Circulating Glucocorticoid Bioactivity and Serum Glucocorticoid-Responsive Biomarkers during Steroid Therapy in Children and Adolescents with Inflammatory Bowel Disease

Objective: Glucocorticoid therapy is used worldwide to treat various inflammatory and immune conditions, including inflammatory bowel disease (IBD). In IBD, 80% of the patients obtain a positive response to the therapy; however the development of glucocorticoid-related side-effects is common. Our aim was therefore to study the possibility of optimizing glucocorticoid therapy in children and adolescents with IBD by measuring circulating glucocorticoid bioactivity (GBA) and serum glucocorticoid-responsive biomarkers in patients receiving steroid treatment for active disease. Methods: A total of sixty-nine paediatric IBD patients from the Paediatric Outpatient Clinics of the University Hospitals of Helsinki and Tampere participated in the studies. Control patients included 101 non-IBD patients and 41 disease controls in remission. In patients with active disease, blood samples were withdrawn before the glucocorticoid therapy was started, at 2-4 weeks after the initiation of the steroid and at 1-month intervals thereafter. Clinical response to glucocorticoid treatment and the development of steroid adverse events was carefully registered. GBA was analyzed with a COS-1 cell bioassay. The measured glucocorticoid therapy-responsive biomarkers included adipocyte-derived adiponectin and leptin, bone turnover-related collagen markers amino-terminal type I procollagen propeptide (PINP) and carboxyterminal telopeptide of type I collagen (ICTP) as well as insulin-like growth factor 1 (IGF-1) and sex hormone-binding globulin (SHBG), and inflammatory marker high-sensitivity C-reactive protein (hs-CRP). Results: The most promising marker for glucocorticoid sensitivity was serum adiponectin that associated with steroid therapy–related adverse events. Serum leptin indicated a similar trend. In contrast, circulating GBA rose in all subjects receiving glucocorticoid treatment but did not associate with the clinical response to steroids or with glucocorticoid therapy-related side-effects. Of notice, young patients (<10 years) showed similar GBA levels than older patients, despite receiving higher weight-adjusted doses of glucocorticoid. Markers of bone formation were lower in children with active IBD than in the control patients, probably reflecting the suppressive effect of the active inflammation. The onset of the glucocorticoid therapy further suppressed bone turnover. Inflammatory marker hs-CRP decreased readily after the initiation of the steroid, however the decrease did not associate with the clinical response to glucocorticoids. Conclusions: This is the first study to show that adipocyte-derived adiponectin associates with steroid therapy-induced side-effects. Further studies are needed, but it is possible that the adiponectin measurement could aid the recognition of glucocorticoid-sensitive patients in the future. GBA and the other markers reflecting glucocorticoid activity in different tissues changed during the treatment, however their change did not correlate with the therapeutic response to steroids or with the development of glucocorticoid-related side effects and therefore cannot guide the therapy in these patients. Studies such as as the present one that combine clinical data with newly developed biomolecular technology are needed to step-by-step build a general picture of the glucocorticoid actions in different tissues.

Insulin analog preparations and their use in children and adolescents with type 1 diabetes mellitus.

Standard or 'traditional' human insulin preparations such as regular soluble insulin and neutral protamine Hagedorn (NPH) insulin have shortcomings in terms of their pharmacokinetic and pharmacodynamic properties that limit their clinical efficacy. Structurally modified insulin molecules or insulin 'analogs' have been developed with the aim of delivering insulin replacement therapy in a more physiological manner. In the last 10 years, five insulin analog preparations have become commercially available for clinical use in patients with type 1 diabetes mellitus: three 'rapid' or fast-acting analogs (insulin lispro, aspart, and glulisine) and two long-acting analogs (insulin glargine and detemir). This review highlights the specific pharmacokinetic properties of these new insulin analog preparations and focuses on their potential clinical advantages and disadvantages when used in children and adolescents with type 1 diabetes mellitus. The fast-acting analogs specifically facilitate more flexible insulin injection timing with regard to meals and activities, whereas the long-acting analogs have a more predictable profile of action and lack a peak effect. To date, clinical trials in children and adolescents have been few in number, but the evidence available from these and from other studies carried out in adults with type 1 diabetes suggest that they offer significant benefits in terms of reduced frequency of nocturnal hypoglycemia, better postprandial blood glucose control, and improved quality of life when compared with traditional insulins. In addition, insulin detemir therapy is unique in that patients may benefit from reduced risk of excessive weight, particularly during adolescence. Evidence for sustained long-term improvements in glycosylated hemoglobin, on the other hand, is modest. Furthermore, alterations to insulin/insulin-like growth factor I receptor binding characteristics have also raised theoretical concerns that insulin analogs may have an increased mitogenic potential and risk of tumor development, although evidence from both in vitro and in vivo animal studies do not support this assertion. Long-term surveillance has been recommended and further carefully designed prospective studies are needed to evaluate the overall benefits and clinical efficacy of insulin analog therapy in children and adolescents with type 1 diabetes.

Mangrove forests and shrimp culture in Ngoc Hien District, Minh Hai Province, Vietnam

As a result of increased population growth, the attraction of high profits from shrimp culture and ineffective mangrove forest management, a number of serious environmental problems exist in Ngoc Hien District, Minh Hai Province, Vietnam. These environmental problems are highlighted in this article.

Adoption, productivity and profitability of rice-fish and fingerling culture in three selected districts of Bangladesh

The study aimed to investigate the productivity and profitability of rice-fish farming. It also determined the factors affecting rice-fish and fingerling production in Bangladesh. Among the total respondents about 55% were involved in rice-fish farming, 37% in pond fish culture and rest 9% in fish nursery. Integrated rice-fish farming contributed about 83% of the annual farm income in Comilla while it was about 20% in both Kishoregonj and Chandpur districts. Among the different farming systems integrated rice-fish culture and rearing fingerlings in the nursery pond were more profitable at the farm level. Farmers earned a net return of Tk. 49,714/ha from integrated fish culture with boro rice while the net return of boro rice-alone was only Tk. 11,179/ha. This indicated that farmer could earn 218% higher net return from integrated rice-fish farming than that of boro rice only farming. Moreover, integrated rice-fish culture also reduced pesticides cost to about 77% and weeding cost to about 51% in boro season. Fingerling nursing earned highest net returns among the three technologies.

Effects of fish and prawn culture on physico-chemical parameters of water and rice yield in rice fields

An experiment was conducted with five treatments i.e. rice combined with fish having regular urea fertilization (T1), rice combined with prawn having regular urea fertilization (T2), rice combined with fish with supplementary feeding (T3), rice combined with prawn with supplementary feeding (T4) and without fish and prawn (T5) was kept as control. The dissolved oxygen values obtained in treatments with fish both in morning and afternoon were lower than the values of prawn containing treatments and control. The values of nitrate-N, ammonia-N, phosphate-P and chlorophyll-a were higher in fish containing treatments than the prawn containing treatments and control. Between the two fish containing treatments the higher gross (539.44 kg/ha) and net (440.14 kg/ha) yield were obtained in T3 with supplementary feeding and the lower gross (424.88 kg/ha) and net (314.32 kg/ha) yield were recorded in T1 without supplementary feeding. Again, between two prawn containing treatments the higher gross (108.69 kg/ha) and net (81.92 kg/ha) yield were obtained in T4 with supplementary feeding and lower gross (64.32 kg/ha) and net (30.98 kg/ha) yield were recorded in T2 without supplementary feeding. The highest yield of rice grain (3.45 mt/ha) and straw (6.37 mt/ha) were obtained in T1 with fish having urea fertilization without feeding.

The basics of cage and pen culture

The article discusses the basics of cage and pen aquaculture. Factors to consider are: site selection; choice of nets, floats, frames, and anchors; and the choice of culture method.

Growth, survival and immune activity of scallops, Chlamys farreri Jones et Preston, compared between suspended and bottom culture in Haizhou Bay, China

We examined the growth, survival and immune response of the scallop, Chlamys farreri, during a 1-year period in deep water of Haizhou Bay. Scallops were cultured using two methods: (1) in lantern nets at a 5 m depth and (2) in a bottom culture system (sleeves) on the seabed at about a 25 m depth. Shell heights, meat dry weight and immune activities in the haemolymph (superoxide dismutase and myeloperoxidase) were measured bimonthly or quarterly from July 2007 to June 2008. Survival was measured at the end of the study and environmental parameters in the experimental layers were monitored during the experiment. The growth and immune activities of scallops were lower when the water temperature was high, which was consistent with the main mortality occurring in summer. The growth and immunity of scallops were higher in the suspended culture than in the bottom culture during the experiment, with the exception of shell growth during the last study period. Survival of scallops in the suspended culture (54.6 +/- 12.3%) was significantly lower than that in the bottom culture (86.8 +/- 3.5%) at the end of this study. We conclude from our results that the high mortality of C. farreri can be prevented by culturing them in a bottom culture system before November of the first year, and then transferring them to a suspended culture to improve scallop production.

Women, Authorship and Literary Culture, 1690 - 1740

Prescott, S. (2003). Women, Authorship and Literary Culture, 1690 - 1740. Basingstoke: Palgrave Macmillan. RAE2008

Media History and Media Studies: aspects of the development of the study of media history in the UK 1945-2000

O'Malley, T. (2002). Media History and Media Studies: aspects of the development of the study of media history in the UK 1945-2000. Media History. 8 (2), 155-173. RAE2008

National food consumption surveys: micronutrient intakes and the role of fortified foods in the diets of Irish pre-school children and adults

This research investigated the micronutrient intakes of Irish pre-school children (1-4 years) and adults (18-64 years) and the role that fortified foods (FFs) play in the diets of these population groups. Dietary intake data were collected as part of the National Pre-school Nutrition Survey (NPNS) (2010-2011) and the National Adult Nutrition Survey (NANS) (2008-2010) using 4-day food and beverage records. Nutrient intakes were estimated using WISP©, which encompasses McCance and Widdowson’s The Composition of Foods and the Irish Food Composition Database. A FF is one in which one or more micronutrients are added. Key dietary sources of micronutrients in NPNS and NANS were “milk”, “meat & meat products”, “breakfast cereals”, “fruit & fruit juices” and “breads”. In general, intakes of most micronutrients were adequate with the exception of iron (1 year old children and adult women) and vitamin D (in all population groups). Small proportions of the pre-school population had intakes which exceeded the upper level (UL) (zinc: 11%, folic acid: 5%, retinol: 4%, copper: 2%). Less than 2% of adults had intakes of iron, copper, zinc and vitamin B6 which exceeded the UL. FFs were consumed by 97% of pre-school children and 82% of adults, representing 17% and 9% of mean daily energy intake respectively. Relative to energy intake, FFs contributed substantially greater proportions to intakes of key micronutrients, such as iron and vitamin D. FFs were effective in reducing the prevalence of inadequate micronutrient intakes in these population groups, particularly for iron in women and 1 year old children. FFs made a significant contribution to folate intake in women of childbearing age (72µg). FFs contributed greater proportions of carbohydrate and lower proportions of fat to the diets of consumers. Voluntary addition of nutrients to foods did not contribute appreciably to intakes exceeding the UL in these population groups.