed cancer, bacteria or viruses (in laboratory experiments), can be achieved using oral doses of vitamin C. Design . This was a single blind study, measuring plasma levels in two subjects, in samples taken halfhourly or hourly for 6 hours, following ingestion of vitamin C. Data were compared with published results and with data from 10 years of laboratory plasma determinations. Materials and methods . Standard 1 gram tablets of vitamin C; liposomal vitamin C. Plasma levels were analysed using the method of Butts and Mulvihill. Results . Preliminary investigations of the effects of liposomal and standard formulation ascorbate showed that blood plasma levels in excess of the previously assumed maximum of 220 mML 21 are possible. Large oral doses of liposomal ascorbate resulted in plasma levels above 400 mML 21 . Conclusions . Since a single oral dose can produce plasma levels in excess of 400 mML 21 , pharmacokinetic theory suggests that repeated doses could sustain levels well above the formerly assumed maximum. These results have implications for the use of ascorbate, as a nutrient and as a drug. For example, a short in vitro treatment of human Burkitt’s lymphoma cells with ascorbate, at 400 mML 21 , has been shown to result in ,50% cancer cell death. Using frequent oral doses, an equivalent plasma level could be sustained indefinitely. Thus, oral vitamin C has potential for use as a non-toxic, sustainable, therapeutic agent. Further research into the experimental and therapeutic aspects of high, frequent, oral doses of ascorbic acid either alone or (for cancer therapy) in combination with synergistic substances, such as alpha-lipoic acid, copper or vitamin K3, is needed urgently.
Background. Small colony variants have been implicated as the cause of several chronic disease states unmanageable by antibiotic therapy. Thus, this review evaluates the mechanisms employed by this subpopulation in the propagation of nosocomial infections involving the staphylococcal species. Furthermore, we propose several hypotheses for the evolutionary role this phenotype may play in clinical settings.Results. Research suggests that a combined effort of certain auxotrophies contributes to a reduced metabolic rate within small colony variant bacteria. This minimizes the effect of antibiotics used against them and allows this phenotype to endure as an intracellular infection. Additionally, numerous studies have suggested that perhaps these variants alter the mechanisms of the immune system that are normally fashioned against such invasive pathogens. Studies have shown that although these variants possess reduced virulence factors compared with parental strains, they exhibit an increased ability to attach and colonize intracellularly in the host cells, making eradication difficult.Conclusions. The formation of a small colony variant phenotype has been found to be a vital mode of existence for nosocomial bacteria, as it offers numerous survival options without expending valuable metabolic resources while sustaining severe chronic infections. It is suggested that intracellular survivability is the major role played by this variant. There is a need to develop clinical techniques that will be sensitive for the rapid detection and diagnosis of these variant populations. Ultimately, understanding the survival mechanisms used by these variants is imperative for the administration of suitable treatment regimens.
Background. In view of plans for dietary fortification with folic acid, there is a need to reassess the advice being given in primary care. Patients and professionals may assume that fortification will make preconceptional folic acid supplementation unnecessary, but this is unlikely to be correct.Aim. To calculate the intake of total folic acid and folate at conception and to estimate the impact of fortification on the incidence of neural tube defect (NTD) conceptions.Design. An in‐depth investigation of dietary folate intake of 18 women and a survey of preconception supplementation in a group of 130 women, including an assessment of the probable impact of mandatory fortification.Method. Dietary folate intake of six infertile women and 12 age‐matched fertile controls was assessed using a 7‐day weighed diet diary. Mean values for this group were used as an estimate of local dietary folate intake. Questionnaires about periconceptional intake of supplements that included folic acid in their formulation were given to newly pregnant women attending district midwife clinics, a series of women attending an assisted conception unit and a self‐help group of lesbians who were either pregnant or planning a pregnancy.Results. Of the 18 women in the dietary study there was suboptimal dietary folate intake in all infertile subjects and in eight of 12 controls. An approximate value for the combined intake of dietary folate and folic acid in the larger survey (n = 130) was calculated. We estimated that UK dietary fortification will double the number of pregnancies with adequate total folate intake. From previous data on folic acid intake and NTD births we estimate that this will prevent 226–343 conceptions per year in the UK from developing NTD malformations.Conclusions. Fortification should prevent approximately 226–343 conceptions a year from developing NTDs, but 45% of women will still have an inadequate total folate intake, unless supplementation levels improve.
Purpose. To compare the nutritional status of infertile women with non‐pregnant fertile age‐matched controls and to assess the periconceptional intake of nutritional supplements in pregnancy with an estimation of total micronutrient (diet and supplementary) intake.Design. An assessment of the nutritional status of infertile women and fertile, age‐matched non‐pregnant controls and a survey of the periconceptional intake of folic acid and other nutritional supplements.Materials and methods. Group 1: a 7‐day weighed diet diary and blood tests for magnesium, mineral and pyridoxine status were used to assess the nutritional status of six infertile women and 12 non‐pregnant, healthy, age‐matched controls. Group 2: the periconceptional dietary intake of folic acid and other nutritional supplements was estimated in 87 pregnant women attending midwife clinics, 36 women attending an assisted conception clinic and 7 women attending a self help group for lesbian pregnancy.Results. In the group of six infertile subjects and 12 fertile controls, there was a non‐significant trend for micronutrient intake in the controls to be higher than for the infertile subjects. Comparisons with the UK reference nutrient intake confirmed suboptimal nutrition in all subjects and some controls. Twenty‐five per cent of controls and 33% of infertile subjects had subnormal serum selenium consistent with reduced antioxidant defence. There was also a non‐significant trend for non‐caeruloplasmin copper and cadmium to be higher in the infertile subjects. The combined mean dietary intake for all subjects and controls was similar to the values from the National Diet and Nutrition Survey. Therefore, an approximate value for the total intake of nutrients (diet and supplementation) of the 130 women in the larger survey was calculated using the mean dietary intake of the smaller group as an estimate of the dietary component. This analysis suggested suboptimal total intake for >50% of the subjects for selenium, zinc, magnesium and iodine and borderline total intake for >50% of subjects for vitamins B12, C and E, betacarotene, iron, folate + folic acid and essential fatty acids.Conclusions. Current levels of supplementation with folic acid and other nutrients are failing to compensate for poor mean dietary intake of these nutrients at the time of conception. These nutritional deficiencies are probably important contributory factors in infertility, spontaneous abortion, pregnancy complications and post‐partum health problems in the mother and infant (including congenital malformations and postnatal depression).
Background. This study describes a decision‐theoretic approach to nutrient assessment based on Bayesian methods, which can be used to give accurate estimates of optimum intakes. Analysis of risk is an incomplete technique for dealing with nutrients and other substances that, by definition, have an associated benefit.Results. This paper shows that the risk analysis methods being developed by the Codex Commission on Nutrition and European Food Safety Authority, among others, are inappropriate for assessing safe nutrient intake levels. Decision theoretic methods incorporate benefits associated with these essential nutrients, as well as potential risk. Conclusion. These methods allow for missing or incomplete data, which conventional risk analysis does not.
Purpose. Numerous studies have found that exposures to neurotoxins such as solvents, pesticides, heavy metals, carbon monoxide and mycotoxins can cause many neuropsychiatric deficits. Neuropsychological test batteries are often useful in diagnosing and treating neurotoxin exposed patients; however, these batteries have a number of shortcomings. Increasingly, brain scans with SPECT (Single Photon Emission Computed Tomography) are being used to diagnose neurotoxin‐exposed patients. The purpose of this study is to measure specific regional brain functional findings with SPECT on seven patients with various encephalopathic diseases and occupational and/or environmental chemical exposure.Design. Case series.Methods and materials. Detailed exposure/occupational histories were made of seven patients exposed to neurotoxins. Some patients had possible confounding factors such as a past history of alcohol abuse or mild trauma brain injury. SPECT scans were taken with a triple headed SPECT camera on patients injecte...
Background. Prolonged exposure to oestrogens (17β‐estradiol)(E2), xenoestrogens, hormone replacement therapy and contraceptives has been recognized as a key aetiological factor of human breast cancer. The biological and carcinogenic effects of E2 and xenoestrogens are mediated via oestrogen receptors alpha (ERα) and beta (ERβ). Both receptors are localized in the nucleus of E2‐targeted cells including human breast cells where they are involved in the regulation of nuclear gene expression. There is increasing evidence indicating that a small fraction of total cellular ERs, particularly ERα, are localized in the membrane of E2‐targeted cells where they mediate E2‐dependent and/or E2‐independent rapid and non‐nuclear genomic signal pathways.Results. The present work will present evidence that: (1) there is mitochondrial localization of ERs in human breast cancer cells; (2) there is a functional role of the mitochondrial ERs in the regulation of mitochondrial genes encoding respiratory chain proteins.Conclusi...
Background. Clinical rickets is a childhood bone disorder that is infrequently seen in the Western World. It is still frequently seen in Uzbekistan, Eastern Europe. This is the first study undertaken to estimate the prevalence and factors associated with deficiency of vitamin D in infants in this region of Eastern Europe.Methods. Information was obtained by parental questionnaires for 474 infants aged 5–61 weeks attending rural out‐patient clinics in Samarkand. Blood was assayed for 25‐OHD and ferritin concentration.Results. Prevalence of vitamin D deficiency (25‐OHD <30 nmol l−1) was 78.7% and was significantly associated with continued breastfeeding (p<0.05), lack of vitamin supplementation (p<0.05), residence in a rural area (p<0.05) and reduced time spent outdoors (p<0.05). Maternal characteristics did not differ between mothers of infants with and without biochemical rickets. Possible causes are a combination of factors including vitamin D deficiency in pregnancy, prolonged breastfeeding without supplementation, a vitamin D poor diet and traditional avoidance of sunlight in the first year of life. Over 40% of the children had low ferritin values. Most children with low ferritin values were also vitamin D deficient (90.3%). Almost 10% of infants had persistently low 25‐OHD levels following 6 weeks of therapy (4000 IU/day).Conclusion. There is an urgent need for adherence to clear recommendations for primary and secondary prevention of this major clinical and public health problem in Samarkand infants.
Inflammation is universally agreed to represent the body's mechanism for removing germs and toxins from the tissues and the beginning of cleansing and repair. Healing would be impossible without inflammation. We argue herein that the same is true of allergic inflammation, that the lung inflammation that leads to asthma is an exaggerated form of a healthy physiological process and should not be suppressed by drugs. We argue that nutritional manoeuvres and desensitisation are not subject to the same criticism and should be the treatments of choice.
Background. In arid regions water is vital and large bodies of waste water that are returned to the environment penetrate the ground and re‐emerge as surface water to be used for domestic purposes.Results. Waste water from oil is disposed of in this way and this study showed that waste water from this origin produced activities of 40K that exceeded the domestic admissible limit of 0.2 Bq L−1. This was used as an indicator to evaluate the threat of contamination to underground aquatic supplies. Several samples were collected and monitored for gamma rays for a period of 1 year. In some cases 40K levels were as high as 100 Bq L−1.Conclusions. The potential impact of these raised levels on aquatic resources and the general environment is discussed. The thrust of this paper is of considerable benefit to oil‐producing countries throughout the world from the perspective of potential contamination by 40K from produced water that is returned to the environment.
Background. Four adult patients presented with fever and chest symptoms following accidental aspiration of kerosene oil while siphoning (n = 3) and use as an analgesic mouthwash (n = 1).Results. The patients developed clinical pneumonia with effusion and one patient developed empyema. All the patients were managed with antibiotics and routine measures with uneventful recovery.Conclusion. Sucking by mouth for siphoning the potential lung irritant needs to be seriously deprecated.
The plant Camellia sinensis yields a variety of white, green and black tea. Tea is one of the most widely consumed beverages in the world, next only to water for enjoyment and health. In general, green tea has been found to be superior to black tea in terms of health benefits. The major components of interest are the polyphenols which are responsible for the antioxidant and other health benefits of green tea. The major polyphenols in green tea are flavonoids. The four major flavonoids in green tea are the catechins, epicatechin (EC), epigallocatechin (EGC), epicatechin gallate (ECG) and epigallocatechin gallate (EGCG). Epigallocatechin gallate is viewed as the most significant active component. The processes used in the manufacture of black tea are known to decrease levels of the monometric catechins to a much greater extent than the less severe conditions applied to other teas. Much research is available depicting the health benefits of green tea for a wide variety of implications, including different types of cancer, heart disease, liver disease, etc. There is also a wide range of uses for green tea in diabetes, exercise enhancement, inflammatory bowel disease, skin disorders, hair loss, weight loss and iron overload. This paper will review the major health benefits of green tea, focusing on the catechins.
Background. Recent evidence indicates that boron has a widespread role in biochemistry and nutrition and may have anti‐carcinogenic properties. It interacts with calcium, vitamin D and magnesium, which are all important in bone metabolism. Boron also increases steroid hormone concentrations in animals and humans and hints at a role in the prevention of chronic diseases such as osteoporosis, arthritis and other steroid hormone dependent diseases. It has been suggested that the interaction between boron and steroid hormone metabolism is mediated by the hydroxylation process that steroids need to be biologically active. Thus, the aim of this study was to investigate the effect of boron supplementation on the selected steroid hormone productions or steroidogenesis.Methods. The experimental design consisted of two trials, in two different occasions. Seven healthy male volunteers in one group and another nine healthy male volunteers in the second group consumed two tablets each containing 5 mg of boron per day and blood samples were collected prior to supplementation and after 4 and 8 weeks.Results. The mean total testosterone concentrations increased after supplementations. The mean plasma 17‐B oestradiol concentrations increased significantly after 4 weeks (p = 0.009) and 8 weeks (p = 0.05) supplementations. The ratio of 17‐B oestradiol to testosterone increased significantly (p = 0.01) after 4 weeks supplementation.Conclusions. It can be speculated that the elevation of endogenous oestrogen as a result of boron supplementation suggests a potential protective role for boron in preventing a number of clinical conditions or chronic diseases, with emphasis in animals or humans who are under stress conditions, which requires further studies and clarifications.
Background. A systematic review of provocation studies concluded that while persons with multiple chemical sensitivities (MCS) react to chemical challenges, these responses occur more often when they can discern differences between active and sham substances. The authors of the review interpreted these findings as evidence that the symptoms may not be specific to the chemical but related to expectations and prior beliefs. Given the complexity of the subject matter, the studies were re‐examined using additional criteria.
Several mysteries surround the structure and function of the nitric oxide synthases (NOS). The NOS oxygenase domain structure is unusually open with a large area of solvent that could accommodate an unidentified ligand. The exact mechanism of the two-step five-electron monoxygenation of arginine to NG-hydroxy-L-arginine, thence to citrulline and nitric oxide (NO), is not clear, particularly as arginine/NG-hydroxy-L-arginine is bound at a great distance to the supposed catalytic heme Fe [III], as the anti-stereoisomer. The Return of the Scarlet Pimpernel Paper proposed that cobalamin is a primary indirect regulator of the NOS. An additional direct regulatory effect of the ‘base-off’ dimethylbenzimidazole of glutathionylcobalamin (GSCbl), which may act as a sixth ligand to the heme iron, promote Co-oriented, BH4/BH3 radical catalysed oxidation of L-arginine to NO, and possibly regulate the rate of inducible NOS/NO production by the NOS dimers, is further advanced. The absence of homology between the NOS and methionine synthase/methylmalonyl CoA mutase may enable GSCbl to regulate both sets of enzymes simultaneously by completely separate mechanisms. Thus, cobalamin may exert central control over both pro-and anti-inflammatory systems.
Objective. To evaluate dietary habits among 5–13‐year old school children of farmers, anthroposophic families and controls and to evaluate the validity of a food questionnaire as part of a lifestyle questionnaire of the PARSIFAL‐study.Methods. Food questionnaires were completed by the parents of the children. Validity was assessed with 24‐h recalls performed as telephone interviews with a parent accompanied by the child.Results. Dietary habits were assessed among 14 901 children. Farm children consumed most farm milk, dairy products made from farm milk and meat. Children from anthroposophic families consumed most fruits and vegetables, whole grain products and olive oil and least meat and margarine. Among 493 participants included in the validation study, validity of the food items studied was determined to be moderate‐to‐adequate.Conclusions. Dietary habits differ substantially among children of farmers and children from anthroposophic families. Validity of the diet questionnaire should be sufficiently accurate for most foods when used in diet‐disease analyses. Validity was generally higher among frequently consumed foods and among food whose consumption does not vary by season.
Purpose. Chronic obstructive pulmonary disease (COPD) is a common disease related to smoking. Oxidative stress and antioxidant status may play an important role in the pathogenesis of COPD. The aims of the present study were to determine the pathogenic effects of oxidative stress and antioxidant status in COPD smokers, and the role of dietary antioxidant supplementation in the ventilatory function tests (VFT) of the COPD smokers.Design. This study comprised two phases. The first phase explored oxidative stress and antioxidant status and its relationship with the ventilatory functions of COPD diagnosed smokers. The second phase was a self‐controlled clinical trial to study the changes in the oxidative–antioxidant status and the VFT of the COPD smoking patients after dietary supplementation with freshly prepared juice for 30 days.Methods. Personal, occupational and medical questionnaires, a clinical examination, VFT, serum antioxidants (vitamin A, C and E and β‐carotene), malondialdehyde (MDA) and superoxide dismutase (SOD).Results. There was a significant correlation between vitamin E and the ventilatory functions of the COPD smokers at baseline. After supplementation, the ventilatory functions were significantly improved. Plasma vitamin A, C and E, β‐carotene and SOD were also significantly increased. The level of MDA was significantly decreased.Conclusions. Daily fresh juice supplementation provides correction of the antioxidant status and significantly improves the VFT of COPD smokers.
Purpose: To illustrate the hypothesis that alterations in mucosal glycosylation, particularly O‐glycosylation, may result in altered interaction with carbohydrate‐binding proteins (lectins) in the diet.Design & methods: A summary of recent literature focussing on work by the author's group demonstrating in vitro and in vivo lectin–epithelial interactions, particularly in the colonic epithelium.Results: Similar alterations in O‐glycosylation occur in the colonic epithelium in inflammatory diseases and in cancer. They include shortening of O‐glycans and increased expression of onco‐fetal carbohydrate antigens. Peanut lectin, which selectively binds the TF antigen, is shown to survive transit through the intestine and to cause significantly increased epithelial proliferation. Other lectins inhibit proliferation, e.g. edible mushroom lectin which becomes internalised and blocks nuclear‐localising‐sequence‐dependent nuclear protein import.Conclusions: Intestinal epithelial glycosylation is commonly altered in inflammation and cancer and we are only just beginning to understand the implications that this may have for interaction with carbohydrate‐binding proteins that could originate from the diet, the gut microbiota or the host.
