Interleukin-1 system gene polymorphisms are associated with fat mass in young men

CONTEXT: There is growing evidence for interactions between the regulation of body fat and the immune system. Studies of knockout mice indicate that IL-1 has an antiobesity effect. OBJECTIVE: The objective of the study was to investigate our hypothesis that common polymorphisms of the IL-1 system, which are associated with IL-1 activity, also are associated with fat mass. DESIGN, SETTING, AND STUDY SUBJECTS: The Gothenburg Osteoporosis and Obesity Determinants (GOOD) study is a population-based cross-sectional study of 18- to 20-yr-old men (n = 1068), mostly Caucasian, from the Gothenburg area (Sweden). Three different polymorphisms, IL-1beta +3953 C/T, IL-1beta-31 T/C, and IL-1 receptor antagonist (IL-1RN) variable number tandem repeat of 86 bp, were investigated in relation to body fat mass. MAIN OUTCOME MEASURE: The main outcome measures were genotype distributions and their association with body fat mass in different compartments, measured with dual-energy x-ray absorptiometry. RESULTS: Carriers of the T variant (CT and TT) of the +3953 C to T (F(T) = 0.25) IL-1beta gene polymorphism had significantly lower total fat mass (P = 0.013) and also significantly reduced arm, leg, and trunk fat, compared with CC individuals. IL-1RN*2 carriers with two repeats of the IL-1RN variable number tandem repeat polymorphism had increased total fat (P = 0.036), serum leptin, and fat of trunk and arm as well as serum levels of IL-1RN and IL-1RN production ex vivo. The IL-1beta-31 polymorphism did not correlate with the fat measurements. CONCLUSIONS: The IL-1 system, recently shown to affect fat mass in experimental animals, contains gene polymorphisms that are associated with fat mass in young men.     

Mothers' experiences of having their newborn child in a neonatal intensive care unit

BACKGROUND: From birth the child has an ability to respond to the environment, which influences the interaction between mother and child. If this attachment is interrupted, the child's emotional development is negatively influenced. When the child needs care in a neonatal intensive care unit (NICU) it is difficult to establish contacts between mother and child. Separation from the child is found to be the most difficult aspect for mothers when their newborn child is hospitalized in a NICU. AIM: The aim of this study was to describe mothers' experiences when their full-term newborn child was cared for in a NICU during the postpartum maternity care period. METHOD: A phenomenological hermeneutic interview study was performed. Ten mothers were interviewed once, 6 months to 6 years after the experience. RESULTS: The essence of the experience is understood as an alternation between two opposite concepts, exclusion and participation, with emphasis on exclusion. A feeling of exclusion dominates when the new mother feels a lack of interaction and a sense of not belonging to either the maternity care unit or the NICU. This has a negative effect on her maternal feelings. On the contrary, when a feeling of participation dominates, a continuous dialogue exists and the mother is cared for as a unique person with unique needs. This supports her maternal feelings in a positive direction. The implication of the result for nurses is that it is important to decrease mothers' experience of exclusion and to increase their feeling of participation when their child is cared for in a NICU. A return visit to the responsible nurse to go through the treatment and experiences should be offered to all parents whose child has been cared for in a NICU.     

Subcutaneous sumatriptan provides symptomatic relief at any pain intensity or time during the migraine attack

Over the years the paradigm of treating early during the migraine attack has become well established in clinical practice. It is also recommended that the 5-HT(1B/1D) agonists be administered early during the migraine attack for efficacy. This is because it has been proposed that most migraineurs are less responsive to delayed treatment, owing to the development of central sensitization of the pain transmission. The main objective of this prospective, cross-over study at a specialist clinic was to evaluate if these recommendations should also apply to the subcutaneous formulation of sumatriptan. Results are based on 20 adult International Headache Society migraineurs. Two attacks (n=40) were treated with 6 mg subcutaneous sumatriptan as early as possible after the onset of migraine headache and two attacks (n=40) as late as the patients could bear. The median intra-individual difference between the two strategies in time from first occurrence of pain to injection was 5.7 h and the median intra-individual difference in pain intensity at the time of injection was 29 visual analogue units. No significant differences were found in time to freedom from pain, pain severity at 1 and 2 h, area under the curves from injection to pain free or in headache recurrence after injection. At the end of the study, most of the patients claimed that their medication was as effective when given early as when given late in the course of the attack. The discrepancy between our present findings and retrospective analyses of trials on oral triptans probably has more to do with the less disturbed pharmacokinetics early during the migraine attack than with central sensitization. Consequently, we recommend nonoral formulations of triptans, which do not necessarily have to be administered early during the migraine attack to provide efficacy. In conclusion, it is reassuring for migraineurs that it is worthwhile taking their medication in an appropriate formulation even if they have not been able to do so early in the course of the attack.     

Chronic tension-type headache treated with acupuncture, physical training and relaxation training. Between-group differences

The aim of this study was to compare acupuncture, relaxation training and physical training in the treatment of chronic tension-type headache (CTTH). The study comprised 90 consecutive patients with CTTH who were randomly allocated to acupuncture, relaxation training or physical training. Headache intensity, headache-free days and headache-free periods were registered using a visual analogue scale and a headache diary. The measurements were made 4 weeks before, immediately after, and 3 and 6 months after the treatment period. Immediately after the last treatment, the number of headache-free periods and of headache-free days was higher in the relaxation group compared with the acupuncture group. There were no other significant differences between the groups at any time point. The clinical implications of our findings are that relaxation training induced the most pronounced effects directly after the treatment period, compared with acupuncture and physical training.     

Secular trends of dental status in five 70-year-old cohorts between 1971 and 2001

Abstract – Objective: The aims of this study, which are part of the gerontological and geriatric population studies in Göteborg, Sweden (H70), were to describe cohort differences and trends in dental status and utilization of dental care in 70‐year‐olds. The study is based on five cohorts examined in 1971/72, 1976/77, 1981/82, 1992/93 and 2000/01 (called cohort I, II, III, V and VI, respectively). The total number of participants was 2290 and varied between 386 and 583 in the different cohorts. The proportion of dentate 70‐year‐olds changed gradually from 49% in the first to 93% in the last cohort. The mean number of teeth in the dentate 70‐year‐olds was 14 in cohort I and 21 in cohort VI. The proportion of subjects with 20 or more teeth changed from 13% in cohort I, to 20% in cohort III, and to 65% in cohort VI. In cohort I, 76% of the 70‐year‐olds had some kind of removable denture; 37% in cohort III, but only 17% in cohort VI. About 20% of all 70‐year‐olds in cohort I reported regular yearly visits to a dentist. The corresponding figures in cohort III and cohort VI were 50% and 80%, respectively. Even though positive cohort trends were observed in all studied subgroups, factors such as low education, smoking, being un‐married, having high waist circumference and being physically inactive were negatively associated with dental status at the end of the study period as well as at the beginning.     

Full-mouth ultrasonic debridement and risk of disease recurrence: a 1-year follow-up

AIM: To evaluate the incidence of disease recurrence following a full-mouth pocket/root debridement approach with ultrasonic instrumentation versus that following a traditional approach of quadrant-wise scaling and root planing (Q-SRP) performed with hand instrumentation. METHODS: Thirty-seven patients were re-examined 1 year after the completion of a 6-month clinical trial comparing two different treatment protocols: a 1-h session of full-mouth ultrasonic debridement (UD--19 patients) or four sessions of Q-SRP with hand instruments (Q-SRP--18 patients). At 3 months, re-instrumentation was performed of pockets showing a remaining probing pocket depth (PPD) of > or =5 mm using the same type of instruments as used during the initial treatment phase. The clinical examinations comprised assessments of plaque, bleeding on probing (BoP) and PPD. The primary outcome variable was the incidence of recurrent diseased sites (i.e., sites showing PPD > or =5 mm and BoP+) between the post-treatment and 1-year follow-up examinations. All sites that were healed (PPD < or =4 mm and BoP(-)) at the post-treatment examination were included in the study sample, with a mean number of sites per patient of 23.5. RESULTS: In the UD group, 29 (7%) out of 430 initially healed sites showed disease recurrence at the 1-year follow-up examination compared with 47 (11%) of 440 sites in the Q-SRP group (p>0.05). Twelve patients (63%) in the UD group presented recurrent diseased pockets, compared with 14 patients (78%) in the Q-SRP group. Two or more recurrent, diseased pockets were observed in nine patients in the UD group versus 11 in the Q-SRP group. All but one of the smokers belonged to the group of patients presenting recurrences. A tendency towards a higher mean plaque score was observed for the patients with recurrent sites. CONCLUSION: The study revealed no significant difference in the incidence of recurrence of diseased periodontal pockets between the full-mouth UD approach and the traditional approach of Q-SRP.     

Periodontal conditions in a Swedish city population of adolescents: a cross-sectional study

The aim of this epidemiological survey was to analyze the periodontal conditions of 19-year old individuals in an urban area of Sweden, with special reference to gender and socioeconomic factors. A randomized sample of 272 individuals living in G?teborg, Sweden, was clinically examined with regard to oral hygiene, gingivitis, periodontal pockets, probing attachment loss (PAL) and gingival recession. Bitewing radiographs were used for assessments of alveolar bone level (ABL) and dental calculus. A questionnaire-based interview regarding oral hygiene habits was included. Data were analyzed with regard to differences between gender and socioeconomic grouping. The subjects showed a mean plaque score of 59% and a gingivitis score of 44%. 70% of the adolescents had a plaque score of > or = 50%, whereas corresponding figure for gingivitis was 37%. 27% of the subjects had at least one tooth with gingival recession. The mean prevalence of sites with probing depth of > or = 6 mm was 0.5, and the prevalence of PAL > or = 2 mm was 0.7. A radiographic bone level of > or = 2 mm was observed at on average 0.8 teeth per subject. Females had significantly less plaque and gingivitis than males and significantly higher number of teeth with gingival recession. There were no clinically significant differences in periodontal conditions between socioeconomic groups. In conclusion,the survey revealed higher prevalence of plaque and gingivitis among male than female adolescents but no differences between socioeconomic groups.     

Molecular characterization of Haemophilus ducreyi isolates from different geographical locations

The technique of random amplified polymorphic DNA (RAPD) was adapted and optimized to study Haemophilus ducreyi isolates. A panel of 43 strains isolated from chancroid patients from different countries in Africa, Europe, North America, and Asia were characterized. The strains were also studied with respect to lipooligosaccharide (LOS) migration and immunoblotting patterns and the presence of cytolethal distending toxin genes. The RAPD method with the OPJ20 primer generated nine banding patterns (1 to 9). The majority of the isolates were clustered into two major profiles, 14 and 13 strains into profiles 1 and 2, respectively, and just a few strains revealed patterns 3 and 4. The isolates from Thailand were exceptional in that they showed greater diversity and were represented by six different RAPD patterns, i.e., patterns 3 and 5 to 9. The LOS migration and immunoblotting analyses revealed two different patterns, which indicated long and short forms of LOS; the former was found in 20/23 tested strains. Two strains that expressed the short form of LOS were grouped into RAPD pattern 4. The absence of cdtABC genes was observed in only 4/23 strains, and three of these isolates were assigned to RAPD pattern 4. Our results showed limited genotypic and phenotypic variations among H. ducreyi strains, as supported by the conserved RAPD and LOS profiles shared by the majority of the studied strains. However, the RAPD method identified differences between strains, including those from different geographic areas, which indicate the potential of RAPD as an epidemiological tool for the typing of H. ducreyi isolates in countries where chancroid is endemic.     

An intravital microscopy method permitting continuous long-term observations of ovulation in vivo in the rabbit

BACKGROUND: A method for intravital microscopy of the rabbit ovary was developed to enable observations of real-time changes during ovulation in vivo. The aim was to correlate these events to biochemical events at specific stages of ovulation. METHODS: Virgin, female rabbits were primed with equine chorionic gonadotrophin (CG) (30-100 IU) then HCG (100 IU) 2 days later to induce ovulation. During anaesthesia, the right ovary was surgically exteriorized and submerged in an organ chamber with a microscopy lens positioned close to the ovary. Continuous video recordings were performed. RESULTS: Initial equine CG priming experiments revealed the highest ovulation rate, without premature luteinization, after 30 IU equine CG. This priming protocol subsequently demonstrated follicular ruptures 11.5-14 h after HCG. Numbers of ovulations from the exteriorized and contralateral non-exteriorized ovary were similar. The sequence of typical features of ovulation was: shutdown of microcirculation in the follicular apex, formation of petechiae in the follicular wall and a cone-shaped structure over the future rupture site, marked bleeding in connection with follicular rupture and a fairly steady extrusion velocity of granulosa cells and the oocyte. CONCLUSION: This method captured a sequence of structural changes during ovulation. It could be combined with blood and follicular fluid sampling for biochemical analysis and could be used in studies on biochemical reactions in relation to specific changes in the follicular structure during ovulation.