Intra-uterine growth restriction and increased risk of hypertension in adult life: A follow-up study of 50-year-olds

OBJECTIVE:

To compare blood pressure between 50-year-old adults who were born at term (37-42 weeks of gestation) with intra-uterine growth restriction (IUGR; birth weight <10th centile) and a control group of similar age born at term without IUGR (birth weight =10th centile).

STUDY DESIGN:

Controlled comparative study.

METHODS:

Participants included 232 men and women who were born at the Royal Maternity Hospital, Belfast, a large regional maternity hospital in Northern Ireland, between 1954 and 1956. One hundred and eight subjects who were born with IUGR were compared with 124 controls with normal birth weight for gestation. The main outcome measures were systolic and diastolic blood pressure at approximately 50 years of age, measured according to European recommendations.

RESULTS:

The IUGR group had higher systolic and diastolic blood pressure than the control group: 131.5 [95% confidence interval (CI) 127.9-135.1] vs 127.1 (95% CI 124.3-129.2) mmHg and 82.3 (95% CI 79.6-85.0) vs 79.0 (95% CI 77.0-81.0) mmHg, respectively. After adjustment for gender, the differences between the groups were statistically significant: systolic blood pressure 4.5 (95% CI 0.3-8.7) mmHg and diastolic blood pressure 3.4 (95% CI 0.2-6.5) mmHg (both P < 0.05). More participants in the IUGR group were receiving treatment for high blood pressure compared with the control group [16 (15%) vs 11 (9%)], although this was not statistically significant. The proportion of subjects with blood pressure >140/90 mmHg or currently receiving antihypertensive treatment was 45% (n = 49) for the IUGR group, and 31% (n = 38) for the control group (odds ratio 1.9, 95% CI 1.1-3.3). Adjustment for potential confounders made little difference.

CONCLUSIONS:

IUGR is associated with higher blood pressure at 50 years of age. Individuals born with IUGR should have regular blood pressure screening and early treatment as required. Hypertension remains underdiagnosed and undertreated in adult life.

Intra-epithelial T cells in coeliac disease

Coeliac disease is an enteropathy associated with dietary gluten which occurs in individuals with a genetic predisposition. The pathogenesis remains obscure although it is clear that only certain parts of the gliadin molecule are toxic and there is considerable evidence of immunological activity, including antibody production. In this issue of European Journal of Gastroenterology and Hepatology Carton et al. present evidence in favour of an inherent depletion of CD4CD8 T cells, which could result in a loss of oral tolerance to ingested gliadin. Using flow cytometry they also demonstrated that the classic T-cell infiltration of coeliac disease is not due to an increase in T cells but is an apparent increase associated with a relative decrease in enterocytes as a result of the change in architecture of the mucosa. These could be important fundamental observations in helping to unravel the pathogenesis of coeliac disease.

Intra-operative decision making by ophthalmic surgeons

Research on surgical decision making and risk management usually focuses on peri-operative care, despite the magnitude and frequency of intra-operative risks. The aim of this study was to examine ophthalmic surgeons' intra-operative decisions and risk management strategies in order to explore differences in cognitive processes.

Magma Evolution in the Primitive, Intra-oceanic Tonga Arc: Petrogenesis of Basaltic Andesites at Tofua Volcano

Tofua volcano is situated midway along the Tonga oceanic arc and has undergone two phases of ignimbrite-forming activity. The eruptive products are almost entirely basaltic andesites (52 center dot 5-57 wt % SiO2) with the exception of a volumetrically minor pre-caldera dacite. The suite displays a strong tholeiitic trend with K2O <1 wt %. Phenocryst assemblages typically comprise plagioclase + clinopyroxene +/- orthopyroxene with microlites of Ti-magnetite. Olivine (Fo(83-88)) is rare and believed to be dominantly antecrystic. An increase in the extent and frequency of reverse zoning in phenocrysts, sieve-textured plagioclase and the occurrence of antecrystic phases in post-caldera lavas record a shift to dynamic conditions, allowing the interaction of magma batches that were previously distinct. Pyroxene thermobarometry suggests crystallization at 950-1200 degrees C and 0 center dot 8-1 center dot 8 kbar. Volatile measurements of glassy melt inclusions indicate a maximum H2O content of 4 center dot 16 wt % H2O, and CO2-H2O saturation curves indicate that crystallization occurred at two levels, at depths of 4-5 center dot 5 km and 1 center dot 5-2 center dot 5 km. Major and trace element models suggest that the compositions of the majority of the samples represent a differentiation trend whereby the dacite was produced by 65% fractional crystallization of the most primitive basaltic andesite. Trace element models suggest that the sub-arc mantle source is the residuum of depleted Indian mid-ocean ridge basalt mantle (IDMM-1% melt), whereas radiogenic isotope data imply addition of 0 center dot 2% average Tongan sediment melt and a fluid component derived from the subducted altered Pacific oceanic crust. A horizontal array on the U-Th equiline diagram and Ra excesses of up to 500% suggest fluid addition to the mantle wedge within the last few thousand years. Time-integrated (Ra-226/Th-230) vs Sr/Th and Ba/Th fractionation models imply differentiation timescales of up to 4500 years for the dacitic magma compositions at Tofua.

Magma Evolution in the Primitive, Intra-oceanic Tonga Arc: Rapid Petrogenesis of Dacites at Fonualei Volcano

Fonualei is unusual amongst subaerial volcanoes in the Tonga arc because it has erupted dacitic vesicular lavas, tuffs and phreomagmatic deposits for the last 165 years. The total volume of dacite may approach 5 km(3) and overlies basal basaltic andesite and andesite lavas that are constrained to be less than a few millennia in age. All of the products are crystal-poor and formed from relatively low-viscosity magmas inferred to have had temperatures of 1100-1000 degrees C, 2-4 wt % H2O and oxygen fugacities 1-2 log units above the quartz-fayalite-magnetite buffer. Major and trace element data, along with Sr-Nd-Pb and U-Th-Ra isotope data, are used to assess competing models for the origin of the dacites. Positive correlations between Sc and Zr and Sr rule out evolution of the within-dacite compositional array by closed-system crystal fractionation of a single magma batch. An origin by partial melting of lower crustal amphibolites cannot reproduce these data trends or, arguably, any of the dacites either. Instead, we develop a model in which the dacites reflect mixing between two dacitic magmas, each the product of fractional crystallization of basaltic andesite magmas formed by different degrees of partial melting. Mixing was efficient because the two magmas had similar temperatures and viscosities. This is inferred to have occurred at shallow (2-6 km) depths beneath the volcano. U-Th-Ra disequilibria in the basaltic andesite and andesite indicate that the parental magmas had fluids added to their mantle source regions less than 8 kyr ago and that fractionation to the dacitic compositions took less than a few millennia. The 165 year eruption period for the dacites implies that mixing occurred on a similar timescale, possibly during ascent in conduits. The composition of the dacites renders them unsuitable candidates as contributors to average continental crust.

Predation in the marine intertidal amphipod Echinogammarus marinus Leach: implications of inter- and intra-individual variation

Studies of competition, predator–prey dynamics and food webs typically consider conspecifics as equal, however, individuals from the same population that are seemingly identical can show considerable variation with regards to a number of processes. Such phenomena may be demonstrated in terms of diet, and the quantities and types of resources that are consumed are commonly considered. The marine amphipod Echinogammarus marinus, a recently demonstrated predator on intertidal rocky shores, has been shown to consume a wide range of food types but it is unknown how this may vary between individuals. Here, we investigated the variation that occurs both among and within individuals of a population of E. marinus with respect to the mean numbers consumed of a common prey item, the isopod Jaera nordmanni. First, by comparing the length of starvation times, used as a proxy for hunger level, individuals maintained without food for up to 24 h consumed significantly less prey during feeding trials than those starved for 48 h and longer. The degree of inter-individual variation within each starvation period was also found to differ, with greater variation among individuals starved for shorter periods of time than those starved for longer time periods. Secondly, we tested whether individual amphipods tracked over time consumed consistently similar numbers of prey or whether they showed intra-individual variation, and if so, to what degree. We found that the numbers of prey consumed per individual could be predicted in the short-term between consecutive feeding trials, however over the long-term this relationship broke down. These results are discussed with respect to potential physiological and behavioural mechanisms, as well as the implications that such variation may have for stability of prey populations in the field.

Intra-testicular varicocele presenting as acute scrotum

The term varicocele describes a dilated, tortuous and elongated pampiniform plexus of veins, which is well known in relation to the spermatic cord. Recently varicocele has also been observed inside the testis, and this new entity is known as intra-testicular varicocele. We present a case of intra-testicular varicocele presenting as acute scrotum and discuss the management issues.

Identification of systemic immune response markers through metabolomic profiling of plasma from calves given an intra-nasally delivered respiratory vaccine

Vaccination procedures within the cattle industry are important disease control tools to minimize economic and welfare burdens associated with respiratory pathogens. However, new vaccine, antigen and carrier technologies are required to combat emerging viral strains and enhance the efficacy of respiratory vaccines, particularly at the point of pathogen entry. New technologies, specifically metabolomic profiling, could be applied to identify metabolite immune-correlates representative of immune protection following vaccination aiding in the design and screening of vaccine candidates. This study for the first time demonstrates the ability of untargeted UPLC-MS metabolomic profiling to identify metabolite immune correlates characteristic of immune responses following mucosal vaccination in calves. Male Holstein Friesian calves were vaccinated with Pfizer Rispoval® PI3 + RSV intranasal vaccine and metabolomic profiling of post-vaccination plasma revealed 12 metabolites whose peak intensities differed significantly from controls. Plasma levels of glycocholic acid, N-[(3α,5β,12α)-3,12-Dihydroxy-7,24-dioxocholan-24-yl]glycine, uric acid and biliverdin were found to be significantly elevated in vaccinated animals following secondary vaccine administration, whereas hippuric acid significantly decreased. In contrast, significant upregulation of taurodeoxycholic acid and propionylcarnitine levels were confined to primary vaccine administration. Assessment of such metabolite markers may provide greater information on the immune pathways stimulated from vaccine formulations and benchmarking early metabolomic responses to highly immunogenic vaccine formulations could provide a means for rapidly assessing new vaccine formulations. Furthermore, the identification of metabolic systemic immune response markers which relate to specific cell signaling pathways of the immune system could allow for targeted vaccine design to stimulate key pathways which can be assessed at the metabolic level.