This paper presents interview survey data by social scientists using established health measures on the health effects of flooding for residents in 30 locations in England and Wales. Firstly, it examines the extent to which flooded residents reported suffering physical and psychological health effects during and after the event. Secondly, it explores the issue of whether these effects were long-lasting by comparisons with the general population and with those at risk but not flooded. In the study, about two thirds of the flood victims were found to have scores on the General Health Questionnaire-12 scale indicative of mental health problems (scores of 4+) at their worst time after flooding. The evidence of the study also suggests that some flood victims suffered long term mental health effects as a result of their experience of flooding. The study examines the influence of a wide range of factors: characteristics of the flood event, types of property, and socio-demographic and the intervening factors such as the extent of family or community support that may explain the health effects of flooding. It finds that a complex set of social and other factors are involved and that some factors susceptible to human intervention such as having adequate flood insurance cover are important factors in the stress experienced by flood victims.

Malnutrition is one of the main burdens of disease in cystic fibrosis (CF) along with lung disease. Data from the most recent Cystic Fibrosis Foundation registry report show the prevalence of malnutrition is decreasing in the CF population primarily from interventions focusing on preventing malnutrition. Despite success of interventions and decreased prevalence of malnutrition in this population, prevention of malnutrition in CF patients remains a dilemma that must be managed throughout the life cycle. The pathogenesis of malnutrition in CF can be further categorized into 3 main areas: increased energy losses, increased energy needs, and inadequate calorie intake. The purpose of this review is to further explore the causes of malnutrition and explain current research to prevent malnutrition in the CF population.

Recent studies have demonstrated that the hallucinogen 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) enhances glutamatergic transmission in the prefrontal cortex. This increase can be suppressed by metabotropic glutamate2/3 (mGlu2/3) receptor activation. In addition to enhancing glutamatergic transmission, DOI increases cortical c-fos expression. We tested if a reduction in glutamate release produced by mGlu2/3 receptor activation attenuates DOI-induced c-fos expression in the cortex. Similar to previous studies, DOI produced a robust increase in c-fos mRNA throughout the cortex, including the prefrontal, frontoparietal, and somatosensory regions. Pretreatment with the mGlu2/3 agonist LY379268 attenuated the DOI-induced increase in the prefrontal cortex. This suppression was blocked by the mGlu2/3 antagonist LY341495. In contrast, the DOI-induced increase in c-fos mRNA in the frontoparietal and somatosensory cortex was unaffected by the mGlu2/3 agents. These findings suggest that Group II metabotropic glutamate receptor agonists are capable of modulating postsynaptic function preferentially in the limbic cortex under conditions of enhanced glutamate release.

Summary Aim:  To study features in older patients with autoimmune hepatitis, as this was considered mainly a disease of young females. Methods:  Analysis of 28 patients diagnosed at age ≥65 years compared with 84 younger patients. Results:  The incidence was similar at all age decades. The ratio M:F was 1 : 3 (≥65 years) vs. 1 : 2 (<65 years). Presenting symptoms were not different when compared with younger patients and consisted of general malaise and fatigue (36%), jaundice ± other symptoms (50%), or ascites (11%). Antinuclear antibodies (ANA) ≥ 1/80 were positive in 93%, smooth muscle antibodies (SMA) > 1/40 in 50%, anti‐liver kidney microsomes (anti‐LKM) proved always negative. Histology showed acute necrotizing hepatitis in 19%, severe interphase hepatitis in 15%, chronic hepatitis with plasmo‐lymphocytic infiltrate in 30%, cirrhosis in 29% (with active inflammation in one‐third); biopsy was refused in 11%. The elderly responded very well to low doses of methylprednisolone (≤8 mg) and azathioprine (1 mg/kg). This schedule obviates side‐effects such as infections seen with higher dosages. Conclusion:  Autoimmune hepatitis has to be also looked for in the elderly with acute and chronic hepatitis. The steroid therapy should be individualized but kept at a low dose.

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