Long-term weight regulation in treated hyperthyroid and hypothyroid subjects

Body weight regulation after treatment was studied in 87 hyperthyroid and 18 hypothyroid subjects. Mean body weight was 83.9 percent of the premorbid weight at the time of initial treatment for hyperthyroidism and 102.5 percent at 96 months following treatment. Mean (+/- SD) post-treatment weight difference from baseline was 3.4 +/- 18.6 pounds at 96 months (n = 44). Early weight gain was greatest in subjects in whom thyroxine values normalized quickly. Hyperthyroid subjects from whom a body mass index could be calculated (n = 45) were divided into two groups. The obese group had a greater mean weight loss (35.2 +/- 15.0 pounds versus 21.2 +/- 9.9 pounds, p less than 0.001) and a lower weight (percent of baseline weight) at the time of treatment for hyperthyroidism (81.6 +/- 7.7 percent versus 86.0 +/- 5.1 percent, p less than 0.05). Subjects with thyroxine levels of 20 micrograms/dl or more had higher premorbid body weights and greater weight loss from baseline than subjects with thyroxine values below 20 micrograms/dl. Hypothyroid subjects showed a small decline in mean body weight over the first six months of treatment but returned to pretreatment weight by 24 months. In the absence of significant metabolic derangement, body weight is regulated within narrow limits over many years. Effective treatment of hyperthyroidism is accompanied by weight gain.     

Cardiovascular risk in systemic lupus erythematosus--evidence of increased oxidative stress and dyslipidaemia

OBJECTIVES: Systemic lupus erythematosus (SLE) is associated with severe and premature cardiovascular disease, which is not explained by traditional risk factors alone. This study aimed to investigate markers of oxidative stress, lipid metabolism and inflammation as potential cardiovascular risk factors in women with SLE. METHODS: Venous blood samples were taken from 53 female Caucasian patients with SLE and from healthy age- and sex-matched controls. Samples were analysed for markers of oxidative stress, lipid metabolism [including low-density lipoprotein (LDL) subfraction profile] and C-reactive protein (CRP). RESULTS: Female SLE patients had an atherogenic lipid profile characterized by raised total cholesterol and triglycerides, and the presence of small, dense LDL subfractions compared with healthy controls. These changes were associated with increased oxidative damage and a moderately raised CRP. CONCLUSIONS: The results provide evidence for free radical and inflammatory activity in SLE and suggest potential targets to reduce the risk of cardiovascular disease in these patients.     

Antiplatelet‐derived growth factor (PDGF) activity in the saliva of ixodid ticks is linked with their long mouthparts

The saliva of blood‐feeding arthropods modulates their vertebrate hosts' haemostatic, inflammatory and immune responses to facilitate blood feeding. In a previous study, we showed that salivary gland products from ixodid tick species also manipulate the wound‐healing response by targeting at least four different mammalian growth factors: transforming growth factor β1, hepatocyte growth factor, fibroblast growth factor 2 and platelet‐derived growth factor (PDGF). In addition, species that showed PDGF‐binding activity also inhibited cell proliferation in vitro and induced changes in cell morphology accompanied by disruption of the actin cytoskeleton. Here, we show a correlation between the length of the tick hypostome, the sclerotized feeding tube of the mouthparts inserted into the host's skin and anti‐PDGF activity. This apparent link between hypostome length, and hence the potential depth of skin damage, and PDGF‐binding activity was not apparent for the other growth factors or for other cytokines important in wound healing (keratinocyte growth factor, interleukin 6 and stromal cell‐derived factor 1). However, PDGF‐binding activity was no longer correlated with anti‐cell activities, indicating that an additional as yet unidentified activity in tick saliva may affect cellular changes in wound repair.     

Factors Affecting Job Satisfaction and Their Correlation with Educational Standards among Dental Assistants

A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs.     

Father involvement with three-to-four-year olds at home: giving fathers a chance

This study examined fathers' perceptions regarding their home-based activities (HBA) and the influence of fathers' demographic characteristics on their perceptions and practices at home. A total of 396 fathers completed a survey questionnaire describing their demographic information, perceptions and their practices regarding their involvement in HBA. Results indicated that fathers have moderate level of practice concerning their HBA, yet they have low perception of their actual practice at HBA. In addition, there was a statistical significance in HBA due to fathers' age, educational level and specialisation which had an influence on their perceptions as well. Recommendations and implications of future research were discussed.     

CCL3L1 copy number, CCR5 genotype and susceptibility to tuberculosis

Background

22q11.2 deletion syndrome (22q11.2DS) is a common microdeletion syndrome, which occurs in approximately 1:4000 births. Familial autosomal dominant recurrence of the syndrome is detected in about 8-28% of the cases. Aim of this study is to evaluate the intergenerational and intrafamilial phenotypic variability in a cohort of familial cases carrying a 22q11.2 deletion.

Methods

Thirty-two 22q11.2DS subjects among 26 families were enrolled.

Results

Second generation subjects showed a significantly higher number of features than their transmitting parents (212 vs 129, P?=?0.0015). Congenital heart defect, calcium-phosphorus metabolism abnormalities, developmental and speech delay were more represented in the second generation (P?<?0.05). Ocular disorders were more frequent in the parent group. No significant difference was observed for the other clinical variables. Intrafamilial phenotypic heterogeneity was identified in the pedigrees. In 23/32 families, a higher number of features were found in individuals from the second generation and a more severe phenotype was observed in almost all of them, indicating the worsening of the phenotype over generations. Both genetic and epigenetic mechanisms may be involved in the phenotypic variability.

Conclusions

Second generation subjects showed a more complex phenotype in comparison to those from the first generation. Both ascertainment bias related to patient selection or to the low rate of reproductive fitness of adults with a more severe phenotype, and several not well defined molecular mechanism, could explain intergenerational and intrafamilial phenotypic variability in this syndrome.     

Presentation and outcome of tuberculous meningitis among children: experiences from a tertiary children's hospital

Background

Diagnosis of tuberculous meningitis (TBM) is complicated and outcome is poor especially in resource limited settings. Early diagnosis and prompt treatment are vital in effective treatment. We set out to describe experiences in the management and immediate outcome of TBM a tertiary-level children''s hospital in a high HIV and tuberculosis co-infection setting.

Methods

This retrospective study included children who were diagnosed with TBM in the year 2009. A pre-coded questionnaire was used to extract data on presentation, diagnostics, treatment and outcome at the time of hospital discharge. Data was analyzed using STATA statistical package (StataCorp, Version 11).

Results

Of the 40 children diagnosed with TBM, 6 (15%) had definitive TBM, 17 (42.5%) had probable TBM and 17 (42.5%) had possible TBM. The cerebrospinal fluid (CSF) chemistry and cells were abnormal in 39/40 (98%). Mantoux test was reactive in 16/29 (55%) and 17/30 (57%) had Chest X-rays suggestive of tuberculosis. Only 3/21 (14%) had positive sputum tuberculosis culture and 89% (32/36) had neuro-imaging abnormalities. Outcome at discharge was; 8% died, 49% improved with neurological sequelae and 43% improved without sequelae. Having TBM stage 3 at admission was associated with mortality (p=0.001).

Conclusions

Most children had early diagnosis of TBM and mortality was lower than in previous studies. We recommend a larger prospective study to further understand the outcome of TBM.