J.A. Dodge

Cystic fibrosis serum stimulates mucin secretion but not calcium efflux from rat submandibular acini

Cystic fibrosis serum stimulated release of mucins from rat submandibular acini to a significantly greater degree than did control serum. This action was not due to non-specific cell lysis, as monitored by lactate dehydrogenase release and was not accompanied by increases in 45Ca2+-efflux. The actions of cystic fibrosis serum and control serum in stimulating amylase release from rat exocrine pancreatic acini could not be distinguished. Thus, a specific action of cystic fibrosis serum in increasing mucin secretion, but not calcium permeability, in rat exocrine acini has been demonstrated.

Screening for cystic fibrosis.

Neonatal screening for cystic fibrosis (CF) reduces short-term morbidity but its long term effects remain to be demonstrated. The best available method is the assay of immunoreactive trypsin in dried blood spots, and specificity can be improved by adding direct or indirect genetic analysis. Pregnancies known to be at risk of CF can also be screened by molecular methods, and affected pregnancies terminated. The application of genetic testing to whole communities, to detect unknown heterozygotes, raises many questions which require consideration by society and the health professions. The development of effective treatment of the basic abnormality of cell function in CF would enhance the need for neonatal screening, and possibly reduce the requirement for abortion.

ENERGY CONTENT OF BREAST MILK OF POOR BRAZILIAN MOTHERS

The Brazilian Ministry of Health with UNICEF support has in the past 2 years been implementing a largescale national breastfeeding program addressed mainly at low-income women. The objective is to get mothers to breastfeed their infants exclusively for 4-6 months. This is a comprehensive program based on supply of information and mobilization of support through mass media training of health personnel organization of womens support groups modification of health services and other measures. Since malnutrition is common in low-income mothers we decided to find out if the milk of poorly nourished mothers suppplied enough energy for babies fed exclusively from the breast. 71 low-income nursing mothers (less than 1 basic monthly wage in the family US

PARASITIC INFECTIONS OF SKIN

30) from the rural and slum urban area of northeastern Brazil who were exclusively breastfeeding their infants were selected and categorized as malnourished ( 90% weight for height; n=43). 10 further well-nourished women and their infants from a high social class attending a private clinic in Sao Paulo were also studied. Samples of milk were obtained by manual expression or suckling via a nipple shield with a side channel at the start middle and end of 1 feeding and the fat total and caloric content of the samples were estimated according to the creamatocrit method. The weight for age of the infants was plotted on the national charts (Marcondes) which are similar to the Harvard standards. Analysis of variance examined the possible individual influences of nutritional status parity and method of milk sample collection and also the interaction among them. A Student t test showed that the nutritional status of the mothers did not influence the total fat or caloric content of the breastmilk. When other criteria for defining malnutrition were used numbers included in the groups varied but no difference in the results was demonstrated. The mean weight of exclusively breastfed infants was adequate whether they were fed by poorly or by well-nourished mothers. We conclude that low-income mothers milk contains enough energy to sustain growth of their infants at acceptable levels for the 1st 6 months even when the women were malnourished and the babies exclusively breastfed. This does not mean that attention should not be given to maternal diet in pregnancy and lactation but rather that the priorities of the present Brazilian breastfeeding program are correct. (full text)

FLUID, ELECTROLYTES AND ACID-BASE BALANCE

A wide range of parasitic infections can involve the skin and subcutaneous tissues. Depending on the species of parasite, this involvement may be transient, the parasite passing through the skin on its migration to the blood stream and so to a specific target organ, or the infection may be localised to the skin. In the latter infections, the skin may be the primary site of infection or there may be a secondary invasion of the skin. All parasitic groups (protozoa, trematodes, cestodes, nematodes and arthropods) have species which can involve the skin or subcutaneous tissues: