CYP2B6, ABCB1 and OPRM1 profile in a stillborn affected by chronic methadone intoxication

Forensic Toxicology -     

Developmental trajectories of social cognition from preschool to adolescence

This longitudinal study aims to define the developmental trajectories of social cognition (SC) in a community sample (N = 378) assessed from preschool (3 years old) to preadolescence (12 years old). Parents and teachers reported on a SC measure at ages 5, 10, and 12. We tested the existence of different trajectories and whether they discriminated outcomes in early adolescence. The data were collected from different sources, the children, the parents, and teachers, by means of different methods. Using Growth Mixture Modeling (GMM), we identified three distinct social cognition trajectories: persistently mild difficulties reported by parents and teachers (7.9% of the children), stable low problems reported by parents and increased difficulties reported by teachers (10.5% of the sample), and stable low problems reported by both informants for most of the participants (81.5%). Comparison of the psychological outcomes between classes using regression models showed that the two trajectories including children with any level of problems differ from the normative one as regards their association with psychological problems, daily functioning, and variables, such as aggressive behavior and callousness. The two non-normative trajectories also differ from each other in terms of the personal characteristics of the adolescents included in them. Adolescents in the increasing problematic class in the school have a tougher and more problematic style of social relating, while children with persistent and non-context-dependent difficulties are more anxious. These results might help to better detect and design specific interventions for children with deficits in SC that might respond to different personal characteristics leading to different outcomes.

     

GOKIO KUMBU/AMADABLAM TREK 2012: stabilometric adaptation in women to exercise training at low and high altitude

Purpose

Balance is the essential ability to maintain posture during physical activity and daily life. Exercise can have acute and chronic effects on postural stability. Individual exercise sessions can decrease postural stability, while long-term training improves balance and postural sway. Consequently, athletes and people undergoing training have better postural sway than more sedentary subjects. Hypobaric hypoxia has also been suggested to cause stress and adaptation of balance abilities. Thus, the aim of this study was to determine the effects of exercise training under normoxia and hypobaric hypoxia on postural sway.

Methods

Seven adult females participated in this study. They underwent assessments of posture before and after 12 days of low-to-moderate exercise training at low altitude, and the same 4 months later, after 12 days of exercise training at high altitude. The data collected included: centre of pressure, average speed oscillation, and Romberg Quotient. This generated a total of 56 posture tests for these seven subjects.

Results and conclusions

The results of this research suggest that comparing the each period of activity (pre-exercise) and after the end of each period (post-exercise), both at low and at high altitudes, did not influence the postural stability.

     

Hydroelectrolytic balance of Brazilian jiu-jitsu athletes during a simulated competition

Purpose

To analyze the hydroelectrolytic balance of Brazilian jiu-jitsu athletes during a simulated competition.

Methods

Eight athletes were analyzed in simulated competition (four matches of 10 min). Blood lactate and rating of perceived exertion (6–20 scale) were used to infer the intensity of the matches. Blood samples were taken to determine the serum levels of osmolality, total protein and some electrolytes (chlorides, sodium, potassium, calcium, magnesium, phosphorus and iron).

Results

The lactate concentration changed during the simulated competition (F _7.49 = 35.5; P < 0.001; η ² = 0.85), with an increase post-match compared to the pre-match in matches 1, 2 and 4, but not for match 3. For rating of perceived exertion, no changes were found during the competition (F _3.21 = 9.4; P = 0.440; η ² = 0.12). The matches did not change the osmolality, chlorides, sodium, potassium, magnesium and iron values. For total protein, a difference was observed between the time-points (F _{2.8; 19.6} = 4.6; P = 0.015; η ² = 0.40), with lower concentrations in pre-match 2 than pre-match 1, post-matches 2 and 3. The calcium concentration was also affected by the simulated competition (F _7.49 = 4.0; P = 0.002; η ² = 0.37), with values lower in pre-match 2 than post-matches 1 and 2. The phosphorus serum was changed by matches (F _{3.1; 21.7} = 18.6; P < 0.001; η ² = 0.73), with post-match 1 values higher than the pre-matches 1, 2, 3 and 4 and post-match 3. The pre-match 4 values were lower than post-matches 2 and 4.

Conclusion

Although there were some changes during simulated competition, important alterations in the hydroelectrolytic balance did not occur.

     

<Emphasis Type="Italic">V</Emphasis>O<Subscript>2Max</Subscript> and <Emphasis Type="Italic">V</Emphasis>O<Subscript>2AT</Subscript>: athletic performance and field role of elite soccer players

Purpose

Maximal oxygen consumption (VO_2max) and oxygen consumption at anaerobic threshold (VO_2AT) are commonly measured parameters to test elite soccer players; however, studies relating metabolic parameters of professional soccer players with performance and best fitting to the field role are scarce. Our aim was to study the relations of VO_2max and VO_2AT with the field role of elite soccer players to generate a robust dataset with a solid statistical analysis.

Method

Over a 12-year period we performed 953 field evaluation tests of VO_{2 max} and VO_2AT on 450 elite soccer players of 13 professional teams by incremental, continuous and exhausting test modified from Conconi’s test. Statistical analysis was performed by one-way ANOVA followed—when appropriate—by Tukey post hoc test. Effect size was evaluated by the Cohen D test and η partial squared test. Statistical significance was set for p < 0.05.

Results

VO_2max mean values increased at the beginning of season by 1.073 ± 0.06 respect to pre-season then decreased again up to pre-season levels and remained stable, while VO_2AT did not change during time. VO_2max differences were also related to players’ field role. VO_2max mean value for Goalkeeper was 50.85 ± 4.2, for central Defender was 57.58 ± 4.3, for Winger-sides back was 60.53 ± 5.02, for Midfielder was 59.53 ± 5.08, for Forward was 56.52 ± 4.14. On the contrary, as expected, VO_2AT percentage variations among the roles were not significant.

Conclusions

VO_2max is the choice parameter to consider for the metabolic compliance of athletes to the field role requirements, consequently influencing training programs, recovery and injury prevention strategies.

     

Changes in Vascular Tone Occur Early During Hemodialysis Treatments Independently of Volume Reduction

Hypotension commonly occurs during hemodialysis (HD). Hypotension can result from an absolute reduction in plasma volume following excessive ultrafiltration or from a reduction in vascular tone. We hypothesized that changes in vascular tone could occur during dialysis. Aortic pulse wave velocity (aPWV) was measured in 197 HD patients, mean age 63.3 ± 16.6 years, 62% male, 49% diabetic, during a single HD session. aPWV did not change (9.6 ± 2.2 vs. 9.6 ± 2.2 m/s) with HD. Systolic blood pressure (SBP) declined from 151 ± 31 to 147 ± 32 after 20 min and to 140 ± 36 mm Hg on completion of HD (P < 0.05), with an ultrafiltration volume of 2.2 ± 0.9 L over a 3.9 ± 0.4 h HD session. Aortic SBP declined from 154 ± 32 to 146 ± 29 after 20 min and 143 ± 35 at the end of HD, P < 0.001. Aortic augmentation index (Aortic Aix) decreased from 65% (52–79%) to 36.7% (23.3–52.9%) by 20 min and to 34.3 (15.1–49.1%) on completion of HD (P < 0.05), and brachial augmentation index (brachial Aix) from 5.7% (?25.2 to 27.5%) to ?1.9% (?2.2 to 30.1%) and ?6.6% (?44 to 22.7%), respectively, P < 0.05. Diastolic reflection area (DRA) increased from 36.7 (27.9–46.3) to 40.4 (32.2–51) after 20 min and 47.1 (34.2–60.5) on completion of HD, P < 0.05. We report changes in arterial tone within 20 min of starting HD, when minimal ultrafiltration has occurred, suggesting that volume changes may not be the only predisposing cause of intradialytic hypotension. The combination of a fall in SBP and a rise in DRA would suggest a reduction in coronary blood flow in keeping with reports of “myocardial stunning” during HD.     

DAA‐based antiviral treatment of patients with chronic hepatitis C in the pre‐ and postkidney transplantation setting

DAA‐based regimens for chronic hepatitis C infection encourage treatment of “difficult‐to‐treat” cohorts. This study investigated efficacy and safety of DAA‐based regimens in HCV patients on dialysis or postkidney or liver/kidney transplantation. Twenty‐five patients treated with DAA combinations were evaluated: 10 were on dialysis (eight: hemodialysis, two: peritoneal dialysis), eight were kidney transplant recipients, and seven were liver/kidney transplant recipients. Except for one patient treated with daclatasvir ([DCV]/60 mg/QD)/simeprevir ([SMV]/150 mg/QD), the others received sofosbuvir‐based regimens ([SOF];400 mg/QD) combined with SMV:eight, DCV:13 or either ledipasvir ([LDV]90 mg/QD), ribavirin ([RBV];weight based) or pegylated interferon/RBV. HCV‐RNA was determined by Abbott RealTime (LLOQ]:12 IU/ml) or Roche AmpliPrep/COBAS TaqMan assay (LLOQ:15 IU/ml); treatment response evaluated every 4 weeks, at the end of treatment, and 4 and 12 weeks thereafter. Twenty‐four (96%) patients achieved SVR 12/24 (ITT‐analysis). Mean treatment duration was 15.1 ± 5.1 weeks (±SD), and two patients terminated prematurely – both reached SVR12. Six patients were hospitalized due to complications of underlying disease. One patient achieved SVR24 but was re‐infected (week 27). Kidney function remained stable; serum creatinine increased in only one patient – SOF was reduced to 400 mg/48 h. Treatment with DAA combinations in renally impaired HCV patients is highly effective and well tolerated. These findings call for further controlled trials and data from real‐life cohorts.