Soy isoflavone intake and prevalence of depressive symptoms during pregnancy in Japan: baseline data from the Kyushu Okinawa Maternal and Child Health Study

Objective

Several observational studies and trials examined the relationship between isoflavones or soybeans and depressive symptoms among peri- and postmenopausal women. We cross-sectionally evaluated the associations between intake of soy products and isoflavones and depressive symptoms during pregnancy in Japan.

Methods

Study subjects were 1745 pregnant women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Depressive symptoms were defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale.

Results

Higher intake of total soy products, tofu, tofu products, fermented soybeans, boiled soybeans, miso soup, and isoflavones was independently related to a lower prevalence of depressive symptoms during pregnancy: The adjusted prevalence ratios (95 % confidence intervals, P for trend) between extreme quartiles were 0.63 (0.47–0.85, 0.002), 0.72 (0.54–0.96, 0.007), 0.74 (0.56–0.98, 0.04), 0.57 (0.42–0.76, <0.0001), 0.73 (0.55–0.98, 0.03), 0.65 (0.49–0.87, 0.003), and 0.63 (0.46–0.86, 0.002), respectively. A significant positive exposure–response relationship was found between miso intake and depressive symptoms during pregnancy. No material relationship was observed between soymilk intake and depressive symptoms during pregnancy.

Conclusions

Our study is the first to show independent inverse relationships between intake of total soy products, tofu, tofu products, fermented soybeans, boiled soybeans, miso soup, and isoflavones and depressive symptoms during pregnancy.

     

Perception thresholds for electrical stimulation of the palatal mucosa

PURPOSE: To define the normative ranges of the Current Perception Threshold (CPT) of the palatal mucosa and to correlate it with the subjects' attributes. MATERIALS AND METHODS: A group of 129 informed healthy subjects consented to participate in the study. A Neurometer NS3000 device was used to evaluate the CPTs of the nasopalatine nerve (NPN) and the greater palatine nerve (GPN) by using 2000-, 250-, and 5-Hz stimulations. After confirming the relationships with regard to gender, age, weight, height, alcohol consumption, duration of sleep, weight percentage of water content, smoking, and CPT, the normative ranges of the CPT measurements were obtained. RESULTS: Correlations were observed between age and CPTs obtained with the 2000- and 250-Hz stimulations of the GPN. The CPTs of the GPN were higher than those of the NPN. With the exception of the 5-Hz stimulation of the NPN, the CPTs in men were higher than those in women; however, the within- and between-site ratios exhibited no differences between the male and female subjects. No significant effects of smoking and alcohol consumption on CPT were observed. Range analysis revealed an increase in the CPTs as the frequency increased from 5 to 250 to 2,000 Hz. Within-site ratio analysis revealed increasing and spreading CPT ratios in the following order: 250/5 Hz, 2000/250 Hz, and 2,000/5 Hz. In the order of 5-, 250-, and 2000-Hz stimulations, decreasing ratios were observed for the between-site ratio analysis. CONCLUSION: This study provides useful diagnostic criteria for CPTs in the palatal mucosa.     

ASO Visual Abstract: Fecal Microbes Associated with the Outcomes After Esophagectomy in Patients with Esophageal Cancer

Annals of Surgical Oncology -     

Prognostic Significance of Hiatal Hernia in Patients with Gastric Cancer Located within the Upper-Third of the Stomach

World Journal of Surgery - Gastric cancers located within the upper-third of the stomach (UGC), especially the esophagogastric junction GC (EGJGC), have distinct clinicopathological features due to...     

Surgical repair of candida mycotic pseudoaneurysm with extensive vegetations of the ascending aorta and pulmonary artery after heart and kidney transplant

We report a case of invasive candidiasis causing a mycotic pseudoaneurysm involving the ascending aorta and pulmonary artery. The patient presented two years after heart-kidney transplant with acute limb ischemia resulting from embolization of fungal vegetations. Operative findings included a pseudoaneurysm resulting from near-complete dehiscence of the aortic suture line, and large vegetations within the ascending aorta extended to the aortic arch and pulmonary artery, with localized dehiscence of the pulmonic suture line. The ascending aorta was replaced, and the pulmonary artery was repaired with bovine pericardium. The patient did well, and blood cultures were negative at 6 months follow-up.     

The combination of the serum carbohydrate antigen 19-9 and carcinoembryonic antigen is a simple and accurate predictor of mortality in pancreatic cancer patients

Purpose

The aim of this study was to detect high-performance prognostic biomarkers of pancreatic cancer which would enable the identification of high-risk patients.

Methods

The subjects were 324 patients who underwent radical surgery for pancreatic ductal adenocarcinoma without neoadjuvant therapy. We evaluated the prognostic impact of four perioperative serum tumor markers, including carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). We also evaluated the indices by multiplying the values of two tumor markers (e.g., CA19-9 × CEA).

Results

The preoperative CA19-9 × CEA index had a strong correlation with the prognosis of patients with pancreatic cancer, even when the cut-off was set at the median value. CA19-9 × CEA ≥500 was an independent predictor of mortality (hazard ratio: 1.642, p = 0.021). In the ROC curve analysis of early mortality after surgery, the CA19-9 × CEA index had the highest goodness of fit. The presence of CA19-9 × CEA ≥500 had the largest attributable risk proportion because of its combined high predictive performance and prevalence. The postoperative CA19-9 × CEA index was also a significant predictive marker of mortality.

Conclusion

The CA19-9 × CEA index is a strong prognostic biomarker that could help identify pancreatic cancer patients expected to have a poor prognosis so that they can be administered appropriate multidisciplinary treatment.     

Health-related quality of life and prognosis in patients with chronic kidney disease: a 3-year follow-up study

Background

Chronic kidney disease (CKD) is a major global problem and is also associated with a decreased health-related quality of life (HRQOL). The aim of this study was to evaluate measured HRQOL based on the new CKD classification including proteinuria stage, and the effect of measured HRQOL on CKD progression and clinical outcomes over a 3-year period.

Methods

EuroQol (EQ-5D), a generic preference-based questionnaire, was administered to 537 CKD outpatients at the University of Tsukuba Hospital between November and December 2008. We evaluated disease progression in CKD patients including the incidence of end-stage kidney disease (ESKD), cardiovascular disease (CVD) and all-cause mortality over a 3-year follow-up period.

Results

The proportions progressing to the higher stages were 32.6, 20.0, 36.6, 39.5, and 45.8 % from glomerular filtration rate (GFR) stages (G) 1–4, respectively. The proportion progressing to ESKD (G5D) was 0.7 % from G2, 3.9 % from G3b, 20.8 % from G4 and 63.4 % from G5. The incidence of CVD and/or death was 1.2, 4.6, 4.9, 5.3, 8.3 and 21.1 % from G1?G5, respectively. The quality-adjustment weights at G4–5 were significantly lower than at G1–2 and the weights at proteinuria stage (A) 3 were significantly lower than at A1–2. The quality-adjustment weights of patients with events such as 50 % estimated GFR decline, dialysis, CVD, and/or death were significantly lower than those without events.

Conclusion

We showed CKD progression and clinical outcomes over a 3-year period. Quality-adjustment weights in CKD patients were associated with not only disease progression such as initiation of dialysis treatment and incidence of CVD events and all-cause death, but also the level of proteinuria at baseline.     

Modafinil augments brain activation associated with reward anticipation in the nucleus accumbens

Rationale

The nucleus accumbens (NAc) works as a key brain structure of the reward system, in which reward-related neural activity is well correlated with dopamine release from mesolimbic dopaminergic neurons.

Objectives

Since modafinil can modulate dopaminergic transmission through re-uptake inhibition of dopamine, we investigated whether modafinil affects the reward-related brain activity in the NAc in healthy subjects.

Methods

Twenty healthy participants underwent two series of functional magnetic resonance imaging while performing monetary incentive delay task in which they were cued to anticipate and respond to a rapidly presented target to gain or avoid losing varying amounts of money, under modafinil or placebo condition. Blood oxygenation-level dependent (BOLD) activation signals during gain and loss anticipations were analyzed in the NAc as an a priori region of interest as well as the whole brain.

Results

Modafinil significantly changed subjective feelings toward positive ones. The activation of BOLD signals was observed during gain anticipation under the placebo and modafinil conditions in the left and bilateral NAc, respectively. The modafinil condition showed significantly higher BOLD signal change at the highest gain (+¥500) cue compared to the placebo condition.

Conclusions

The present study showed that modafinil affects reward processing in the NAc in healthy subjects through enhancing more positive anticipation, and it may provide a basis for the use of this drug for treating anhedonia observed in psychiatric disorders.     

Influence of laparoscopy-aided gastrostomy on gastroesophageal reflux in neurologically impaired patients using multichannel intraluminal impedance pH measurements

Esophagus - Development of gastroesophageal reflux disease (GERD) after gastrostomy remains debatable. Therefore, this study aimed to evaluate whether laparoscopy-aided gastrostomy (LAG) influence...