Zinc and copper levels in preeclampsia: a study from coastal South India

Background: Preeclampsia is one of the major causes of maternal and fetal morbidity and mortality. Though the etiology is obscure, studies indicate the role of oxidative stress and antioxidants may have a role in the prevention of preeclampsia. Micronutrients such as copper and zinc are involved in the antioxidant defense mechanism.Methods: The present study was undertaken in a medical college hospital in coastal South India to assess the serum levels of zinc and copper in women with preeclampsia and to compare them with normal pregnant women. The blood samples from 60 preeclamptic women and an equal number of controls were analyzed for zinc and copper levels. Outcome of pregnancy was analyzed and compared. Data were expressed as mean ± standard deviation. Comparison of levels of the elements between the two groups was performed by independent t test and Chi square test and P value of <0.05 was considered as statistically significant.Results: The serum zinc and copper levels were significantly lower in the preeclamptic group compared to the normotensives. Also preeclamptic women were older, their BMI was higher and birth weight of babies lower compared to normotensives.Conclusions: Increased knowledge about the importance of specific antioxidant micronutrients and their part in successful pregnancy outcome should be the focus for future health strategies. Low levels of maternal copper and zinc are related to preeclampsia and might have a causal role in this disease. Further investigation is needed to establish the role of these elements in this dangerous condition of pregnancy

Association of triglycerides/high density lipoprotein cholesterol ratio with insulin resistance in polycystic ovary syndrome

Background: Insulin resistance (IR) is frequently observed in women with polycystic ovary syndrome (PCOS). Recent studies advocated that triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) can be used as a simple clinical indicator of IR. Hence, the present study was performed to investigate the use of TG/HDL-C and its association with IR in PCOS.Methods: Forty-one patients with PCOS and 40 healthy age matched women were randomly enrolled. Demographic and clinical characteristics were obtained. Insulin resistance was defined by the homeostasis model assessment for insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI).Results: In PCOS group, the insulin, HOMA-IR and TG/HDL-C ratio were significantly higher (p=0.001) than controls while, QUICKI was lower (p=0.001). Insulin, HOMA-IR were positively correlated with TG/HDL-C (ρ=0.303, p=0.006 and ρ=0.312, p=0.005 respectively) while, QUICKI was negatively correlated (ρ=-0.698, p=0.001). In receiver operating characteristic (ROC) analysis, area under the curve (AUC) for model based on QUICKI levels was better 0.898 (95% CI: 0.811-0.955, p=0.001) than HOMA-IR 0.636 (95% CI: 0.522-0.740, p=0.03). A cut-off value 3.23 for TG/HDL-C is proposed from the model based on QUICKI with best combination of sensitivity 83.3% and specificity 86.7%.Conclusions: Results of present study support that TG/HDL-C ratio may be a simple indicator of IR in PCOS patients which helps clinicians to identify IR in small centers, where the assays for insulin measurement are not available

Effect of a single Dialysis session on plasma Lp(a) levels in patients on Maintenance haemodialysis

Background: &#xd;&#xa;Cardiovascular disease (CVD) is a major cause of mortality in End stage renal disease (ESRD) patients on Maintenance haemodialysis (MHD). Lp (a), is a specialized form of glycoprotein-LDL-cholesterol complex and is an independent risk factor for myocardial infarction. The risk is related to its atherogenic and thrombogenic properties. The present study was taken up to evaluate changes in Lp(a) and Lipid profile in patients undergoing hemodialysis session. &#xd;&#xa;&#xd;&#xa;Methodology: &#xd;&#xa;Twenty seven patients with end stage renal disease who were on maintenance hemodialysis were included. Plasma samples were collected hourly during a dialysis session with polysulfone membrane using bicarbonate dialysate. Plasma cholesterol, triglycerides, and Lp(a) were estimated on Beckmann CX9 Fully Automated Analyzer using commercial kits. Statistical analysis was performed using SPSS for windows version 11.5.&#xd;&#xa;&#xd;&#xa;Results: &#xd;&#xa;Results of analysis of variance for repeated measures after correction for hemoconcentration where necessary revealed a decrease in Lp(a) (p=0.022) and triglycerides (p=0.001) levels and no change in cholesterol (p=0.48) levels.&#xd;&#xa;&#xd;&#xa;Conclusion: &#xd;&#xa;Maintenance dialysis program is known to produce Dyslipidemia. Study of Lp(a) in dialysis patients is important as this is an independent risk marker. However there are very few reports on changes in Lp(a) due to the dialysis session. Our findings will be discussed in comparison with other reports.&#xd;&#xa

Effect Of A Dialysis Session On Plasma Branched Chain Aminio Acids In Hemodialysis Patients

Protein and amino acid (AA) metabolism is abnormal in End stage renal disease (ESRD). Hemodialysis (HD) procedure is a strong catabolic stimulus. Branched chain amino acids (BCAAs) can affect other AA levels by reducing AA efflux from muscle due to inhibition of muscle protein degradation. Essential amino acids and keto acid supplements including BCAA and branched-chain keto acid (BCKA) are proposed to decrease protein intake while maintaining protein status. This study was taken up to evaluate the effect of a dialysis session on plasma BCAA&#x2019;s for which fifteen patients of ESRD on Maintenance HD, thrice a week were recruited into the study. Analysis was done on samples drawn at the beginning (pre-HD) and after the end of each dialysis session (post-HD). Plasma BCAA&#x2019;s were estimated by Reverse phase High performance liquid chromatography using pre column derivatization with O-pthalaldehyde-Mercaptoethanol. A significant decrease in plasma concentration of Valine and Isoleucine were observed post-HD compared to the pre-HD levels (p&#x3c;0.05). After correcting the data by creatinine, the decrease in plasma concentrations of Valine and Isoleucine were still found to be statistically significant. The percentage losses after the completion of HD were &#x2013;24.45, &#x2013;23.19, and &#x2013;6.22% respectively for valine, isoleucine, and leucine. The lower reduction in leucine could be due to its appearance from muscle catabolism during the dialysis session. In conclusion, hemodialysis itself may influence dialysate amino acid losses and may have an effect on muscle protein breakdown and this negative protein can be reversed with nutritional supplementation

The First Global Integrated Marine Assessment: World Ocean Assessment I

We used satellite-derived sea-surface-temperature (SST) data along with in-situ data collected along a meridional transect between 18.85 and 20.25°N along 69.2°E to describe the evolution of an SST filament and front during 25 November to 1 December in the northeastern Arabian Sea (NEAS). Both features were &#8764; 100 km long, lasted about a week and were associated with weak temperature gradients (&#8764; 0.07°C km⁻¹). The in-situ data were collected first using a suite of surface sensors during a north–south mapping of this transect and showed the existence of a chlorophyll maximum within the filament. This surface data acquisition was followed by a high-resolution south–north CTD (conductivity–temperature–depth) sampling along the transect. In the two days that elapsed between the two in-situ measurements, the filament had shrunk in size and moved northward. In general, the current direction was northwestward and advected these mesoscale features. The CTD data also showed an SST front towards the northern end of the transect. In both these features, the chlorophyll concentration was higher than in the surrounding waters. The temperature and salinity data from the CTD suggest upward mixing or pumping of water from the base of the mixed layer, where a chlorophyll maximum was present, into the mixed layer that was about 60 m thick. A striking diurnal cycle was evident in the chlorophyll concentration, with higher values tending to occur closer to the surface during the night. The in-situ data from both surface sensors and CTD, and so also satellite-derived chlorophyll data, showed higher chlorophyll concentration, particularly at sub-surface levels, between the filament and the front, but there was no corresponding signature in the temperature and salinity data. Analysis of the SST fronts in the satellite data shows that fronts weaker than those associated with the filament and the front had crossed the transect in this region a day or two preceding the sampling of the front

Clonal associations between lymphocyte subsets and functional states in rheumatoid arthritis synovium

Rheumatoid arthritis (RA) is an autoimmune disease involving antigen-specific T and B cells. Here, we perform single-cell RNA and repertoire sequencing on paired synovial tissue and blood samples from 12 seropositive RA patients. We identify clonally expanded CD4 + T cells, including CCL5+ cells and T peripheral helper (Tph) cells, which show a prominent transcriptomic signature of recent activation and effector function. CD8 + T cells show higher oligoclonality than CD4 + T cells, with the largest synovial clones enriched in GZMK+ cells. CD8 + T cells with possibly virus-reactive TCRs are distributed across transcriptomic clusters. In the B cell compartment, NR4A1+ activated B cells, and plasma cells are enriched in the synovium and demonstrate substantial clonal expansion. We identify synovial plasma cells that share BCRs with synovial ABC, memory, and activated B cells. Receptor-ligand analysis predicted IFNG and TNFRSF members as mediators of synovial Tph-B cell interactions. Together, these results reveal clonal relationships between functionally distinct lymphocyte populations that infiltrate the synovium of patients with RA

Deconstruction of rheumatoid arthritis synovium defines inflammatory subtypes

Rheumatoid arthritis is a prototypical autoimmune disease that causes joint inflammation and destruction1. There is currently no cure for rheumatoid arthritis, and the effectiveness of treatments varies across patients, suggesting an undefined pathogenic diversity1,2. Here, to deconstruct the cell states and pathways that characterize this pathogenic heterogeneity, we profiled the full spectrum of cells in inflamed synovium from patients with rheumatoid arthritis. We used multi-modal single-cell RNA-sequencing and surface protein data coupled with histology of synovial tissue from 79 donors to build single-cell atlas of rheumatoid arthritis synovial tissue that includes more than 314,000 cells. We stratified tissues into six groups, referred to as cell-type abundance phenotypes (CTAPs), each characterized by selectively enriched cell states. These CTAPs demonstrate the diversity of synovial inflammation in rheumatoid arthritis, ranging from samples enriched for T and B cells to those largely lacking lymphocytes. Disease-relevant cell states, cytokines, risk genes, histology and serology metrics are associated with particular CTAPs. CTAPs are dynamic and can predict treatment response, highlighting the clinical utility of classifying rheumatoid arthritis synovial phenotypes. This comprehensive atlas and molecular, tissue-based stratification of rheumatoid arthritis synovial tissue reveal new insights into rheumatoid arthritis pathology and heterogeneity that could inform novel targeted treatments

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe