Σάββατο, 26 Νοεμβρίου 2016

Mechanisms Underlying Positive Modulation of a Current through P-Type Calcium Channels in Purkinje Neurons by an Agonist of Opioid Receptors

In experiments on isolated rat Purkinje neurons using the whole-cell patch-clamp technique, the addition of 10 nM of an agonist of μ-opioid receptors (μ-ORs), DAMGO, to the bath solution led to moderate but highly significant intensification of the current through high-threshold calcium channels of the P type (increment 9-10%). We found that this effect was independent of the kind of cations (Ca2+ or Ba2+) coming via the plasma membrane. This effect (positive modulation of the current) was practically preserved in the case where a prepulse shifting the membrane potential to +50 mV preceded the test pulse, i.e., the effect was voltage-independent. The above-mentioned effect was almost unchanged under conditions where the intracellular solution contained 0.5 mM GTPβS (an irreversible blocker of G-proteins) or the same amount of GTPγS (a nonspecific activator of these proteins) instead of GTP. The addition of 0.5 mM cAMP to the intracellular solution also did not practically influence positive modulation of the P-current under the action of DAMGO. Preliminary 10-min-long incubation of the examined cells in a solution containing 0.5 μM calmidazolium (an antagonist of calmodulin-regulated enzymes) induced a twofold decrease in the DAMGO-evoked increment of the P-current. Based on the obtained data, we hypothesize that there is a high-affinity allosteric site of binding with agonists of μ-ORs in the molecule of the calcium P-channel, and that voltage-, calcium-, and G-protein-independent positive modulation of the current through these channels is realized by just such a mechanism.



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Concept of Suicide: Neurophysiological/Genetic Theories and Possible Oxytocin Relevance

The suicidal behavior is regarded as the act by which a person seeks to take his life, being aware of the consequences of his action. In our review, besides describing the main introductory aspects for the concept of suicide, we focus our attention on the main neurophysiological and genetical mechanisms relevant for this extremely difficult to manage and controversial behavior. Moreover, considering the latest interests in the current literature on the relevance of central oxytocin to various superior cognitive behaviors, we will also make a short description on how important effects of oxytocin could be in the context of suicidal behavior.



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Relationship Between the Reaction Time and EEG Parameters During Judgments on the Correspondence of Delayed or Simultaneously Presented Images of Two Models

Abstract

This study examined how judging whether the poses of two figures are the same in tasks with delayed and simultaneous image presentation affects the participants' reaction times and electroencephalograms (EEGs). Eighteen university students performed a delayed task, in which an image of a doll was first presented for 3 sec followed by a second image of the doll, and a simultaneous task, in which images of two dolls were presented on the left and right sides of the monitor at the same time. The dolls were shown from the front and rear angles. The participants were instructed to judge whether the images were the same as accurately and quickly as possible, and the reaction times were recorded. EEG signals were recorded from Fp1, Fp2, F3, F4, C3, C4, P3, and P4. The reaction times in the delayed task were found to be shorter then those in the simultaneous task, and that these times for the 0° condition were shorter than for the 180° condition. The amplitudes of EEG responses at Fp1 and Fp2 were larger than those at other electrodes, and the responses in the right hemisphere during the 180° condition and the delayed task within the α1 frequency band were smaller than the responses at other electrodes. These results indicate that cerebral activity in the frontal region of the right hemisphere is associated with the judgment of correspondence or non-correspondence in spatial compatibility tasks.



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Theoretical Analysis of the Force and Position Synergies in Two-Joint Movements

Abstract

A theoretical approach is proposed to define the force and position singular points (FSPs and PSPs) in the circular, ellipsoidal, and linear planar two-joint movements produced under steady loadings directed along the movement traces. The FSPs coincide with changes in the direction of the force moments acting around the joints; the PSPs show the locations of the extrema at the joint angle trajectories. The force synergy (defined by the location of FSPs) provides a strong influence on the activation synergy; the latter is largely described by correlations between the activities recorded from the muscles participating in the movement. The position synergy (defined by the location of PSPs) is responsible for a hysteresis-related modulation of the activation synergy. Geometrical procedures are proposed to define positions of the FSPs and PSPs along various movement traces; this can provide a general description of the force and position synergies for the movements. The force synergies in the circular movements cover four sectors with diverse loading combinations of the flexor and extensor muscles belonging to different joints. The variability of the synergy effects for changes in the size and position of the circular trajectories is analyzed; the synergy patterns are also considered for ellipsoidal and linear movement traces. A Force Feedback Control Hypothesis is proposed; it allows one to explain the decrease in the number of controlled variables during real multi-joint movements.



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Effects of a Supernatant of Fetal Neurogenic Cells on Proliferative Activity in Glioma C6 Cell Culture

We estimated the effects of a rat fetal neurogenic cell supernatant (RFNCS) on proliferative activity of cultured cells of rat brain glioma (C6 cell line). The RFNCS was obtained from a cell suspension of the brains from rat fetuses (gestation day 14, E14). We added 0.10 mg/ml of RFNCS to the culture medium of experimental cultures and incubated the latter for 48 h. Immunocytochemical staining with respect to the Ki-67 proliferation marker was performed using rabbit monoclonal antibodies against this protein. In glioma C6 cell cultures, we observed degenerating and necrobiotically modified tumor cells with rounded cell bodies and reduction of the processes. Under the action of RFNCS, the mean density of the cells in 10 test fields of vision in experimental cultures (0.04 mm2) became significantly smaller than that in the control (332.0 ± 36.0 vs. 569.5 ± 70.5; P = 0.00026); the mean value of the nuclear/cytoplasmic ratio in malignant cells mildly (insignificantly) decreased (0.28 ± 0.01 vs. 0.32 ± 0.02; P = 0.64) and the share of cells with multiple nucleoli was more than two times smaller (3.53 ± 0.33% and 7.97 ± 0.25%, respectively; P = 0.053). The mitotic index of cultured malignant cells subjected to the action of RFNCS became four times lower (1.10 ± 0.04% vs. 4.90 ± 0.09%; P = 0.009), while the share of malignant cells immunopositive with respect to Ki-67 decreased (10.47 ± 0.91% vs. 27.86 ± ± 2.91%; P = 0.0015). The observed antiproliferative effect of RFNCS confirms the possibility and expedience of the development of complex pathogenetic therapy for malignant tumors of the brain using preparations obtained from fetal neurogenic cells.



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Indices of Coherence of EEG Rhythms in the Course of Cognitive Activity as Markers of Creative Thinking: Gender Specificity

Abstract

According to the results of psychological testing, persons aged 18 to 21 years were divided into four groups, women and men with low and high productivity of divergent (creative, nonroutine) thinking (n = = 18 to 23). Results of EEG recording (19 leads) were used for calculation of the coherence coefficients for oscillations of the delta, theta, alpha1, alpha2, alpha3, beta, and gamma frequencies in lead pairs and estimation of integral indices of coherence within the anterior and posterior cortical regions and between these zones (interaction coefficients, IC1-IC3, respectively). EEG was recorded in the resting state and in the course of resolving convergent- and divergent-type cognitive test tasks. It was found that, during the performance of tests of both types, men with a higher productivity of divergent thinking demonstrated significantly higher values of IC1 (that characterizes the coherence in associative linkages within the anterior cortex) for oscillations of all EEG frequency ranges compared with the respective estimates for "low-creative" men. Similar increments were typical of the IC2 values for low- and midfrequency EEG rhythms (delta, theta, and alpha). At the same time, values of the "interregional" IC3 for theta, beta, and gamma activity in "high-creativity" men were significantly lower. In women of both groups (low and high creativity), such specificity of the IC1-IC3 patterns was practically not observed, i.e., the respective aspect demonstrated clear gender specificity. The sex of the subjects and type of the performed cognitive tests could not be considered factors significantly affecting the calculated absolute IC values. The observed specificities of integral coherence indices are probably associated with different strategies of the performance of cognitive tasks in men and women. Our findings allow us to believe that the above interrelations between integrated coherence indices can be used as EEG markers of high productivity of divergent thinking in men. The more flexible strategies of thinking in women are probably related to more variable neurophysiological cortical mechanisms (compared with those in men), and this type of organization is not clearly reflected in the pattern of intracortical interactions estimated by coherence indices.



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Effects of Systemic Introductions of Nanoparticles and Salts of Gold and Silver on the Size of the Nuclei of Hypothalamic Neurons in Male Rats

We studied the effects of course (10 days) intraperitoneal injections of salts of gold and silver and colloid solutions of nanoparticles of these metals on the size (mean value of the cross-sections) of the nuclei of hypothalamic neurocytes localized in the preoptic and arcuate nuclei of immature male albino rats. In animals injected with a solution containing tetrachloroaurate ions, the examined morphometric parameters in both structures significantly exceeded the control values. Injections of gold nanoparticles led to significant decreases in the cross-sections of the neurocyte nuclei; thus, the pattern of the effects of gold depended on its physicochemical form. Injections of both silver salt (AgNO3) and silver nanoparticles led to drops in the mean values of cross-sections of the nuclei of neurocytes. Therefore, shifts of the studied morphofunctional characteristics of the cells belonging to the hypothalamic nuclei resulting from systemic injections of colloid solutions (nanoparticles) of gold and silver are indicative of suppression of functions of the central link of the hypothalamo-hypophyseal-gonadal system after the influence of these factors.



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Ketosis Level as a Factor Determining Addictive Behavior of Alcoholized Rats

A group of 20 rats was subjected to long-lasting alcoholization (90-day-long forced consumption of 10% aqueous ethanol solution, ES). Every day at 17.00, the ES volume consumed by the animals per day was measured, and the level of ketone bodies in the urine was estimated in points using a semiquantitative quick ketone test. Then, rats were divided into two equivalent groups, experimental and control ones (n = 10 in each group). During the subsequent three-day-long main stage of the experiment, animals of the experimental group were preliminarily (at 17.00 of the preceding day) subjected to peroral administration of 1.0 ml of solution of unithiol, i.e., an agent neutralizing ketone bodies. Within three days of the mentioned period, the level of ketonuria was estimated within a 9.00–17.00 observation period with one-hour-long intervals. This time, free access of rats to water or ES was provided. We found that rats of the experimental group consumed more than one-third of the daily ES norm within the first hour of observation; i.e., within the interval where the level of ketonuria was minimum (0.17 points, on average). After this, the amount of the consumed ES decreased, while the level of ketonuria increased significantly in a parallel manner. In control rats throughout the observation period, hourly consumption of ES and the level of ketonuria demonstrated no significant dynamics. We hypothesize that there is a causal relationship between the ketosis level and the behavioral reaction of alcohol consumption (the lower the ketosis, the higher the consumption). Under conditions of alcoholization resulting in the development of hypoglycemia, ketone bodies begin to be used in the brain as an energy substrate, and the brain becomes dependent on the level of ketonemia to a significant extent. These level is a rather important factor determining alcohol addiction; direct factors initiating a situational drive for alcohol consumption are hypoketonemia episodes.



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Effect of Cyclosporin A on the Viability of Hippocampal Cells Cultured under Conditions of Modeling of Alzheimer’s Disease

The presence of amyloid plaques and neurofibrillary tangles accompanied by manifestations of intense neurodegeneration in the brain is the main syndrome of Alzheimer's disease (AD). Until now, the mechanisms underlying neurotoxic properties of the protein specific with respect to AD (amyloid β1–42) have not been fully interpreted. There are reasons to believe that the opening of mitochondrial permeability transition pores (MPTPs) may play a significant role in the respective processes. We estimated the impact of the mentioned protein on the viability of cultured hippocampal cells of rats. The use of confocal microscopy after staining of the cells by two dyes, Hoechst 33258 and propidium iodide, allowed us to measure the numbers of viable and necrotized units. When 2.0 μm of amyloid β1–42 was added to the culturing medium, the cell death index (CDI) of hippocampal cells (number of cells stained by propidium iodide normalized with respect to the number of examined units) on day in vitro (DIV) 14 was 59 ± 4%, on average, as compared with 28 ± 6% under control conditions. When not only amyloid β1–42 was added to the medium but cells were also treated with 1.25 μM of a MPTP blocker, cyclosporin A (CsA), the mean CDI was significantly smaller than that with no treatment (42 ± 6%; P < 0.05). Thus, changes in the mitochondria resulting in opening of MPTPs can be considerably involved in the process of necrotic death of hippocampal cells under conditions of modeling of AD.



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Ethical Responsibilities of the Authors



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Effects of a Cardiotonic Medicine, Danshen Pills, on Cognitive Ability and Expression of PSD-95 in a Vascular Dementia Rat Model

Abstract

A widely used Chinese cardiotonic proprietary medicine, compound Danshen dripping pills (CDDP, Fufang Danshen Diwan) has also begun to be used for treatment of vascular dementia (VaD). We tried to explore the mechanism of CDDP action in this case. A VaD experimental model was built in rats by bilateral ligation of the common carotid arteries. The cognitive ability of experimental animals was evaluated in the Morris water maze test. Synaptic ultrastructural changes in the hippocampus were detected by transmission electron microscopy; expression of PSD-95 mRNA in the hippocampus was examined using hybridization in situ. The latter index (mRNA expression) in the VaD group was significantly lower than those in the CDDP and sham-operated groups (P < 0.05). CDDP treatment considerably improved disturbed ultrastructural synaptic characteristics in the hippocampus of VaD rats. The mean escape latency in the Morris water maze test was significantly shorter in CDDP-treated VaD rats, compared with that those of the VaD group (P < 0.05). In the CDDP group compared to the VaD one, escape strategies improved from edge and random searches to more linear swim pathway (P < 0.05). Thus, decreasing expression of PSD-95 plays an important role in the pathogenesis of VaD. CDDP treatment improves the learning and memory ability of VaD rats by improving neural synaptic ultrastructural characteristics and increasing expression of PSD-95 mRNA in the hippocampus.



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Control of the Power of Strokes and Muscle Activities in Cyclic Rowing Movements (a Research using Rowing Simulators)

We investigated the relationship between the power of rowing movements strokes and the rate of the latter in various testing modes and under different conditions of rowing performance; 25 elite sportsmen specialized in rowing on racing shells were involved in the tests. Two series of tests were carried out on rowing simulators of two types; mechanographic parameters (in particular, joint angles) and EMG activity of broad sets of the muscles involved in this type of locomotor activity were simultaneously recorded. Separate tasks included (i) evaluation of the maximum power of rowing movements, (ii) a controlled step-like increase in the power of the latter, (iii) passing a test "distance" with the maximum speed, (iv) performance of the rowing movements with the presence of visual feedback (with visual presentation of the parameters of motor activity on a monitor), and (v) "rowing" with variations of the external loading. It was found that increases in the power of rowing motions rather rigidly correlated with a nearly proportional increase in the rate of rowing cycles (at all performance modes); a subjectively comfortable rate of such cyclic movements increased with increase in the external loading. Under conditions where rowing movements were initiated with the presence of visual feedback that provided the subject with information on the characteristics of these movements, tested subjects were capable of controlling the power and rate of rowing movements separately. The intensities of EMG discharges of the muscles involved in realization of separate rowing movements correlated mostly with the velocity of these movements and not with the power of the latter. Thus, a strong interrelation between the power and rate of the movements in rowing is, to a great extent, a universal phenomenon; it can be disturbed only at the additional involvement of some external conditions. The value of this interrelation significantly varies between individuals and can be used for characterization of the functional productivity of the athletes and of their functional state.



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Species-Related Differences in the Properties of TRPC4 Channels in Intestinal Myocytes of Rodents

TRPC4 proteins form receptor-operated cation channels that are activated in synergy by M2 and M3 ACh receptors coupled to Gq/11 and Gi/o proteins, respectively. These channels are widely expressed in the brain and smooth muscles where they perform a number of important functions, including control of GABA release from the dendrites and cholinergic excitation of smooth muscles. The biophysical properties of TRPC4 currents directly activated by GTPγS in mouse cells remain mostly unknown. We, thus, aimed to investigate these channels in mouse ileal myocytes where a prominent TRPC4-mediated cation current termed mICAT is observed, and to compare the behavior of this current to that of the better studied mICAT in guinea-pig myocytes. Although cation current responses to carbachol at –50 mV (i.e., at the value close to the normal resting potential in these cells) were highly similar, mICAT in the mouse lacked the permissive action of intracellular Ca2+ on channel opening. The slope factor of the muscarinic cation conductance, which is a defining property of voltage-dependent behavior, was identical in both species. There were differences in the potential at which the current peaked at negative potentials, but not in the maximal current densities. Major differences were found in the kinetics of mICAT voltagedependent relaxations, which were much faster in the mouse. The above rodent species employ two different strategies for the open probability increase by activated G-proteins; the mean open time was shorter in the mouse compared to that in the guinea-pig (15.1 ± 5.2 msec, n = 8, vs. 80.0 ± 19.7 msec, n = 9; P < 0.01). Correspondingly, the instantaneous frequency of channel opening was much higher in the mouse (154.1 ± 18.8 sec–1vs. 70.2 ± 7.3 sec–1 in the guinea-pig; P < 0.001). These functional differences are discussed based on structural differences found in the corresponding TRPC4 amino acid sequences of the two rodent species, which are mainly clustered in the cytosolic C-terminus of TRPC4 protein.



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Recommend, but also Discuss: Different Patterns of Physician-Perceived Barriers to Discussing HPV Vaccination and Their Association with Vaccine Administration in 11–12 Year-Old Girls

Abstract

Objectives We examined variation in primary care physicians' (PCPs') perceptions of barriers to physician-initiated discussion of HPV vaccination, and how this is associated with the rates at which they discuss, initiate and continue to administer vaccination with 11–12 year-old girls. Methods We surveyed 301 PCPs using systematic random sampling. PCP variation in perceived barriers to discussing HPV vaccination was modeled using latent class analysis (LCA). The distinct PCP groups identified were compared with each other using three iterative logistic regression models to predict the likelihood of initiating vaccine discussion and the reported percentages of 11–12 year-old patients who initiated HPV vaccination and received follow-up shots. Results LCA revealed three groups of PCPs who perceived major, moderately significant and relatively minor barriers (17.9, 41.9 and 40.2 % of respondents, respectively). Pediatricians, PCPs who were female, had minority racial/ethnic status and who perceived only minor barriers had significantly higher odds of initiating discussion. PCPs were more likely to initiate HPV vaccination if they had initiated discussion and perceived minor or moderate communication barriers. Increased likelihood to administer follow-up HPV vaccine was associated with having initiated discussion, perceiving only minor barriers and working outside Deep South states, but not with having initiated vaccination. Conclusions for Practice PCPs who discuss HPV vaccination with girls aged 11–12 and their mothers are more likely to start and sustain vaccine administration. However, different PCPs perceive barriers to discussion in different ways. Interventions tailored to different groups of PCPs should assist them in overcoming barriers to discussing their recommendations when necessary.



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Use of maternal health services: comparing refugee, immigrant and US-born populations

Abstract

Objectives To determine use of recommended maternal healthcare services among refugee and immigrant women in a setting of near-universal insurance coverage. Methods Refugee women age ≥18 years, who arrived in the US from 2001 to 2013 and received care at the same Massachusetts community health center, were matched by age, gender, and date of care initiation to Spanish-speaking immigrants and US-born controls. The primary outcome was initiation of obstetrical care within the first trimester (12 weeks gestation). Secondary outcomes were number of obstetrical visits and attending a postpartum visit. Results We included 375 women with 763 pregnancies (women/pregnancies: 53/116 refugee, 186/368 immigrant, 136/279 control). More refugees (20.6 %) and immigrants (15.0 %) had their first obstetric visit after 12 weeks gestation than controls (6.0 %, p < 0.001). In logistic regression models adjusted for age, education, insurance, BMI, and median census tract household income, both refugee (odds ratio [OR] 4.58, 95 % confidence interval [CI] 1.73–12.13) and immigrant (OR 2.21, 95 % CI 1.00–4.84) women had delayed prenatal care initiation. Refugees had fewer prenatal visits than controls (median 12 vs. 14, p < 0.001). Refugees (73.3 %) and immigrant (78.3 %) women were more likely to have postpartum care (controls 54.8 %, p < 0.001) with differences persisting after adjustment (refugee [OR 2.00, 95 % CI 1.04–3.83] and immigrant [OR 2.79, 95 % CI 1.72–4.53]). Conclusions for Practice Refugee and immigrant women had increased risk for delayed initiation of prenatal care, but greater use of postpartum visits. Targeted outreach may be needed to improve use of beneficial care.



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An Integrated Model of Breastfeeding Peer Counseling Support is Feasible and Associated with Improved Exclusive Breastfeeding

Abstract

Background Though in-person contacts in the home have demonstrated efficacy in improving breastfeeding outcomes in peer counseling programs, home contacts are resource-intensive. Objective To compare the feasibility and effectiveness of an Integrated Model of peer counseling breastfeeding support characterized by select home visits augmented with individual WIC clinic visits and group education, in contrast to the Standard Model which includes a standard number of in-person home contacts. Methods Six counties (n = 226 participants) and nine counties (n = 472 participants) were assigned to the Standard Model and the Integrated Model, respectively. Differences in demographic characteristics and breastfeeding outcomes were tested using Chi square tests and Cox proportional hazards regression models. Results Participants in counties where the Integrated Model was implemented had fewer home contacts (p = 0.03) and were more likely to have a hospital (p = 0.03) or group education (p < 0.001) contact, whereas Standard Model participants were more likely to receive an individual WIC clinic contact (p < 0.001). While there was no difference in the hazard of discontinuing any breastfeeding between groups, participants in the Integrated Model group had a lower hazard of discontinuing exclusive breastfeeding by 3 months postpartum (p = 0.02). Among participants within the Integrated Model, group education classes were associated with higher hazard of discontinuation (p = 0.04 and p = 0.003 for any and exclusive breastfeeding, respectively). Conclusions It was feasible for peer counselors to implement changes in program delivery to achieve fewer home visits without a detrimental impact on breastfeeding outcomes. However, group education classes did not appear to be beneficial for improving breastfeeding outcomes in this population.



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Maternal Perceptions Related to Eating and Obesity Risk Among Low-Income African American Preschoolers

Abstract

Objectives Health disparities are prevalent in the U.S., with low-income African American children suffering from high rates of obesity and related conditions. Better understanding of parental attitudes and barriers related to healthy eating and obesity risk is needed to suggest more effective intervention foci for this at-risk population. Methods African American caregivers of 3–5 year old children were recruited for focus groups and a questionnaire completion from two Head Start programs in a southeastern state of the U.S. The Social Cognitive Theory was utilized to develop a focus group guide. Focus group recordings were transcribed verbatim and analyzed using the comparative content analysis. Results Eight focus groups (all participants were mothers) yielded the following main themes: (1) general nutrition knowledge but common misconceptions about foods/beverages; (2) beliefs that meals have to include meat and starch and be home-cooked to be healthy; (3) desire to feed children better than their own parents; (4) lack of family support and child pickiness perceived as the greatest barriers to healthy eating; (5) awareness of family history of diseases; and (6) low concern about children's current diet and weight status. Over 25 % of mothers underestimated their child weight status. Conclusions Our findings highlight the importance of understanding maternal perspectives related to food, eating, and weight among low-income African American mothers of preschoolers. Nutrition educators should be aware of misconceptions and recognize that mothers might not perceive diet quality in early childhood as having strong impact on the child's future health and/or obesity risks.



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A Survey of Obstetric Healthcare Utilization in the Rural Western Indian Himalayas

Abstract

Objectives To determine the socio-economic factors affecting access to antepartum, intrapartum, and postpartum healthcare in the rural Western Indian Himalayas over the past 20 years. Methods Face-to-face surveys were conducted with 197 women in Chamoli District, Uttarakhand from October 2011 to May 2012. Participants who gave birth within the past 20 years were included in the final analysis (n = 158). Stratified odds ratios and analysis of variance were calculated. Results Among women who delivered in the prior 7 years, there was a nine-fold increase (95 % CI 4–20.8) in institutionalized births compared to women who delivered 8–20 years before the study. Among women who delivered 7 years prior to the study, low income increased the risk of home delivery (OR 3.07, 95 % CI 1.15–8.54). Low caste (OR 2.79, 95 % CI 1.04–7.72) and low level of education (OR 3.93 95 % CI 1.41–11.81) decreased the use of antepartum medications (vitamins and vaccines). Remote location among all participants was a risk factor for not seeking care for obstetric morbidities (OR 0.44 95 % CI 0.2–0.95). Conclusions The incidence of institutionalized delivery has increased over the past decade in rural Uttarakhand. Income, caste, education, and remote location correlated with poor access to antepartum and intrapartum healthcare. These correlations have increased in statistical significance over the past 20 years, except for location. This indicates that the Western Himalayas face similar challenges to obstetric service utilization as the north Indian plains and that several of these inequalities in healthcare access have become more pronounced in recent years.



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Intimate Partner Violence Against HIV-Positive Women is Associated with Sub-Optimal Infant Feeding Practices in Lusaka, Zambia

Abstract

Objectives The aim of this study is to determine how intimate partner violence against HIV-positive women affects safe infant feeding practices in Lusaka, Zambia. Methods A cross-sectional face-to-face survey was conducted with 320 married postpartum women at a large public health center in Lusaka, Zambia, in 2014. Variables were measured using previously validated instruments from the Demographic and Health Survey. Data were analyzed using simple and multivariate logistic regression in Stata 12. Results Thirty-seven percent of women report early mixed infant feeding prior to six months. Women who experienced intimate partner violence have 2.8 higher adjusted odds of early mixed infant feeding (p < 0.001). Women who experienced emotional violence, specifically, have 1.9 higher adjusted odds of early mixed infant feeding (p < 0.05), while women who experienced sexual violence have 2.3 higher adjusted odds (p < 0.01). There is also a dose–response relationship between IPV and early mixed infant feeding (p < 0.05). Lastly, disclosing one's HIV-positive status to the husband is associated with at least 67 % lower adjusted odds of early mixed feeding (p < 0.05). Conclusions Intimate partner violence against HIV-positive women, in particular emotional and sexual violence, increases the likelihood of early mixed infant feeding, putting infants at greater risk for both mother-to-child transmission of HIV and other infant morbidities. Intimate partner violence should thus be given increased attention within the context of infant feeding and HIV in sub-Saharan Africa.



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Indication of Risk of Mother-to-Child Toxoplasma gondii Transmission in the Greater Accra Region of Ghana

Abstract

Objectives Congenital infection with Toxoplasma gondii is known to result in neurological and brain disorders including ophthalmic disorders later in life. Research in Ghana revealed high sero-prevalence among pregnant women and eye patients. This study determines the risk of congenital transmission of T. gondii infection in Accra, Ghana. Methods One hundred consented pregnant women aged 18–45 years (mean 29.85 ± 5.76) participated. Venous blood and tissue samples were taken from the maternal side of each placenta after delivery. Cord blood samples were also taken after they were separated from the infants. Finger-prick blood was taken from infants of participating women at 2 or 6 weeks post-natal. ELISA was used to detect T. gondii antibodies in all blood samples while Nested-PCR was used to detect T. gondii DNA from placental tissues. Data was analysed using SPSS v. 16. Results Overall, 37.6 % of maternal blood, 39.5 % of umbilical cord blood, and 57.5 % of post-natal infant blood were positive for anti-T. gondii IgG. No anti-T. gondii IgM was detected in any of those samples. Toxoplasma gondii DNA was detected in 39.8 % of placental tissue samples. Strong association was observed in the occurrence of placental T. gondii DNA and anti-T. gondii IgG positive women (ø = 0.810, p < 0.00001) as well as high Relative risk shown in the likelihood of foetal exposure to infection in latently-infected women (RR 10.39; CI 4.47–24.17; p < 0.00001). Conclusions for Practice The presence of anti-T. gondii IgG antibodies only, and T. gondii DNA in placental tissues indicate the women might have been infected early during the pregnancy, placing about 39.8 % of the babies at risk. These results can strongly influence policy to screen and treat pregnant women for T. gondii infection.



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Maternal Child and Family Health Nurses: Delivering a Unique Nursing Speciality

Abstract

Introduction This study aimed to describe Maternal Child and Family Health Nurses' (MCaFHNs) perception of their role across Australia. MCaFHNs deliver services to positively influence the growth and development of children in the early years. Little is known about their role as they deliver care to children and families in Australia. Methods This study used in-depth qualitative inquiry. Sixteen expert MCaFHNs from the eight jurisdictions in Australia took part in semi-structured interviews conducted from April 2013 to August 2013. The data were transcribed verbatim, validated by participants, and analysed thematically. Results The results indicated that the MCaFHNs' role is embedded in the principles of primary health care under an umbrella of universal service delivery with increasing overall complexity. Health promotion and early intervention are key components of the role, with services focused heavily on child growth and development and maternal mental health. Delivery of services by MCaFHNs was enriched by specific approaches to care, such as working in partnership with families, and all aspects of the role were enabled by essential specialist skills and knowledge. Discussion While role descriptors, educational backgrounds and experiences vary, participants overwhelmingly report similarities in practice. This study identified tangible reasons for the development of a nationally consistent role and practice in Australia, enabling consistency and equity of best models of practice. Such a description is essential to enable transferability and comparison with nurses working in similar contexts internationally.



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Patterns of Internet Use by Pregnant Women, and Reliability of Pregnancy-Related Searches

Abstract

Objective To assess patterns of e-health use in pregnancy in an underserved racially diverse inner-city population, and to assess the accuracy of pregnancy-related information obtained from the Internet. Methods A cross sectional study of 503 pregnant/postpartum women belonging to an underserved racially diverse inner-city population who completed a survey regarding e-health use. To assess accuracy, four independent expert-reviewers rated the first 10 webpages on Google searches for each of five questions based upon those in ACOG bulletins. Results 70.8 % of pregnant/postpartum women belonging to an underserved racially diverse inner-city population were e-health users. E-health users were younger (mean age 29.4 vs. 31.2, P = 0.009), more likely to be nulliparous (50.3 vs. 21.3 %, P < 0.001), have English as their primary language (62.3 vs. 49.1 %, P = 0.014) and have a college/graduate education (78 vs. 26.6 %, P < 0.001). While 60 % of these women said e-health influenced decision making, only 71.3 % of them discussed their searches with their provider. Expert reviewers determined that the online information was fairly accurate (mean score: +1.48 to +4.33 on a scale of −5 to +5) but not uniformly accurate, and there was at least one webpage with inaccurate information for every question. Conclusions for practice Pregnant women frequently use e-health resources but do not routinely share their findings with their providers. Most, but not all, information obtained is accurate. Therefore it is important for providers to discuss their patients' use, and help to guide them to reliable information.



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Mountain Child: Systematic Literature Review

Abstract

Objectives This systematic review identifies and reviews both peer-reviewed and 'grey' literature, across a range of disciplines and from diverse sources, relating to the condition of children living in mountain communities in low- and middle-income countries. Findings The literature on poverty in these communities does not generally focus on the particular vulnerabilities of children or the impact of intersecting vulnerabilities on the most marginalised members of communities. However, this literature does contribute analyses of the broader context and variety of factors impacting on human development in mountainous areas. The literature on other areas of children's lives—health, nutrition, child mortality, education, and child labour—focuses more specifically on children's particular vulnerabilities or experiences. However, it sometimes lacks the broader analysis of the many interrelated characteristics of a mountainous environment which impact on children's situations. Themes Nevertheless, certain themes recur across many disciplines and types of literature, and point to some general conclusions: mountain poverty is influenced by the very local specificities of the physical environment; mountain communities are often politically and economically marginalised, particularly for the most vulnerable within these communities, including children; and mountain communities themselves are an important locus for challenging and interrupting cycles of increasing inequality and disadvantage. While this broad-scale review represents a modest first step, its findings provide the basis for further investigation.



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Utility of Population Attributable Fraction Assessment in Guiding Interventions to Reduce Low Birthweight in the High-Altitude State of Colorado

Abstract

Objectives We evaluated the ability of population attributable fraction (PAF) assessments to alter significant modifiable risks for low birthweight (LBW) and the impact of high altitude as a risk for LBW in Colorado. Methods Logistic regression analysis of birth certificate parameters in 1995–1997 identified risk factors for PAF assessment. PAF for birth at high altitude, multiple births, and LBW in singleton births were determined. Subsequent analysis of singleton LBW risks, using number needed to treat (NNT) analysis, estimated how elimination of major modifiable risk factors could reduce LBW in the study population. Public health interventions were initiated and PAF analysis conducted 12 years afterward to determine the effect of interventions. Results PAF in singleton births revealed low maternal weight gain in pregnancy and maternal smoking as the greatest modifiable attributable risk factors for LBW (12.7/12.5 %, respectively, in 1995–1997 and 12.9/7.1 % in 2007–2009). Significant interaction between these variables resulted in PAF of 34.4 % when the two occurred together in 1995–1997, decreasing to 19.4 % in 2007–2009. NNT analysis of singleton births in 1995–1997 revealed that eliminating low maternal weight gain, smoking, late prenatal care in all women and interpregnancy intervals <1 year in multiparous women reduced LBW by 46.5 %. The respective proportional reductions in PAF of 40.3 and 46.3 % for maternal smoking and weight gain/smoking interaction were associated with a 1.4 % LBW reduction in singleton births between the two study periods. Conclusions for Practice PAF and NNT analyses are valuable tools to predict intervention targets to lower LBW.



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Improving Adolescent Health Risk Assessment: A Multi-method Pilot Study

Abstract

Objectives Given poor compliance by providers with adolescent health risk assessment (HRA) in primary care, we describe the development and feasibility of using a health information technology (HIT)-enhanced HRA to improve the frequency of HRAs in diverse clinical settings, asking adolescents' recall of quality of care as a primary outcome. Methods We conducted focus groups and surveys with key stakeholders (Phase I) , including adolescents, clinic staff and providers to design and implement an intervention in a practice-based research network delivering private, comprehensive HRAs via tablet (Phase II). Providers and adolescents received geo-coded community resources according to individualized risks. Following the point-of-care implementation , we collected patient-reported outcomes using post-visit quality surveys (Phase III). Patient-reported outcomes from intervention and comparison clinics were analyzed using a mixed-model, fitted separately for each survey domain. Results Stakeholders agreed upon an HIT-enhanced HRA (Phase I). Twenty-two academic and community practices in north-central Florida then recruited 609 diverse adolescents (14–18 years) during primary care visits over 6 months; (mean patients enrolled = 28; median = 20; range 1–116; Phase II). Adolescents receiving the intervention later reported higher receipt of confidential/private care and counseling related to emotions and relationships (adjusted scores 0.42 vs 0.08 out of 1.0, p < .01; 0.85 vs 0.57, p < .001, respectively, Phase III) than those receiving usual care. Both are important quality indicators for adolescent well-child visits. Conclusions Stakeholder input was critical to the acceptability of the HIT-enhanced HRA. Patient recruitment data indicate that the intervention was feasible in a variety of clinical settings and the pilot evaluation data indicate that the intervention may improve adolescents' perceptions of high quality care.



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Caregiver Burdens and Preventive Dental Care for Children with Autism Spectrum Disorder, Developmental Disability and/or Mental Health Conditions: National Survey of CSHCN, 2009–2010

Abstract

Objective The purpose of this study is to examine the burdens of caregivers on perception of the need and receipt of preventive dental care for a subset of children with special health care needs—children with Autism Spectrum disorder, developmental disability and/or mental health conditions (CASD/DD/MHC). Methods The authors used the 2009–2010 National Survey of CSHCN. The survey included questions addressing preventive dental care and caregivers' financial, employment, and time-related burdens. The associations of these burdens on perceptions and receipt of preventive dental care use were analyzed with bivariate Chi square analyses and multinomial logistic regressions for CASD/DD/MHC (N = 16,323). Results Overall, 16.3 % of CASD/DD/MHC had an unmet preventive dental care need. There were 40.0 % of caregivers who reported financial burden, 20.3 % who reported employment burden, and 10.8 % who reported time burden. A higher percentage of caregivers with financial burden, employment burden, and time-related burden reported that their CASD/DD/MHC did not receive needed preventive dental care (14.1, 16.5, 17.7 % respectively) compared to caregivers without financial, employment, or time burdens (9.0, 9.6 %, 11.0 % respectively). Caregivers with financial burden (adjusted multinomial odds ratio, 1.38 [95 % CI 1.02, 1.86] and employment burden (adjusted multinomial odds ratio, 1.45 [95 % CI 1.02, 2.06] were more likely to report that their child did not receive preventive dental care despite perceived need compared to caregivers without financial or employment burdens. Conclusions for practice Unmet needs for preventive dental care were associated with employment and financial burdens of the caregivers of CASD/DD/MHC.



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Dietary Patterns During Pregnancy are Associated with Gestational Weight Gain

Abstract

Objective The role of diet during pregnancy on gestational weight gain is unclear. This study aimed to evaluate the hypothesis that dietary patterns during pregnancy are differentially associated with the adequacy of gestational weight gain at different stages of pregnancy. Methods A total of 391 pregnant women in National Health and Nutrition Examination Survey (NHANES) 2003–2006 were included. Dietary intake was obtained using a National Cancer Institute's food-frequency questionnaire. Results Three dietary patterns were identified by factor analysis with 36 food groups among pregnant women, and they were named according to food group factor loadings: 'mixed', 'healthy', and 'western'. The 'mixed' pattern characterized by a high intake of meat, dairy products, fruits, vegetables, potatoes, nuts and seeds and sweets. After adjusting for maternal sociodemographic variables and physical activity level, women in the highest tertile of 'mixed' pattern score had significantly greater odds of being in the inadequate gestational weight gain compared to those in the lowest tertile (adjusted odds ratio (AOR) 4.72; 95 % CI 1.07–20.94). Women in the mid tertile of the 'mixed' pattern had significantly lower odds of being in the excessive gestational weight gain compared to those in the lowest tertile (AOR 0.39; 95 % CI 0.15–0.99). Conclusion These results suggest that a diet high in meat, dairy products, fruits, vegetables, potatoes, and nuts and seeds during pregnancy might be associated with reducing excessive gestational weight gain.



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EFFECT OF ENVIRONMENTAL POLLUTION ON OXIDATIVE STRESS BIOMARKERS IN AFRICAN CAT FISH (CLARIAS GARIEPINUS) FROM ASEJIRE RIVER IN OYO STATE, NIGERIA

2016-11-26T17-32-23Z
Source: Journal of Environmental and Occupational Science
Oluwatosin Adetola Arojojoye, Abiola Muhammad Adeosun.
Background: Fishes are widely used as model organisms for the assessment of the quality of aquatic environment and can therefore serve as bioindicators of environmental pollution. In this study, the activities of Superoxide dismutase, Catalase , Glutathione S-transferase (GST), reduced glutathione (GSH) concentration and Malondialdehyde formation were determined in the organs of African Catfish, Clarias gariepinus from Asejire River in Ibadan, Oyo State, Nigeria. The River receives effluents discharged from various industries and it is suspected to be polluted. Materials and Methods: Clarias gariepinus weighing between 250g-400g were collected from Asejire River and Clarias gariepinus from a clean fish farm (Durantee fisheries) were used as the control. Results: A significant increase in malondialdehyde formation was observed in the liver, kidney and gills of Clarias gariepinus from Asejire River compared with control. Superoxide dismutase, Catalase and GST activities decreased in the organs of the fish. There was also a decrease in GSH concentration in the liver and kidney of Clarias gariepinus from Asejire River compared with control but GSH concentration increased in the gills of the fish. Conclusion: The results of this study show that there was induction of oxidative stress in the organs of Clarias gariepinus from Asejire River reflecting the pollution status of the River.


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Transfer factors for natural radioactivity into date palm pits

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Publication date: Available online 25 November 2016
Source:Journal of Environmental Radioactivity
Author(s): Mohammad Abu Shayeb, Thamer Alharbi, Muzahir Ali Baloch, Omar Abdul Rahman Alsamhan
Palm pits are used in various human and animal feed products. In this study, the natural radioactivity levels from soil and date palm pits of 9 samples collected from major date palm farms in three different regions (Buraidah, Al-Zulfi and Al-Majmaah) of Saudi Arabia were determined by using the high purity germanium (HPGe) gamma-ray spectrometer. The mean activity concentrations of 226Ra, 232Th, 137Cs and 40K in soil samples were 12.8 ± 2.2, 10.2 ± 2.1, 0.28 ± 0.10 and 329 ± 87 Bg kg−1, respectively. Similarly the mean activity concentrations of 226Ra, 232Th, and 40K in date palm pits were 5.6 ± 1.2, 2.8 ± 0.4 and 181 ± 17 Bq kg−1, respectively, whereas 137Cs could not be detected. The geometric mean of TF values (geometric standard deviation in parentheses) of 226Ra, 232Th, and 40K were 0.33 (2.1), 0.22 (1.8) and 0.51 (2.0), respectively.



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Left Ventricular Speckle Tracking-Derived Cardiac Strain and Cardiac Twist Mechanics in Athletes: A Systematic Review and Meta-Analysis of Controlled Studies

Abstract

Background

The athlete's heart is associated with physiological remodeling as a consequence of repetitive cardiac loading. The effect of exercise training on left ventricular (LV) cardiac strain and twist mechanics are equivocal, and no meta-analysis has been conducted to date.

Objective

The objective of this systematic review and meta-analysis was to review the literature pertaining to the effect of different forms of athletic training on cardiac strain and twist mechanics and determine the influence of traditional and contemporary sporting classifications on cardiac strain and twist mechanics.

Methods

We searched PubMed/MEDLINE, Web of Science, and ScienceDirect for controlled studies of aged-matched male participants aged 18–45 years that used two-dimensional (2D) speckle tracking with a defined athlete sporting discipline and a control group not engaged in training programs. Data were extracted independently by two reviewers. Random-effects meta-analyses, subgroup analyses, and meta-regressions were conducted.

Results

Our review included 13 studies with 945 participants (controls n = 355; athletes n = 590). Meta-analyses showed no athlete–control differences in LV strain or twist mechanics. However, moderator analyses showed greater LV twist in high-static low-dynamic athletes (d = –0.76, 95% confidence interval [CI] –1.32 to –0.20; p < 0.01) than in controls. Peak untwisting velocity (PUV) was greater in high-static low-dynamic athletes (d = –0.43, 95% CI –0.84 to –0.03; p < 0.05) but less than controls in high-static high-dynamic athletes (d = 0.79, 95% CI 0.002–1.58; p = 0.05). Elite endurance athletes had significantly less twist and apical rotation than controls (d = 0.68, 95% CI 0.19–1.16, p < 0.01; d = 0.64, 95% CI 0.27–1.00, p = 0.001, respectively) but no differences in basal rotation. Meta-regressions showed LV mass index was positively associated with global longitudinal (b = 0.01, 95% CI 0.002–0.02; p < 0.05), whereas systolic blood pressure was negatively associated with PUV (b = –0.06, 95% CI –0.13 to –0.001; p = 0.05).

Conclusion

Echocardiographic 2D speckle tracking can identify subtle physiological differences in adaptations to cardiac strain and twist mechanics between athletes and healthy controls. Differences in speckle tracking echocardiography-derived parameters can be identified using suitable sporting categorizations.



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Assessing contamination of microalgal astaxanthin producer Haematococcus cultures with high-resolution melting curve analysis

Abstract

Due to its superior antioxidant capabilities and higher activity than other carotenoids, astaxanthin is used widely in the nutraceutical and medicine industries. The most prolific natural producer of astaxanthin is the unicellular green microalga Haematococcus pluvialis. The correct identification of any contaminants in H. pluvialis cultures is both essential and nontrivial for several reasons. Firstly, while it is possible to distinguish the main microalgal contaminant Coelastrella sp. (in H. pluvialis cultures), in practice, it is frequently a daunting and error-prone task for personnel without extensive experience in the microscopic identification of algal species. Secondly, the undetected contaminants may decrease or stop production of astaxanthin. Lastly, the presence of other contaminants such as fungi can eventually infect and destroy the whole algae collection. In this study, high-resolution melting (HRM) analysis was developed to detect microalgal and fungal contamination. The developed diagnostic procedure allowed to distinguish pure H. pluvialis samples from cultures contaminated with low amounts (1.25 ng/ml) of microalgal DNA and fungal DNA (2.5 ng/ml). Such discrimination is not possible with the use of microscopy observations and allows fast and efficient collection testing.



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Corrigendum to “Brain and cognitive functions in two groups of naïve HIV patients selected for a different plan of antiretroviral therapy: A qEEG study” [Clin. Neurophysiol. 127 (2016) 3455–3469]

The authors regret that the full address details for Professor Limatola did not appear in the published article. The updated address has been included as affiliation "g".

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Ability of Lactobacillus kefiri LKF01 (DSM32079) to colonize the intestinal environment and modify the gut microbiota composition of healthy individuals

Probiotics have been observed to positively influence the host's health, but to date few data about the ability of probiotics to modify the gut microbiota composition exist.

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Borderline resectable pancreatic cancer: more than an anatomical concept

Borderline resectable pancreatic cancer (BRPC) accounts for about 10-15% of newly diagnosed pancreatic cancer, and its management requires a skilled multidisciplinary team. The main definition of BRPC refers to resectability, but also a high risk of positive surgical margins and recurrence. This raises questions about the value of surgery and suggests an opportunity to utilize preoperative treatment in this subset of patients.Besides technical borderline resectable disease which is defined on anatomical and radiological criteria, there is also a biological borderline resectable disease which is defined on clinical and biological prognostic factors.

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Reactivation of hepatitis B virus in cancer patients treated with chemotherapy for solid tumors. Is the prophylaxis really required?

Reactivation of hepatitis B virus during cancer chemotherapy for non-hematological tumors is not fully clear.

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Ability of Lactobacillus kefiri LKF01 (DSM32079) to colonize the intestinal environment and modify the gut microbiota composition of healthy individuals

Probiotics have been observed to positively influence the host's health, but to date few data about the ability of probiotics to modify the gut microbiota composition exist.

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Borderline resectable pancreatic cancer: more than an anatomical concept

Borderline resectable pancreatic cancer (BRPC) accounts for about 10-15% of newly diagnosed pancreatic cancer, and its management requires a skilled multidisciplinary team. The main definition of BRPC refers to resectability, but also a high risk of positive surgical margins and recurrence. This raises questions about the value of surgery and suggests an opportunity to utilize preoperative treatment in this subset of patients.Besides technical borderline resectable disease which is defined on anatomical and radiological criteria, there is also a biological borderline resectable disease which is defined on clinical and biological prognostic factors.

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Reactivation of hepatitis B virus in cancer patients treated with chemotherapy for solid tumors. Is the prophylaxis really required?

Reactivation of hepatitis B virus during cancer chemotherapy for non-hematological tumors is not fully clear.

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Standing on the shoulders of giants



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Corner fracture type spondylometaphyseal dysplasia: Overlap with type II collagenopathies

Spondylometaphyseal dysplasia (SMD) corner fracture type (also known as SMD "Sutcliffe" type, MIM 184255) is a rare skeletal dysplasia that presents with mild to moderate short stature, developmental coxa vara, mild platyspondyly, corner fracture-like lesions, and metaphyseal abnormalities with sparing of the epiphyses. The molecular basis for this disorder has yet to be clarified. We describe two patients with SMD corner fracture type and heterozygous pathogenic variants in COL2A1. These two cases together with a third case of SMD corner fracture type with a heterozygous COL2A1 pathogenic variant previously described suggest that this disorder overlaps with type II collagenopathies. The finding of one of the pathogenic variants in a previously reported case of spondyloepimetaphyseal dysplasia (SEMD) Strudwick type and the significant clinical similarity suggest an overlap between SMD corner fracture and SEMD Strudwick types. © 2016 Wiley Periodicals, Inc.



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Catastrophic Cellular Events Leading to Complex Chromosomal Rearrangements in the Germline

Abstract

Although complex chromosomal rearrangements were thought to reflect the accumulation of DNA damage over time, recent studies have shown that such rearrangements frequently arise from "all-at-once" catastrophic cellular events. These events, designated chromothripsis, chromoanasynthesis, and chromoanagenesis, were first documented in the cancer genome and subsequently observed in the germline. These events likely result from micronucleus-mediated chromosomal shattering and subsequent random reassembly of DNA fragments, although several other mechanisms have also been proposed. Typically, only one or a few chromosomes of paternal origin are affected per event. These events can produce intrachromosomal deletions, duplications, inversions, and translocations, as well as interchromosomal translocations. Germline complex rearrangements of autosomes often result in developmental delay and dysmorphic features, whereas X chromosomal rearrangements are usually associated with relatively mild clinical manifestations. The concept of these catastrophic events provides novel insights into the etiology of human genomic disorders. This review introduces the molecular characteristics and phenotypic outcomes of catastrophic cellular events in the germline.

Thumbnail image of graphical abstract

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Geographical and ethnic distribution of MTHFR gene polymorphisms and their associations with diseases among Chinese population

Abstract

Numerous studies have investigated the distribution of methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms and their associations with diseases in China. In this study we conducted a systematic review and meta-analysis of these studies (715 eligible studies in total).Results revealed that the frequencies of the MTHFR C677T and A1298C polymorphisms varied markedly in different areas and ethnicities, and even showed geographical gradients. The MTHFR C677T polymorphism was significantly associated with 42 clinical disorders (P<0.05), mostly relating to the diseases of circulatory system, birth defects, and cancers. The association of the A1298C polymorphism with 3 diseases (coronary heart disease, breast cancer, and neural tube defects fathers) was statistically significant (P<0.05)However, according to the Venice criteria, only the associations of the C677T polymorphism with breast and ovarian cancers were assessed as having strong epidemiological credibility. This is the first study to provide a comprehensive assessment ofthe current status and gaps in genetic epidemiological study of the two polymorphisms in China, and its findings may be useful for medical and public health practices. Future studies are warranted to focus on the interactions of MTHFR genes with environmental exposure and with other genes, and to improve their methodological quality and reporting of findings.

Thumbnail image of graphical abstract

Graphical Abstract



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