Emotional eating in adolescents: A gene (SLC6A4/5-HTT) - Depressive feelings interaction analysis

Eating in response to distress - i.e. emotional eating - is highly prevalent in (female) adults with binge eating, but has only a very low prevalence in young children. The present study addresses the emergence of emotional eating in adolescence in relation to depressive feelings. Because a reduction of food intake is considered the biologically natural response to distress, we tested whether the a-typical stress-response of emotional eating develops in interaction with genetic vulnerability. We hypothesized that the short allele of the 5-HTTLPR polymorphism in the serotonin transporter gene, which is associated with lower serotonin activity, would moderate the relation between depressive feelings and the increase in emotional eating, particularly in females. A sample of Dutch families with two adolescents was included in a longitudinal study with a four-year follow-up. A moderator effect of 5-HTTLPR genotype on the relation between depressive feelings and the increase in emotional eating was found in both sexes in the youngest siblings (n = 286). In the older siblings (n = 298), this specific moderator effect was only found in the girls. Younger adolescents and older adolescent girls showed a higher increase in emotional eating if they carried the 5-HTTLPR short allele. This is the first study that found support for a gene × depressive feelings interaction on emergence of emotional eating in (female) adolescents     

Acute renal failure after licorice ingestion: A case report

A 39-year-old female presented to the nephrology clinic emergency department with a complaint of muscle weakness and stomach pain. A detailed personal history revealed ingestion of 50–100 g herbal products which contained licorice, every day for 8 weeks to treat sterility. The herbal product was studied and determined to contain ‘licorice’ containing glycyrrhizic acid. Licorice (a plant which contains glycyrrhizic acid) induced hypokalemia which usually has a mild progression. However, it may cause critical failure in physical action by means of weakness followed by paralysis and may cause rhabdomyolysis, acute renal failure and hyperaldosteronism. This report presents the first case with acute renal failure due to licorice consumption from Serbia. In addition, the report aims to emphasize the importance of obtaining the detailed personal history of a patient for precise diagnosis.     

Discharge Coordinator Intervention Prevents Hospitalizations in Patients With COPD: A Randomized Controlled Trial

ObjectivesTo test whether coordination of discharge from hospital reduces hospitalizations in patients with chronic obstructive pulmonary disease (COPD).DesignRandomized controlled clinical trial.SettingSpecialized pulmonary hospital.ParticipantsPatients hospitalized for an acute exacerbation of COPD.InterventionCare as usual included routine patient education, supervised inhaler use, respiratory physiotherapy, and disease-related communication. The discharge coordinator intervention added assessment of patient situation and homecare needs. Patients and caregivers were actively involved and empowered in the discharge planning process, which was communicated with community medical professionals to provide continuity of care at home.MeasurementsThe primary end-point of the study was the number of patients hospitalized because of worsening COPD. Key secondary end-points were time-to-COPD hospitalization, all-cause mortality, all-cause hospitalization, days alive and out of hospital, and health-related quality of life.ResultsOf 253 eligible patients (71 ± 9 years, 72% men, 87% GOLD III/IV), 118 were assigned to intervention and 135 to usual care. During a follow-up of 180 days, fewer patients receiving intervention were hospitalized for COPD (14% versus 31%, P = .002) or for any cause (31% versus 44%, P = .033). In time-to-event analysis, intervention was associated with lower rates of COPD hospitalizations (P = .001). A Cox model of proportional hazards, adjusted for sex, age, GOLD stage, heart failure, malignant disease, and long-term oxygen treatment, demonstrated that intervention reduced the risk of COPD hospitalization (hazard ratio 0.43, 95% confidence interval 0.24–0.77, P = .002).ConclusionAmong patients hospitalized for acute COPD exacerbation, discharge coordinator intervention reduced both COPD hospitalizations and all-cause hospitalizations.     

Bisphosphonates modulate vital functions of human osteoblasts and affect their interactions with breast cancer cells

Bisphosphonates (BPs) are in clinical use for the treatment of breast cancer patients with bone metastases. Their anti-resorptive effect is mainly explained by inhibition of osteoclast activity, but recent evidence also points to a direct action of BPs on bone-forming osteoblasts. However, the mechanisms how BPs influence osteoblasts and their interactions with breast cancer cells are still poorly characterized. Human osteoblasts isolated from bone specimens were characterized in depth by their expression of osteogenic marker genes. The influence of the nitrogen-containing BPs zoledronate (Zol), ibandronate (Iban), and pamidronate (Pam) on molecular and cellular functions of osteoblasts was assessed focusing on cell proliferation and viability, apoptosis, cytokine secretion, and osteogenic-associated genes. Furthermore, effects of BPs on osteoblast–breast tumor cell interactions were examined in an established in vitro model system. The BPs Zol and Pam inhibited cell viability of osteoblasts. This effect was mediated by an induction of caspase-dependent apoptosis in osteoblasts. By interfering with the mevalonate pathway, Zol also reduces the proliferation of osteoblasts. The expression of phenotypic markers of osteogenic differentiation was altered by Zol and Pam. In addition, both BPs strongly influenced the secretion of the chemokine CCL2 by osteoblasts. Breast cancer cells also responded to Zol and Pam with a reduced cell adhesion to osteoblast-derived extracellular matrix molecules and with a decreased migration in response to osteoblast-secreted factors. BPs revealed prominent effects on human osteoblasts. Zol and Pam as the most potent BPs affected not only the expression of osteogenic markers, osteoblast viability, and proliferation but also important osteoblast–tumor cell interactions. Changing the osteoblast metabolism by BPs modulates migration and adhesion of breast cancer cells as well.