Identification of zebrafish ARNT1 homologs: 2,3,7,8-tetrachlorodibenzo-p-dioxin toxicity in the developing zebrafish requires ARNT1

To use the zebrafish (Danio rerio) as a model to study 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) developmental toxicity, it is essential to know which proteins are involved in mediating toxicity. Previous work has identified zfAHR2 as the receptor that binds TCDD mediating downstream responses. Although zfARNT2b can form a functional heterodimer with zfAHR2 in vitro, zfarnt2 null mutants show no protection against endpoints of TCDD developmental toxicity, demonstrating that zfARNT2b cannot be the physiological dimerization partner for zfAHR2 mediating responses to TCDD in zebrafish embryos. The purpose of the current study was to identify an alternate dimerization partner(s) for zfAHR2 that may function to mediate TCDD developmental toxicity. By searching zebrafish genomic sequence and using the polymerase chain reaction-based rapid amplification of cDNA ends technique, three forms of cDNA that seem to be alternate mRNA splice variants of a zebrafish homolog of ARNT1 were detected. Analysis of the zfARNT1 proteins in vitro demonstrates that the two longest forms of zfARNT1, zfARNT1b and zfARNT1c, can form functional heterodimers with zfAHR2. However, the shortest form, zfARNT1a, seems to be nonfunctional with zfAHR2 in vitro. To determine whether a zfARNT1 protein functions with zfAHR2 in vivo, a morpholino targeted against the 5' end of zfARNT1 (zfarnt1-MO) was used. Injection of the zfarnt1-MO before TCDD treatment significantly decreases the induction of zfCYP1A mRNA and protein. In addition, zfarnt1 morphants show complete protection against TCDD-induced pericardial edema and show partial protection against reduced blood flow and craniofacial malformations caused by TCDD, demonstrating the role of zfARNT1 proteins in mediating these responses.     

Psychosocial Work Characteristics Predict Cardiovascular Disease Risk Factors and Health Functioning in Rural Women: The Wisconsin Rural Women''s Health Study

BACKGROUND: The aim of the present study is to investigate the association between psychosocial work characteristics and health functioning and cardiovascular disease risk factors among rural women of central Wisconsin and compare psychosocial work characteristics between farm and nonfarm women. METHODS: Stratified sampling was used to select a random sample (n = 1500) of farm and nonfarm women aged 25 to 71 years from the Central Marshfield Epidemiologic Study Area. The baseline examination included measurements of blood pressure, height, weight, and fasting blood lipids, glucose, and insulin. Psychosocial job condition was measured with the Karasek Job Content Questionnaires (JCQ). Health functioning was assessed by the Short Form-36 Health Survey. RESULTS: The analysis of JCQ showed that nonfarm residents were more likely to have jobs with high demand and high decision latitude compared to farm residents. Also, the farm residents (40.3%) were more likely to be occupied in passive jobs (jobs with low levels of demand and control) than the nonfarm residents (26.9%). Among farm residents, psychological job demand was associated with HDL level (beta = 0.17), triglycerides (beta = 0.0), their ratio (beta = 0.005), and blood insulin level (beta = 0.014), and among nonfarm residents, psychological job demand was associated with diastolic blood pressure (beta = 0.17) and total cholesterol level (beta = 0.002). CONCLUSION: Our results showed that rural farm residents had a higher prevalence of CVD risk factors and were more likely to be occupied in jobs with low levels of demand and control. Job stress predicted more CVD risk factors among farm residents compared to nonfarm residents. Therefore, interventions reducing job strain among rural farm residents are timely and necessary.     

Transvaginal repair of complex and complicated vesicovaginal fistulae

Objective

To document the experience at a tertiary referral hospital in India with managing complex and complicated vesicovaginal fistulae (VVF) by the transvaginal route, and to document the complications and the long-term outcome of the patients.

Methods

The medical records of 102 patients with complex or complicated VVF who underwent transvaginal surgical repair during 2000-2009 were reviewed retrospectively.

Results

The mean age of the patients was 24 years and the mean duration of urinary incontinence was 3 years (range 6 months to 12 years). The patients were followed up for a median of 48 months. In total, 78 patients had obstetric fistulae, 20 patients had surgical (gynecologic) fistulae, and 4 patients had postradiation fistulae. The overall success rate for the transvaginal approach was 86.3%. Fourteen patients remained incontinent despite the surgical repair. Early failure of the repair was observed in 11.8% of the patients and delayed failure in 2.0%. Postoperative complications included stress urinary incontinence (9.8%), urge urinary incontinence (7.8%), dyspareunia (5.9%), and chronic labial pain (2.0%).

Conclusion

The transvaginal approach to the repair of complex and complicated VVF gives good long-term results with low complication rates.     

Differentiation of tuberculous from pyogenic brain abscesses with in vivo proton MR spectroscopy and magnetization transfer MR imaging

BACKGROUND AND PURPOSE: MR imaging features are nonspecific with respect to the causative organism for patients with brain abscesses. On the basis of the hypothesis that the biochemical environment depends on the infecting organism and might be different in tuberculous compared with pyogenic brain abscesses, this study attempted to determine whether pyogenic brain abscesses can be differentiated from tuberculous brain abscesses by use of magnetization transfer (MT) MR imaging and in vivo proton MR spectroscopy. METHODS: Twenty-seven patients with a total of 33 pyogenic brain abscesses and three patients with a total of 12 tuberculous abscesses were evaluated with in vivo MR spectroscopy and MT MR imaging. The diagnosis in all cases was based on the culture of the causative organisms and histopathology whenever done as a part of clinical management. RESULTS: All 27 patients with pyogenic brain abscesses had lipid and lactate levels of 1.3 ppm and amino acid levels of 0.9 ppm with or without the presence of succinate, acetate, alanine, and glycine, while the three patients with tuberculous abscesses showed only such lipid and lactate levels. The MT ratio from the wall of the pyogenic abscesses was significantly higher (P <.001) than that from the tuberculous abscess wall. CONCLUSION: It might be possible to differentiate tuberculous abscesses from pyogenic abscesses by using MT MR imaging and in vivo MR spectroscopy, which could be of value in influencing the management of such cases.     

Posterior fossa arachnoid cyst presenting as high cervical cord compression

We report a 16-year-old boy who presented with high cervical cord compression caused by a midline posterior fossa arachnoid cyst lying below the vermis. Cystoperitoneal shunting resulted in a dramatic improvement of neurological signs.     

Death by Suicide—The EMS Profession Compared to the General Public

Background: In 2016, nearly 45,000 deaths in the United States were attributed to suicide making this the 10th leading cause of death for all ages. National survey data suggest that among Emergency Medical Technicians (EMTs), including firefighters and Paramedics, rates of suicide are significantly higher than among the general public. EMTs face high levels of acute and chronic stress as well as high rates of depression and substance abuse, which increase their risk of suicide.

Objective/Aim: To determine the statewide Mortality Odds Ratio (MOR) of suicide completion among EMTs as compared to non-EMTs in Arizona.

Methods: We analyzed the Arizona Vital Statistics Information Management System Electronic Death Registry of all adult (≥18) deaths between January 1, 2009 and December 31, 2015. Manual review of decedent occupation was performed to identify the EMT cohort; all other deaths were included in the non-EMT cohort. Using the underlying cause of death as the outcome, we calculated the MOR of both the EMT and non-EMT cohorts.

Results: There were a total of 350,998 deaths during the study period with 7,838 categorized as suicide. The proportion of deaths attributed to suicide among EMTs was 5.2% (63 of 1,205 total deaths) while the percentage among non-EMTs was 2.2% (7,775/349,793) (p?<?0.0001). The crude Mortality Odds Ratio for EMTs compared with non-EMTs was [cMOR 2.43; 95% CI (1.88–3.13)]. After adjusting for gender, age, race, and ethnicity, EMTs had higher odds that their death was by suicide than non-EMTs [aMOR: 1.39; 95% CI (1.06–1.82)].

Conclusion: In this statewide analysis, we found that EMTs had a significantly higher Mortality Odds Ratio due to suicide compared to non-EMTs. Further research is necessary to identify the underlying causes of suicide among EMTs and to develop effective prevention strategies.     

MR demonstration of brain abscess rupture into the subarachnoid space and its possible implication in management

BACKGROUND: Rupture of brain abscess into the subarachnoid space as a cause of meningitis is rare. Early diagnosis improves the outcome. There is no previous report of MR demonstration of rupture of brain abscess into the subarachnoid space. CASE DESCRIPTION: Two young adults with chronic suppurative otitis media presenting with signs of increased intracranial pressure and meningeal irritation underwent magnetic resonance imaging, which showed brain abscess with evidence of rupture into the subarachnoid space and meningitis. This helped in early diagnosis and aggressive management. CONCLUSION: In cases of brain abscess where meningitis is suspected clinically, documentation of rupture of the abscess into the subarachnoid space will help in avoiding cerebrospinal fluid (CSF) examination that may be disastrous in these patients who already have increased intracranial pressure.