bluuebunny/crossref_metadata_2025 huggingface dataset:
Decreased Expression of Endometrial Decay Accelerating Factor (DAF), a Complement Regulatory Protein, in Patients With Luteal Phase Defect
Authors: KAUL ANIL , NAGAMANI MANUBAI , NOWICKI BOGDAN
Published: May 2013

PROBLEM: We investigated the level of decay accelerating factor (DAF) in the endometrium of luteal phase defect (LPD) patients, before and after treatment with progesterone.

METHODS: Endometrial samples from fourteen normal‐cycling controls and six samples from infertility patients with LPD before and four samples after progesterone treatment were stained by anti‐DAF IgG using immunohistochemistry.

RESULTS: Mean DAF OD in LPD patients was 15% compared to 60% in the control group. The mean DAF OD was 88% after treatment with progesterone.

CONCLUSION: Results support interpretation that progesterone upregulates DAF while decreased progesterone may be associated with reduced expression of the DAF in LPD patients.
Placental Tissue From Human Miscarriages Expresses Class II HLA‐DR Antigens
Authors: ATHANASSAKIS IRENE , AIFANTIS YIANNIS , MAKRYGIANNAKIS ANTONY , KOUMANTAKIS EUGENE , VASSILIADIS SIMON
Published: May 2013

PROBLEM: Class II major histocompatibility antigens occupy a central role in the development of humoral or cellular immunologic responses. Surprisingly, in the maternal‐fetal interphase, where two genetically different organisms come in direct contact, these antigens are absent. Based on previous studies in mice we have demonstrated that the absence of class II antigens represents another mechanism of fetal protection from the maternal immune response and, furthermore, that the induction of these antigens in the placenta makes the tissue immunogenic and susceptible to maternal immune attack, leading thus to fetal abortion. In order to test this hypothesis in humans, we analyzed the presence of class II antigens in aborted placentae.

METHOD: Class II expression on aborted placentae was examined by immunoperoxidase staining on frozen sections. We also studied hematologic changes that accompany such events, measuring white and red blood cell counts, hematocrit, hemoglobin, as well as IgG serum levels by standard techniques.

RESULTS: The detection of class II antigens on the aborted tissue indicates that these antigens are indeed major components of a pathway, which leads to a plethora of abnormal phenomena for the maternal organism such as low hematocrit levels, elevated IgG production, and increase of white blood cell numbers.

CONCLUSION: The results presented are consistent with our previous observations in mice and point to novel directions not only to pregnancy failure diagnosis, but also to new therapeutic approaches.
Metalloproteinase Secretion by Endometrial Leukocyte Subsets
Authors: SHI WENLIANG , MOGNETTI BARBARA , CAMPANA ALDO , BISCHOF PAUL
Published: May 2013

PROBLEM: Human endometrium contains up to 40% leukocytes. Since their function is unclear, we cultured these cells separately to analyze their proteolytic potential in vitro.

METHOD: Endometrium was obtained from hysterectomies or from first trimester abortion. After collagenase digestion, the different leukocyte subsets (CD56, CD3, CD19, CD16, CD45) were immuno‐separated and cultured. Gelatine zymography and a quantitative type IV gelatinase assay were run on all culture supernatants.

RESULTS: On zymography, all subtypes of endometrial leukocytes released gelatinases. The 72‐kDa gelatinase was absent from peripheral leukocyte supernatants, whereas it was secreted by all endometrial leukocytes. The 92‐kDa gelatinase was present in all culture supernatants. Large granular lymphocytes (CD56+, LGL) expressed the highest type VI gelatinase activity as compared to all other leukocytes. This activity increased during the cycle in LGL and T cells but remained unchanged in glandular and stromal cells.

CONCLUSIONS: Endometrial leukocytes, particularly LGL, secrete significant amounts of gelatinases.
Regulation of Classical HLA Class I Genes in Human Choriocarcinoma Cells by Nuclear Proteins Binding to MHC Class I Regulatory Elements
Authors: WAKIMOTO AKINORI , OHASHI KAZUTOMO , KOYAMA MASAYASU , KATO MUNEHIRO , TSUTSUI TATEKI , SAJI FUMITAKA , TANIZAWA OSAMU
Published: May 2013

PROBLEM: The regulation of classical HLA class I genes in choriocarcinoma have been reported.

METHODS: We determined whether four choriocarcinoma cell lines expressed classical HLA class I or HLA‐G by a reverse transcription‐polymerase chain reaction (RT‐PCR) and studied the regulatory mechanism of classical class I using a gel mobility shift assay.

RESULTS: NUC1 and SCH expressed classical class I but not HLA‐G. GCH1 and Jar did neither. Nuclear protein binding to the class I regulatory element (CRE) was detected in NUC1 and SCH. Interferon‐γ augmented both classical class I expression and the DNA‐protein complex in NUC1. The DNA‐protein complex was not observed in GCH1, and Jar showed a CRE‐binding protein with different electrophoretic mobility and binding affinity from that of SCH and NUC1.

CONCLUSION: The CRE is one of the regulatory elements of classical HLA class I genes in choriocarcinoma cells.
Intravenous Immunoglobulin for Treatment of Recurrent Pregnancy Loss
Authors: COULAM CAROLYN B. , KRYSA LOIS , STERN J. JAROSLAV , BUSTILLO MARÍA
Published: May 2013

PROBLEM: Efficacy of immunotherapy for treatment of recurrent spontaneous abortion (SA) has been controversial. The low treatment effect of white blood cell immunization lead to investigations of alternative treatments including intravenous (IV) immunoglobulin (Ig). To evaluate the efficacy of IVIg for treatment of recurrent SA, a prospective, randomized, double blinded, placebo‐controlled trial was performed.

METHODS: Ninety‐five women experiencing two or more consecutive spontaneous abortions with no known cause were randomized and received either IVIg 500 mg/kg/month or placebo (albumin).

RESULTS: Of 95 women participating in the study, 47 received IVIg and 48 received placebo. Medication was discontinued in 34 women who failed to conceive within four cycles. The remaining 61 women achieved pregnancy. Pregnancy outcomes included 29 deliveries and 32 recurrent SA. Among women delivering live births 18 (62%) received IVIg and 11 (38%) received placebo. By contrast, 21 (66%) women experiencing recurrent SAs received placebo and 11 (34%) received IVIg. Among 61 women who conceived, 29 received IVIg and 32 received placebo. Of the 29 women who conceived and received IVIg, 18 (62%) delivered live births and 11 (38%) experienced recurrent SA. Of 32 women who conceived and received placebo 11 (34%) delivered live births and 21 (66%) had recurrent SA. The difference in live birth rates between women receiving IVIg and placebo was significant (P = 0.04, odds ratio 3.1).

CONCLUSION: IVIg is effective in enhancing the percentage of live births among women experiencing unexplained recurrent SA.
The Expression of a Progesterone‐Induced Immunomodulatory Protein in Pregnancy Lymphocytes
Authors: SZEKERES‐BARTHO JULIA , FAUST ZS. , VARGA P.
Published: May 2013

PROBLEM: The immunological effects of progesterone are mediated by a protein, named the progesterone‐induced blocking factor (PIBF). The PIBF blocks NK activity in vitro and therefore prevents the abortive effect of high NK activity in mice. Increased NK activity has been suggested to play a role in pregnancy termination; thus NK inhibitory effect of the PIBF should contribute to the maintenance of normal gestation. This study was designed to investigate the relationship between in vivo PIBF‐producing capacity and in vitro cytotoxic activity of pregnancy lymphocytes, as well as the clinical status or the outcome of pregnancy.

METHOD: Lymphocytes of 168 pregnant women (96 normal pregnancies, 16 showing clinical symptoms of threatened preterm pregnancy termination, 46 recurrent aborters, and 10 women sampled at the onset of spontaneous abortion or preterm delivery) were isolated on Ficoll‐Paque gradient. The lymphocytes were tested for reactivity with a PIBF‐specific antibody by immunocytochemistry, and simultaneously for cytotoxic activity to human embryonic fibroblast targets.

RESULTS: The percentage of PIBF‐positive lymphocytes in peripheral blood of healthy pregnant women was significantly higher than in that of women at risk for premature pregnancy termination. In peripheral blood of patients undergoing spontaneous pregnancy termination at the time of sampling, and in those of women showing symptoms of premature pregnancy termination we found lower than normal percentage of PIBF‐positive cells. PIBF expression of the lymphocytes showed an inverse correlation with NK activity, and the rate of PIBF positive lymphocytes was related to the outcome of pregnancy.

CONCLUSION: These data suggest a strong relationship between PIBF producing capacity as well as NK activity of the lymphocytes and the success of gestation.
Interleukin‐1β (IL‐1β) Is Increased in the Follicular Fluids of Patients With Premature Luteinization
Authors: CHEN HSIN‐FU , HO G‐NERNG , CHEN SHEE‐UAN , CHAO KUANG‐HAN , LIN HENG‐RU , HUANG SU‐CHENG , LEE TZU‐YAO , YANG YU‐SHIH
Published: May 2013

PROBLEM: Most, but not all, studies indicate that premature luteinization correlates with poor pregnancy outcome in in‐vitro fertilization (IVF) programs. It remains unclear whether cytokines (IL‐1β, TNFα), the established immune mediators, play a role in regulation or initiation of an abnormal follicular or embryo development in patients with premature luteinization.

METHODS: Levels of cytokines (IL‐1β, TNFα), estradiol (E2), progesterone (P4), and androstenedione (Aione) were examined in 18 preovulatory follicular fluid (FF) samples from patients with premature luteinization (group 1) and 37 FF samples from patients without premature luteinization (group 2). The number of oocytes recovered, fertilization rate, and pregnancy outcome were evaluated in these two groups.

RESULTS: IL‐1β (25.4±11.9 pg/ml, mean ±SD) and TNFα (13.4±10.7 pg/ml) were present in these FF samples. The mean level of IL‐1β in group 1 was significantly higher than that in group 2 (37.3±12.3 vs. 20.0±7.6 pg/ml; P<0.00001) and the mean level of E2 was significantly lower in group 1 than that in group 2 (1064±686 vs. 1570±641 ng/ml; P=0.02). The levels of TNFα, P4, and A'ione showed no distinction between these two groups. There was no correlation between the levels of either IL‐1β or TNFα and P4, E2 or A'ione. The fertilization rate in group 1 (62/77; 80%) was similar to that in group 2 (124/160;78%). Five of 7 patients in group 1 and seven of 20 patients in group 2 achieved pregnancy following embryo transfer. One of five pregnancies in group 1 aborted.

CONCLUSION: The exaggerated levels of IL‐1β in patients with premature luteinization may arise from accumulation of this cytokine owing to sustained high LH stimulation, and this may be a protective response to the abnormal LH surge and function to inhibit prematurely increased secretion of P4. These data indicate the important role of LH in the induction of IL‐1β secretion and the possible regulatory action of IL‐1β in luteinization. According to the diminution of E2 in group 1, there may be a subtle atretic process progressing in follicles primed with prematurely elevated LH. However, the detrimental effect of premature luteinization, if it exists, may work at the stage during or after implantation.
Menopause Is Associated With a Significant Increase in Blood Monocyte Number and a Relative Decrease in the Expression of Estrogen Receptors in Human Peripheral Monocytes
Authors: BEN‐HUR H. , MOR G. , INSLER V. , BLICKSTEIN I. , AMIR‐ZALTSMAN Y. , SHARP A. , GLOBERSON A. , KOHEN F.
Published: May 2013

PROBLEM: The clinical significance of the differential expression of estrogen receptor (ER) in human monocytes was evaluated.

METHOD: Two color flow cytometry analysis was used on peripheral blood samples of young and postmenopausal females and postmenopausal females treated with estrogen replacement therapy. In addition, the monocyte and lymphocyte counts and the blood estrogen levels of each patient were determined.

RESULTS: During menopause there is a significant decrease in the percentage of ER positive monocytes, and an increase in blood monocyte number, which declines following estrogen replacement therapy to values of the young.

CONCLUSIONS: These findings suggest that estrogen modulates the monocyte numbers and its effects may be mediated through the ER in the monocytes.
IL‐1β TNF‐α, and IL‐2 in Peritoneal Fluid and Macrophage‐Conditioned Media of Women With Endometriosis
Authors: KEENAN JEFFREY A. , CHEN THOMAS T. , CHADWELL NANCY L. , TORRY DONALD S. , CAUDLE MICHAEL R.
Published: May 2013

PROBLEM: The presence of various cytokines in human peritoneal fluid has been incompletely evaluated. Changes in cytokine levels may be related to the development of endometriosis, infertility, and activation of peritoneal macrophages. This study assesses levels of IL‐1β, IL‐2, and TNF‐α in peritoneal fluid and macrophage conditioned media of women with endometriosis.

METHOD: Peritoneal fluid was collected from 51 women at the time of diagnostic or operative laparoscopy for benign gynecologic disease. Peritoneal macrophages were isolated, cultured for 24 h, and the culture media collected. IL‐1β, IL‐2, and TNF‐α levels were determined by commercial ELISA kits.

RESULTS: The mean concentration of IL‐1β and TNF‐α was significantly higher in macrophage conditioned media of patients with endometriosis (P < 0.02). However, there were no significant changes in peritoneal fluid cytokine levels. Peritoneal macrophage concentrations were also higher in patients with endometriosis.

CONCLUSION: This study supports the concept that endometriosis is associated with activation of peritoneal macrophages, and a higher concentration of these cells. This activation is reflected by the increased levels of cytokines found in macrophage conditioned media. The absence of significant changes in peritoneal fluid cytokine levels would seem to indicate that the above derangements are not responsible for the development or progression of endometriosis.
Maternal Cells in Chorionic Villi From Placentae of Normal and Abnormal Human Pregnancies
Authors: Labarrere Carlos A. , Faulk W. Page
Published: May 2013

PROBLEM: We asked if activated macrophages and CD4 positive T lymphocytes in placental chorionic villi with villitis were of maternal or fetal origin.

METHOD: We employed a double antibody immunocytochemical technique on placental sections from three normal and four abnormal pregnancies with small‐for‐gestational‐age infants. All studied placentae were mismatched for the maternal‐fetal HLA‐DRw 52 antigen. Areas of immunopathology were identified by using a monoclonal antibody to a monomorphic determinant on HLA‐DR, and the origin of immunological cells in areas of immunopathology was identified by using a monoclonal antibody to a polymorphic determinant on HLA‐DRw 52.

RESULTS: We used a double antibody technique that employed monoclonal antibodies to HLA‐DR and HLA‐DRw 52 antigens and placentae that were mismatched for the maternal‐fetal HLA‐DRw 52 antigen. We found that the vast majority of immunological cells within villi with inflammation were of maternal origin. Quantitative studies showed that between 75 and 100% of the cells in normal as well as in abnormal pregnancies were of maternal origin, and that abnormal pregnancies had a significantly higher percentage of villi with maternal cellular infiltrates.

CONCLUSION: Our data show unequivocally that cells in areas of placental immunopathology are predominantly of maternal origin, and that abnormal pregnancies are associated with significantly more villi containing immunological cells of maternal origin.
A Novel Bioassay for Detection of Preimplantation Factor (PIF)
Authors: Roussev Roumen G. , Barnea Eytan R. , Thomason Edward J. , Coulam Carolyn B.
Published: May 2013

PROBLEM: To identify the presence of vital preimplantation embryos in vivo in humans, a newly observed phenomenon based on autorosette formation between lymphocytes and platelets, when treated with pregnant sera, was used as a marker.

METHOD: Serum samples were obtained from 65 patients on the fourth day after embryo transfer (ET). Sera from 10 healthy males and 47 nonpregnant women were used as controls. The preimplantation factor (PIF) was detected by using blood group 0+ donor lymphocytes and platelets incubated with blinded serum in the presence of anti‐CD2 antibody and rabbit complement. Human chorion gonadotropin (hCG) concentrations were determined 7 days later and compared with results of the lymphocyte‐platelets assay. Implantation was confirmed by ultrasonographic evidence of presence of an intrauterine gestational sac. The role of platelet activating factor (PAF) in the observed phenomena was studied experimentally.

RESULTS: Significantly more lymphocyte‐platelet rosette formations were observed when sera from women who successfully implanted were compared to sera from women who failed to implant. This assay yielded a specificity of 95%, sensitivity of 88%, positive predictive value of 94%, and negative predictability of 90%. PAF added directly to the cell suspension and tested sera controls did not influence the percentage of lymphocyte/platelets rosettes.

CONCLUSION: The application of PIF assay will enable the identification and study of early pregnancy events before the implantation occur. PAF by itself is not responsible for the rosette formation.
Is Spontaneous Resorption in the DBA/2‐Mated CBA/J Mouse due to a Defect in “Seed” or in “Soil”?
Authors: Muzikova Ewa , Clark David A.
Published: May 2013

PROBLEM: Recurrent spontaneous resorption in DBA/2‐mated CBA/J mice has been attributed to damage by NK‐lineage cells and TNF‐α beginning several days after implantation. However, some recent data have suggested CBA/J female mice have a high proportion of preimplantation embryo abnormalities resulting in defective in vitro implantation and impaired trophoblast outgrowth. Could spontaneous abortion be due to a defective embryo (“seed”) rather than a hostile post‐implantation uterine lining (“soil”).

METHOD: Mated CBA/J females were manipulated so as to have high spontaneous abortion rates and a high percent abnormal embryos, or low resorption rates and a low percent abnormal embryos. Embryos from low aborting females were transferred into high aborting female recipients that were pseudopregnant, and vice versa.

RESULTS: Abnormal embryos from females with high abortion rates implanted in low aborting females and did not show any greater tendency to resorb than normally developed embryos in these recipients. By contrast, normal embryos to some extent and abnormal embryos to a much greater extent, gave a high abortion rate when the recipient female was a high aborter.

CONCLUSION: Properties of the “soil” into which embryos implant determines the likelihood of success or failure (abortion). Abnormal pre‐implantation embryos can be “rescued” by “good soil”; “sick soil” damages both normal and abnormal embryos. Defining the cellular and molecular mechanisms may be useful in understanding basic mechanisms leading to aborting and nonaborting pregnancy.
Effects of Endometrial Serpin‐Like Proteins on Immune Responses in Sheep
Authors: Skopets Boris , Liu Wen‐Jun , Hansen Peter J.
Published: May 2013

PROBLEM: The uterine milk proteins (UTMP) are a pair of related glycoproteins that are the major secretory products of the endometrium of the pregnant ewe. UTMP are members of the serpin superfamily of serine protease inhibitors but have no known antiprotease activity. One possible role for UTMP is to inhibit uterine immune responses—UTMP inhibit mitogen and mixed lymphocyte‐induced proliferation of peripheral blood lymphocytes, natural killer (NK) cell activity and abortion caused by NK cell activation. Present objectives were to further evaluate the lymphocyte‐inhibitory activity of UTMP and test whether UTMP modify immune responses in vivo.

METHOD: One experiment demonstrated that UTMP inhibited antigen‐induced lymphocyte proliferation induced by Candida albicans extract. In another experiment, ewes were immunized with OVA mixed with 3.75 mg/ml of UTMP or ovine serum albumin (OSA control). Injections of 1 mg OVA + UTMP or OSA in incomplete adjuvant were administered 6 wk later. Titers of antibody to OVA were lower (P<0.001) for ewes administered UTMP than for ewes administered OSA. Effects of UTMP on delayed hypersensitivity reactions were evaluated in three experiments using skin‐fold thickness assays.

RESULTS: UTMP did not inhibit the increase in skin‐fold thickness caused by PHA and Mycobacterium tuberculosis but rather tended to increase the response to PHA.

CONCLUSION: Results strengthen the thesis that UTMP are physiologically relevant immunoregulatory molecules. Nonetheless, effects on skin‐fold responses indicate that actions of UTMP can be more complex than would be predicted based on the proteins only having a single biological effect.
Vascular regenerative therapies for the treatment of erectile dysfunction: current approaches
Authors: Condorelli R. A. , Calogero A. E. , Vicari E. , Favilla V. , Morgia G. , Cimino S. , La Vignera S.
Published: May 2013

The pharmacological treatment of erectile dysfunction (ED) is mainly represented by the administration of inhibitors of phosphodiesterase‐5 (PDE5). However, in the clinical practice many patients do not benefit from such a treatment, hence the scientific interest extends to other therapeutic strategies; in particular, to the vascular regenerative therapy. This review describes the main acquisitions related to this approach represented by the mesenchymal stem cell or adipose tissue stem cell transplantation and endothelial nitric oxide synthase or vascular endothelial growth factor gene therapy. Moreover, there are other two aspects of wide interest represented by the potential vascular regenerative effects exerted by the PDE5 inhibitors and the therapeutic strategies for a category of patients who more frequently do not respond to the conventional treatment for ED, the patients with diabetes mellitus.
Receptor mediated amelioration of the detrimental effects of sperm agglutinating factor on sperm parameters
Authors: Kaur S. , Prabha V.
Published: May 2013

Sperm agglutinating factor (SAF) isolated from Staphylococcus aureus immobilizes spermatozoa by agglutination and causes sperm death. This interaction of SAF with spermatozoa is receptor mediated and this receptor has been isolated and purified from human spermatozoa. In this study we attempt to study whether the receptor could ameliorate the detrimental effects of SAF on sperm parameters. Receptor was evaluated against SAF mediated compromised sperm parameters such as Mg2+dependent ATPase activity, acrosome status and apoptosis, in vitro using fluorescent microscopy and flow cytometry as well as in vivo by studying the impact on fertility in mice. Incubation of SAF (80 μg) with spermatozoa resulted in reduced Mg2+dependent ATPase activity and premature acrosomal loss whereas a higher concentration (100 μg), induced apoptosis. However, in the presence of receptor a dose dependent blockage of SAF induced inhibition of Mg2+dependent ATPase activity was observed. At higher concentrations 100 and 125 μg, receptor could inhibit both the premature acrosomal loss and apoptosis. In vivo studies showed that receptor (50 μg) could alleviate SAF induced infertility in female Balb/c mice following a single intravaginal application before mating. The work highlights the efficacy of the receptor as a corrective measure against negative influence of SAF on functional parameters of spermatozoa as well as fertility and presents receptor as a potential therapeutic intervention against SAF induced infertility
The natural history of periodontal attachment loss during the third and fourth decades of life
Authors: Thomson W. Murray , Shearer Dara M. , Broadbent Jonathan M. , Foster Page Lyndie A. , Poulton Richie
Published: May 2013

Aim

To describe changes in the occurrence of periodontal attachment loss (AL) through ages 26, 32 and 38 in a complete birth cohort.

Materials and Methods

Systematic periodontal examinations conducted at ages 26, 32 and 38 in a longstanding New Zealand cohort study (N = 1037). Periodontitis extent data were used to assign participants to periodontitis trajectories using group‐based trajectory analysis.

Results

Eight hundred and thirty‐one individuals were periodontally examined at all three ages; the prevalence and extent of AL increased as the cohort aged. Between 26 and 32, one in nine participants had 1+ sites showing new or progressing AL; that proportion almost doubled between ages 32 and 38. Four periodontitis trajectory groups were identified, comprising 55.2%, 31.5%, 10.7% and 2.5% of the cohort; these were termed the “Very low”, “Low”, “Moderately increasing” and “Markedly increasing” trajectory groups respectively. Those who had smoked tobacco at all ages from 15 through 38 were at higher risk of being in the “Moderately increasing” or “Markedly increasing” trajectory groups. There was a similar risk gradient for those who were in the highest 20% of cannabis usage.

Conclusions

Periodontitis commences relatively early in adulthood, and its progression accelerates with age, particularly among smokers.
Glucagon and insulin have opposite effects on tissue chromium distribution in an obese mouse model
Authors: Lin Chang , Chen Po‐Wen , Chen Wen‐Ying , Sun Chi‐Ching , Mao Frank Chiahung
Published: May 2013

Aims/Introduction

Previous studies have suggested that chromium (Cr) is an essential cofactor for normal carbohydrate metabolism and affects insulin sensitivity, especially in rodent models. Several factors, such as insulin challenge, high carbohydrate intake, and response to stress (e.g., in obesity), alter Cr excretion or distribution. Glucagon is known to regulate carbohydrate metabolism and hyperglucagonemia plays a role in the development of hyperglycemia in diabetic subjects.

Materials and Methods

In the present study we investigated possible modulation of Cr levels by glucagon using an obese mouse model. Mice were kept on a high‐fat diet and then used as an obesity model. These obese mice were injected with one dose of glucagon or insulin and Cr levels in their tissues were determined.

Results

In obese mice, glucagon challenge significantly increased Cr levels in bone but decreased them in the fat and liver. In contrast, insulin challenge significantly decreased Cr levels in bone but increased them in the fat, liver and muscle.

Conclusions

The results show that glucagon and insulin have opposite effects on Cr levels in bone, fat, liver, and muscle.
Evaluation of a national evidence‐based health care course via teleconference in a developing country
Authors: Macedo Cristiane Rufino , Macedo Elizeu Coutinho , Torloni Maria Regina , Atallah Álvaro Nagib
Published: May 2013

Rationale, aims and objectives

Continuing health education is essential but challenged. In 2006, the Brazilian Cochrane Center, in collaboration with the Ministry of Health, launched a mass teaching initiative in evidence‐based health care (EBH) for public‐sector professionals via teleconferencing. This 152‐hour, interactive EBH course has enrolled over 4500 professionals. This study aimed to assess the acquisition EBH knowledge and skills, as well as the attitudes and perceptions of a sample of students enrolled in the 2009 course via teleconferencing.

Methods

This prospective cohort study analyzed three aspects of this 152‐hour EBH course that recruited 1040 volunteer participants, all public health sector employees working in 131 different hospitals or health agencies. Pre‐ and post‐course tests using a modified version of the Berlin questionnaire with 20 multiple‐choice questions were used to examine knowledge acquisition in a sample of 297 students. Tests were completed upon registration and at course completion. The research projects submitted by 872 participants were evaluated to assess skill acquisition. Answers to an anonymous survey assessed the attitudes and perceptions of 914 participants.

Results

There was a significant increase in knowledge from baseline to course completion (mean scores 8.2 ± 3.3 versus 13.7 ± 3.0, P < 0.001). Over 90% of the research projects were judged to be of adequate quality (appropriate rationale for the study, well‐formulated research question and feasible execution); over 95% of the participants were satisfied with the course.

Conclusion

The Brazilian EBH course via teleconference improved the knowledge and skills of public‐sector health professionals and was approved by the vast majority of students.
Nutrition labelling and the choices logo in Israel: positions and perceptions of leading health policy makers
Authors: Gesser‐Edelsburg A. , Endevelt R. , Tirosh‐Kamienchick Y.
Published: May 2013

Background

Based on the Social Marketing approach and Diffusion of Innovations Theory that indicates the importance of opinion leaders with respect to the spreading of new ideas, concepts or practices within a community, the present study aimed to examine positions and perceptions of Israeli leading dietitians and health officials regarding nutrition labelling and the Choices logo, before it was launched in Israel in February 2011, as well as how they would communicate it to the public as agents of influence.

Methods

The study involved in‐depth face‐to‐face and telephone interviews with 15 senior dietitians and Health Ministry officials using semi‐structured protocols including questions about nutrition labelling and the Choices logo.

Results

The respondents considered that the nutrition facts panels usually found on the backs of packages are too complicated for the average consumer. Simiularly, fronts of packages are cluttered with advertisements and health claims, causing confusion. The study participants would like to see an integrative label on the front of the package to facilitate consumers' decisions. However, the Choices logo raises ethical and social questions about the conflict between corporate interests and public health: (i) the label's relativity versus objectivity; (ii) the consumer's responsibility to create a balanced diet; (iii) the label's credibility; and (iv) bias against companies, products and audiences.

Conclusions

The results of the present study highlight the importance of a need for an integrated programme of nutrition promotion, including the use of social marketing based on a cooperative effort between the food industry, regulators and professionals, to recommend changes and adjustments in nutritional front of package labelling with the aim of promoting healthier nutrition consumption.
A dietary survey of patients with irritable bowel syndrome
Authors: Hayes P. , Corish C. , O'Mahony E. , Quigley E. M. M.
Published: May 2013

Background

Food is one of the most commonly reported triggers of irritable bowel syndrome (IBS) symptoms. However, the role of diet in the aetiology and management of IBS has not been clearly established. The present study aimed to examine the dietary practices of Irish patients with IBS and to determine whether these practices increased their vulnerability to nutritional inadequacies.

Methods

A questionnaire was completed by 135 IBS patients on their perceptions of the role of diet in their symptoms and whether they restrict their diet according to the symptoms experienced. A similar questionnaire was used to investigate the perceptions of 111 healthy subjects to the gastrointestinal symptoms experienced on the consumption of food.

Results

Food was considered to cause or worsen their gastrointestinal symptoms in 89.6% of IBS patients compared to 55% of healthy subjects (P < 0.001). Cereal‐based foods, predominantly bread or its components, were the most frequently cited (53.3%), and spicy foods (39.3%), vegetables and fatty foods (35.6% for both) also featured prominently. A significantly greater number of patients with IBS reported changing their diet to minimise symptoms compared to healthy controls (91.9% versus 45.5%, P < 0.001). In relation to whole food groups, milk products (9.6%), fruit (7.4%) and vegetables (5.2%) were those most commonly restricted, with only a small number of IBS patients seeking professional healthcare advice.

Conclusions

The majority of IBS patients consider their symptoms to be related to food, and change their diet by limiting the foods that they perceive as problematic, with some restricting whole food groups. Few patients sought professional healthcare advice when implementing dietary change, possibly exposing a considerable number to an increased risk of nutritional deficiency.
The postschool outcomes of students with mild intellectual disability: does it get better with time?
Authors: Bouck E. C.
Published: May 2013

Background

Although students with mild intellectual disability (MID) present unique educational needs and considerations, in research and in practice, they are sometimes aggregated with students with learning disabilities and emotional disorders and considered mild disabilities or aggregated with students with moderate/severe intellectual disability and labelled as intellectual disability.

Method

This study is a secondary analysis of the NLTS2 data to understand the immediate (i.e. within 2 years) and longer‐term outcomes (i.e. within 4 years, within 6 years and within 8 years) of secondary students with MID. Frequency distributions and a significant test were conducted to analyse data from the NLTS2.

Results

Students with MID struggled with postschool success when considering employment, postsecondary education, and independent living. Across the span of time since graduation (i.e. within 2 years, within 4 years, within 6 years, and within 8 years), a lack of consistent pattern existed, in general, for these students with regards to outcomes. Students did not necessarily improve or decline in their outcomes the longer they were out of school.

Conclusions

The postschool outcome data warrant critical examination of the factors contributing to the poor outcomes. The field needs to systematically understand what schools can control with regards to improved outcomes for students with MID – particularly employment regardless of the length of time out of school and independent living as the time since school exit increases – and then implement such practices.
Using the Interpersonal Skills tool to assess interpersonal skills of internationally educated nurses
Authors: Shen Jay J. , Xu Yu , Staples Shelley , Bolstad Anne L.
Published: May 2013

Aim

To assess interpersonal skills of internationally educated nurses (IEN) while interacting with standardized patients.

Methods

Participants included 52 IEN at two community hospitals in the southwestern region of the USA. Standardized patients were used to create patient–nurse encounter. Seventeen items in four domains (“skills in interviewing and collecting information”; “skills in counseling and delivering information”; “rapport”; and “personal manner”) in an Interpersonal Skills (IPS) instrument were measured by a Likert scale 1–4 with 4 indicating the best performance. The average composite score per domain and scores of the 17 items were compared across the domains.

Results

On 10 of the 17 items, the nurses received scores under 3. Counseling with an average score of 2.10 and closure with an average score of 2.44 in domain 2, small talk with an average score of 2.06 in domain 3, and physical exam with average score of 2.21 in domain 4 were below 2.5. The average composite score of domain 1 was 3.54, significantly higher than those of domains 2–4 (2.77, 2.81, and 2.71, respectively). Age was moderately related to the average score per domain with every 10 year increase in age resulting in a 0.1 increase in the average score. Sex and country of origin showed mixed results.

Conclusion

The interpersonal skills of IEN in three of the four domains need improvement. Well‐designed educational programs may facilitate the improvement, especially in areas of small talk, counseling, closure, and physical exam. Future research should examine relationships between the IPS and demographics factors.
Intranasal Application of Vasopressin Fails to Elicit Changes in Brain Immediate Early Gene Expression, Neural Activity and Behavioural Performance of Rats
Authors: Ludwig M. , Tobin V. A. , Callahan M. F. , Papadaki E. , Becker A. , Engelmann M. , Leng G.
Published: May 2013

Intranasal administration has been widely used to investigate the effects of the neuropeptides vasopressin and oxytocin on human behaviour and neurological disorders, although exactly what happens when these neuropeptides are administered intranasally is far from clear. In particular, it is not clear whether a physiological significant amount of peptide enters the brain to account for the observed effects. In the present study, we investigated whether the intranasal administration of vasopressin and oxytocin to rats induces the expression of the immediate‐early gene productFos in brain areas that are sensitive to centrally‐administered peptide, whether it alters neuronal activity in the way that centrally‐administered peptide does, and whether it affects behaviour in the ways that are expected from studies of centrally‐administered peptide. We found that, whereas i.c.v. injection of very low doses of vasopressin or oxytocin increasedFos expression in several distinct brain regions, intranasal administration of large doses of the peptides had no significant effect. By contrast to the effects of vasopressin applied topically to the main olfactory bulb, we saw no changes in the electrical activity of olfactory bulb mitral cells after intranasal vasopressin administration. In addition, vasopressin given intranasally had no significant effects on social recognition or short‐term recognition memory. Finally, intranasal infusions of vasopressin had no significant effects on the parameters monitored on the elevated plus maze, a rodent model of anxiety. Our data obtained in rats suggest that, after intranasal administration, significant amounts of vasopressin and oxytocin do not reach areas in the brain at levels sufficient to change immediate early gene expression, neural activity or behaviour in the ways described for central administration of the peptides.
Magnetic Resonance Imaging in Paediatric Psychoneuroendocrinology: A New Frontier for Understanding the Impact of Hormones on Emotion and Cognition
Authors: Mueller S. C.
Published: May 2013

Mounting magnetic resonance imaging (MRI) research is characterising the neurobiological trajectories of healthy human brain development. In parallel, studies increasingly acknowledge the relevance of perturbations of these trajectories for adolescent and adult psychopathology. Although an influence of steroid hormones on mood and anxiety disorders has been demonstrated in adults, very little is known about how steroid hormones alter human brain development and contribute to adolescent psychopathology. This review focuses on recent evidence obtained from structural and functional MRI in children and adolescents with genetic endocrine disorders and with characteristic fluctuations in androgen or oestrogen levels (familial male precocious puberty, congenital adrenal hyperplasia, Klinefelter syndrome and Turner syndrome). It aims to highlight how neurobiological findings from these paediatric endocrine disorders can provide insight into the contribution of sex steroids with respect to the development of neurocircuitry involved in affective processing (amygdala, hippocampus) and cognitive control (prefrontal cortex, inferior frontal gyrus, striatum). In addition, findings from these populations may also provide important information on aberrant psychological processes relevant for the clinical care and management of these populations. Finally, the findings are discussed within the context of current frameworks in animal models, such as the organisational–activational hypothesis or the aromatisation hypothesis. The review ends with a discussion of open questions for future enquiry with the goal of integrating translational models with current knowledge of endocrine disorders and developmental studies in healthy populations.
‘Be our guest’: challenges and benefits of using ‘family conversations’ to collect qualitative data about infant feeding and parenting
Authors: Reid Judy , Schmied Virginia , Sheehan Athena , Fenwick Jennifer
Published: May 2013

Aims and objectives

To describe the use of family conversations as a data collection strategy in a study that aimed to explore how ‘social context’ impacts on the infant feeding and early parenting choices of first‐time mothers. Specifically, the authors aim to describe the challenges and benefits of facilitating ‘family conversations’ and the importance of considering the needs of the researcher and the research participants in the data collection process.

Background

Breastfeeding is endorsed by the World Health Organisation as a key health promotion strategy, and yet many women in Australia cease breastfeeding (either fully or partially) before the recommended time frame of six months. Engaging with and interviewing families is a well‐established research strategy, but interviewing the family as a whole has rarely been used as a part of breastfeeding research.

Design

A component of a study, conducted in Sydney, Australia, was to use ‘family conversations’ to ascertain the views and beliefs that are held by those in the first‐time mother's social network and how these impact on her experience of mothering and associated decision‐making.

Conclusions

Being able to balance the needs of the researcher and the research participants is an important challenge that is a core component of conducting ethical research.

Relevance to clinical practice

This paper highlights the viability of ‘family conversations’ as a data collection method for midwifery and nursing research and the need for midwives and child and family health nurses to more actively engage with a woman's support network with education and other strategies to assist in creating an environment for new mothers that is conducive to the continuation of breastfeeding and thriving as a mother.
Immunohistochemical detection of Helicobacter pylori without association of TLR5 expression in oral squamous cell carcinoma
Authors: Grimm Martin , Munz Adelheid , Exarchou Alexandros , Polligkeit Joachim , Reinert Siegmar
Published: May 2013

Background

Approximately 15% of human deaths from cancer are associated with chronic viral or bacterial infections. Helicobacter pylori (HP), a flagellated, Gram‐negative, spiral, microaerophilic bacteria is considered to be the most common chronic bacterial infection in humans. Toll‐like receptor 5 (TLR5) is involved in recognition of bacterial flagella and is thought to promote tumour growth through inflammation‐dependent mechanisms in epithelial cells.

Methods

Expression of HP and TLR5 was analysed in OSCC specimen (n = 191) by immunohistochemistry. TLR5 expression specificity was conducted by Western blotting in cancer cell lines (BICR3, BICR56). TLR5‐stained sections were scanned and digitally analysed using ImageJ and the immunomembrane plug‐in. HP expression and TLR5 expression were associated with clinicopathological characteristics and impact on survival.

Results

Helicobacter pylori detection was significantly associated with recurrence of the tumour, whereas TLR5 expression was not. Multivariate analysis demonstrated HP expression as an independent prognostic factor (P = 0.0260). TLR5 specificity was confirmed by Western blot analysis.

Conclusions

For the first time, this study provides evidence that immunohistochemically detected HP expression in OSCC is associated with reduced disease‐free survival in a large patient cohort. Although TLR5 was not associated with any clinicopathological characteristics or impact on survival, investigation of the TLR family seems to be reasonable due to the possible existence of other pathogenic bacterial or viral compounds in oral cavity cancer.
The Association Between Peer and Own Aggression is Moderated by the BDNF Val‐Met Polymorphism
Authors: Kretschmer Tina , Vitaro Frank , Barker Edward D.
Published: May 2013

Peer antisocial behavior robustly predicts adolescents' own behavior, but not all adolescents are equally vulnerable to their peers' influence and genetic factors may confer vulnerability. This study used data of n = 3,081 adolescents from the Avon Longitudinal Study of Parents and Children to examine whether brain‐derived neurotrophic factor (BDNF), a polymorphism that affects psychological functioning, moderates the association between affiliation with aggressive peers at age 10 and own aggression at age 15. A significant gene–environment interaction was found, where those who affiliated with aggressive peers in childhood showed increased risk of being aggressive in adolescence if they carried the BDNF met‐met variant compared with val‐val carriers. Our findings underline the importance of both biological and social factors for adolescent development.
Sub‐acute and chronic MRI findings in bilateral canine fibrotic contracture of the infraspinatus muscle
Authors: Orellana‐james N. G. , Ginja M. M. , Regueiro M. , Oliveira P. , Gama A. , Rodriguez‐Altonaga J. A. , gonzalo‐orden J. M.
Published: May 2013

A six‐year‐old, 30‐kg female German pointer dog was presented for examination with a history of pre‐existing right‐forelimb lameness and more recent (3 months) persistent lameness in the left‐forelimb. Physical examination revealed mild left‐forelimb lameness and a mild circumduction movement. There were no signs of pain or crepitation detected during manipulation of the shoulders, but the animal was unable to fully flex both glenohumeral joints. Magnetic resonance imaging, using fast recovery fast spin echo T2‐weighted and fat saturated proton density sequences, revealed abnormal heterogeneous hypointensity in the right infraspinatus muscle and a heterogeneous hyperintense area in the left infraspinatus muscle. Surgical treatment consisting of a bilateral infraspinatus tenectomy resulted in improved limb function. Histopathological examination demonstrated tissue changes in the right infraspinatus, characterised by myofibre degeneration and fibrosis, compatible with a chronic degenerative process, while changes in the left infraspinatus muscle were characterised by variable degrees of fibre degeneration, haemorrhage and interstitial oedema.
Promoting mother–infant interaction and infant mental health in low‐income Korean families: Attachment‐based cognitive behavioral approach
Authors: Lee Gyungjoo , McCreary Linda , Breitmayer Bonnie , Kim Mi Ja , Yang Soo
Published: May 2013

Purpose

This study evaluated the attachment‐based cognitive behavioral approach (ACBA) to enhance mother–infant interaction and infant mental health.

Design and Methods

This quasi‐experimental study used a pre‐posttest control group design. Participants were 40 low‐income, mother–infant (infant ages 12–36 months) dyads, 20 dyads per group. The ACBA group received 10 weekly 90‐min sessions. Dependent variables were changes in mother–infant interaction and infant mental health. Additionally, we explored changes in mothers' attachment security.

Results

The groups differed significantly in changes in mother–infant interaction, infant mental health problems, and mothers' attachment security.

Practice Implications

ACBA may enhance mother–infant interaction and infants' mental health.