Arabs in Israel are at greater risk for adult-onset diabetes than Jews and are younger at diabetes presentation. Culturally sensitive interventions aimed at maintaining normal body weight and active lifestyle should be targeted at this population. Possible genetic factors and gene-environmental interactions underlying the high risk for diabetes among Arabs should be investigated.

Recent reports have demonstrated an immunomodulating activity of dehydroepiandrosterone (DHEA) different from that described for glucocorticoids. The present study was designed to test DHEA's activity in endotoxic shock and to investigate its effect on endotoxin-induced production of tumor necrosis factor (TNF).Mortality of CD-1 mice exposed to a lethal dose of lipopolysaccharide (LPS; 800 ,ug per mouse) was reduced from 95 to 24% by treatment with a single dose of DHEA, given 5 min before LPS. LPS administration resulted in high levels of TNF, a response that was significantly blocked by DHEA, both in vivo and in vitro. DHEA treatment also reduced LPS-induced increments in serum corticosterone levels, a parameter considered not to be mediated by TNF. In another experimental model, mice sensitized with D-galactosamine, followed by administration of recombinant human TNF, were subjected to 89% mortality rate, which was reduced to 55% in DHEA-treated mice. These data show that DHEA protects mice from endotoxin lethality. The protective effect is probably mediated by reduction of TNF production as well as by effecting both TNF-induced and non-TNF-induced phenomena.Dehydroepiandrosterone (DHEA) is an abundantly secreted, weak androgenic, adrenocortical steroid hormone that is an intermediate in the biosynthesis of other hormones including testosterone and estradiol-171. Concentrations of DHEA in plasma gradually decline after the third decade of life, reaching 10 to 20% of the peak level in the e!derly (20,24).The precise biological functions of DHEA are uncertain. A growing body of evidence, both experimental and epidemiological, suggests an inverse relationship between low levels of DHEA in serum and morbidity from atherosclerotic cardiovascular disease (1, 9), cancer (10,11,26) and human immunodeficiency virus (HIV) infection (31). Moreover, low levels of DHEA were found to be independently predictive of death from any cause (1).Recent reports proposed an immunomodulating activity of DHEA. It was found to prevent dexamethasone-induced thymic involution in mice (19), increase interleukin-2 production both in vitro and in vivo (6), and prevent the development of systemic lupus erythematosus in a mouse model (18). Lymphopoiesis, but not myelopoiesis or erythropoiesis, was inhibited in irradiated mice fed with DHEA (28, 29). Although lacking an in vitro antiviral activity, DHEA was effective in protecting mice from a variety of lethal viral infections (2, 17).During the course of gram-negative infections, bacterial cell wall products, such as endotoxin (lipopolysaccharide [LPS]), are released, inducing intense pathophysiologic alterations (22). It is not LPS alone that causes the damage, but rather the host response, which may be described as an "overshoot" of the immune system. One of the major responses to LPS in vivo is the rapid production and secretion of cytokines, the soluble mediators of inflammation, like tumor necrosis factor (TNF) (3,5).LPS toxicity can be reduced by administration of potent immunosuppresi...

Most H. pylori infections are acquired at preschool age and transient infection beyond this age is uncommon in this population. Helicobacter pylori-infected siblings are the major reservoir of H. pylori in early and late childhood demonstrating sustained intra-familial transmission of H. pylori.

As the Walton-Bijvoet nomogram for estimating renal phosphate (P) threshold (TmP/GFR) is not applicable to children of all ages, we sought an alternative method for measuring renal handling of P. Recognizing that the nomogram represents an indirect correlation between TmP/GFR and TP/GFR under fasting conditions, we examined this directly in 26 children. An excellent correlation was found, expressed as TmP/GFR = (fasting TP/GFR × 1.1) -0.3 (r = 0.95). The regression line in adults, expressed as TmP/GFR = (fasting TP/GFR × 1.4) – 0.9 (calculated from published studies) is markedly different at the higher values typical for children. Since no advantage could be seen in the use of a mathematically derived TmP, we investigated the direct use of measured TP/GFR (tubular P reabsorption per 100 ml glomerular filtrate) as a measure of renal P handling in clinical practice. No differences were found between morning fasting and nonfasting values. Measurements in 151 healthy subjects aged 3 days to 53 years established normal values in relation to age. The use of this parameter in patients is shown to accurately reflect defects and changes in renal P handling. We believe it to be the preferred parameter because it represents a directly measured physiologic function applicable to all age-groups.

Proloneed unex~lained fever is a continuine ~roblem in a s s o c i a t e d w i t h s i g n i f i c a n t m o r b i d i t y and m o r t a l i t y f o r very low b i r t h w e i g h t (LBW) i n f a n t s , <1300gm, and i n f a n t-t o-i n f a n t t r a n s m i s s i o n h a s a p p a r e n t l y occurred.