Reduced Abundance of Nitrate-Reducing Bacteria in the Oral Microbiota of Women with Future Preeclampsia

The oral microbiota can contribute to the regulation of blood pressure by increasing the availability of nitric oxide through the reduction of nitrate to nitrite, which can be converted into nitric oxide in the stomach and then enter the circulation. It is unclear if the composition of the oral microbiota is different between women who do and do not develop preeclampsia. This study aimed to compare the composition of the buccal microbiota just prior to the development of symptoms at 36 weeks gestation in 12 women who developed late-onset preeclampsia and 24 matched women who remained normotensive throughout pregnancy by 16S rRNA gene amplicon sequencing. The abundance of the nitrate-reducing Veillonella spp V. parvula and V. dispar and a subunit of nitrate reductase narH was compared using real-time PCR. The abundance of bacteria was correlated with maternal blood pressure and dietary intake of nitrate-containing vegetables. The results showed that the abundance of nitrate-reducing bacteria including Veillonella, specifically V. parvula, and Prevotella was reduced in women who developed preeclampsia. Veillonella but not Prevotella abundance was negatively correlated with maternal blood pressure. The dietary intake of nitrate-containing vegetables did not differ between the groups and was not correlated with the abundance of Veillonella. There was no difference in the abundance of the nitrate reductase subunit narH between the groups. These results suggest that the abundance of nitrate-reducing bacteria is reduced in the oral microbiota of women who later develop preeclampsia, indicating a potential pathway for prevention.     

Parental communication of holocaust experiences and personality characteristics among second-generation survivors

Examined communication concerning wartime experiences that went on in survivor families. Sixty-four Jewish children of survivors filled out questionnaires on parental communication, as well as the MMPI, Mosher's Forced Choice Scale of Guilt, and Hogan's Scale of Empathy. Findings indicate that mother's willingness to talk about her experiences and the frequency of her communication were related significantly to the presence of negative personality traits in the second generation. Guilt-inducing communication (by both parents), early experiential awareness of the Holocaust, and indirect communication about the Holocaust also were related significantly to negative characteristics. Father's willingness to talk about his experiences and the frequency of his communication, however, were related to positive factors among his offspring. When separated along gender lines, most forms of communication were related to negative personality factors for female, but not male, children of survivors.     

An Evaluation of Patients' Willingness to Trade Symptom-Free Days for Asthma-Related Treatment Risks: A Discrete Choice Experiment

Background. Not taking treatment preferences into account may lead to patients' inappropriate use of asthma treatments. The objective of this study was to quantify these preferences, in terms of risk-benefits trade-offs, for six asthma treatment attributes using a discrete choice experiment (DCE). Methods. Adult asthma patients (n = 157) participated in the study. The custom-designed DCE measured preferences for treatment effectiveness (symptom-free days), potential risk (oral thrush and tremor/heart palpitation), ease of use (frequency of daily administration and number of inhalers required), and cost. A nested logit model was used to determine the relative preferences of each attribute, from which the marginal rates of substitution were calculated. Segmented models were used to test for interactions between cost and treatment benefit with socioeconomic status and medication use. Results. Relationships between preferences and all attributes were in the hypothesized direction. On average, patients were willing to pay an additional $14 per month to receive one additional symptom-free day, and $26, $79, and $112 monthly to avoid one, two, and three annual episodes of oral thrush, respectively. Income and the magnitude of short-acting β -agonist use also affected treatment preferences. Conclusions. Overall, asthma patients desired treatments that offered more symptom-free days, but they were willing to trade days without symptoms in exchange for a reduction in adverse events and greater convenience.     

Evaluation of sensory stimulation as a treatment for prolonged coma—seven single experimental case studies

Abstract

An earlier paper discussed the results from the four single case studies that evaluated the immediate within-session effects of sensory stimulation for the treatment of patients in prolonged coma (vegetative state). All four patients were found to show behavioural changes, which suggested increased arousal when treated with the version of the procedure known as multimodal stimulation (in which each sense was stimulated in turn in every session). The procedure known as unimodal stimulation (in which just one sense was treated in any session) did not produce any significant behavioural changes in these four patients. This paper presents even further single case experiments, which give a diversity of findings. Three of the patients showed significant behaviour changes, which suggested increased arousal to unimodal stimulation and not to multimodal stimulation, one subject showed apparent decreased arousal in response to unimodal stimulation and no response to multimodal stimulation, one subject showed apparent increased arousal to multimodal stimulation and decreased arousal to unimodal stimulation and two cases showed no significant findings whatsoever. The findings are discussed in relation to the case histories of the patients.     

Technology-based approaches to patient education for young people living with diabetes: a systematic literature review

Cooper H, Cooper J, Milton B. Technology-based approaches to patient education for young people living with diabetes: a systematic literature review.     

An IgG complexed form of vitamin B12 is a common cause of elevated serum concentrations

ObjectivesTo report detailed investigations in a case of elevated serum B₁₂ due to the presence of an IgG–B₁₂ complex, to determine the prevalence of this phenomenon and to review the literature.Design and methods431 samples with elevated B₁₂ (median 1250 ng/L, range 901–114,480 ng/L) were treated with polyethylene glycol to precipitate immunoglobulin complexes. Samples with > 50% of precipitable B₁₂ (PPB₁₂) were further investigated by protein G adsorption, gel filtration chromatography and measurement of B₁₂ on different analytical platforms.ResultsMedian PPB₁₂ was 22.6%, but in 35 samples (8.1%), median PPB₁₂ was more than 50%. Investigation of 27 of these samples with protein G-Sepharose confirmed the presence of an IgG–B₁₂ complex in 24, and in 15 cases, B₁₂ fell to within the reference range. After treatment of serum with reagents releasing B₁₂ from binding proteins, immunoreactivity co-eluted with free B₁₂. Immunoreactivity of the IgG-bound form of B₁₂ was confirmed using five B₁₂ assays in common use in the UK.ConclusionsAt least 8% of samples with elevated vitamin B₁₂ contain an immunoglobulin complexed form of circulating B₁₂; this possibility should be considered in the interpretation of results.