Salivary Cortisol Lower in Posttraumatic Stress Disorder

Altered cortisol has been demonstrated to be lower in those with posttraumatic stress disorder (PTSD) in most studies. This cross‐sectional study evaluated salivary cortisol at waking and 30 minutes after, and at bedtime in 51 combat veterans with PTSD compared to 20 veterans without PTSD. It also examined the relationship of cortisol to PTSD symptoms using 2 classifications: the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM‐IV; American Psychiatric Association, 1994) and the more recent 4‐factor classification proposed for DSM‐5. The PTSD group had lower cortisol values than the control group, F(6, 69) = 3.35, p = .006. This significance did not change when adding age, body mass index, smoking, medications affecting cortisol, awakening time, sleep duration, season, depression, perceived stress, service era, combat exposure, and lifetime trauma to the model. Post hoc analyses revealed that the PTSD group had lower area‐under‐the‐curve ground and waking, 30 min, and bedtime values; the cortisol awakening response and area‐under‐the‐curve increase were not different between groups. The 4‐factor avoidance PTSD symptom cluster was associated with cortisol, but not the other symptom clusters. This study supports the finding that cortisol is lower in people with PTSD.     

Brucella glomerulonephritis resulting in end-stage renal disease: a case report and a brief review of the literature

Brucella glomerulonephritis is a rare condition with only a few reported cases. We review the literature, and describe a 24-year-old female who presented with edema and proteinuria. Blood grew Brucella melitensis. Renal biopsy showed diffuse proliferative glomerulonephritis. The patient progressed to end-stage renal disease despite antibiotic and steroid therapy.     

Public Discourse Against Masks in the COVID-19 Era: Infodemiology Study of Twitter Data

BackgroundDespite scientific evidence supporting the importance of wearing masks to curtail the spread of COVID-19, wearing masks has stirred up a significant debate particularly on social media.ObjectiveThis study aimed to investigate the topics associated with the public discourse against wearing masks in the United States. We also studied the relationship between the anti-mask discourse on social media and the number of new COVID-19 cases.MethodsWe collected a total of 51,170 English tweets between January 1, 2020, and October 27, 2020, by searching for hashtags against wearing masks. We used machine learning techniques to analyze the data collected. We investigated the relationship between the volume of tweets against mask-wearing and the daily volume of new COVID-19 cases using a Pearson correlation analysis between the two-time series.ResultsThe results and analysis showed that social media could help identify important insights related to wearing masks. The results of topic mining identified 10 categories or themes of user concerns dominated by (1) constitutional rights and freedom of choice; (2) conspiracy theory, population control, and big pharma; and (3) fake news, fake numbers, and fake pandemic. Altogether, these three categories represent almost 65% of the volume of tweets against wearing masks. The relationship between the volume of tweets against wearing masks and newly reported COVID-19 cases depicted a strong correlation wherein the rise in the volume of negative tweets led the rise in the number of new cases by 9 days.ConclusionsThese findings demonstrated the potential of mining social media for understanding the public discourse about public health issues such as wearing masks during the COVID-19 pandemic. The results emphasized the relationship between the discourse on social media and the potential impact on real events such as changing the course of the pandemic. Policy makers are advised to proactively address public perception and work on shaping this perception through raising awareness, debunking negative sentiments, and prioritizing early policy intervention toward the most prevalent topics.     

Nephelometric urinary protein profile as an index of renal involvement in hypertensive disorders of pregnancy

Protein analysis was performed on the urine of 62 pregnant women with the use of a nephelometric technique. Thirty-seven women were classified as having mild or severe pregnancy-induced hypertension and/or chronic hypertension. The protein analysis was performed on urine samples obtained prior to delivery and was compared to the degree of proteinuria as determined by the dipstick technique. The degree of immunoglobulinuria increases with increasing severity of pregnancy-induced hypertension while the urine concentration of albumin and transferrin becomes nondetectable. The urinary protein profile appears to be extremely sensitive and accurate in predicting severity of disease.     

Intra-amniotic bacterial colonization in premature labor

Bacterial culturing was performed on amniotic fluid obtained by transabdominal amniocentesis from 33 patients with singleton pregnancies who were in idiopathic premature labor with intact membranes prior to the thirty-fifth week of gestation. Bacteria were isolated in seven patients (21.2%). The patients who were at highest risk for intra-amniotic colonization were those who had two or more clinical parameters suspicious for intra-amniotic infection in a pregnancy prior to the thirtieth week. Anaerobic bacteria were isolated from all seven patients. Only one patient had mixed aerotolerance isolates. Anaerobic that were classified as significant pathogens were isolated in four patients. Three patients had isolates that grew on primary plates, and the rest were recovered only from broth. The greatest impact of intra-amniotic bacterial colonization in premature labor with intact membranes on perinatal outcome is expressed in extreme prematurity and appears to be a function of the pathogenicity and concentration of the offending organism(s).     

Nutritional Therapy in Very Early-Onset Inflammatory Bowel Disease: A Case Report

Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract caused by a dysregulated immune response to the fecal microbiota. Very early-onset inflammatory bowel disease (VEO-IBD) refers to a subgroup of pediatric patients with IBD diagnosed before 6 years of age. This subgroup is often characterized by increased severity, aggressive progression, strong family history of IBD, and often poor response to conventional treatments. Nutritional therapies have been utilized to treat IBD, but their role in VEO-IBD is unclear. Disease behavior in VEO-IBD is often different from disease in adolescents and adults, as it is often restricted to the colon and refractory to standard medical therapies. Up to 25% of VEO-IBD patients have an identified underlying immunodeficiency, which may impact response to therapy. While specific mutations in interleukin 10 (IL-10), the IL-10 receptor (IL-10R), and mutations in NCF2, XIAP, LRBA, and TTC7 have been identified in VEO-IBD, polymorphisms in these genes are also associated with increased risk of developing IBD in adolescence or adulthood. We describe two cases in which infants presenting with VEO-IBD achieved clinical remission using exclusive enteral nutrition, a formula-based diet which has been shown to induce remission in older children with active Crohn’s disease.

     

Prospects for the prenatal diagnosis and obstetric management of cloacal exstrophy. A report of two cases

Two cases of cloacal exstrophy, a rare congenital anomaly featuring exstrophy of the urinary, genital and intestinal systems, occurred. Possibilities for the prenatal diagnosis of such structural anomalies are alpha-fetoprotein screening, ultrasonography and fetal heart rate and activity patterns. Careful preoperative evaluation of affected neonates and staging of the surgical correction are recommended.