Urinary and Fecal Incontinence and Quality of Life in African Americans

OBJECTIVES: To investigate associations between quality of life (QoL) and incontinence in a population‐based African‐American sample. DESIGN: Cross‐sectional survey. SETTING: Metropolitan St. Louis, Missouri. PARTICIPANTS: Eight hundred fifty‐three non‐institutionalized African Americans aged 52 to 68 in the African American Health study. MEASUREMENTS: Respondents who reported having involuntarily lost urine over the previous month were classified as having urinary incontinence (UI), and respondents who reported having lost control of their bowels or stool over the past year were classified as having fecal incontinence (FI). QoL was measured using the Medical Outcomes Study 36‐Item Short‐Form Health Survey (SF‐36) and the 11‐item Center for Epidemiologic Studies Depression Scale (CES‐D). RESULTS: Prevalences of UI and FI were 12.1% (weighted n=102/841) and 5.0% (weighted n=42/841). Participants with UI and those with FI had worse SF‐36 scores than their referent groups (physical function ?15.5 and ?38.1 points, respectively; role physical ?13.2 and ?26.5 points; bodily pain ?15.7 and ?24.5 points; general health perceptions ?15.5 and ?27.6 points; vitality ?15.0 and ?16.5 points; social functioning ?18.4 and ?25.6 points; role emotional ?13.2 and ?22.1 points; mental health ?12.2 and ?17.5 points; all Ps<.001), adjusting for age, sex, body mass index, and chronic conditions. Proportions with clinically relevant levels of depressive symptoms were also higher in both groups (UI+17.9%; P<.001) and FI (+37.2%; P<.001) than in their referent groups. CONCLUSION: UI and FI were strongly associated with worse health‐related QoL as well as symptoms of depression in this population‐based sample of African Americans.     

Role of malaria induced oxidative stress on anaemia in pregnancy

ObjectiveTo assess the role of oxidative stress on anaemia in pregnancy.MethodsBlood samples were collected from pregnant and non-pregnant women who came for antenatal clinic and medical check at Comprehensive Health Center, Akungba-Akoko and Iwaro General Hospital in Akoko Area of Ondo State, Nigeria. Thick and thin blood films were prepared and used for malaria parasite counts. Haemoglobin level was determined by colorimetric method using Drabkin's solution. Oxidative status was determined using malondiadelhyde level as an indicator of lipid peroxidation, while ascorbic acid and reduced glutathione levels were measured by standard spectrophotometric methods.ResultsMean parasite density was significantly higher in pregnant women than non-pregnant women (P<0.05). Haemoglobin level was significantly reduced in malaria positive pregnant and non-pregnant women than malaria negative (8.3-10.0 g/dL) (P<0.05). The oxidative status indicated that malondialdehyde (MDA) was significantly increased in pregnant [(2.5±0.7) nmol/mL] than non-pregnant women [(1.8±0.1) nmol/mL] (P<0.05), while Vit C and superoxide dismutase (SOD) levels were significantly reduced in pregnant than non-pregnant women(P<0.05). There was an inverse correlation between Hb and MDA levels in pregnant women studied. Positive correlation was observed between the mean MDA level and parasite density (r = 0.53). The Hb level decreased as the parasite density and MDA level increased in pregnant women.ConclusionsThis study shows that oxidative stress, caused by malaria infection could be part of the contributing factors responsible for anaemia in pregnancy.     

Impaired hippocampal rhythmogenesis in a mouse model of mesial temporal lobe epilepsy

Mesial temporal lobe epilepsy (mTLE) is one of the most common forms of epilepsy, characterized by hippocampal sclerosis and memory deficits. Injection of kainic acid (KA) into the dorsal hippocampus of mice reproduces major electrophysiological and histopathological characteristics of mTLE. In extracellular recordings from the morphologically intact ventral hippocampus of KA-injected epileptic mice, we found that theta-frequency oscillations were abolished, whereas gamma oscillations persisted both in vivo and in vitro. Whole-cell recordings further showed that oriens-lacunosum-moleculare (O-LM) interneurons, key players in the generation of theta rhythm, displayed marked changes in their intrinsic and synaptic properties. Hyperpolarization-activated mixed cation currents (Ih) were significantly reduced, resulting in an increase in the input resistance and a hyperpolarizing shift in the resting membrane potential. Additionally, the frequency of spontaneous excitatory postsynaptic currents (sEPSCs) was increased, indicating a stronger excitatory input to these neurons. As a consequence, O-LM interneurons increased their firing rate from theta to gamma frequencies during induced network activity in acute slices from KA-injected mice. Thus, our physiological data together with network simulations suggest that changes in excitatory input and synaptic integration in O-LM interneurons lead to impaired rhythmogenesis in the hippocampus that in turn may underlie memory deficit.     

Extensive orf infection in a toddler with associated id reaction

Orf is a zoonotic parapoxvirus typically transmitted to humans by a bite from goats or sheep. We present an unusual case of multiple orf lesions on the fingers of a 13‐month‐old child who was bitten by a goat and subsequently developed progressive swelling, blistering, and necrotic papulonodules of the hand followed by an additional diffuse, pruritic, papular rash. A primary diagnosis of orf infection was confirmed using real‐time polymerase chain reaction, and the diffuse eruption was clinically consistent with an id reaction. Extensive necrosis and papular id reaction associated with orf rarely have been described.     

Hereditary coproporphyria and epilepsy

A 9-year-old boy with mental deterioration and epilepsy suffered an acute attack of hereditary coproporphyria associated with worsening of seizure control. Leucocyte coproporphyrinogen oxidase activity was undetectable in the patient during this attack, and was reduced in his mother, a latent case. The complex relationship between porphyria, epilepsy, and anticonvulsant drugs is discussed.     

The effect of abdominal surgery on the serum concentration of the tumour-associated antigen CA 125

Summary. The CA 125 assay is used to monitor the course of disease in women with adenocarcinoma of the genital tract. We measured serum CA 125 levels longitudinally in three different groups of patients who had normal scrum CA 125 levels (16 U/ml) before extensive intraperitoneal abdominal surgery (group 1, second-look laparotomy in 28 women with ovarian cancer; group 2, radical hysterectomy in 42 patients with cervical cancer; group 3,13 men and one woman who had aortic surgery for atherosclerotic occlusive disease or aneurysm formation). Following surgery, rising serum CA 125 levels were observed in 69 out of the 84 patients (82%), irrespective of the primary diagnosis, type of operation or sex. The highest levels were found during the second week after the operation (range 3–336 U/ml) and decreased gradually thereafter, to become normal at 8 weeks after surgery. It was concluded that abdominal surgery interferes with the specificity of CA 125 as a tumour marker during the early postoperative period.