Fetal thoracic circumference in mid-pregnancy and infant lung function

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.Background and Aim: Impaired lung function in early infancy is associated with later wheeze and asthma, while fetal thoracic circumference (TC) predicts severity of neonatal lung hypoplasia. Exploring fetal origins of lung function in infancy, we aimed to determine if fetal TC in mid‐pregnancy was associated with infant lung function. Methods: From the prospective Scandinavian general population‐based PreventADALL mother–child birth cohort, all 851 3‐month‐old infants with tidal flow‐volume measurements in the awake state and ultrasound fetal size measures at 18 (min–max 16–22) weeks gestational age were included. Associations between fetal TC and time to peak tidal expiratory flow to expiratory time (tPTEF/tE) were analyzed in linear regression models. To account for gestational age variation, we adjusted TC for simultaneously measured general fetal size, by head circumference (TC/HC), abdominal circumference (TC/AC), and femur length (TC/FL). Multivariable models were adjusted for maternal age, maternal asthma, pre‐pregnancy body mass index, parity, nicotine exposure in utero, and infant sex. Results: The infants (47.8% girls) were born at mean (SD) gestational age of 40.2 (1.30) weeks. The mean (SD) tPTEF/tE was 0.39 (0.08). The mean (SD) TC/HC was 0.75 (0.04), TC/AC 0.87 (0.04), and TC/FL 4.17 (0.26), respectively. Neither TC/HC nor TC/AC were associated with infant tPTEF/tE while a week inverse association was observed between TC/FL and tPTEF/tE (β ^ = −0.03, 95% confidence interval [−0.05, −0.007], p = 0.01). Conclusion: Mid‐pregnancy fetal TC adjusted for fetal head or abdominal size was not associated with tPTEF/tE in healthy, awake 3‐month‐old infants, while a weak association was observed adjusting for fetal femur length.publishedVersio

Birth mode is associated with development of atopic dermatitis in infancy and early childhood

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Proliferation of CD4+ T cells in response to self and non-self antigens. Role in memory formation

The goal of this thesis project was to determine the role of peptides (self vs. non-self) and CD28 signaling on proliferation and differentiation of responding CD4+ T cells into effector and memory cells in vivo. For this purpose, we used murine TCR transgenic CD4 + T cells that recognize chicken ovalbumin peptide (OVAp). The cells were adoptively transferred into either syngeneic wild type mice followed by immunization with OVAp or into lymphopenic mice, where proliferation occurs due to encounter with self-peptides. Proliferation, in the presence or absence of CD28 costimulation, was measured by labeling the T cells with a bright fluorochrome dye, CFSE, prior to adoptive transfer. Subsequently, proliferative history, cytokine production and capacity for memory were compared. CD28 augmented the proliferative response of CD4+ T cells following stimulation with the non-self peptide (OVAp), by increasing both the number of antigen-specific T cells that initiated division, as well as increasing the number of cell divisions. Differentiation into effector cells was cell cycle dependent, as the appearance of surface memory phenotype (CD44-hi, CD45RB-low, CD62L-low) and production of cytokines IL-2 and IFN-γ, correlated with division cycle, independent of costimulation. Thus, CD28 signals enhanced production of IL-2 and IFN-γ by augmenting proliferation of responding T cells. Encounters with self-peptides generated two discrete populations of T cells. One, which was highly proliferative and dependent on CD28 signaling, and the other which contained cells undergoing low levels of CD28-independent proliferation. Interestingly, following encounters with self-peptides, the responding CD4+ T cells never became effector cells as they remained small and did not upregulate early activation marker CD69. Yet, these cells acquired phenotypic and functional characteristics of memory cells, indicating that naïve CD4+ T cells can differentiate directly into memory cells. These results indicate that optimal proliferative responses of antigen-specific CD4+ T cells in response to either self or non-self peptides was dependent on CD28 signals. Differentiation into effector cells required stimulation by the exogenous peptide and correlated best with cell cycle progression and not CD28 signals. Finally, following encounters with self-peptides naïve cells differentiated directly into memory T cells

A parallel, randomized, double-blind, placebo-controlled study to investigate the effect of SagaPro on nocturia in men.

To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.This study aimed to investigate the effect of SagaPro, a product derived from Angelica archangelica leaf, on nocturia.Sixty-nine male patients 45 years or older with at least two nocturnal voids were randomized to receive SagaPro or placebo in a double-blind design for 8 weeks. Voiding diaries were assessed before and after the treatment.The results indicate that SagaPro is safe. The actual number of nocturnal voids (ANV), nocturnal polyuria index (NPi) and nocturnal bladder capacity index (NBC index) decreased in the test population, but there was no significant difference between the treatment groups. Subsequent subgroup analysis showed that SagaPro significantly reduced the NBC index and nocturnal voids per sleeping hour in comparison to the placebo in participants with baseline NBC index above 1.3. When participants with sleep disorders were excluded from this group, ANV was also significantly reduced for the SagaPro group in comparison to the placebo group.SagaPro, made from an extract of the medicinal herb Angelica archangelica, is safe. This study did not show that SagaPro improved nocturia overall compared to placebo. Subgroup analysis suggested a beneficial effect in individuals with decreased nocturnal bladder capacity, which warrants further study.Technology Development Fund of the Icelandic Research Counci

Change in Albuminuria and Estimated GFR as End Points for Clinical Trials in Early Stages of CKD: A Perspective From European Regulators.

To access publisher's full text version of this article click on the hyperlink belo

Family members of cancer patients: Needs, quality of life and symptoms of anxiety and depression

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldBACKGROUND: Family members of cancer patient's have multiple needs, many of which are not adequately met. Unmet needs may affect psychological distress and quality of life (QOL). The purpose of this study was to assess needs and unmet needs, QOL, symptoms of anxiety and depression, and the relationship between those variables in a large sample of family members of cancer patients in different phases of illness. MATERIAL AND METHODS: Of 332 family members invited to participate, 330 accepted and 223 (67%) completed a cross-sectional, descriptive study. Data was collected with the Family Inventory of Needs (FIN), Quality of Life Scale (QOLS) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: Of 20 needs assessed the mean (SD) number of important needs and unmet needs was 16.4 ± 4.3 and 6.2 ± 5.6, respectively. Twelve important needs were unmet in 40-56% of the sample. The mean number of unmet needs was significantly higher among women than men, other relatives than spouses, younger family members, those currently working and those of patients with metastatic cancer. QOL was similar to what has been reported for healthy populations and cancer caregivers in advanced stages. The prevalence of symptoms of anxiety and depression was high (20-40%). Anxiety scores were higher among women than men and both anxiety and depression scores were highest during years 1-5 compared to the first year and more than five years post diagnosis. There was a positive relationship between number of important needs and QOL, and between needs met and QOL. Additionally, there was a significant relationship between anxiety and unmet needs. Finally, there was a significant relationship between QOL and symptoms of anxiety and depression. CONCLUSION: The results support the importance of screening needs and psychological distress among family members of cancer patients in all phases of illness

Protein expression within the human renal cortex and renal cell carcinoma: The implication of cold ischemia

To access Publisher full text version of this article. Please click on the hyperlink in Additional LinkCold ischemia of tissue during tissue treatment may influence protein expression, but has not been well studied. Better understanding of this is fundamental prior to using stored fresh-frozen tissue where the time from organ harvest until tissue collection and storage is most often not documented. We collected samples from normal renal cortex and cancerous tissues at serial time points for up to 60 min from three nephrectomized individuals with newly diagnosed clear cell renal cell carcinoma (RCC). Samples were processed onto protein chips and identified using surface-enhanced laser desorption/ionization- time of flight mass spectrometry (SELDI). The number and size of proteins expressed at separate sites within homogenous tissue sections were comparable. Cold ischemia time neither affected the number nor the size of proteins expressed. While the quantity of most proteins was similar between separate sites and unaffected by cold ischemia time, we noted variation in the quantity of some proteins compared to duplicate measurements. Such variation was noted between separate samples collected at same cold ischemia time points. Taken together, these data indicate that cold ischemia time for up to 60 min does not influence the number or size of proteins expressed within renal tissue. © Mary Ann Liebert, Inc

Comparing GFR Estimating Equations Using Cystatin C and Creatinine in Elderly Individuals.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageCurrent guidelines recommend reporting eGFR using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations unless other equations are more accurate, and recommend the combination of creatinine and cystatin C (eGFRcr-cys) as more accurate than either eGFRcr or eGFRcys alone. However, preferred equations and filtration markers in elderly individuals are debated. In 805 adults enrolled in the community-based Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we measured GFR (mGFR) using plasma clearance of iohexol, standardized creatinine and cystatin C, and eGFR using the CKD-EPI, Japanese, Berlin Initiative Study (BIS), and Caucasian and Asian pediatric and adult subjects (CAPA) equations. We evaluated equation performance using bias, precision, and two measures of accuracy. We first compared the Japanese, BIS, and CAPA equations with the CKD-EPI equations to determine the preferred equations, and then compared eGFRcr and eGFRcys with eGFRcr-cys using the preferred equations. Mean (SD) age was 80.3 (4.0) years. Median (25th, 75th) mGFR was 64 (52, 73) ml/min per 1.73 m(2), and the prevalence of decreased GFR was 39% (95% confidence interval, 35.8 to 42.5). Among 24 comparisons with the other equations, CKD-EPI equations performed better in 9, similar in 13, and worse in 2. Using the CKD-EPI equations, eGFRcr-cys performed better than eGFRcr in four metrics, better than eGFRcys in two metrics, and similar to eGFRcys in two metrics. In conclusion, neither the Japanese, BIS, nor CAPA equations were superior to the CKD-EPI equations in this cohort of community-dwelling elderly individuals. Using the CKD-EPI equations, eGFRcr-cys performed better than eGFRcr or eGFRcys.National Institute of Diabetes and Digestive and Kidney Diseases R01-DK082447 01A1S