Histological analysis of gallbladder diseases in relation to opisthorchiasis in endemic areas of Thailand

Chronic gallbladder disease frequently accompanies infection with the liver fluke, Opisthorchis viverrini, in Northeast Thailand. However, the pathology and pathogenesis of the gallbladder disease have not been described. Accordingly, gallbladder specimens from 187 consecutive patients who had undergone cholecystectomy at a referral hospital in an endemic area in Thailand were histologically characterized in relation to O. viverrini infection. The infection was assessed by the presence of parasite eggs in the bile and/or antibody response to the liver fluke. The average level of parasite-specific IgG was significantly higher in patients with Opisthorchis eggs in the bile than those without (P < 0.001). The main histopathologic features of the gallbladder included inflammation, mucosal atrophy/or hyperplasia, goblet cell metaplasia, mucous gland hyperplasia, Rokitansky-Aschoff sinus formation, dysplasia and fibrosis. The fibrosis was strongly associated with elevated levels of Opisthorchis-specific antibody (P < 0.001) but not with the presence of parasite eggs. Other pathologic features did not vary in frequency or severity with parasitological status. Our results show that severe fibrosis of the gallbladder is a more common histologic feature of cholecystitis among those with O. viverrini infection compared to those without infection. The close relationship between parasite-specific IgG and severe fibrosis suggests that specific immune response to the parasite play an important role in the pathogenesis of the fibrotic change. (C) 2003 Elsevier B.V. All rights reserved.

Graduate attributes in relation to curriculum design and delivery in a Bachelor of Materials Engineering Programme

This paper presents a critical analysis of the Bachelor of Materials Engineering programme compared with the expectations of the Institution of Engineers Australia (IEAust) and of UQ. To set the scene, the graduate attributes are listed, the programme framework is presented and the educational culture and available facilities are described Then, the programme delivery is described; this includes an analysis of the learning opportunities that allow students to develop the graduate attributes. Finally, an assessment is made of programme outcomes relating to graduate attributes.

Year-round presence of dugongs in Pumicestone Passage, south-east Queensland, examined in relation to water temperature and seagrass distribution

Pumicestone Passage is a narrow waterway that lies to the north of and adjacent to Moreton Bay, and between mainland Queensland and Bribie Island, Australia. Anecdotal reports have suggested that the Passage is home to dugongs year-round despite winter water temperatures that are known to cause dugongs to migrate elsewhere. To examine the pattern of distribution and abundance of dugongs within the passage on a year-round basis, eight years of sightings data collected by a charter boat operator were examined. Dedicated aerial surveys of the passage were also conducted at two-monthly intervals over two years, and more intensively over a single winter. Dugong sightings were examined in relation to water temperatures and seagrass prevalence. The number of dugongs sighted in the area on any one survey varied from 0 to 13. Dugongs were seen in all months of the year and in each of the eight winters, indicating that Pumicestone Passage is used year-round despite winter water temperatures dropping to below 18 degrees C from June to August inclusive and below 16 degrees C in June. All dugong sightings occurred in the southern part of the passage, south of Tripcony Bight. Dugongs were associated with shallows that support Halophila and Halodule species of seagrass, food species that are favoured elsewhere in their range. The northern part of the passage also supports seagrasses that are eaten by dugongs and has water temperature ranges that are not appreciably different to those of the southern passage. However, the narrow channels and very shallow nature of the northern passage provides little to no deep-water refugia for dugongs and the seagrass beds are less extensive. This study suggests that southern Pumicestone Passage requires protection concomitant with it being a year-round refuge of the vulnerable dugong.

Greene Climacteric Scale: norms in an Australian population in relation to age and menopausal status

Objectives The aim of this study was two-fold: to assess climacteric symptoms and provide normative data for the Greene Climacteric Scale during the menopause transition, and to investigate the prevalence of climacteric symptoms in a representative sample of postmenopausal Australian women. Method A cohort of 500 premenopausal, perimenopausal and postmenopausal women aged 40-80 years participated in the Longitudinal Study of Ageing in Women (LAW study) at the Royal Brisbane and Women's Hospital, Brisbane, Australia. In year 1 of the study (2001), all participants completed the Greene Climacteric Scale and information regarding their menopausal status and the use of hormone therapy (HT) was obtained through a clinical interview with a qualified medical practitioner. Results The 50-59-year age group achieved the highest scores on the vasomotor and the depression scales in comparison to other age groups. Significant differences were also evident on the vasomotor and the depression scales on the basis of menopausal status, especially in perimenopausal women. Approximately 10% of women in the 60-79-year age group continued to experience vasomotor symptoms. Conclusion Vasomotor symptoms, as assessed by the Greene Climacteric Scale, are common during the menopause transition and remain elevated for some years in a minority of older postmenopausal women. The norms presented in this study are appropriate for use in an Australian population.

Rethinking the "diseases of affluence" paradigm: Global patterns of nutritional risks in relation to economic development

Background Cardiovascular diseases and their nutritional risk factors-including overweight and obesity, elevated blood pressure, and cholesterol-are among the leading causes of global mortality and morbidity, and have been predicted to rise with economic development. Methods and Findings We examined age-standardized mean population levels of body mass index (BMI), systolic blood pressure, and total cholesterol in relation to national income, food share of household expenditure, and urbanization in a cross-country analysis. Data were from a total of over 100 countries and were obtained from systematic reviews of published literature, and from national and international health agencies. BMI and cholesterol increased rapidly in relation to national income, then flattened, and eventually declined. BMI increased most rapidly until an income of about I$5,000 (international dollars) and peaked at about I$12,500 for females and I$17,000 for males. Cholesterol's point of inflection and peak were at higher income levels than those of BMI (about I$8,000 and I$18,000, respectively). There was an inverse relationship between BMI/cholesterol and the food share of household expenditure, and a positive relationship with proportion of population in urban areas. Mean population blood pressure was not correlated or only weakly correlated with the economic factors considered, or with cholesterol and BMI. Conclusions When considered together with evidence on shifts in income-risk relationships within developed countries, the results indicate that cardiovascular disease risks are expected to systematically shift to low-income and middle-income countries and, together with the persistent burden of infectious diseases, further increase global health inequalities. Preventing obesity should be a priority from early stages of economic development, accompanied by population-level and personal interventions for blood pressure and cholesterol.