Circulating Levels of Adiponectin, Leptin, Fetuin-A and Retinol-Binding Protein in Patients with Tuberculosis: Markers of Metabolism and Inflammation

BACKGROUND: Wasting is known as a prominent feature of tuberculosis (TB). To monitor the disease state, markers of metabolism and inflammation are potentially useful. We thus analyzed two major adipokines, adiponectin and leptin, and two other metabolic markers, fetuin-A and retinol-binding protein 4 (RBP4). METHODS: The plasma levels of these markers were measured using enzyme-linked immunosorbent assays in 84 apparently healthy individuals (=no-symptom group) and 46 patients with active pulmonary TB around the time of treatment, including at the midpoint evaluation (=active-disease group) and compared them with body mass index (BMI), C-reactive protein (CRP), chest radiographs and TB-antigen specific response by interferon-γ release assay (IGRA). RESULTS: In the no-symptom group, adiponectin and leptin showed negative and positive correlation with BMI respectively. In the active-disease group, at the time of diagnosis, leptin, fetuin-A and RBP4 levels were lower than in the no-symptom group [adjusted means 2.01 versus 4.50 ng/ml, P<0.0001; 185.58 versus 252.27 µg/ml, P<0.0001; 23.88 versus 43.79 µg/ml, P<0.0001, respectively]. High adiponectin and low leptin levels were associated with large infiltrates on chest radiographs even after adjustment for BMI and other covariates (P=0.0033 and P=0.0020). During treatment, adiponectin levels increased further and then decreased. Leptin levels remained low. Initial low levels of fetuin-A and RBP4 almost returned to the normal reference range in concert with reduced CRP. CONCLUSIONS: Our data and recent literature suggest that low fat store and underlying inflammation may regulate these metabolic markers in TB in a different way. Decreased leptin, increased adiponectin, or this ratio may be a promising marker for severity of the disease independent of BMI. We should further investigate pathological roles of the balance between these adipokines

Genome-Wide Analysis of the Emerging Infection with Mycobacterium avium Subspecies paratuberculosis in the Arabian Camels (Camelus dromedarius)

Mycobacterium avium subspecies paratuberculosis (M. ap) is the causative agent of paratuberculosis or Johne's disease (JD) in herbivores with potential involvement in cases of Crohn's disease in humans. JD is spread worldwide and is economically important for both beef and dairy industries. Generally, pathogenic ovine strains (M. ap-S) are mainly found in sheep while bovine strains (M. ap-C) infect other ruminants (e.g. cattle, goat, deer), as well as sheep. In an effort to characterize this emerging infection in dromedary/Arabian camels, we successfully cultured M. ap from several samples collected from infected camels suffering from chronic, intermittent diarrhea suggestive of JD. Gene-based typing of isolates indicated that all isolates belong to sheep lineage of strains of M. ap (M. ap-S), suggesting a putative transmission from infected sheep herds. Screening sheep and goat herds associated with camels identified the circulation of this type in sheep but not goats. The current genome-wide analysis recognizes these camel isolates as a sub-lineage of the sheep strain with a significant number of single nucleotide polymorphisms (SNPs) between sheep and camel isolates (∼1000 SNPs). Such polymorphism could represent geographical differences among isolates or host adaptation of M. ap during camel infection. To our knowledge, this is the first attempt to examine the genomic basis of this emerging infection in camels with implications on the evolution of this important pathogen. The sequenced genomes of M. ap isolates from camels will further assist our efforts to understand JD pathogenesis and the dynamic of disease transmission across animal species

The first national public breast cancer screening program in Saudi Arabia

<b>Background and Objectives:</b> Despite its relatively low incidence in Saudi Arabia, breast cancer has been the most common cancer among Saudi females for the past 12 consecutive years. The objective of this study was to report the results of the first national public breast cancer screening program in Saudi Arabia. <b>Methods:</b> Women 40 years of age or older underwent breast cancer screening. Mammograms were scored using the Breast Imaging-Reporting and Data System (BI-RADS). Correlations between imaging findings, risk factors and pathological findings were analyzed. <b>Results:</b> Between September 2007 and April 2008, 1215 women were enrolled. The median age was 45 years, and median body mass index was 31.6 kg/m ² . Sixteen cases of cancer were diagnosed. No cancer was diagnosed in 942 women with R1/R2 scores, and only 1 case of cancer was diagnosed in 228 women with R0/R3 scores. However, among 26 women with R4/R5 scores, 50&#x0025; had malignant disease and 35&#x0025; had benign lesions. No correlation was found between known risk factors and imaging score or cancer diagnosis. <b>Conclusions:</b> Public acceptance of the breast cancer screening program was encouraging. Longitudinal follow-up will help in better determining the risk factors relevant to our patient population

Impact of Maternal Infant Weight Perception on Infant Feeding and Dietary Intake

Introduction Obesity is a global problem that is challenging to prevent and expensive to treat. Early childhood interventions show promise in establishing lifelong healthy eating patterns, however a better understanding of how parental feeding practices develop is needed. The study aimed to investigate maternal perception of infant weight and its relationship to feeding practices and infant dietary intake. Methods A questionnaire was completed by 263 Queensland mothers of infants aged between 5 and 13 months. Logistic regression was used to describe the association between maternal feeding practices (restriction, pressure-to-eat, monitoring), parenting style (warmth, hostility), infant weight concern and infant dietary intake. Correlation and linear regression were used to identify relationships between maternal feeding practices, parenting style, infant weight concern and infant weight. Results Mothers were found to be more concerned about underweight than overweight, misjudge infants as being underweight and failed to recognise overweight infants. Underweight concern was associated with infant weight (r = −0.27, p < 0.01), early introduction of solids (OR 0.24, CI 0.11–0.51) and pressure-to-eat (r = 0.19, p < 0.01). Pressure-to-eat was associated to maternal perception of infant weight (r = − 0.21, p < 0.01), infant weight (r = − 0.17, p < 0.05) and lower fruit and vegetable intake (OR 0.50, CI 0.27–0.92). Restrictive feeding practices were correlated to overweight concern (r = 0.08, p < 0.05). Discussion Maternal infant weight perception and concerns are related to control feeding practices which can be detrimental to infant dietary intake. Inability to recognise healthy weight may ignite these concerns or fail to address infant feeding risk factors. Discussing healthy growth should be a fundamental component of strategies to support healthy infant feeding and eating