Evaluating the effects of an Internet education programme on newborn care in Taiwan

Aim. The objectives of this study were to evaluate an Internet education programme provided to primigravida in the third trimester of pregnancy with the aim of enhancing mothers’ knowledge about newborn care and increasing their maternal confidence. Background. Shorter hospital stays have had an impact on the traditional role of mother–baby nurses in providing education about parenting to their parturient women. Internet education is an efficient way to provide nursing instruction. Design. A randomised controlled trial was used. A total of 118 women receiving prenatal care in a hospital clinic who met study criteria and who consented were assigned randomly to intervention and control groups. The study was conducted at a hospital in Taiwan. Methods. The target population was women at 32–34 weeks gestation, using the Internet on a regular basis. The primigravida were randomly assigned to either the control group (n = 57) or the experimental group (n = 61). Two primary outcome measures were newborn‐care knowledge and maternal confidence. Results. The changes in newborn‐care knowledge were 7·21 for the experimental group, compared with 1·95 for the control group; the difference between the least‐squares means computed by ancova was 5·73 and statistically significant (p < 0·001). The changes in maternal confidence were 8·46 for the experimental group and 3·05 for the control group; the difference between the least‐squares means computed by ancova was 5·94 and statistically significant (p < 0·001). Conclusion. Results suggest that Internet education about newborn care may contribute to greater care knowledge and maternal confidence. Relevance to clinical practice. Internet newborn‐care education programmes can achieve success in promoting newborn care and provide health professionals with evidence‐based intervention.     

The use of yeast to understand TRP-channel mechanosensitivity

Mechanosensitive (MS) ion channels likely underlie myriad force-sensing processes, from basic osmotic regulation to specified sensations of animal hearing and touch. Albeit important, the molecular identities of many eukaryotic MS channels remain elusive, let alone their working mechanisms. This is in stark contrast to our advanced knowledge on voltage- or ligand-sensitive channels. Several members of transient receptor potential (TRP) ion channel family have been implicated to function in mechanosensation and are recognized as promising candidate MS channels. The yeast TRP homolog, TRPY1, is clearly a first-line force transducer. It can be activated by hypertonic shock in vivo and by membrane stretch force in excised patches under patch clamp, making it a useful model for understanding TRP channel mechanosensitivity in general. TRPY1 offers two additional research advantages: (1) It has a large (∼300 pS) unitary conductance and therefore a favorable S/N ratio. (2) Budding yeast allows convenient and efficient genetic and molecular manipulations. In this review, we focus on the current research of TRPY1 and discuss its prospect. We also describe the use of yeast as a system to express and characterize animal TRP channels.     

mda-9/Syntenin promotes metastasis in human melanoma cells by activating c-Src

The scaffold PDZ-domain containing protein mda-9/syntenin functions as a positive regulator of cancer cell progression in human melanoma and other tumors. mda-9/Syntenin regulates cell motility and invasion by altering defined biochemical and signaling pathways, including focal adhesion kinase (FAK), p38 mitogen-activated protein kinase (MAPK) and NF-κB, but precisely how mda-9/syntenin organizes these multiprotein signaling complexes is not well understood. Using a clinically relevant human melanoma model, we demonstrate that mda-9/syntenin physically interacts with c-Src and this communication correlates with an increase in FAK/c-Src complex formation and c-Src activation. Inhibiting mda-9/syntenin, using an adenovirus expressing antisense mda-9/syntenin or addition of c-Src siRNA, suppresses melanoma cell migration, anchorage-independent growth, and spontaneous tumor cell dissemination in vivo in a human melanoma animal metastasis model. These data are compatible with a model wherein interaction of MDA-9/syntenin with c-Src promotes the formation of an active FAK/c-Src signaling complex, leading to enhanced tumor cell invasion and metastatic spread. These provocative findings highlight mda-9/syntenin and its interacting partners as promising therapeutic targets for intervention of metastasis.     

Two polymorphisms in NEDD4L gene and essential hypertension in Chinese Hans - a population-based case-control study

Neural precursor cell expressed developmentally down-regulated 4-like (NEDD4L) gene may play an important role in the development of hypertension by regulating the amiloride-sensitive epithelial sodium channel for sodium reabsorption. Recently, a functional polymorphism located at the last nucleotide of exon 1 (rs4149601) of the NEDD4L gene were found to be associated with hypertension both in African Americans and whites, and a "flip-flop" association with hypertension was found in two white samples for a polymorphism located at intron 13 (rs3865418). In this study, we aimed at examining the role of these two variants on essential hypertension in Chinese Hans. In a population-based association study, we observed significantly higher prevalence of T allelic frequencies (p = 0.023) in hypertensives than normotensives. In logistic regression analysis, the stronger association was found under the additive model with an odds ratio of 1.31 (1.04-1.67) for T allele (p = 0.025). The association remained significant (p = 0.039) with an odds ratio of 1.29 (1.01-3.66) when adjusting for age and sex. We also constructed an ANCOVA factorial model by using clinical parameters as the dependent variable for rs3865418 polymorphisms. A significantly higher diastolic blood pressure was observed at rs3865418 in the dominant model for the T allele (p = 0.009). The positive association still exist after controlling age and sex (p = 0.013). For rs4149601 polymorphism, however, we did not observe a positive association with hypertension by implicating either logistic regression models or ANCOVA models. Thus, our results support rs3865418 but not rs4149601 polymorphism of NEDD4L gene implicated in the prevalence of hypertension in Chinese Hans.     

非心脏病住院患者Brugada心电图征发生率的初步调查

目的　通过大量住院的非心脏病患者心电图资料的回顾、分析 ,初步了解特发性Brugada心电图征 (idiopathicBrugadaelectrocardiogrampattern)的发生率 ,获取有关中国人Brugada综合征流行病学的信息。方法　制定严格的筛选标准 ,调查了 2 30 82份近年住院的非心脏病患者的心电图资料 ,筛选出具有Brugada心电图征特征的心电图 ,并对部分患者进行随访跟踪。 结果　共获 31份具有Brugada心电图征特征的心电图 ,占总数的 1 34‰ ,其中男性 30例 ,女性 1例。初步随访了 6例患者 ,发现其中 3例的家系成员中有晕厥史或Brugada心电图征。结论　特发性Brugada心电图征在中国人中并非罕见 ,且男性远比女性多 ,其临床及遗传学意义有待进一步研究。     

Levofloxacin-azithromycin combined triple therapy for Helicobacter pylori eradication]

BACKGROUND/AIMS: Antibiotic resistance and poor compliance are the main causes of Helicobacter pylori (H. pylori) eradication failure. This study evaluated the eradication rate, tolerability, and compliance of levofloxacin- azithromycin combined triple therapy for H. pylori eradication. METHODS: 1) First-line eradication: A total of 78 H. pylori-positive patients were enrolled. Seventeen military men in Armed Forces Capital Hospital were treated with 7 days of levofloxacin-azithromycin combined triple therapy (omeprazole 20 mg bid, levofloxacin 500 mg od, and azithromycin 500 mg od), and 61 patients in Kangbuk Samsung Hospital were treated with standard PPI-based triple therapy (omeprazole 20 mg bid, amoxicillin 1.0 g bid, and clarithromycin 500 mg bid) for 7 days. 2) Second-line eradication: A consecutive series of 59 patients who failed H. pylori eradication with standard PPI-based triple therapy in Kangbuk Samsung Hospital were randomized to two groups. Thirty patients were retreated with 7 days of bismuth-based quadruple therapy (omeprazole 20 mg bid, bismuth 120 mg qid, metronidazole 500 mg tid, and tetracycline 500 mg qid), and remaining 29 patients were retreated with levofloxacin-azithromycin combined triple therapy. Patient's compliance and tolerability were evaluated at the end of treatment. The status of H. pylori infection was assessed 8 weeks later then. The successful eradication of H. pylori was defined as negative results from histology and CLO test, or 13C-urea breath test. RESULTS: First-line eradication rate of levofloxacin-azithromycin triple therapy was lower than that of standard PPI-based triple therapy, but there was no statistically significant difference (70.6% vs. 80.3%, p=0.390). Second-line eradication rate of levofloxacin-azithromycin combined triple therapy was significantly lower than that of bismuth-based quadruple therapy (ITT/PP 65.5%/73.1% vs. 90%/90%, p<0.0001). The compliances of all patients were more than 85%. Two of patients with levofloxacin-azithromycin combined triple therapy complained self-limiting side effects (mild dizziness; mild insomnia with general weakness). CONCLUSIONS: Levofloxacin-azithromycin combined triple therapy should not be recommended as the first-line or second-line H. pylori eradication regimen in Korea.     

Choosing calcium channel blockers for pregnant women with paroxysmal supraventriclar tachycardia and preterm labor: a case report

Preterm labor is a major clinical hazard causing both maternal and neonatal morbidity and mortality. Paroxysmal supraventricular tachycardia (PSVT) complicated by preterm labor is rare. Of the many drugs used to treat PSVT, only calcium channel blockers are tocolytics. Here, we present the case of a 29-year-old female admitted to our ward with previously diagnosed PSVT and preterm labor at 31 weeks' gestation of her fourth pregnancy. Calcium channel blockers were administered and her uterine contractions subsided. Afterwards, no side effects were noted and she suffered no further tachycardic attacks during her pregnancy. She successfully delivered a full-term baby and received subsequent regular follow-up at the outpatient clinic.     

Effectiveness of anemia and chronic kidney disease as predictors for presence and severity of coronary artery disease in patients undergoing stress myocardial perfusion study

Chronic kidney disease (CKD) and anemia portend a higher risk of cardiac events and mortality. We sought to ascertain whether coronary artery disease (CAD) by myocardial perfusion single-photon emission computed tomography is more common in patients with CKD (glomerular filtration rate < or =60 ml/min/1.73 kg/m(2)) and/or anemia (hemoglobin level < or =13 g/L) and the impact of different degrees of CKD. One thousand five hundred eighty patients (mean age 65 +/- 10 years) underwent gated myocardial perfusion single-photon emission computed tomography and clinical evaluation. Patients were divided into 4 groups (group 1, no anemia/no CKD, n = 800; group 2, anemia/no CKD, n = 195; group 3, CKD/no anemia, n = 332; group 4, anemia/CKD, n = 253). Multivariate logistic regression analysis was undertaken to examine the association of these diagnoses with abnormal myocardial perfusion single-photon emission computed tomogram. Compared with patients with neither diagnosis, an abnormal scan was more common in those with anemia or CKD. Patients with anemia and CKD exhibited more severe CAD (mean summed stress score 6.8 vs 4.7, p <0.01). Established high-risk findings were more prevalent in patients with anemia and/or CKD, including a summed stress score > or =8, transient ischemic dilation, or a left ventricular ejection fraction < or =40% (group 1 28%, group 2 38%, group 3 38%, group 4 48%, all p values <0.01). Patients with moderate CKD demonstrated an increased risk of an abnormal scan (odds ratio 2.66, p <0.0001). After adjustment in multivariate analysis, anemia and CKD each remained predictors for an abnormal scan. The association was stronger in those with the 2 conditions (odds ratio for high-risk scan 1.89, p = 0.0002). In conclusion, in patients with suspected CAD, anemia and CKD are predictors of myocardial perfusion single-photon emission computed tomographic markers for worsened outcomes. The relation was independent of other risk factors, supporting the inclusion of anemia and CKD in global risk assessment for patients with suspected CAD.