Miracle-dz/UniFAR-FTUs huggingface dataset:
TNFα dynamics during the oral glucose tolerance test vary according to the level of insulin resistance in pregnant women.

INTRODUCTION TNFα is suspected to play a role in inflammation and insulin resistance leading to higher risk of metabolic impairment. Controversies exist concerning the role of TNFα in gestational insulin resistance. We investigated the interrelations between TNFα and insulin resistance in a large population-based cohort of pregnant women. METHODS Women (n = 756) were followed prospectively at 5-16 weeks and 24-28 weeks of pregnancy. Anthropometric measures and blood samples were collected at both visits. A 75-g oral glucose tolerance test (OGTT) was conducted at the second trimester to assess insulin sensitivity status (homeostasis model of assessment of insulin resistance and Matsuda index). TNFα was measured at the first trimester (nonfasting) and at each time point of the OGTT. RESULTS Participants were 28.4 ± 4.4 years old and had a mean body mass index of 25.5 ± 5.5 kg/m(2) at first trimester. Median TNFα levels were 1.56 (interquartile range, 1.18-2.06) pg/mL at first trimester and 1.61 (interquartile range, 1.12-2.13) pg/mL at second trimester (1 h after glucose load). At second trimester, higher TNFα levels were associated with higher insulin resistance index levels (r = 0.37 and -0.30 for homeostasis model of assessment of insulin resistance and Matsuda index, respectively; P < .0001), even after adjustment for age, body mass index, triglycerides, and adiponectin. Women with higher insulin resistance showed a continuing decrease in TNFα levels during the OGTT, whereas women who were more insulin sensitive showed an increase in TNFα at hour 1 and a decrease at hour 2 of the test. CONCLUSION Higher insulin resistance is associated with higher levels of circulating TNFα at first and second trimesters of pregnancy. TNFα level dynamics during an OGTT at second trimester vary according to insulin-resistance state.
Anti-mullerian hormone deficiency in girls with congenital multiple pituitary hormone deficiency.

CONTEXT Anti-Mullerian hormone (AMH) is believed to validly reflect the ovarian reserve. We wanted to test whether congenital absence of gonadotropin stimulation of the ovaries affects AMH production. OBJECTIVE The objective of the study was to test the validity of AMH as a marker for the ovarian reserve in females with congenital multiple pituitary hormone deficiency (MPHD; deficiency of three or more axes). DESIGN This was a retrospective laboratory study. SETTING The study was conducted in the Department of Pediatric Endocrinology in a tertiary center. PATIENTS The AMH serum levels were assessed in females with congenital (n = 16; median age 12.5 y, range 0.7-31 y) or acquired (n = 20; 18.5 y, range 2-33 y) MPHD and in controls with short stature (n = 100; 9.7 y, range 2-17 y). MAIN OUTCOME MEASURE AMH was measured by AMH Gen II ELISA from Beckmann Coulter. RESULTS In the controls, AMH ranged between 1.8 (P3) and 67.8 pmol/L (P97). Three patients with a severe form of congenital MPHD were AMH deficient, whereas the other 33 patients with MPHD had normal AMH levels. There was significantly more AMH deficiency in congenital than in acquired MPHD (P < .05). CONCLUSIONS Most girls with MPHD have normal serum AMH levels. However, some females with severe congenital MPHD are AMH deficient. This deficiency might be the result of the total absence of gonadotropins. In these females, AMH is unlikely to be an accurate prognostic parameter of the efficacy of fertility treatment.
Determination of Hesperetin in Pericarpium Citri Reticulatae and Human Serum Using Flow Injection Chemiluminescence

A sensitive chemiluminescence (CL) method for the determination of hesperetin at nanogram levels was first presented. It was based on the inhibitory effect of hesperetin on luminol-dissolved oxygen CL reaction in a flow injection system. The decrements of CL intensity were logarithm over the concentrations of hesperetin in a range of 0.5 to 1000 ng mL−1, with a detection limit of 0.2 ng mL−1 (3𝜎) and the relative standard deviations lower than 2.1%. At a flow rate of 2.0 mL min−1, the whole determining performance including sampling and washing could be accomplished in 30 s, giving a sampling efficiency of 120 h−1. The proposed method was applied successfully to the direct hesperetin determination in human serum with recoveries from 97.0 to 106.6%, and indirect hesperidin quantification in 2.5 g pericarpium citri reticulatae showing that the content is 8.1±0.2%. The possible CL mechanism of luminol-dissolved oxygen-hesperetin reaction was also discussed in detail.
Determinants of the Blood Lead Level of US Women of Reproductive Age

Objectives: Blood lead concentration of an infant is largely affected by maternal blood lead recycling. This study aimed to identify sociodemographic, lifestyle, and nutritional determinants for blood lead levels (BLLs) of women of reproductive age in the United States. Methods: Subjects (n = 4,394) were women (20–49 years old) included in the most recent complete National Health and Nutritional Survey (NHANES III). Certain sociodemographic, lifestyle and nutritional determinants for BLL were identified. Results: The BLL of reproductive age women was 1.78 μg/dL geometric mean, The BLL was inversely associated with poverty income ratio and education level, hematocrit, intake of thiamine, and serum levels of folate, and positively associated with ethnicity (Black, Hispanic), living in urban areas or the Northeast region, age, alcohol consumption, cigarette smoking, serum protoporphyrin, and intake of pyridoxine, iron, and folate. Subjects in the lowest decile for serum ascorbic acid had significantly higher BLLs than those in the 2nd through 8th deciles. Conclusion: Infants born to women who smoke, drink and maintain poor nutritional status for selected nutrients are at a greater risk of lead toxicity than those born to other women. Nutritional manipulation of thiamine, ascorbic acid and folate may impact BLL in women.
Maturation of growth differentiation factor 15 in human placental trophoblast cells depends on the interaction with Matrix Metalloproteinase-26.

CONTEXT Matrix Metalloproteinase-26 (MMP-26) is the smallest member of matrix metalloproteinase (MMP) family that functions mainly in the extracellular milieu to cleave the extracellular matrix proteins. It is expressed in various cell types of placenta, but its function in placentation has been poorly understood. Considering the existence of a unique cysteine switch sequence in MMP-26 protein sequence, as well as the evidence in cancer cells indicating the digestion of the NH2-terminal domain of ERβ by MMP-26, we hypothesize that MMP-26 may have specific intracellular activity in human placental trophoblast cells. OBJECTIVE This study aimed to identify the intracellular binding partners of MMP-26 and investigate how MMP-26 is involved in placentation through the interactions with its partners. SETTING AND DESIGN Yeast two-hybrid system was employed to screen potential binding partners of MMP-26 in human placenta. Immunoprecipitation and immunofluorescence assays were conducted to verify the interactions between MMP-26 and the binding partners. HEK293T and HTR8/SVneo cell lines were used as in vitro models to investigate the roles of the interaction between MMP-26 and its binding partner on cell behaviors. RESULTS RESULTS of yeast two-hybrid assay, immunoprecipitation, and immunofluorescence assays revealed that MMP-26 could bind to growth differentiation factor 15 (GDF15) in the intracellular milieu. The binding of MMP-26 to GDF15 was responsible for the processing and maturation of pro-GDF15, and the process was dependent on the enzymatic activity of MMP-26. In human placental trophoblast cells, MMP-26 could facilitate the pro-apoptotic effect of GDF15. CONCLUSIONS This is the first report to demonstrate the physiological function of placental MMP-26 in processing GDF15 and subsequently promoting trophoblast cell apoptosis. These findings expand our understanding of the working mechanism of the metalloproteinase in the process of placentation.
The use of interface workers to facilitate child and adolescent mental health services in primary care: a qualitative assessment

The need to improve the skills of primary care workers in the management of mild-to-moderate mental health problems in children and adolescents is widely recognized. One model for providing such skills is the use of specialist psychiatric nurses as interface workers in a consultation–liaison role. This aims to provide training and expert advice to facilitate the detection, assessment and management of child and adolescent mental health problems. The objective of this study is to assess the impact of a pilot scheme which placed three consultation–liaison interface workers, for 15% of their time, in primary care. This study involved a qualitative assessment of health professionals' experiences of the new system, using constant comparison analysis of the transcribed texts of five focus groups. The setting was within the participating surgeries and at the secondary care centre. The participants comprised ten secondary care workers, ten GPs, seven health visitors and three school nurses. The main outcome measure was the views of the health care professionals of the interface worker service. The results showed that primary care staff reported strong, positive effects on confidence, morale and patient care, although a few possible problems were perceived in terms of carers' understanding of brief intervention. Prior to the introduction of the new system, they felt they had little to offer children and adolescents with mental health problems, but now they had a service to offer. The interface workers had particularly enhanced their treatment skills/options. However, the secondary care workers felt that there had been little effect on their workload although only four out of 54 practices feeding into them had had interface workers appointed. Although they recognized the potential benefits for mild to moderate cases in primary care, they were also concerned that scarce resources might be being directed towards lower priority cases. This pilot study concluded that this was an efficient, effective service offering a quick response to patients, equipping primary care workers with treatment skills and having a positive effect on the numbers of referrals to secondary care. Further, more extensive quantitative work is needed to find out if these conclusions are really justified.
Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) – focus on the UK

Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) can be bothersome and negatively impact on a patient's quality of life (QoL). As the prevalence of LUTS/BPH increases with age, the burden on the healthcare system and society may increase due to the ageing population. This review unifies literature on the burden of LUTS/BPH on patients and society, particularly in the UK. LUTS/BPH is associated with high personal and societal costs, both in direct medical costs and indirect losses in daily functioning, and through its negative impact on QoL for patients and partners. LUTS/BPH is often underdiagnosed and undertreated. Men should be encouraged to seek medical advice for this condition and should not accept it as part of ageing, while clinicians should be more active in the identification and treatment of LUTS/BPH.
Zooplankton and Trophic State Relationships in Florida Lakes

Zooplankton, including ciliated protozoans, were collected from 39 Florida lakes of widely ranging trophic state. Annual mean biomass values for different zooplankton groups were regressed against Carlson's Trophic State Index based on annual mean chlorophyll a concentration. Whereas total zooplankton biomass yielded a significant regression with increasing trophic state, microzooplankton (ciliates, rotifers, and nauplii) accounted for more of the relationship than macrozooplankton (cladocera, calanoids, and cyclopoids). Within the microzooplankton, the regression improved with decreasing body size. Macrozooplankton biomass exhibited a weak statistical relationship with lake trophic state, but the different component groups were variable in their response. The dominance within the zooplankton community shifts from macrozooplankton to microzooplankton with increasing trophic state, and the microzooplankton can constitute between 50 and 90% of the total zooplankton biomass in eutrophic lakes. Changes in zoo.
Solitary rectal diverticulum: A case report

Rektal divertikuller cok nadirdir. Hastalarin tanisi cogunlukta tesadufen ve inflamatuar bir sureci takiben konur. Calismada; Stapler ile transanal rezeksiyon sonrasi rektal divertikul gelisen bir hasta taktim ettik. Abdominal Manyetik Rezonans goruntuleme'de rektumda buyuk bir divertikul tespit edildi. Yapilan rektosigmoidoskopide; rektumda dar bir agzi olan ve fekaloidle dolu rektal divertikul tespit edildi. Endoskop esliginde, tespit edilen fekalom parcalanarak rektumdan disariya alindi.
Lack of Association Between the α-Adducin Locus and Essential Hypertension in the Japanese Population

Abstract —Significant linkage and association of α-adducin, a cytoskeleton protein involved in transmembrane ion transport, with essential hypertension were recently shown in Caucasian populations, especially in relation to salt sensitivity. The present study investigated the relevance of this candidate gene to hypertension in a well-characterized Japanese population. A total number of 507 individuals were selected from clinic outpatients. Hypertensive subjects were defined on the basis of the individual’s blood pressure readings before starting medications; the criteria included systolic blood pressure ≥160 mm Hg and/or diastolic blood pressure ≥95 mm Hg. Patients with diabetes mellitus, renal failure, and secondary forms of hypertension had been excluded. Control subjects had blood pressure values <130/85 mm Hg. The allele frequency of a genetic variant at amino acid residue 460 of α-adducin (460Trp) was compared between cases and control subjects with χ2 statistics; in addition, the association was tested with blood pressure as a continuous variable. No significant association was found in either of the statistics tested. The 460Trp variant appeared to be relatively common in the Japanese (54% to 60%) compared with a reported prevalence of 13% to 23% in Caucasians. The present study brought up an important issue concerning the pathophysiological role of α-adducin in non-Caucasian populations, given the likely ethnic variation in the nature of genetic susceptibility loci. The 460Trp variant of the α-adducin gene is unlikely to have a major effect on susceptibility to hypertension in the Japanese population studied, although the present study does not exclude the involvement of α-adducin in the pathogenesis of hypertension.
Avaliação do ombro doloroso pela radiologia convencional

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Long-term echocardiographic and cardioscintigraphic effects of growth hormone treatment in adults with Prader-Willi syndrome.

CONTEXT In Prader-Willi syndrome (PWS), an altered GH secretion has been related to reduced cardiac mass and systolic function compared to controls. OBJECTIVE The objective was to evaluate the cardiovascular response to a 4-year GH therapy in adult PWS patients. STUDY PARTICIPANTS Study participants were nine severely obese PWS adults (three females, six males) and 13 age-, gender-, and body mass index-matched obese controls. METHODS In an open-label prospective study, assessment of endocrine parameters and metabolic outcome, whole-body and abdominal fat scans, echocardiography, and radionuclide angiography in unstimulated and dobutamine-stimulated conditions were conducted at baseline and after 1 and 4 years of GH treatment. RESULTS GH treatment increased IGF-1 (P < .0001), decreased C-reactive protein levels (P < .05), improved visceral fat mass (P < .05), and achieved near-significant changes of fat and fat-free body mass in PWS patients. Left ventricle mass indexed by fat mass increased significantly after 1 and 4 years of GH therapy (P < .05) without evident abnormalities of diastolic function, while a trend toward a reduction of the ejection fraction was documented by echocardiography (P = .054). Radionuclide angiography revealed stable values throughout the study of both the left and right ventricle ejection fractions, although this was accompanied by a statistically nonsignificant reduction of the left ventricle filling rate. A positive association between lean body mass and left ventricle ejection fraction was evident during the study (P < .05). CONCLUSIONS GH therapy increased the cardiac mass of PWS adults without causing overt abnormalities of systolic and diastolic function. Although the association between lean mass and left ventricle ejection fraction during GH therapy corroborates a favorable systemic outcome of long-term GH treatment in adults with PWS, subtle longitudinal modifications of functional parameters advocate appropriate cardiac monitoring in the long-term therapeutic strategy for PWS.
Expanding the Clinical Spectrum Associated With GLIS3 Mutations

Context: GLIS3 (GLI-similar 3) is a member of the GLI-similar zinc finger protein family encoding for a nuclear protein with 5 C2H2-type zinc finger domains. The protein is expressed early in embryogenesis and plays a critical role as both a repressor and activator of transcription. Human GLIS3 mutations are extremely rare. Objective: The purpose of this article was determine the phenotypic presentation of 12 patients with a variety of GLIS3 mutations. Methods: GLIS3 gene mutations were sought by PCR amplification and sequence analysis of exons 1 to 11. Clinical information was provided by the referring clinicians and subsequently using a questionnaire circulated to gain further information. Results: We report the first case of a patient with a compound heterozygous mutation in GLIS3 who did not present with congenital hypothyroidism. All patients presented with neonatal diabetes with a range of insulin sensitivities. Thyroid disease varied among patients. Hepatic and renal disease was common with liver dysfunction ranging from hepatitis to cirrhosis; cystic dysplasia was the most common renal manifestation. We describe new presenting features in patients with GLIS3 mutations, including craniosynostosis, hiatus hernia, atrial septal defect, splenic cyst, and choanal atresia and confirm further cases with sensorineural deafness and exocrine pancreatic insufficiency. Conclusion: We report new findings within the GLIS3 phenotype, further extending the spectrum of abnormalities associated with GLIS3 mutations and providing novel insights into the role of GLIS3 in human physiological development. All but 2 of the patients within our cohort are still alive, and we describe the first patient to live to adulthood with a GLIS3 mutation, suggesting that even patients with a severe GLIS3 phenotype may have a longer life expectancy than originally described.
Regulation of TNF-α by 1α,25-dihydroxyvitamin D3 in human macrophages from CAPD patients

Regulation of TNF-α by 1α,25-dihydroxyvitamin D 3 in human macrophages from CAPD patients. Background We have previously reported that 1α,25-dihydroxyvitamin D 3 [1α,25(OH) 2 D 3 ] accumulates in the dialysis fluid of uremic patients treated by continuous ambulatory peritoneal dialysis (CAPD). It has been reported that this metabolite regulates the production of cytokines by monocytes/macrophages. Since tumor necrosis factor-α (TNF-α) initiates an inflammatory cascade during peritonitis, the aim of the present study was to investigate the effect of 1α,25(OH) 2 D 3 on the production of TNF-α by human peritoneal macrophages (HPMs). Methods HPMs were obtained from patients on CAPD. Cells were incubated with various concentrations of 1α,25(OH) 2 D 3 , 1α,24(S) dihydroxyvitamin D 2 [1α,24(S)(OH) 2 D 2 ] or 25-hydroxyvitamin D 3 (25-OH-D 3 ) for 16 hours. This was followed by lipopolysaccharide (LPS; 1 μg/mL) incubation for 2.5 to 6 hours. TNF-α protein production was determined by enzyme-linked immunosorbent assay. TNF-α mRNA was assayed by the reverse transcriptase-polymerase chain reaction procedure, using internal synthetic mRNA standards for quantitative results. Results Incubation of HPMs with 1α,25(OH) 2 D 3 prior to stimulation with LPS dose dependently inhibited the expression of TNF-α on both mRNA and protein levels. Similar results were obtained with the less calcemic vitamin D 2 analogue 1α,24(S)(OH) 2 D 2 . Incubation of HPMs with 25-OH-D 3 also revealed a down-regulation of TNF-α expression. Since this down-regulatory effect was blocked by ketoconazole, it is likely that this effect was caused by the conversion of 25-OH-D 3 into 1α,25(OH) 2 D 3 by HPMs. Conclusions 1α,25(OH) 2 D 3 has a potent inhibitory effect on the production of TNF-α by LPS-activated HPMs. We hypothesize that 1α,25(OH) 2 D 3 may constitute a regulatory mechanism that, by controlling the intensity of the inflammatory response of the peritoneum, will moderate tissue damage during peritonitis.
One-Hour Postload Hyperglycemia Is a Stronger Predictor of Type 2 Diabetes Than Impaired Fasting Glucose.

CONTEXT Subjects with normal glucose tolerance (NGT) but 1-h postload glucose ≥ 155 mg/dL (NGT-1h-high) exhibit an intermediate cardiometabolic risk profile between individuals with NGT and impaired glucose tolerance (IGT). OBJECTIVE This study aimed to evaluate whether NGT-1h-high subjects have different cardiometabolic characteristics and an increased risk of type 2 diabetes compared with individuals with isolated impaired fasting glucose (IFG). SETTING, DESIGN, AND PATIENTS A cross-sectional analysis was performed on 595 nondiabetic subjects who underwent an oral glucose tolerance test and an euglycemic hyperinsulinemic clamp in an ambulatory care setting. In addition, a longitudinal analysis was performed on 392 individuals, who were reexamined after a followup of 5.2 ± 0.9 y. MAIN OUTCOME MEASURES Insulin sensitivity, beta-cell function, and risk of developing diabetes were measured. RESULTS Subjects with NGT-1h-high have a significant reduction of peripheral insulin sensitivity and beta-cell function, assessed by the disposition index, compared with either 1-h postload glucose < 155 mg/dL (NGT-1h-low) or IFG individuals, but not compared with IGT. Among the 392 subjects studied in the longitudinal analysis the incidence rate of type 2 diabetes over the follow-up period was 2.9, 16.7, 12.5, and 31.4% for subjects with NGT-1h-low, NGT-1h-high, IFG, and IGT, respectively. In a Cox proportional hazard regression analysis the risk of developing diabetes for NGT-1h-high subjects was 4.02 (95% confidence interval [CI] 1.06-15.26); an even higher risk (6.67; 95% CI, 2.09-21.24) was observed in subjects with IGT, but not in the isolated IFG group (1.91; 95% CI, 0.44-8.29). CONCLUSIONS NGT-1h-high subjects exhibit a higher risk of developing diabetes than those with IFG or NGT-1h-low, likely due to decreased insulin sensitivity and beta-cell function.