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Repeated multiple intracranial hemorrhages induced by cardiac myxoma mimicking cavernous angiomas: a case report
No full textAbstract
Background
Repeated intracranial hemorrhages caused by cardiac myxoma is very rare. It is essential for physicians to be aware of such uncommon clinical feature of myxoma.
Case presentation
We report a-49-year-old female patient complained of repeated multiple intracranial hemorrhages, with no sign of cardiac dysfunction or cerebral infarction before admission. Cavernous angioma (CA) was misdiagnosded due to the clinical and magnetic resonance (MR) presentation. A sudden ischemic event after admission led to the finding of a left atrial myxoma.
Conclusions
Repeated intracranial hemorrhages can be the early and primary clinical presentation of cardiac myxoma, probably caused by its metastasis, without obvious ischemic stroke or cardiac symptoms
Women\u2019s descriptions of childbirth trauma relating to care provider actions and interactions
No full textAbstract
Background
Many women experience psychological trauma during birth. A traumatic birth can impact on postnatal mental health and family relationships. It is important to understand how interpersonal factors influence women\u2019s experience of trauma in order to inform the development of care that promotes optimal psychosocial outcomes.
Methods
As part of a large mixed methods study, 748 women completed an online survey and answered the question \u2018describe the birth trauma experience, and what you found traumatising\u2019. Data relating to care provider actions and interactions were analysed using a six-phase inductive thematic analysis process.
Results
Four themes were identified in the data: \u2018prioritising the care provider\u2019s agenda\u2019; \u2018disregarding embodied knowledge\u2019; \u2018lies and threats\u2019; and \u2018violation\u2019. Women felt that care providers prioritised their own agendas over the needs of the woman. This could result in unnecessary intervention as care providers attempted to alter the birth process to meet their own preferences. In some cases, women became learning resources for hospital staff to observe or practice on. Women\u2019s own embodied knowledge about labour progress and fetal wellbeing was disregarded in favour of care provider\u2019s clinical assessments. Care providers used lies and threats to coerce women into complying with procedures. In particular, these lies and threats related to the wellbeing of the baby. Women also described actions that were abusive and violent. For some women these actions triggered memories of sexual assault.
Conclusion
Care provider actions and interactions can influence women\u2019s experience of trauma during birth. It is necessary to address interpersonal birth trauma on both a macro and micro level. Maternity service development and provision needs to be underpinned by a paradigm and framework that prioritises both the physical and emotional needs of women. Care providers require training and support to minimise interpersonal birth trauma
Did you get any help? A post-hoc secondary analysis of a randomized controlled trial of psychoeducation for patients with antisocial personality disorder in outpatient substance abuse treatment programs
No full textAbstract
Background
People in treatment for substance use disorder commonly have comorbid personality disorders, including antisocial personality disorder. Little is known about treatments that specifically address comorbid antisocial personality disorder.
Methods
Self-rated help received for antisocial personality disorder was assessed during follow-ups at 3, 9 and 15 months post-randomization of a randomized trial of psychoeducation for people with comorbid substance use and antisocial personality disorder ( n \u2009=\u2009175).
Results
Randomization to psychoeducation was associated with increased perceived help for antisocial personality disorder. Perceived help for antisocial personality disorder was in turn associated with more days abstinent and higher treatment satisfaction at the 3-month follow-up, and reduced risk of dropping out of treatment after the 3-month follow-up, and perceived help mediated the effects of random assignment on days abstinent at 3-month.follow-up.
Conclusions
Brief psychoeducation for antisocial personality disorder increased patients\u2019 self-rated help for antisocial personality disorder in substance abuse treatment, and reporting having received help for antisocial personality disorder was in turn associated with better short-term outcomes, e.g., days abstinent, dropout from treatment and treatment satisfaction.
Trial registration
ISRCTN registry, ISRCTN67266318 , retrospectively registered 17/7/2012
Cumulative exposure to shift work and sickness absence: associations in a five-year historic cohort
No full textAbstract
Background
Exposure to shift work has been associated with negative health consequences, although the association between shift work and sickness absence remains unclear. The aim of this study is to investigate associations between cumulative exposure to shift work and sickness absence among ground staff employees of an airline company.
Methods
This study used data from the MORE (Monitoring Occupational Health Risks in Employees) cohort, which is a 5-year historic cohort. The population of the present study consisted of 7562 ground staff employees. For each employee, work schedules and sickness absence days between 2005 and 2009 were obtained from company records. For the exposure to different shift schedule types and to the cumulative number of night shifts, the association with long-term sickness absence (>7 consecutive sickness absence days) and the number of sickness absence episodes during 2009, was calculated using logistic and Poisson regression analyses. Socio-demographic variables, work-related variables, job classification variables, and previous sickness absence days were regarded as confounders.
Results
After adjusting for previous sickness absence and job classification variables, only the group of employees that switched into working in a three-shift schedule, showed a significantly increased risk for long-term sickness absence (OR\u2009=\u20091.31, 95%CI 1.02\u20131.69). Night shift exposure was not significantly associated with long-term sickness absence. Exposure to shift work was negatively associated with more sickness absence episodes. Employees who were exposed to more than 46 night shifts also showed a lower risk for more sickness absence episodes. Subgroup analyses showed that single employees and employees without children had an increased risk for long-term sickness absence when exposed to a three-shift schedule, and when they had changed between shift schedule types.
Conclusions
Cumulative exposure to shift work proved to be negatively associated with more sickness absence episodes, and was not associated with more long-term sickness absence, although selection bias could not be ruled out. Future research should explore the influence of household composition, and take into account both previous sickness absence and psychosocial and physical work factors to obtain a better estimation of the association between shift work and sickness absence
Indoor and outdoor PM 10 levels at schools located near mine dumps in Gauteng and North West Provinces, South Africa
No full textAbstract
Background
Few studies in South Africa have investigated the exposure of asthmatic learners to indoor and outdoor air pollution at schools. This study compared outdoor PM
10
and SO
2
exposure levels in exposed (1\u20132\ua0km from gold mine dumps) and unexposed schools (5\ua0km or more from gold mine dumps). It also examined exposure of asthmatic children to indoor respirable dust at exposed and unexposed schools.
Methods
The study was conducted between 1 and 31 October 2012 in five schools from exposed and five from unexposed communities. Outdoor PM
10
and SO
2
levels were measured for 8-h at each school. Ten asthmatic learners were randomly selected from each school for 8-h personal respirable dust sampling during school hours.
Results
The level of outdoor PM
10
for exposed was 16.42 vs. 11.47\ua0mg.m
\u22123
for the unexposed communities ( p \u2009<\u20090.001). The outdoor SO
2
for exposed was 0.02\ua0ppb vs. 0.01\ua0ppb for unexposed communities ( p \u2009<\u20090.001). Indoor respirable dust in the classroom differed significantly between exposed (0.17\ua0mg.m
\u22123
) vs. unexposed (0.01\ua0mg.m
\u22123
) children with asthma at each school ( p \u2009<\u20090.001).
Conclusion
The significant differences between exposed and unexposed schools could reveal a serious potential health hazard for school children, although they were within the South African Air Quality Standards\u2019 set by the Department of Environmental Affairs. The indoor respirable dust levels in exposed schools could have an impact on children with asthma, as they were significantly higher than the unexposed schools, although there are no published standards for environmental exposure for children with asthma
Perceived barriers to achieving a healthy weight: a qualitative study using focus groups at public and private schools in Guatemala City
No full textAbstract
Background
Overweight prevalence among Guatemalan girls is higher in public than in private schools. Little is known about adolescent girls\u2019 perceptions of the right ways to achieve a healthy weight. This study examines public and private school adolescent girls\u2019 perceptions of a \u201chealthy weight,\u201d and barriers and facilitators to achieving it.
Methods
We conducted 4 focus groups in public and private schools in Guatemala City with girls from 13 to 15\ua0years old. The discussion guide included open-ended questions and activities aimed at examining perceptions of \u201chealthy weight\u201d and barriers and motivators to achieving it within the school environment. Focus groups were audio-recorded and transcribed. Data analyses followed established methods of content analysis.
Results
Twenty-eight girls (private school, n \u2009=\u200912; public school, n \u2009=\u200916) of ages ranging from 13.1 to 15.9\ua0years (median, 14, IQR, 13.6\u201314.9) participated in the study. Girls identified images of thin and fit women as healthy. They cited healthy eating and physical activity as ways to achieve a healthy weight. Within the school environment, barriers to maintaining a healthy weight included a lack of healthy food options and the prioritization of sports for boys over girls. In public schools, facilities were less than optimal; in private schools, girls\u2019 access to facilities was limited. Public school girls stated that their uniforms were inappropriate for exercising.
Conclusion
Our findings support the need to provide more healthy food options in Guatemalan schools. In addition, physical activity for girls should be promoted and facilities made available for their use
Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study\ua0- The HUNT Study
No full textAbstract
Background
Lifestyle risk behaviours are responsible for a large proportion of disease burden and premature mortality worldwide. Risk behaviours tend to cluster in populations. We developed a new lifestyle risk index by including emerging risk factors (sleep, sitting time, and social participation) and examine unique risk combinations and their associations with all-cause and cardio-metabolic mortality.
Methods
Data are from a large population-based cohort study in a Norway, the Nord-Tr\uf8ndelag Health Study (HUNT), with an average follow-up time of 14.1\ua0years. Baseline data from 1995\u201397 were linked to the Norwegian Causes of Death Registry. The analytic sample comprised 36 911 adults aged 20\u201369 years. Cox regression models were first fitted for seven risk factors (poor diet, excessive alcohol consumption, current smoking, physical inactivity, excessive sitting, too much/too little sleep, and poor social participation) separately and then adjusted for socio-demographic covariates. Based on these results, a lifestyle risk index was developed. Finally, we explored common combinations of the risk factors in relation to all-cause and cardio-metabolic mortality outcomes.
Results
All single risk factors, except for diet, were significantly associated with both mortality outcomes, and were therefore selected to form a lifestyle risk index. Risk of mortality increased as the index score increased. The hazard ratio for all-cause mortality increased from 1.37 (1.15-1.62) to 6.15 (3.56-10.63) as the number of index risk factors increased from one to six respectively. Among the most common risk factor combinations the association with mortality was particularly strong when smoking and/or social participation were included.
Conclusions
This study adds to previous research on multiple risk behaviours by incorporating emerging risk factors. Findings regarding social participation and prolonged sitting suggest new components of healthy lifestyles and potential new directions for population health interventions
An in vitro screening assay for dental stain cleaning
No full textAbstract
Background
The present study aimed to develop an in vitro model for stain removal from natural enamel for the assessment and comparison of oral hygiene products.
Methods
Bovine teeth ( n \u2009=\u20098 per group) were ground/polished to provide flat enamel specimens and ferric-tannate deposits were precipitated onto the enamel surfaces. The ferric-tannate stained enamel specimens were brushed using an in vitro tooth-brushing simulator with slurries containing commercially available toothpaste products, dental abrasive particles, and sodium tripolyphosphate (STP) solutions of different concentrations. The colour of the enamel surfaces was measured using a spectrophotometer before and after stain application as well as after the brushing treatments.
Results
Differences in stain removal efficacy were found between the toothpastes categorised as whitening and non-whitening comprising of different types of dental abrasives (hydrated silica and alumina). A mean value of 27% for stain removal was detected for the three non-whitening toothpastes and 59% of stain removal was detected for the three whitening toothpastes after 1000 strokes. Compared with the slurry with Zeodent 113 abrasive alone, the addition of STP provided better performance for stain removal under the same brushing conditions (mean value of 62% for Zeodent 113 abrasive alone and 72% with the addition of 5% (w/w) STP after 1000 strokes). No difference was evident between the STP concentration of 5% (w/w) and 10% (w/w).
Conclusions
The ferric-tannate/bovine enamel model reported here provides good stain retention, is rapidly and easily prepared, and is shown to be progressively and reproducibly sensitive to toothbrushing using different toothpastes and surfactant/chelating agent solutions. Importantly, it provides good discrimination between various oral hygiene products.
The stain removal assay reported here has considerable potential to enable comparative assessments of different toothpaste types in terms of their cleaning capabilities
Hypoglycemic and pancreatic protective effects of Portulaca oleracea extract in alloxan induced diabetic rats
No full textAbstract
Background
Diabetes is a major public health concern. In spite of continuous new drug development to treat diabetes, herbal remedies remain a potential adjunct therapy to maintain better glycemic control while also imparting few side-effects. Portulaca oleracea has been traditionally used to manage several diseases due to the anti-oxidant and anti-atherogenic effects it imparts. To better understand the mechanisms associated with potential protective effect of P. oleracea extract against diabetes, alloxan-induced diabetic rats were used in this study.
Methods
Forty Wistar rats (male, 7\u20138-wk-old, 140\u2013160\ua0g) were divided into four groups ( n \u2009=\u200910/group): Group I (control), Group II ( P. oleracea -treated; gavaged with P. oleracea extract daily [at 250\ua0mg/kg] for 4 weeks), Group III (diabetic control; daily IP injection of alloxan [at 75\ua0mg/kg] for 5\ua0days) and Group IV ( P. oleracea -pre-treated diabetic; gavaged with P. oleracea extract daily [at 250\ua0mg/kg] for 4 weeks and then daily IP injection of alloxan [at 75\ua0mg/kg] for 5\ua0days). Body weight, food consumption, blood (serum) levels of glucose, C peptide, Hb A1C, insulin, tumor necrosis factor (TNF)-\u3b1 and interleukin (IL)-6 were determined for all groups.
Results
The results indicated that while Hb A1C, serum levels of glucose, TNF-\u3b1 and IL-6 were all significantly decreased in the P. oleracea- pre-treated diabetic rats, these hosts also had significant increases in C peptide and insulin compared to levels in the\ua0counterpart diabetic rats. These results were confirmed by the histopathological assessments which showed marked improvement of the destructive effect on pancreatic islet cells induced by alloxan.
Conclusion
P. oleracea extract is a general tissue protective and regeneartive agent, as evidenced by increasing \u3b2-cell mass and therefore improved the glucose metabolism. Thus, stimulation of Portulaca oleracea signaling in \u3b2- cells may be a novel therapeutic strategy for diabetes prevention
Oral treatment with Lactobacillus rhamnosus attenuates behavioural deficits and immune changes in chronic social stress
No full textAbstract
Background
Stress-related disorders involve systemic alterations, including disruption of the intestinal microbial community. Given the putative connections between the microbiota, immunity, neural function, and behaviour, we investigated the potential for microbe-induced gut-to-brain signalling to modulate the impact of stress on host behaviour and immunoregulation.
Methods
Male C57BL/6 mice treated orally over 28\ua0days with either Lactobacillus rhamnosus (JB-1)\u2009\u2122 or vehicle were subjected to chronic social defeat and assessed for alterations in behaviour and immune cell phenotype. 16S rRNA sequencing and mass spectrometry were employed to analyse the faecal microbial community and metabolite profile.
Results
Treatment with JB-1 decreased stress-induced anxiety-like behaviour and prevented deficits in social interaction with conspecifics. However, JB-1 did not alter development of aggressor avoidance following social defeat.
Microbial treatment attenuated stress-related activation of dendritic cells while increasing IL-10+ regulatory T cells. Furthermore, JB-1 modulated the effect of stress on faecal metabolites with neuroactive and immunomodulatory properties. Exposure to social defeat altered faecal microbial community composition and reduced species richness and diversity, none of which was prevented by JB-1.
Stress-related microbiota disruptions persisted in vehicle-treated mice for 3\ua0weeks following stressor cessation.
Conclusions
These data demonstrate that despite the complexity of the gut microbiota, exposure to a single microbial strain can protect against certain stress-induced behaviours and systemic immune alterations without preventing dysbiosis. This work supports microbe-based interventions for stress-related disorders