From early twinges to mastery: The process of adjustment in living with rheumatoid arthritis

Objective. To describe the experiences of women who have learned to live with rheumatoid arthritis (RA), and to explore how women manage this chronic illness and the demands of their everyday lives. Methods. Thirty women with a diagnosis of RA were interviewed in their homes. The women were encouraged to “tell their story of living with RA,” from the first symptom to the present, using a semistructured questionnaire. Qualitative data were analyzed using a constant comparative analytic process. Results. Learning to live with RA was characterized by periods of uncertainty, of learning about the illness, discovering strategies that allowed the women to meet the expectations of their roles as women, and the establishment of new patterns of daily life. The women became experts at managing their RA and developed a sense of mastery in coping with their symptoms. Conclusions. Persons with RA need support and guidance, beginning with the onset of the disease, to facilitate achieving mastery in living with this chronic illness.     

Maternal mental health modifies the association of food insecurity and early child development

We examined the association between household food insecurity and early child development and whether or not maternal depression and anxiety modifies this association. The cross‐sectional study included 468 mother–infant pairs recruited at primary health centers of the Federal District, Brazil. Mothers answered a questionnaire that evaluated early child development (outcome), household food insecurity (independent variable), maternal depression and trait anxiety (effect modifiers). Variables were collected with validated questionnaires for the Brazilian population. Pearson's χ² test and logistic regression analyses were conducted. Infants who lived in a moderate or severe food insecure household had 2.52 times (95% confidence interval [CI] [1.13, 5.65]) the odds of having early child development delays compared with infants in secure households. Maternal depression and anxiety modified the strength of association between household food insecurity and early child development, which is an innovative finding. Among infants with depressed mothers, those experiencing mild (adjusted odds ratio [aOR] 3.33, 95% CI [1.17, 9.46]) and moderate/severe household food insecurity (aOR 10.13, 95% CI [2.18, 47.10]) had higher odds of having early child development delays, compared with infants in food secure households. Among infants with both anxious and depressed mothers, these associations were even stronger for mild (aOR 4.69, 95% CI [1.41, 15.59]) and moderate/severe household food insecurity (aOR 16.07, 95% CI [2.70, 95.66]). In conclusion, household food insecurity is a risk factor for early child development delays, and this association is modified by maternal depression and anxiety. Future studies should evaluate the impact of intervention packages that address maternal depression and anxiety and household food insecurity on preventing early child development delays.     

Juvenile mild traumatic brain injury elicits distinct spatiotemporal astrocyte responses

Mild-traumatic brain injury (mTBI) represents ~80% of all emergency room visits and increases the probability of developing long-term cognitive disorders in children. To date, molecular and cellular mechanisms underlying post-mTBI cognitive dysfunction are unknown. Astrogliosis has been shown to significantly alter astrocytes' properties following brain injury, potentially leading to significant brain dysfunction. However, such alterations have never been investigated in the context of juvenile mTBI (jmTBI). A closed-head injury model was used to study jmTBI on postnatal-day 17 mice. Astrogliosis was evaluated using glial fibrillary acidic protein (GFAP), vimentin, and nestin immunolabeling in somatosensory cortex (SSC), dentate gyrus (DG), amygdala (AMY), and infralimbic area (ILA) of prefrontal cortex in both hemispheres from 1 to 30 days postinjury (dpi). In vivo T2-weighted-imaging (T2WI) and diffusion tensor imaging (DTI) were performed at 7 and 30 dpi to examine tissue level structural alterations. Increased GFAP-labeling was observed up to 30 dpi in the ipsilateral SSC, the initial site of the impact. However, vimentin and nestin expression was not perturbed by jmTBI. The morphology of GFAP positive cells was significantly altered in the SSC, DG, AMY, and ILA up to 7 dpi that some correlated with magnetic resonance imaging changes. T2WI and DTI values were significantly altered at 30 dpi within these brain regions most prominently in regions distant from the impact site. Our data show that jmTBI triggers changes in astrocytic phenotype with a distinct spatiotemporal pattern. We speculate that the presence and time course of astrogliosis may contribute to pathophysiological processes and long-term structural alterations following jmTBI.     

Analysis of the Filipinos’ Interest in Searching Online for Oral Cancer

Objective: This study analyzed the health-seeking behavior of Filipinos using Google Trends tool to quantify relative search volume by term . Oral cancer, mouth cancer, tongue cancer, gum cancer, and lip cancer were used as predetermined search terms. Material and method: Comma-separated values file containing relative search volumes of search trends pertaining to oral cancer from 2009 to 2019 were assessed. Brown-Forsythe one-way ANOVA was used to measure differences with respect to oral cancer across different years and months. Two-way repeated measures ANOVA was applied to detect differences regarding mouth cancer, tongue cancer, gum cancer, and lip cancer across the years. Time series models were fitted and used to forecast search interests. Results: The results revealed that interest in oral cancer was significantly higher in 2019 (43.75±5.5, p <0.05) compared to 2009 (29.0 ± 6.7). In terms of months, searches were higher in February (45.0 ± 6.6) compared to May (24.8 ± 3.4, p=0.015), June (25.3 ± 4.4, p=0.020), and December (26.5 ± 4.0, p=0.038). Search interests for gum cancer and lip cancer remained significantly lower from 2011 to 2019, and tongue cancer from 2016 to 2018 but approximated mouth cancer in 2019. The forecast showed that mouth cancer (31.67%), tongue cancer (23.75%), and lip cancer (3.83%) would fluctuate through time pass, while gum cancer (8%) would remain steady in 2020. Conclusion: Health-seeking behavior through search trends showed an increased interest in oral cancer in 2019 and during February. It was anticipated that search interests would fluctuate in 2020, but at the end of the year would decrease for mouth cancer and tongue cancer, increase for lip cancer, and remain steady for gum cancer.     

In Vitro Th17-Polarized Human CD4+ T Cells Exacerbate Xenogeneic Graft-versus-Host Disease

Acute graft-versus-host disease (aGVHD) is a severe complication of allogeneic hematopoietic stem cell transplantation. The role of Th17 cells in its pathophysiology remains a matter of debate. In this study, we assessed whether enrichment of human peripheral blood mononuclear cells (PBMCs) with in vitro Th17-polarized CD4⁺ T cells would exacerbate xenogeneic GVHD (xGVHD) into NOD-scid IL-2Rγ null (NSG) mice. Naive human CD4⁺ T cells were stimulated under Th17-skewing conditions for 8 to 10 days and then coinjected in NSG mice with fresh PBMCs from the same donor. We observed that Th17-polarized cells engrafted and migrated toward xGVHD target organs. They also acquired a double-expressing IL-17A⁺IFNγ⁺ profile in vivo. Importantly, cotransfer of Th17-polarized cells (1?×?10⁶) with PBMCs (1?×?10⁶) exacerbated xGVHD compared with transplantation of PBMCs alone (2?×?10⁶). Furthermore, PBMC cotransfer with Th17-polarized cells was more potent for xGVHD induction than cotransfer with naive CD4⁺ T cells stimulated in nonpolarizing conditions (Th0 cells, 1?×?10⁶?+?1?×?10⁶ PBMCs) or with Th1-polarized cells (1?×?10⁶?+?1?×?10⁶ PBMCs). In summary, our results suggest that human Th17-polarized cells can cooperate with PBMCs and be pathogenic in the NSG xGVHD model.     

Seroprevalence and risk factors associated with herpes simplex virus infection among pregnant women

OBJECTIVES: To estimate the type-specific seroprevalence and identify the risk factors associated with herpes simplex virus (HSV)-2 infection in pregnant women in Bucharest, Romania. METHODS: A prospective survey was conducted in 452 subjects, aged 15-39 years, at the Elias Hospital, during the years 2004-2005. We evaluated serum IgG anti-bodies to HSV-1 and HSV-2 using the HerpeSelect ELISA test. All subjects completed an epidemiological questionnaire. RESULTS: Seroprevalence was 87.3% and 15.1% for HSV-1 and HSV-2, respectively. The risk factors for HSV-2 infection were lower level of education and a greater number of sexual partners. Elementary school and high-school graduates were 6.28 and 2.26 times more exposed than University graduates. Having 2-3 partners and more than three partners was associated with 2.43 and 4.26 times the risk of acquiring HSV-2, compared with having one partner. CONCLUSIONS: In pregnant women, HSV-1 seroprevalence was higher than in Western Europe but similar to that in Eastern Europe. HSV-2 seroprevalence was within European ranges. Both were lower than in the USA. Risk factors for HSV-2 infection may lead to prevention programs.     

Evaluation of antiulcer activity of the main phenolic acids found in Brazilian Green Propolis

Aim of the study

In a previous study, our group described the gastric protective effect of the hydroalcoholic extract of Brazilian green propolis. The main compounds found in Brazilian green propolis include phenolic acids, such as: caffeic, ferulic, p-coumaric and cinnamic acids. This study was therefore carried out to evaluate the antiulcerogenic property of the main phenolic acids found in Brazilian Green Propolis.

Material and methods

The anti-ulcer assays were performed using the following protocols: nonsteroidal-antiinflammatory drug (NSAID)-induced ulcer, ethanol-induced ulcer, and stress-induced ulcer. The effects of the phenolic acids on gastric content volume, pH and total acidity, using the pylorus ligated model, were also evaluated.

Results

It was observed that treatment using doses of 50 and 250 mg/kg of caffeic, ferulic, p-coumaric and cinnamic acids and positive controls (omeprazol or cimetidine) significantly diminished the lesion index, the total area of the lesion and the percentage of lesion in comparison with the negative control groups. In addition, the percentage of ulcer inhibition was significantly higher in the groups treated with the different phenolic acids, cimetidine or omeprazol, in all the protocols used, compared with the negative control groups. In the model to determine gastric secretion, using ligated pylorus, treatment with phenolic acids and cimetidine reduced the volume of gastric juice and total acidity and significantly increased the gastric pH (p < 0.05), compared with the control group, with the exception of the group treated with 50 mg/kg of p-coumaric acid, in which no significant difference was observed, compared with the control. In relation to the acute toxicity, none sign of toxicity was observed when phenolic acids, used in this study, were administered for rats in dose of 2000 mg/kg.

Conclusions

In conclusion, the results of this study show that caffeic, ferulic, p-coumaric and cinnamic acids display antiulcer activity.