Lutein levels in arterial cord blood correlate with neuroprotein activin A in healthy preterm and term newborns: A trophic role for lutein?

BackgroundLutein (LT) is a naturally occurring xanthophyll carotenoid most predominant in the central nervous system (CNS), but its neurotrophic role is still debated. We therefore investigated whether cord blood concentrations correlated with a well-established neurobiomarker, namely activin A.MethodsWe conducted a prospective study on the distribution of LT and activin A in arterial cord blood of healthy preterm (n = 50) and term (n = 82) newborns according to weeks of gestational age (wGA) and gender.ResultsLT and activin A showed a pattern of concentration characterized by higher levels (P < 0.01, for all) at 33–36 wGA followed by a progressive decrease (P < 0.01, for all) from 37 onwards with a dip at term. Both LT and activin A were gender-dependent with significantly (P < 0.01, for all) higher levels in all recruited females and after sub-grouping for preterm and term births. LT (R = 0.33; P < 0.001) correlated with wGA at sampling. There were significant positive correlations between lutein and activin A in male (R = 0.93; P < 0.001) and female (R = 0.89; P < 0.001) groups.ConclusionsThe present data showing a correlation between LT and activin A support the notion of a neurotrophic role gender-dependent for LT and open the way to further investigations correlating LT with well-established biochemical markers of CNS development/damage.     

Urine 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG), a specific marker of oxidative stress,using direct,isocratic LC–MS/MS: Method evaluation and application in study of biological variation in healthy adults

BackgroundUrine 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) is a specific biomarker of oxidative stress. We evaluated a modified LC–MS/MS assay for urine 8-oxodG and determined biological variation in healthy adults.MethodUntreated urine was injected into an isocratic LC–MS/MS system (positive-ion MRM mode). Urine 8-oxodG in 51 healthy volunteers was measured; within- and between-day variations in 23 healthy volunteers were investigated.ResultsDose–response was linear to 452 nmol/l; limit of detection = 2.3 nmol/l; within-run and between-run CVs were < 3.0% and < 4.7%, respectively; recovery = 97%–101%; accuracy = 97.7–103.5%. Urine 8-oxodG (median, mean [SD]): 1.70, 1.70[0.60]nmol/mmol creatinine (n = 51). Men had higher (p = 0.027) concentrations than women matched for age and body mass index: mean [SD]: 1.90[1.60]; n = 26 vs. 1.50[0.55]; n = 25. Within- and between-day variations were wide but random. No significant differences were seen overall across time-points within 1 day or at the same time-point across 5 consecutive days.ConclusionsThe method has advantages of speed and relative simplicity as it does not require sample pre-treatment for 8-oxodG extraction, the use of internal standard or gradient LC elution and has high linearity, specificity, precision and recovery. Biological variation in urine 8-oxodG is wide, but no within- or between-day differences at the group concentration were seen in healthy adults.     

Common genetic polymorphisms in pre-microRNAs were associated with increased risk of dilated cardiomyopathy

BackgroundCommon single nucleotide polymorphisms (SNPs) in pre-microRNAs may change their property through altering microRNAs (miRNAs) expression and/or maturation, resulting diverse functional consequences. We conducted a pilot study to test whether SNPs in pre-microRNAs were associated with dilated cardiomyopathy (DCM).MethodsGenotypes of 3 SNPs in pre-miRNAs (has-mir-196a2 rs11614913 C/T, hsa-mir-499 rs3746444 A/G, hsa-mir-146a rs2910164 C/G) in 221 DCM patients and 321 control subjects were determined with the use of PCR-restriction fragment length polymorphism (RFLP) assay.ResultsSignificantly increased DCM risks were found to be associated with variant allele of has-mir-196a2 rs11614913 C/T (T allele) and hsa-mir-499 rs3746444 A/G (G allele) (P < 0.0001, OR = 1.730, 95% CI = 1.345–2.227, and P < 0.0001, OR = 1.794, 95% CI = 1.350–2.385, respectively). We found that increased DCM risk was statistically significantly associated with these 2 SNPs in a dominant model (P = 0.0001 and P < 0.0001 for rs11614913 and rs3746444, respectively). No association between DCM risk and hsa-mir-146a rs2910164 C/G was observed (P = 0.451, OR = 1.102, 95% CI = 0.856–1.418).ConclusionsBoth the has-mir-196a2 rs11614913 C/T and hsa-mir-499 rs3746444 A/G, but not hsa-mir-146a rs2910164 C/G, are associated with a significantly increased risk of DCM, indicating that common genetic polymorphisms in pre-microRNAs are associated with DCM.     

Measuring and improving cardiopulmonary resuscitation quality inside the emergency department

Aim of studyTo evaluate CPR quality during cardiac resuscitation attempts in an urban emergency department (ED) and determine the influence of the combination of scenario-based training, real-time audiovisual feedback (RTAVF), and post-event debriefing on CPR quality.MethodsCPR quality was recorded using an R Series monitor-defibrillator (ZOLL Medical) during the treatment of adult cardiac arrest patients. Phase 1 (P1; 11/01/2010-11/15/2012) was an observation period of CPR quality. Phase 2 (P2; 11/15/2012-11/08/2013) was after a 60-min psychomotor skills CPR training and included RTAVF and post-event debriefing.ResultsA total of 52 cardiac arrest patients were treated in P1 (median age 56 yrs, 63.5% male) and 49 in P2 (age 60 yrs, 83.7% male). Chest compression (CC) depth increased from 46.7 ± 3.8 mm in P1 to 61.6 ± 2.8 mm in P2 (p < 0.001), with the percentage of CC ≥ 51 mm increasing from 30.6% in P1 to 87.4% in P2 (p < 0.001). CC release velocity increased from 314 ± 25 mm/s in P1 to 442 ± 20 mm/s in P2 (p < 0.001). No significant differences were identified in CC fraction (84.3% P1 vs. 88.4% P2, p = 0.1), CC rate (125 ± 3 cpm P1 vs. 125 ± 3 cpm P2, p = 0.7), or pre-shock pause (9.7 s P1 vs. 5.9 s P2, p = 0.5), though CC fraction and pre-shock pause were within guideline recommendations.ConclusionImplementation of the bundle of scenario-based training, real-time audiovisual CPR feedback, and post-event debriefing was associated with improved CPR quality and compliance with CPR guidelines in this urban teaching emergency department.     

MUC1 expression and its association with other aetiological factors and localization to mitochondria in preneoplastic and neoplastic gastric tissues

BackgroundThe molecular events that underlie the conversion of normal human gastric epithelium into adenocarcinoma are poorly understood. MUC1 overexpression and localization in mitochondria might confer cancer cells with attenuation of stress induced apoptosis. We studied MUC1 expression pattern, interaction with HSP70 and localization in mitochondria in preneoplastic and neoplastic human gastric tissues.MethodsImmunohistochemistry and Western blot were used to study MUC1 expression pattern and localization in mitochondria. Coimmunoprecipitation was used to study MUC1 interaction with HSP70. MUC1 expression was correlated with other causative features including erbB2 expression.ResultsMUC1 was expressed in 75.8% (147/194). MUC1 overexpression was detected in 50.0% (19/38 cases) dysplasia and 58.2% (32/55 cases) adenocarcinoma tissues. MUC1-CT–HSP70 interaction was seen in 71.66% (43/60 cases) and MUC1 localized to mitochondria in 33.33% (5/15) dysplasia samples and in 47.05% (8/17) adenocarcinoma samples. MUC1 expression showed significant association with smoking (χ² = 5.945; p < 0.015), alcohol consumption (χ² = 4.055; p < 0.044) and erbB2 positivity (χ² = 10.75; p < 0.001). MUC1 expression did not show appreciable association with age (χ² = 0.15; p < 0.698), sex (χ² = 0.22; p < 0.640) or Helicobacter pylori infection (χ² = 3.06; p < 0.080).ConclusionsSignificant correlation was found between MUC1 expression and smoking, alcohol and erbB2 expression. MUC1 showed aberrant expression in dysplasia and adenocarcinoma stages. MUC1 cytosolic tail was bound by HSP70 in all the stages but MUC1-CT was found to localize in mitochondria only in dysplasia and adenocarcinoma. MUC1-CT localization to mitochondria in dysplasia and adenocarcinoma might aid in the attenuation of epithelial stress response induced loss of polarity.     

A 4-arm randomized controlled pilot trial of innovative solutions for jugular central venous access device securement in 221 cardiac surgical patients

PurposeTo improve jugular central venous access device (CVAD) securement, prevent CVAD failure (composite: dislodgement, occlusion, breakage, local or bloodstream infection), and assess subsequent trial feasibility.Materials and MethodsStudy design was a 4-arm, parallel, randomized, controlled, nonblinded, pilot trial. Patients received CVAD securement with (i) suture + bordered polyurethane (suture + BPU; control), (ii) suture + absorbent dressing (suture + AD), (iii) sutureless securement device + simple polyurethane (SSD + SPU), or (iv) tissue adhesive + simple polyurethane (TA + SPU). Midtrial, due to safety, the TA + SPU intervention was replaced with a suture + TA + SPU group.ResultsA total of 221 patients were randomized with 2 postrandomization exclusions. Central venous access device failure was as follows: suture + BPU controls, 2 (4%) of 55 (0.52/1000 hours); suture + AD, 1 (2%) of 56 (0.26/1000 hours, P = .560); SSD + SPU, 4 (7%) of 55 (1.04/1000 hours, P = .417); TA + SPU, 4 (17%) of 23 (2.53/1000 hours, P = .049); and suture + TA + SPU, 0 (0%) of 30 (P = .263; intention-to-treat, log-rank tests). Central venous access device failure was predicted (P < .05) by baseline poor/fair skin integrity (hazard ratio, 9.8; 95% confidence interval, 1.2-79.9) or impaired mental state at CVAD removal (hazard ratio, 14.2; 95% confidence interval, 3.0-68.4).ConclusionsJugular CVAD securement is challenging in postcardiac surgical patients who are coagulopathic and mobilized early. TA + SPU was ineffective for CVAD securement and is not recommended. Suture + TA + SPU appeared promising, with zero CVAD failure observed. Future trials should resolve uncertainty about the comparative effect of suture + TA + SPU, suture + AD, and SSD + SPU vs suture + BPU.     

The myeloperoxidase -463G/A polymorphism and coronary artery disease risk: A meta-analysis of 1938 cases and 1990 controls

ObjectivesGenetic polymorphism of human myeloperoxidase (MPO) -463G/A has been implicated to alter the risk of coronary artery disease (CAD), but the results are controversial. To improve the reliability of the conflicting results, we conducted a meta-analysis of studies relating the MPO -463G/A polymorphism with the risk of CAD.Design and methodsTwo investigators independently searched the MEDLINE, EMBASE and Cochrane Library up to June, 2012. Summary odds ratios (OR) and 95% confidence interval (CI) for the MPO -463G/A polymorphism and CAD risk were calculated, and potential sources of heterogeneity and publication bias were explored. Statistical analysis was performed with the software program of Stata 9.0.Results5 case–control studies were finally identified for analyses, involving 1938 cases with CAD and 1990 controls. We found that the MPO -463G/A polymorphism has no significant association with overall CAD risk (G/G vs A/A: OR = 0.595, 95%CI = 0.298–1.188, P = 0.141; G/G vs G/A + A/A: OR = 0.886, 95%CI = 0.779–1.008, P = 0.066; G/G + G/A vs A/A: OR = 0.611, 95%CI = 0.334–1.119, P = 0.111; OR = 0.886, 95%CI = 0.779–1.008, P = 0.066; G vs A: OR = 0.843, 95%CI = 0.675–1.053, P = 0.133). The heterogeneity test showed that there were significant differences between individual studies in additive, recessive and allelic genetic models (P = 0.008, P = 0.021, P = 0.019, respectively); further analyses revealed that age and sex possibly account for the heterogeneity.ConclusionsOur meta-analysis demonstrated the evidence that there was no significant association between the MPO -463G/A polymorphism and the risk of CAD; larger and well-designed multicenter studies are needed to confirm our results.     

Association of genetic variations in aromatase gene with serum estrogen and estrogen/testosterone ratio in Chinese elderly men

BackgroundSingle nucleotide polymorphism (SNP) rs2470152 of the gene CYP19A1 is associated with serum estradiol (E2) levels in Caucasian men. However, it remains to be verified if rs2470152 is the sole determinant accounting for the association. We determined whether 2 CYP19A1 SNPs tagging different haploblocks (rs2470152 and rs2899470) are associated with sex steroid levels in Chinese men.MethodSerum sex steroid level including E2, estrone (E1) and testosterone (T), of 1402 Chinese men aged ≥ 65 years were analyzed. Genotyping of the two CYP19A1 SNPs was performed using T_m-shift allele-specific PCR.ResultsSNP rs2899470 was significantly associated with serum E2, E1 levels and E2/T ratio (p < 0.001). However, SNP rs2470152 was only modestly associated with E2/T ratio (p = 0.023). Analysis of haplotype showed a significant association between C-G, T-T haplotype with serum E2/T ratio (p = 0.019 and p = 1 × 10^? 5, respectively). Similarly, E2 levels was also associated the T-T and T-G haplotypes (p = 1 × 10^? 5).ConclusionThe genetic variation of CYP19A1 was associated with circulating estrogen levels in Chinese elderly men. In addition, it revealed that haplotype of rs2899470 and rs2470152, rather than rs2899470 alone, was a better indicator for the serum E2/T ratio and E2 levels.     

Quantitative relationship between end-tidal carbon dioxide and CPR quality during both in-hospital and out-of-hospital cardiac arrest

ObjectiveCardiopulmonary resuscitation (CPR) guidelines recommend the administration of chest compressions (CC) at a standardized rate and depth without guidance from patient physiologic output. The relationship between CC performance and actual CPR-generated blood flow is poorly understood, limiting the ability to define “optimal” CPR delivery. End-tidal carbon dioxide (ETCO₂) has been proposed as a surrogate measure of blood flow during CPR, and has been suggested as a tool to guide CPR despite a paucity of clinical data. We sought to quantify the relationship between ETCO₂ and CPR characteristics during clinical resuscitation care.MethodsMulticenter cohort study of 583 in- and out-of-hospital cardiac arrests with time-synchronized ETCO₂ and CPR performance data captured between 4/2006 and 5/2013. ETCO₂, ventilation rate, CC rate and depth were averaged over 15-s epochs. A total of 29,028 epochs were processed for analysis using mixed-effects regression techniques.ResultsCC depth was a significant predictor of increased ETCO₂. For every 10 mm increase in depth, ETCO₂ was elevated by 1.4 mmHg (p < .001). For every 10 breaths/min increase in ventilation rate, ETCO₂ was lowered by 3.0 mmHg (p < .001). CC rate was not a predictor of ETCO₂ over the dynamic range of actual CC delivery. Case-averaged ETCO₂ values in patients with return of spontaneous circulation were higher compared to those who did not have a pulse restored (34.5 ± 4.5 vs 23.1 ± 12.9 mmHg, p < .001).ConclusionsETCO₂ values generated during CPR were statistically associated with CC depth and ventilation rate. Further studies are needed to assess ETCO₂ as a potential tool to guide care.     

Up-regulated Golgi phosphoprotein 2 (GOLPH2) expression in lung adenocarcinoma tissue

ObjectivesThe aim of the study was to evaluate Golgi Phosphoprotein 2 (GOLPH2) expression in lung cancer.Design and methodsGOLPH2 expression was analyzed from 178 lung cancer tumor tissue samples using immunohistochemistry. Levels of 133 lung cancer patients' serum GOLPH2 (sGOLPH2) were also quantitatively compared with 70 healthy individuals by a sandwich enzyme-linked immunosorbent assay (ELISA).ResultsAll adenocarcinoma (ADC) tissue samples (100%) displayed strong staining, 83.6% of which displayed cytoplasmic diffused staining. However, for squamous cell carcinoma samples, only 16.3% displayed strong staining intensity. Statistically, GOLPH2 expression in tissues of ADC was significantly higher than in other types of lung cancer (P < 0.001). Levels of sGOLPH2 were also detected. The mean value of sGOLPH2 concentration is 69 ng/ml in lung cancer patients and 53 ng/ml in healthy individuals.ConclusionsSignificantly elevated GOLPH2 expression was observed in ADC tumor tissues. The levels of sGOLPH2 were about 30% higher in lung cancer patients compared with healthy individuals.     

Validating urinary measurement of beta-2-microglobulin with a Roche reagent kit designed for serum measurements

ObjectiveTo validate the use of a Roche serum beta-2-microglobulin (B2MG) kit for urinary B2MG measurements, and to establish reference limits for urinary B2MG/creatinine ratio from healthy individuals.Design and methodsThe Roche B2MG Tina-Quant serum kit was used to measure urinary B2MG immunoturbidimetrically.ResultsUsing human urine as a diluent, the B2MG method was linear from 73–2156 μg/L. The imprecision on a commercially available urine QC was 4.4% at a concentration of 380 μg/L. Limit of quantification at < 20% CV was 40 μg/L. Method comparison with Immulite 2000 (Siemens) yielded slope = 1.180 (95% CI 1.14–1.22), intercept = 11.5 (95% CI ? 3.6–26.6), SEE = 27.6 and r = 0.99 (n = 26) by the Deming regression analysis. The upper reference limit of B2MG/creatinine ratio determined from 195 healthy adults was 29 μg/mmol (97.5th centile).ConclusionsThe serum B2MG Tina Quant reagent kit is acceptable to measure urinary B2MG.     

CYP11B2 gene haplotypes independently and in concurrence with aldosterone and aldosterone to renin ratio increase the risk of hypertension

ObjectivesAldosterone synthase produces aldosterone, which regulates electrolytes and thereby blood pressure. Polymorphisms in aldosterone-synthase gene (CYP11B2) may associate with heterogeneous aldosterone production and hypertension. Hence, we investigated ? 344T/C, Iw/Ic polymorphisms of CYP11B2, plasma renin activity (PRA) and aldosterone concentration (PAC).Design and methodsConsecutive ethnically-matched 450 hypertensive patients and 360 controls were screened by PCR-RFLP for genotypes and haplotypes; PRA and PAC were measured.ResultsThe Iw/Ic polymorphism distribution differed significantly between the two groups (LRT χ² = 15.8, df = 2, P = 0.000). The mutant allele-Ic and genotype-Ic/Ic were overrepresented in patients (35% versus 27% and 13% versus 7%). Overrepresentation of T-Ic haplotype in patients was identified as risk haplotype (P = 0.000). Patients had significantly higher PAC and aldosterone-to-renin ratio (ARR; P  = 0.000), which was Ic-allele dependent.ConclusionsThe haplotype T-Ic associated with hypertension susceptibility. Correlation between Ic-allele and raised ARR likely serve in hypertension management.     

Effects of V279F in the Lp-PLA2 gene on markers of oxidative stress and inflammation in Koreans

BackgroundA single nucleotide polymorphism (SNP), V279F, in the lipoprotein-associated phospholipase A₂ (Lp-PLA₂) gene is known to influence enzyme activity. It is unclear whether Lp-PLA₂ exerts pro- or antiatherogenic effects in humans. We investigated the interplay between V279F, Lp-PLA₂ activity, oxidative stress and inflammation.MethodsWe genotyped 2914 healthy Koreans (43–79 years) for the Lp-PLA₂ V279F and measured anthropometric parameters, lipid profile, fatty acid composition, lipid peroxides, inflammatory markers and Lp-PLA₂ levels.ResultsLp-PLA₂ activity was 24% lower in V/F subjects (n = 641) than in those with the V/V genotype (n = 2227). Enzyme activity was undetectable in F/F subjects. Lp-PLA₂ activity was positively correlated with LDL-cholesterol (r = 0.134, P < 0.001), ox-LDL (r = 0.064, P < 0.01), 8-epi-PGF_2α (r = 0.198, P < 0.001), free fatty acid (r = 0.082, P < 0.001), and fibrinogen (r = 0.112, P < 0.01) levels. Additionally, ox-LDL, 8-epi-PGF_2α, free fatty acid, and fibrinogen levels were positively correlated with hs-CRP. V279F was associated with LDL-cholesterol and arachidonic acid (AA) in serum phospholipid. F/F subjects had lower LDL-cholesterol than V/V subjects (V/V: 120.9 ± 0.69, V/F: 119.4 ± 1.26, F/F: 109.2 ± 4.84 mg/dl, P = 0.025). A significant association between the F/F genotype and increasing AA in serum phospholipids was found in subjects with high LDL-cholesterol (≥ 130 mg/dl) (P = 0.003) but not in those with low LDL-cholesterol (< 130 mg/dl). F/F subjects in the high LDL-cholesterol group had CRP concentrations about three times higher than those with V/V or V/F genotypes (V/V: 1.25 ± 0.09, V/F: 0.97 ± 0.12, F/F: 3.20 ± 0.88 mg/dl, P < 0.001).ConclusionsThe recessive effects of Lp-PLA₂ V279F on LDL-cholesterol and significant correlations between Lp-PLA₂ activity and LDL-cholesterol, 8-epi-PGF_2α and fibrinogen support a pro-oxidative or pro-atherogenic role for this enzyme. Paradoxically, the combination of the complete deficiency of Lp-PLA₂ activity and high LDL-cholesterol enhanced lipid peroxidation and inflammation.     

Increased serum brain-derived neurotrophic factor with high-intensity interval training in stroke patients: A randomized controlled trial

BackgroundPhysiological adaptations of stroke patients after high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) remain unclear.ObjectiveThis study determined the HIIT and MICT effects on aerobic capacity, cerebral oxygenation, peak cardiac output (CO), and serum brain-derived neurotrophic factor (BDNF) in stroke patients.MethodsWe included 23 stroke patients with age about 55 years and stroke duration > 24 months; participants completed 36 sessions of exercise training for 30 min; 13 were randomly assigned to perform MICT at 60% of peak oxygen consumption (VO_2peak) and 10 to perform HIIT at alternating 80% (3 min) and 40% (3 min) VO_2peak. Before and after interventions, we evaluated VO_2peak, peak CO, arteriovenous oxygen difference (AV O_2diff), bilateral frontal cortex oxygenation (relative changes of oxyhemoglobin Δ[O₂Hb], deoxyhemoglobin Δ[HHb], and total hemoglobin Δ[THb] levels), serum brain-derived neurotrophic factor (BDNF) level, and fluorescent cell staining for neuron morphology and percentage of cell-bearing neurites (% neurites).ResultsHIIT induced significant increases in VO_2peak (P = 0.008), CO (P = 0.038), Δ[HHb] (P = 0.046), Δ[THb] (P = 0.046), and serum BDNF level (P = 0.012). The improvement in VO_2peak was significantly greater with HIIT than MICT (20.7% vs. 9.8%, P = 0.031), as was AV O_2diff (P = 0.041), Δ[HHb] (P = 0.027), and serum BDNF level (P < 0.001). HIIT facilitated neuron dendritic protrusions (greater % neurites, P = 0.012) with prominent redistribution of mitochondria.ConclusionAs compared with MICT, HIIT-improved aerobic capacity by increasing systemic tissue O₂ extraction in stroke patients. Increased cerebral O₂ utilization in the involved hemisphere was also identified after HIIT. These physiological adaptations may be associated with increased serum BDNF level. In vitro dendritic growth in neurons treated with serum from HIIT participants may imply significant effects on neuron activities as compared with MICT.ClinicalTrials.gov identifierNCT04135391.     

Intrapartum and postpartum analgesia for women maintained on buprenorphine during pregnancy

ObjectiveTo determine whether buprenorphine maintenance alters intrapartum or postpartum pain or medication requirements.MethodsSixty three patients treated with buprenorphine for opioid dependence during pregnancy (vaginal n = 44; cesarean n = 19) were matched retrospectively to control women. Analgesic medication and pain scores (0–10) were extracted from the medical record. Primary endpoint: opioid utilization postpartum (oxycodone equivalents). Secondary endpoints: pain scores and intrapartum analgesia.ResultsThere were no differences in intrapartum pain or analgesia. Following vaginal birth, buprenorphine maintained women had increased pain (buprenorphine 2.7 (1.7, 4.0); control 2.1 (1.2, 3.0), p = 0.006) but no increase in opioid utilization (buprenorphine: 11.8 ± 24.8; control 5.4 ± 10.4 mg/24 h, p = 0.10); following cesarean delivery both pain (buprenorphine: 5.1 (4.1, 6.1); control: 3.3 (2.5, 4.1), p = 0.009) and opioid utilization (buprenorphine: 89.3 ± 38.0, control: 60.9 ± 13.1 mg/24 h, p = 0.004) were increased.ConclusionBuprenorphine maintained women have similar intrapartum pain and analgesic needs during labor, but experience more postpartum pain and require 47% more opioid analgesic following cesarean delivery.     

Stability of plasma adrenocorticotrophic hormone (ACTH): Influence of hemolysis,rapid chilling,time, and the addition of a maleimide

ObjectivesThe aim of this study was to examine the effects of hemolysis, rapid chilling, time, and the addition of a maleimide on the stability of human plasma ACTH measurements.Design and methodsPartially hemolyzed EDTA blood (n = 10), initially at 37 °C, was centrifuged at 4 °C either immediately or after rapid chilling in ice/water. Plasma ACTH was then measured either immediately, or after 1 h at 22 °C with or without the addition of 2 mM N-phenyl maleimide (NPM).ResultsFor 0.2% hemolysis compared to no hemolysis, the mean (±SEM) loss with immediate centrifugation and immediate ACTH measurement was 11 ± 1%. This loss was significantly (p < 0.002) reduced to 6 ± 1% by an initial rapid chilling of the samples. For analysis after 1 h at 22 °C, the addition of NPM decreased the loss of ACTH from 15 ± 2% to 2 ± 2% (p < 0.002).ConclusionRapid chilling, prompt analysis, and addition of NPM can each reduce the interference of hemolysis in the measurement of plasma ACTH concentrations.     

Receptor for advanced glycation end products (RAGE) and glyoxalase I gene polymorphisms in pathological pregnancy

ObjectivesThe aim of the study was to analyze polymorphisms of receptor for advanced glycation end products (RAGE) gene, and glyoxalase I gene and soluble RAGE, sRAGE, in physiological and pathological pregnancy.Design and methodsPolymorphisms of RAGE gene (? 429 T/C, ? 374 T/A, 557 G/A, 2184 A/G) and glyoxalase I gene (A419C) and sRAGE serum levels were determined in 284 women with pathological and physiological pregnancy.ResultsNo differences in distribution of genotype and allelic frequencies of studied polymorphisms were found. GA genotype of RAGE 557 G/A polymorphism (known as Gly82Ser) is associated with lower sRAGE serum levels in healthy pregnant women compared to GG genotype (483 ± 104 vs. 692 ± 262 pg/mL, p = 0.008). sRAGE correlates negatively with ALT in patients with pregnancy intrahepatic cholestasis (r = ? 0.536, p = 0.05).ConclusionsWe did not show any association of RAGE and glyoxalase I gene polymorphisms with pathological pregnancy, however further studies are needed to confirm the results.     

Predictive value of osteocalcin in bone metastatic differentiated thyroid carcinoma

ObjectivesTo evaluate the diagnostic value of serum osteocalcin in the detection of bone metastases from differentiated thyroid carcinoma (DTC).Design and methodsSerum samples from DTC patients with (DTC BM+, n = 19) or without bone metastases (DTC BM?, n = 19), and matched healthy volunteers (n = 30) were tested for serum osteocalcin with electrochemiluminescent immunoassay.ResultsOsteocalcin was higher in DTC BM+ than in DTC BM? patients (+ 35.8%, p = 0.002), acting as an independent risk factor for bone metastases (R² = 0.142, p = 0.039). The sensitivity was 78.9% and the specificity was 63.2% at a cut-off value of 11.2 μg/L.ConclusionsSerial measurements of osteocalcin could be useful in the detection of bone metastases from DTC.     

Association of haplotypes in the IL8 gene with susceptibility to chronic periodontitis in a Brazilian population

BackgroundInterleukin 8 (IL-8) is a chemokine related to the initiation and amplification of acute and chronic inflammatory processes. Polymorphisms in the IL8 gene have been associated with inflammatory diseases. We investigated whether the ? 845(T/C) and ? 738(T/A) single nucleotide polymorphisms (SNPs) in the IL8 gene, as well as the haplotypes they form together with the previously investigated ? 353(A/T), are associated with susceptibility to chronic periodontitis.MethodsDNA was extracted from buccal epithelial cells of 400 Brazilian individuals (control n = 182, periodontitis n = 218). SNPs were genotyped by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Disease associations were analyzed by the χ² test, Exact Fisher test and Clump program. Haplotypes were reconstructed using the expectation-maximization algorithm and differences in haplotype distribution between the groups were analyzed to estimate genetic susceptibility for chronic periodontitis development.ResultsWhen analyzed individually, no SNPs showed different distributions between the control and chronic periodontitis groups. Although, nonsmokers carrying the TTA/CAT (OR = 2.35, 95% CI = 1.03–5.36) and TAT/CTA (OR = 6.05, 95% CI = 1.32–27.7) haplotypes were genetically susceptible to chronic periodontitis. The TTT/TAA haplotype was associated with protection against the development of periodontitis (for nonsmokers OR = 0.22, 95% CI = 0.10–0.46).ConclusionAlthough none of the investigated SNPs in the IL8 gene was individually associated with periodontitis, some haplotypes showed significant association with susceptibility to, or protection against, chronic periodontitis in a Brazilian population.     

Process evaluation of physical activity counselling with and without the use of mobile technology: A mixed methods study

BackgroundA monitoring-and-feedback tool was developed to stimulate physical activity by giving feedback on physical activity performance to patients and practice nurses. The tool consists of an activity monitor (accelerometer), wirelessly connected to a Smartphone and a web application. Use of this tool is combined with a behaviour change counselling protocol (the Self-management Support Programme) based on the Five A's model (Assess–Advise–Agree–Assist–Arrange).ObjectivesTo examine the reach, implementation and satisfaction with the counselling protocol and the tool.DesignA process evaluation was conducted in two intervention groups of a three-armed cluster randomised controlled trial, in which the counselling protocol was evaluated with (group 1, n = 65) and without (group 2, n = 66) the use of the tool using a mixed methods design.SettingsSixteen family practices in the South of the Netherlands.ParticipantsPractice nurses (n = 20) and their associated physically inactive patients (n = 131), diagnosed with Chronic Obstructive Pulmonary Disease or Type 2 Diabetes, aged between 40 and 70 years old, and having access to a computer with an Internet connection.MethodsSemi structured interviews about the receipt of the intervention were conducted with the nurses and log files were kept regarding the consultations. After the intervention, questionnaires were presented to patients and nurses regarding compliance to and satisfaction with the interventions. Functioning and use of the tool were also evaluated by system and helpdesk logging.ResultsEighty-six percent of patients (group 1: n = 57 and group 2: n = 56) and 90% of nurses (group 1: n = 10 and group 2: n = 9) responded to the questionnaires. The execution of the Self-management Support Programme was adequate; in 83% (group 1: n = 52, group 2: n = 57) of the patients, the number and planning of the consultations were carried out as intended. Eighty-eight percent (n = 50) of the patients in group 1 used the tool until the end of the intervention period. Technical problems occurred in 58% (n = 33). Participants from group 1 were significantly more positive: patients: χ²(2, N = 113) = 11.17, p = 0.004, and nurses: χ²(2, N = 19) = 6.37, p = 0.040. Use of the tool led to greater awareness of the importance of physical activity, more discipline in carrying it out and more enjoyment.ConclusionsThe interventions were adequately executed and received as planned. Patients from both groups appreciated the focus on physical activity and personal attention given by the nurse. The most appreciated aspect of the combined intervention was the tool, although technical problems frequently occurred. Patients with the tool estimated more improvement of physical activity than patients without the tool.