Proton magnetic resonance spectroscopy in patients with early stages of amyotrophic lateral sclerosis

Introduction  

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder primarily affecting upper and lower motor neurons. Due to relative fast progression of the disease, early diagnosis is essential. Proton magnetic resonance spectroscopy (¹H-MRS) is used for objectivization of upper motor neuron (UMN) lesions. The aim of this study was to assess the use of ¹H-MRS in the early stages of ALS.     

Sunlight,hormone replacement status and colorectal cancer risk in postmenopausal women

A reanalysis of the Women's Health Initiative (WHI) randomized clinical trial found a significant interaction between supplementation with vitamin D/calcium and estrogen therapy and the risk of colorectal cancer risk, with reduced risks from supplementation limited to the placebo arms of the estrogen trials. To explore whether the vitamin D effects are modified by estrogen therapy, we report a largely cross‐sectional, analysis of the association between sun exposure, which is an important vitamin D source, and colorectal cancer risk among postmenopausal women in the U.S. Radiologic Technologists study. Among 21,695 participants, there were a total of 108 cases. Sun exposure was based on time outdoors and on ambient ultraviolet radiation (UV) exposure based on residence linked to erythemal exposures derived from the Total Ozone Mapping Spectrometer database. Although there was no relationship between outdoor time or ambient UV measure and colorectal cancer risk in current hormone replacement therapy (HRT) users, in never/past HRT users, there was an inverse association with higher ambient UV exposure, RR for highest vs. lowest tertile = 0.40; 95% CI 017, 0.93; p for trend = 0.04. Non‐significant lower risks were also associated with higher levels of outdoor time (≥3.5 hr/week) in never/past HRT users. The interaction between both indicators of sun exposure and HRT and CRC risk was not significant. These data, although exploratory, are consistent with evidence from the WHI suggesting a decrease in colorectal cancer risk may be associated with vitamin D exposure among postmenopausal women who are not taking HRT, but not among current HRT users.     

Agents of support: psychometric properties of the Cancer Perceived Agents of Social Support (CPASS) questionnaire

Objective: The current study presents the development and the evaluation of the psychometric properties of the Cancer Perceived Agents of Social Support (CPASS). The CPASS is a new self‐rating instrument devised in order to enable both cancer patients and their spouses to report on the level of perceived social support they get. The CPASS evaluates the support given by different agents of support (spouse, family, friends and spiritual or religious beliefs) in several dimensions (emotional, cognitive and instrumental). Methods: The study sample comprised 662 cancer patients and their spouses recruited during a routine medical evaluation from three major cancer centers in Israel. The participants completed the CPASS and two other standardized instruments: The ENRICH Marital Satisfaction Scale (EMS) and the Brief Symptom Inventory (BSI). Results: Principal component analysis confirmed a three‐factor structure based upon the agent of support (spouse; friends/family; spiritual/religious beliefs). Cronbach's α coefficients for the agent of support indexes were high (0.80–0.95), while Cronbach's α levels for the kind of support were lower (0.45–0.72). Smallest Space Analysis (SSA) also confirmed the theoretical structure of the CPASS. Pearson correlation coefficients to the other study variables were high and significant. Conclusions: As a whole, the CPASS was found to be a valid tool for the current Israeli sample. Theoretical and practical conclusions and socio‐cultural implications are discussed. Copyright © 2009 John Wiley & Sons, Ltd.     

Polychlorinated Biphenyls Disrupt Intestinal Integrity via NADPH Oxidase-Induced Alterations of Tight Junction Protein Expression

Background

Polychlorinated biphenyls (PCBs) are widely distributed environmental toxicants that contribute to numerous disease states. The main route of exposure to PCBs is through the gastrointestinal tract; however, little is known about the effects of PCBs on intestinal epithelial barrier functions.

Objective

The aim of the present study was to address the hypothesis that highly chlorinated PCBs can disrupt gut integrity at the level of tight junction (TJ) proteins.

Methods

Caco-2 human colon adenocarcinoma cells were exposed to one of the following PCB congeners: PCB153, PCB118, PCB104, and PCB126. We then assessed NAD(P)H oxidase (NOX) activity and expression and the barrier function of Caco-2 cells. In addition, the integrity of intestinal barrier function and expression of TJ proteins were evaluated in C57BL/6 mice exposed to individual PCBs by oral gavage.

Results

Exposure of Caco-2 cells to individual PCB congeners resulted in activation of NOX and increased permeability of fluorescein isothiocyanate (FITC)-labeled dextran (4 kDa). Treatment with PCB congeners also disrupted expression of TJ proteins zonula occludens-1 (ZO-1) and occludin in Caco-2 cells. Importantly, inhibition of NOX by apocynin significantly protected against PCB-mediated increase in epithelial permeability and alterations of ZO-1 protein expression. Exposure to PCBs also resulted in alterations of gut permeability via decreased expression of TJ proteins in an intact physiological animal model.

Conclusions

These results suggest that oral exposure to highly chlorinated PCBs disrupts intestinal epithelial integrity and may directly contribute to the systemic effects of these toxicants.     

Methicillin-Resistant Staphylococcus aureus Carriage and Risk Factors for Skin Infections, Southwestern Alaska, USA

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are common in southwestern Alaska. Outbreak strains have been shown to carry the genes for Panton-Valentine leukocidin (PVL). To determine if carriage of PVL-positive CA-MRSA increased the risk for subsequent soft tissue infection, we conducted a retrospective cohort study by reviewing the medical records of 316 persons for 3.6 years after their participation in a MRSA nasal colonization survey. Demographic, nasal carriage, and antimicrobial drug use data were analyzed for association with skin infection risk. Skin infections were more likely to develop in MRSA carriers than in methicillin-susceptible S. aureus carriers or noncarriers of S. aureus during the first follow-up year, but not in subsequent years. Repeated skin infections were more common among MRSA carriers. In an area where PVL-containing MRSA is prevalent, skin infection risk was increased among MRSA nasal carriers compared with methicillin-susceptible S. aureus carriers and noncarriers, but risk differential diminished over time.     

Significant correlation between peripheral blood CD34+ cell count in children prior to aphaeresis and CD34+ cell yield following aphaeresis: A single‐center experience

Numerous adults’ studies demonstrated that preaphaeresis CD34+ cells significantly correlate with the number of CD34+ cells collected by the aphaeresis procedure. Equivalent studies in children are scarce. We studied retrospectively 92 aphaeresis procedures performed following chemotherapy (44) or in steady state (48) in 60 pediatric patients (40 males, 20 females), median age of 7.5 years. Aphaeresis procedures were performed using a SPECTRA Optica (TERUMOBCT) continuous flow cell separator. CD34+ cell concentrations were assessed using flow cytometry. A highly significant correlation between peripheral CD34 cell count on the day of aphaeresis and CD34 cell yield per kg (R² = .824, P < .0001) was demonstrated. A higher preaphaeresis CD34 cell count was demonstrated in patients with higher preaphaeresis white blood cell count, in patients with brain tumors, and in patients who received chemotherapy as part of their mobilization protocol. A threshold number of 20 peripheral CD34+ cell/μL was found to predict harvesting of 3 × 10⁶ stem cells/kg, and 30 peripheral CD34+ cell/μL for harvesting of 5 × 10⁶ stem cells/kg. This significant correlation between peripheral CD34 cell count and CD34 cell yield, and the threshold number of peripheral CD34 found to predict adequate harvesting can be useful in planning the optimal time for aphaeresis in children.     

Absence of protein-energy malnutrition in Prague homeless

Summary Objective: Define the prevalence of protein-energy malnutrition (PEM) in a convenient sample of Prague’s homeless population. Methods: The study was conducted in Prague over an 8 month period during 2003. Nutritional status was assessed using anthropometric measurements, biochemical and hematological indicators. Of the initial 217 subjects recruited, 201 participated actively. Thirteen percent of the participants were women. One hundred and thirty four participants were interviewed on the premises of Naděje, a Czech charitable organization; the rest were interviewed in Bulovka University Hospital. Results: Mean BMI values were within the normal range, with only 6 (3%) of the men and 2 (7%) of the women below 18.5 kg/m². Wasted muscle mass was found in only 1 (0.6%) man. Serum protein levels were within normal limits. Lymphocytopenia was reported in 3 (2%) of the men. Results of the CAGE questionnaire gave a strong indication of alcoholism in 24 (12%) and alcoholism in 32 (16%) of the participants. Conclusions: The data fails to demonstrate the existence of protein-energy malnutrition in Prague’s homeless population. Submitted: 9 February 2006; Revised: 23 May, 31 October 2006, 4 January 2007; Accepted 26 April 2007