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Special issue \u201cThe 2015 Gorkha, Nepal, earthquake and Himalayan studies: First results\u201d
No full textNo abstract available
High-risk sexual behaviors while on depot medroxyprogesterone acetate as compared to oral contraception
No full textAbstract
Background
Depot medroxyprogesterone acetate (DMPA) contraceptive use is associated with an increased risk for Chlamydia infection. However, prior studies inadequately account for potential differences in sexual behavior between users of DMPA and users of other contraceptive methods. In this study we compare sexual risk-taking behavior in women using DMPA to women using oral contraceptive pills (OCP) to assess risk of Chlamydia trachomatis infection.
Methods
In this cross-sectional study of 630 reproductive-aged women seeking routine gynecologic care (449 OCP and 181 DMPA users) sexual risk-taking was evaluated by use of the Safe Sex Behavior Questionnaire, a validated measure of sexual behaviors and attitudes. All women were screened for Chlamydia . Logistic regression estimated the association of contraceptive choice, sexual behaviors, and Chlamydia infection.
Results
Oral contraceptive pill users differed from DMPA users in age, race, marital status, education level, and pregnancy history ( p -values all <0.05). Oral contraceptive pill users had used their method of contraception for longer average duration ( p \u2009<\u20090.01) and reported greater frequency of condom use ( p \u2009<\u20090.01). Eleven (2.5%) OCP and 2 (1.1%) DMPA users had Chlamydia ( p \u2009=\u2009NS).
Conclusions
Oral contraceptive pill and DMPA users differed with respect to both demographic factors and frequency of condom use. Odds of current Chlamydia infection did not differ between OCP and DMPA users when controlling for sexual risk-taking or demographic factors, though due to low Chlamydia rates in our population, this study was underpowered to detect this difference
Associations of lifestyle and diet with the risk of nasopharyngeal carcinoma in Singapore: a case\u2013control study
No full textAbstract
Background
Nasopharyngeal carcinoma (NPC) is a commonly diagnosed cancer in Southeast Asia. Many studies have examined the risk factors for NPC, yet the roles of some risk factors remain inconclusive. The purpose of this study was to examine associations between modifiable lifestyle factors and the risk of NPC in the Singaporean population.
Methods
We conducted a case\u2013control study in Singapore with 300 patients and 310 controls who were recruited between 2008 and 2012. Each control was selected and individually matched to each patient based on sex, ethnicity, and age (\ub15\ua0years). A total of 290 pairs of cases and controls were matched successfully. We examined lifestyle factors such as tobacco smoking, alcohol drinking, various salted and preserved food consumption, and weaning practices.
Results
After adjusting for covariates, multivariate analysis showed that those participants who were current smokers and had ever smoked tobacco had a higher risk of NPC than participants who had never smoked, with odds ratios (ORs) of 4.50 (95% confidence interval [CI] 2.58\u20137.86; P \ua0<\ua00.001) and 2.52 (95% CI 1.54\u20134.12; P \ua0<\ua00.001), respectively. Those who consumed salted vegetables at least once a week also showed a significantly increased risk of NPC than those who never or rarely consumed salted vegetables, with an OR of 4.18 (95% CI 1.69\u201310.38; P \ua0=\ua00.002).
Conclusion
Smoking (currently and ever-smoked) and consuming salted vegetables once a week or more were lifestyle risk factors for NPC, and changes of these factors for the better may reduce the risk of NPC
Transforaminal epidural blood patch for intractable spontaneous cerebrospinal fluid leak: a case report
No full textAbstract
Background
Epidural blood patch (EBP) is a recognized treatment for spontaneous cerebrospinal fluid leak (SCFL) and is typically administered by the interlaminar approach. Here, we report a case of a patient in whom SCFL failed to resolve after three applications of interlaminar EBPs before finally being successfully treated with transforaminal EBP.
Case presentation
We report a case of a 41-year-old female with a definitive diagnosis of SCFL according to computed tomography (CT) myelography. A fluoroscopy-guided interlaminar EBP was applied three times without resolution of her orthostatic headache. A second myelography was therefore performed demonstrating a leak point on the ventral side of the dura mater. To close the ruptured ventral dura mater, it was necessary to fill the ventral epidural space with blood. Therefore, transforaminal EBP was performed. On spinal CT performed immediately after treatment, the ventral epidural space was observed to be filled with injected blood. Her headache improved the following day, and her symptoms completely subsided after 5\ua0days.
Conclusion
Transforaminal epidural blood patch is appropriate for patients with intractable cerebrospinal fluid leak. Patients with cerebrospinal fluid leakage due to rupture of the ventral side of the dura mater may be particularly good candidates for this procedure
Effects of ingesting a pre-workout dietary supplement with and without synephrine for 8\ua0weeks on training adaptations in resistance-trained males
No full textAbstract
Background
The purpose of this study was to examine whether ingesting a pre-workout dietary supplement (PWS) with and without synephrine (S) during training affects training responses in resistance-trained males.
Methods
Resistance-trained males ( N \u2009=\u200980) were randomly assigned to supplement their diet in a double-blind manner with either a flavored placebo (PLA); a PWS containing beta-alanine (3\ua0g), creatine nitrate as a salt (2\ua0g), arginine alpha-ketoglutarate (2\ua0g), N-Acetyl-L-Tyrosine (300\ua0mg), caffeine (284\ua0mg), Mucuna pruiriens extract standardized for 15%\ua0L-Dopa (15\ua0mg), Vitamin C as Ascorbic Acid (500\ua0mg), niacin (60\ua0mg), folate as folic acid (50\ua0mg), and Vitamin B12 as Methylcobalamin (70\ua0mg); or, the PWS supplement with Citrus aurantium extract containing 20\ua0mg of synephrine (PWS\u2009+\u2009S) once per day for 8-weeks during training. Participants donated a fasting blood sample and had body composition (DXA), resting heart rate and blood pressure, cognitive function (Stroop Test), readiness to perform, bench and leg press 1 RM, and Wingate anaerobic capacity assessments determined a 0, 4, and 8-weeks of standardized training. Data were analyzed by MANOVA with repeated measures. Performance and cognitive function data were analyzed using baseline values as covariates as well as mean changes from baseline with 95% confidence intervals (CI). Blood chemistry data were also analyzed using Chi-square analysis.
Results
Although significant time effects were seen, no statistically significant overall MANOVA Wilks\u2019 Lambda interactions were observed among groups for body composition, resting heart and blood pressure, readiness to perform questions, 1RM strength, anaerobic sprint capacity, or blood chemistry panels. MANOVA univariate analysis and analysis of changes from baseline with 95% CI revealed some evidence that cognitive function and 1RM strength were increased to a greater degree in the PWS and/or PWS\u2009+\u2009S groups after 4- and/or 8-weeks compared to PLA responses. However, there was no evidence that PWS\u2009+\u2009S promoted greater overall training adaptations compared to the PWS group. Dietary supplementation of PWS and PWS\u2009+\u2009S did not increase the incidence of reported side effects or significantly affect the number of blood values above clinical norms ..
Absence of system x c \u2212 on immune cells invading the central nervous system alleviates experimental autoimmune encephalitis
No full textAbstract
Background
Multiple sclerosis (MS) is an autoimmune demyelinating disease that affects the central nervous system (CNS), leading to neurodegeneration and chronic disability. Accumulating evidence points to a key role for neuroinflammation, oxidative stress, and excitotoxicity in this degenerative process. System x
c
\u2212
or the cystine/glutamate antiporter could tie these pathological mechanisms together: its activity is enhanced by reactive oxygen species and inflammatory stimuli, and its enhancement might lead to the release of toxic amounts of glutamate, thereby triggering excitotoxicity and neurodegeneration.
Methods
Semi-quantitative Western blotting served to study protein expression of xCT, the specific subunit of system x
c
\u2212
, as well as of regulators of xCT transcription, in the normal appearing white matter (NAWM) of MS patients and in the CNS and spleen of mice exposed to experimental autoimmune encephalomyelitis (EAE), an accepted mouse model of MS. We next compared the clinical course of the EAE disease, the extent of demyelination, the infiltration of immune cells and microglial activation in xCT-knockout (xCT
\u2212/\u2212
) mice and irradiated mice reconstituted in xCT
\u2212/\u2212
bone marrow (BM), to their proper wild type (xCT
+/+
) controls.
Results
xCT protein expression levels were upregulated in the NAWM of MS patients and in the brain, spinal cord, and spleen of EAE mice. The pathways involved in this upregulation in NAWM of MS patients remain unresolved. Compared to xCT
+/+
mice, xCT
\u2212/\u2212
..
Does antiretroviral treatment change HIV-1 codon usage patterns in its genes: a preliminary bioinformatics study
No full textAbstract
Background
Codon usage bias has been described for various organisms and is thought to contribute to the regulation of numerous biological processes including viral infections. HIV-1 codon usage has been previously shown to be different from that of other viruses and man. It is evident that the antiretroviral drugs used to restrict HIV-1 replication also select for resistance variants. We wanted to test whether codon frequencies in HIV-1 sequences from treatment-experienced patients differ from those of treatment-naive individuals due to drug pressure affecting codon usage bias.
Results
We developed a JavaScript to determine the codon frequencies of aligned nucleotide sequences. Irrespective of subtypes, using HIV-1 pol sequences from 532 treatment-naive and 52 treatment-experienced individuals, we found that pol sequences from treatment-experienced patients had significantly increased AGA (arginine; p\ua0=\ua00.0002***) and GGU (glycine; p\ua0=\ua00.0001***), and decreased AGG (arginine; p\ua0=\ua00.0001***) codon frequencies. The same pattern was not observed when subtypes B and C sequences were analyzed separately. Additionally, irrespective of subtypes, using HIV-1 gag sequences from 524 treatment-naive and 54 treatment-experienced individuals, gag sequences from treatment-experienced patients had significantly increased CUA (leucine; p\ua0<\ua00.0001***), CAG (glutamine; p\ua0=\ua00.0006***), AUC (isoleucine; p\ua0<\ua00.0001***) and UCU (serine; p\ua0=\ua00.0005***), and decreased AUA (isoleucine; p\ua0=\ua00.0003***) and CAA (glutamine; p\ua0=\ua00.0006***) codon frequencies.
Conclusion
Using pol and gag genes derived from the same HIV-1 genome, we show that antiretroviral therapy changed certain HIV-1 codon frequencies in a subtype specific way
Berberine inhibits enterovirus 71 replication by downregulating the MEK/ERK signaling pathway and autophagy
No full textAbstract
Background
The MEK-ERK signaling pathway and autophagy play an important role for enterovirus71(EV71) replication. Inhibition of MEK-ERK signaling pathway and autophagy is shown to impair EV71 replication. Berberine (BBR), an isoquinoline alkaloid isolated from Berberis vulgaris L. , has been reported to have ability to regulate this signaling pathway and autophagy. Herein, we want to determine whether berberine can inhibit EV71 infection by downregulating the MEK/ERK signaling pathway and autophagy.
Methods
The antiviral effect of berberine was determined by cytopathic effect (CPE) assay, western blotting assay and qRT-PCR assay. The mechanism of BBR anti-virus was determined by western blotting assay and immunofluorescence assay.
Results
We showed that berberine does-dependently reduced EV71 RNA and protein synthesis, which was, at least in part, the result of inhibition of activation of MEK/ERK signaling pathway. Furthermore, we found that berberine suppressed the EV71-induced autophagy by activating AKT protein and inhibiting the phosphorylation of JNK and PI3KIII.
Conclusions
BBR inhibited EV71 replication by downregulating autophagy and MEK/ERK signaling pathway. These findings suggest that BBR may be a potential agent or supplement against EV71 infection
Immunohistochemical features of giant cell ependymoma of the filum terminale with unusual clinical and radiological presentation
No full textAbstract
Background
Giant cell ependymoma of the filum terminale is a rare variant, generally manifested as a well-circunscribed intradural mass with an indolent biological behavior.
Case presentation
We describe the case of a 48-year-old Mexican female who non-relevant past medical history, that developed a GCE of the filum terminale. Magnetic resonance imaging and computed tomography revealed the presence of an intra-axial tumor extending from L3 to L5 with extra-medullary invasion. Therefore the tumor was considered unresectable and only incisional biopsy was obtained, establishing the tentative diagnosis of a poorly differentiated neoplasia. A second evaluation of the case revealed the presence of numerous non-cohesive pleomorphic giant cells with intranuclear inclusions and broad eosinophilic cytoplasm, alternating with intermediate size cells with round, hyperchromatic nuclei and forming a perivascular pseudo-rosettes pattern. The ependymal phenotype was supported by light microscopy and corroborated by immunohistochemistry analysis. The patient was subsequently treated with radiotherapy 54Gy. She is alive after a 27-month follow-up, with residual disease, difficulty ambulating and pain.
Conclusions
GCE of filum terminale may have an atypical clinical and radiological presentation, albeit with invasive characteristics and anaplasia on histologic analysis. However, its biological behavior is indolent and associated to longer survival. Due to the presence of giant cells, the differential diagnosis of other primary neoplasias at that site were considered, including paraganglioma, malignant peripheral nerve sheath tumors as well as metastatic malignant melanoma, adrenal carcinoma, thyroid gland carcinoma and urothelial carcinoma, that may all harbor giant cells
Simplified Chinese version of the Forgotten Joint Score (FJS) for patients who underwent joint arthroplasty: cross-cultural adaptation and validation
No full textAbstract
Background
The Forgotten Joint Score (FJS) is a newly developed health-related quality of life (HRQoL) questionnaire designed to evaluate the awareness after total knee arthroplasty (TKA). This study cross-culturally adapted and psychometrically validated a simplified Chinese version of the FJS (SC-FJS).
Methods
Cross-cultural adaptation was performed according to the internationally recognized guidelines. One-hundred and fifty participants who underwent primary TKA were recruited in this study. Cronbach\u2019s \u3b1 and intra-class correlations were used to determine reliability. Construct validity was analyzed by evaluating the correlations between SC-FJS and the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the short form (36) health survey (SF-36).
Results
Each of the 12 items was properly responded and correlated with the total items. SC-FJS had excellent reliability [Cronbach\u2019s \u3b1\u2009=\u20090.907, intra-class correlation coefficient (ICC)\u2009=\u20090.970, 95% CI 0.959\u20130.978). Elimination of any one item in all did not result in a value of Cronbach\u2019s \u3b1 of <0.80. SC-FJS had a high correlation with symptoms (0.67, p \u2009<\u20090.001) and pain (0.60, p \u2009<\u20090.001) domains of KOOS and social functioning (0.66, p \u2009<\u20090.001) domain of SF-36, and it also moderately correlated with function in daily living (0.53, p \u2009<\u20090.001) and function in sport and recreation (0.40, p \u2009<\u20090.001) domains of KOOS, and physical subscale of SF-36 (0.49\u20130.53, p \u2009<\u20090.001) but had a low ( r \u2009=\u20090.20) or not significant ( p \u2009>\u20090.05) correlation with mental subscale of SF-36.
Conclusions
SC-FJS demonstrated excellent acceptability, internal consistency, reliability, and construct validity, which can be recommended for patients who underwent joint arthroplasty in Mainland China