Smoking, alcohol and caffeine in relation to ovarian age during the reproductive years

BACKGROUND: We sought to determine whether smoking, alcohol and caffeine are related to four indicators of ovarian age: antral follicle count (AFC), follicle stimulating hormone (FSH), inhibin B and estradiol. METHODS: Analyses drew on ultrasound scans and sera from 188 women, aged 22-49. We used least squares regression to estimate differences in AFC and hormone levels for women who smoke cigarettes or who drink alcohol or caffeine. RESULTS: Current smoking is related to elevated FSH (beta for ln(FSH) = 0.21, 95% CI 0.04, 0.39), but not to AFC, inhibin B or estradiol. Neither alcohol nor caffeine is related to any ovarian age indicator. Exploratory analyses suggest that the association of current smoking with FSH varies with age: comparing current with never smokers, at ages 30, 35, 40 and 45, estimated differences in mean FSH are 0.3, 1.3, 3.2 and 6.9 mIU/ml. CONCLUSIONS: The association of current smoking with FSH may reflect accelerated oocyte atresia, impaired follicle quality or dysregulation of the hypothalamic-pituitary-ovarian axis. Identification of the causal mechanism has implications for prevention or treatment of conception delay, infertility and morbidity associated with early menopause.     

Cryptic ins(4;11)(q21;q23q23) detected by fluorescence in situ hybridization: a variant of t(4;11)(q21;q23) in an infant with a precursor B-cell acute lymphoblastic leukemia report of a second case

We report the chromosomal findings in a 4-year-old female with precursor B-cell acute lymphoblastic leukemia (ALL). The diagnostic karyotype showed an isochromosome 7q, i(7)(q10), as well as questionable rearrangements on 9p and 11q. Fluorescence in situ hybridization (FISH) studies on both interphase and metaphase cells using the MLL "break-apart" and the centromeric chromosome 4 probes were instrumental in the characterization of an MLL gene rearrangement, which was cryptic by conventional cytogenetic analysis. Specifically, the FISH pattern was consistent with an insertion of the 5' region of the MLL gene into chromosome 4 at band q21, most likely a variant t(4;11)(q21;q23). This is the second case of FISH detection of an ins(4;11) in ALL. Our case exemplifies the importance of FISH in the further characterization of precursor B-cell ALL cases without any apparent prognostically significant chromosomal abnormalities.     

Rationale for the major changes in the pharmacotherapy section of the National Asthma Education and Prevention Program guidelines

Numerous changes have been incorporated into the new National Asthma Education and Prevention Program's Expert Panel Report 3. In the pharmacotherapy section of the report, many of these changes are minor in that they do not alter the basic philosophy of treatment recommendations from the previous Expert Panel Report but only add new formulations, change dosing or dosage forms, or add discussion of risks. However, 4 major changes have been identified, and the rationales for 3 are discussed in detail here. The treatment of childhood asthma is divided into 2 distinct age groups, infants less than 5 years of age and children 5 to 12 years of age, because of the availability of more data suggesting differences in response in these patients, as well as a relative paucity of quality data in the younger patients. Omalizumab, a humanized mAb to IgE, is the only new entity approved for the treatment of asthma since the previous guidelines, and its recommendations were reviewed. The indication for combination therapy with inhaled corticosteroids and long-acting inhaled beta(2)-agonists (LABAs) has been modified in lieu of the recent black box warning concerning the increased risk of severe asthma exacerbations and death associated with LABA use. However, the inhaled corticosteroids/LABAs are still recommended for patients with moderate-to-severe persistent asthma. The rationale for the continued recommendation is provided.     

Synchrotron-based intravenous cerebral angiography in a small animal model

K-edge digital subtraction angiography (KEDSA), a recently developed synchrotron-based technique, utilizes monochromatic radiation and allows acquisition of high-quality angiography images after intravenous administration of contrast agent. We tested KEDSA for its suitability for intravenous cerebral angiography in an animal model. Adult male New Zealand rabbits were subjected to either angiography with conventional x-ray equipment or synchrotron-based intravenous KEDSA, using an iodine-based contrast agent. Angiography with conventional x-ray equipment after intra-arterial administration of contrast agent demonstrated the major intracranial vessels but no smaller branches. KEDSA was able to visualize the major intracranial vessels as well as smaller branches in both radiography mode (planar images) and tomography mode. Visualization was achieved with as little as 0.5 ml kg-1 of iodinated contrast material. We were able to obtain excellent visualization of the cerebral vasculature in an animal model using intravenous injection of contrast material, using synchrotron-based KEDSA.     

The effects of weight management programs on self-esteem in pediatric overweight populations

OBJECTIVE: Review published findings on self-esteem and pediatric overweight, and changes in self-esteem subsequent to weight management programs. METHODS: We used PsycInfo and MedLine searches to identify peer-reviewed journal articles examining self-esteem changes following participation in weight management programs. RESULTS: Data regarding the relationship between self-esteem and obesity is mixed. Factors that place overweight children "at-risk" for low self-esteem include early adolescence, female gender, identification with majority cultural standards of body shape, exposure to teasing and peer victimization, a history of greater parental control over feeding, and internal attributions about weight status. Data from intervention studies suggest positive effects on self-esteem across settings. Components related to self-esteem improvements include weight change, parent involvement, and group intervention format. CONCLUSIONS: Well-designed, longitudinal studies using multidimensional measures of self-esteem, and following CONSORT guidelines are needed to confirm and expand these findings. Emphasis should be placed on examining mediators and moderators of self-esteem change.     

Dynamics of response to perceptual pop-out stimuli in macaque V1

Contextual modulation due to feature contrast between the receptive field and surrounding region has been reported for numerous stimuli in primary visual cortex. One type of this modulation, iso-orientation surround suppression, has been studied extensively. The degree to which surround suppression is related to other forms of contextual modulation remains unknown. We used shape-from-shading stimuli in a field of distractors to test the latency and magnitude of contextual modulation to a stimulus that cannot be distinguished with an orientation-selective mechanism. This stimulus configuration readily elicits perceptual pop-out in human observers and induces a long-latency contextual modulation response in neurons in macaque early visual cortex. We found that animals trained to detect the location of a pop-out stimulus were better at finding a sphere that appeared to be lit from below in the presence of distractors that were lit from above. Furthermore, neuronal responses were stronger and had shorter latency in the condition where behavioral performance was best. This asymmetry is compatible with earlier psychophysical findings in human observers. In the population of V1 neurons, the latency of the contextual modulation response is 145 ms on average (ranging from 70 to 230 ms). This is much longer than the latency for iso-orientation surround suppression, indicating that the underlying circuitry is distinct. Our results support the idea that a feature-specific feedback signal generates the pop-out responses we observe and suggest that V1 neurons actively participate in the computation of perceptual salience.     

Trends in kidney transplantation rates and disparities

OBJECTIVE: To examine the likelihood of transplantation and trends over time among persons with end-stage renal disease (ESRD) in Wisconsin. METHODS: We examined the influence of patient- and community-level characteristics on the rate of kidney transplantation in Wisconsin among 22,387 patients diagnosed with ESRD between January 1, 1982 and October 30, 2005. We grouped patients by the year of ESRD onset in order to model the change in transplantation rates over time. RESULTS: After multivariate adjustment, all other racial groups were significantly less likely to be transplanted compared with whites, and the racial disparity increased over calendar time. Older patients were less likely to be transplanted in all periods. Higher community income and education level and a greater distance from patients' residence to the nearest dialysis center significantly increased the likelihood of transplantation. Males also had a significantly higher rate of transplantation than females. CONCLUSION: These results demonstrate a growing disparity in transplantation rates by demographic characteristics and a consistent disparity in transplantation by socioeconomic characteristics. Future studies should focus on identifying specific barriers to transplantation among different subpopulations in order to target effective interventions.