Association between Caffeine Consumption and Depression in NHANES 2009-2010

Background and Purpose: Caffeine is ubiquitous in foods, supplements, and medications and has been hypothesized to be associated with several health-related outcomes, including mental health disorders such as anxiety. We explored a possible relationship between caffeine consumption and depression using data from the National Health and Nutrition Examination Survey (NHANES). Methods: Data from 1,342 adult NHANES participants were included. Statistical software for complex survey sample designs was used to perform two multivariable logistic regressions with a binary indicator of depression as the dependent variable: one using dietary caffeine consumption and one using the caffeine metabolite AAMU as the independent variable. Both analyses were adjusted for gender, race/ethnicity, smoking status, and use of anti-depressants. Results: We observed a descriptive, albeit non-significant (p = 0.12), pattern of increasing odds of depression with increasing levels of the AAMU caffeine metabolite. Conclusion: Our finding of a possible association between caffeine metabolite level and depression is compelling because it is independent of self-reported caffeine consumption. Prospective studies are warranted to further explore the temporal relationship

Association between Total Folate Intakes and Depression amongst Three Racial/Ethnic Groups

Background and Purpose: Low dietary folate intake has been associated with depression outcomes, but few studies have been reported on the association in diverse populations. Using data from the National Health and Nutrition Examination Survey (NHANES), we examined the relationship between depression and folate intake from diet and supplementation in non-Hispanic whites, Hispanics and African Americans. Methods: 3,687 adult respondents from the 2009-2010 NHANES cycle were included. Statistical methods for analyzing data from complex survey sample designs were used to assess differences by race/ethnicity in demographic, behavioral, dietary and depression variables and to assess the relationship between depression and folate, adjusting for confounding variables using multivariable logistic regression. Results: We observed significant (p < 0.01) differences by race/ethnicity for all demographic, behavioral, dietary and depression variables, except for physical activity. The relationship between dietary folate and depression significantly differed by race/ethnicity (p = 0.03), with an inverse and significant association in Hispanics only (OR= 0.25; 95% CI= 0.09 – 0.70.; p for trend = 0.02). Conclusion: These data suggest that a diet high in folate, such as from dark green leafy vegetables, may be associated with a reduced odds for depression, and specifically, Hispanics may benefit from nutrition education to potentially reduce depression in the population

Cerebrospinal fluid sodium rhythms

Background: Cerebrospinal fluid (CSF) sodium levels have been reported to rise during episodic migraine. Since migraine frequently starts in early morning or late afternoon, we hypothesized that natural sodium chronobiology may predispose susceptible persons when extracellular CSF sodium increases. Since no mammalian brain sodium rhythms are known, we designed a study of healthy humans to test if cation rhythms exist in CSF. Methods: Lumbar CSF was collected every ten minutes at 0.1 mL/min for 24 h from six healthy participants. CSF sodium and potassium concentrations were measured by ion chromatography, total protein by fluorescent spectrometry, and osmolarity by freezing point depression. We analyzed cation and protein distributions over the 24 h period and spectral and permutation tests to identify significant rhythms. We applied the False Discovery Rate method to adjust significance levels for multiple tests and Spearman correlations to compare sodium fluctuations with potassium, protein, and osmolarity. Results: The distribution of sodium varied much more than potassium, and there were statistically significant rhythms at 12 and 1.65 h periods. Curve fitting to the average time course of the mean sodium of all six subjects revealed the lowest sodium levels at 03.20 h and highest at 08.00 h, a second nadir at 09.50 h and a second peak at 18.10 h. Sodium levels were not correlated with potassium or protein concentration, or with osmolarity. Conclusion: These CSF rhythms are the first reports of sodium chronobiology in the human nervous system. The results are consistent with our hypothesis that rising levels of extracellular sodium may contribute to the timing of migraine onset. The physiological importance of sodium in the nervous system suggests that these rhythms may have additional repercussions on ultradian functions

Does directly observed therapy (DOT) reduce drug resistant tuberculosis?

<p>Abstract</p> <p>Background</p> <p>Directly observed therapy (DOT) is a widely recommended and promoted strategy to manage tuberculosis (TB), however, there is still disagreement about the role of DOT in TB control and the impact it has on reducing the acquisition and transmission of drug resistant TB. This study compares the portion of drug resistant genotype clusters, representing recent transmission, within and between communities implementing programs differing only in their directly observed therapy (DOT) practices.</p> <p>Methods</p> <p>Genotype clusters were defined as 2 or more patient members with matching IS<it>6110 </it>restriction fragment length polymorphism (RFLP) and spoligotype patterns from all culture-positive tuberculosis cases diagnosed between January 1, 1995 and December 31, 2001. Logistic regression was used to compute maximum-likelihood estimates of odds ratios (ORs) and 95% confidence intervals (CIs) comparing cluster members with and without drug resistant isolates. In the universal DOT county, all patients received doses under direct observation of health department staff; whereas in selective DOT county, the majority of received patients doses under direct observation of health department staff, while some were able to self-administer doses.</p> <p>Results</p> <p>Isolates from 1,706 persons collected during 1,721 episodes of tuberculosis were genotyped. Cluster members from the selective DOT county were more than twice as likely than cluster members from the universal DOT county to have at least one isolate resistant to isoniazid, rifampin, and/or ethambutol (OR = 2.3, 95% CI: 1.7, 3.1). Selective DOT county isolates were nearly 5 times more likely than universal DOT county isolates to belong to clusters with at least 2 resistant isolates having identical resistance patterns (OR = 4.7, 95% CI: 2.9, 7.6).</p> <p>Conclusions</p> <p>Universal DOT for tuberculosis is associated with a decrease in the acquisition and transmission of resistant tuberculosis.</p

Phospholipase C activity increases in cerebrospinal fluid from migraineurs in proportion to the number of comorbid conditions: a case--control study

BACKGROUND: Migraineurs are more often afflicted by comorbid conditions than those without primary headache disorders, though the linking pathophysiological mechanism(s) is not known. We previously reported that phosphatidylcholine-specific phospholipase C (PC-PLC) activity in cerebrospinal fluid (CSF) increased during migraine compared to the same individual’s well state. Here, we examined whether PC-PLC activity from a larger group of well-state migraineurs is related to the number of their migraine comorbidities. METHODS: In a case–control study, migraineurs were diagnosed using International Headache Society criteria, and controls had no primary headache disorder or family history of migraine. Medication use, migraine frequency, and physician-diagnosed comorbidities were recorded for all participants. Lumbar CSF was collected between the hours of 1 and 5 pm, examined immediately for cells and total protein, and stored at −80°C. PC-PLC activity in thawed CSF was measured using a fluorometric enzyme assay. Multivariable logistic regression was used to evaluate age, gender, medication use, migraine frequency, personality scores, and comorbidities as potential predictors of PC-PLC activity in CSF. RESULTS: A total of 18 migraineurs-without-aura and 17 controls participated. In a multivariable analysis, only the number of comorbidities was related to PC-PLC activity in CSF, and only in migraineurs [parameter estimate (standard error) = 1.77, p = 0.009]. CONCLUSION: PC-PLC activity in CSF increases with increasing number of comorbidities in migraine-without-aura. These data support involvement of a common lipid signaling pathway in migraine and in the comorbid conditions

Brain tumor risk in children in relation to use of electric blankets and water bed heaters: Results from the United States West Coast childhood brain tumor study

The possible relation between the occurrence of brain tumors in children and exposure to electric blankets or electrically heated water beds was investigated in a multicenter, population-based case-control study conducted on the West Coast of the United States. Information on maternal exposure during pregnancy or direct exposure to the subject child was collected by in- person interview from the mothers of 540 case children and 801 control children. Cases were 19 years of age or younger and were diagnosed between 1984 and 1991. Controls were recruited using a random digit dialing procedure. The risk of brain tumor occurrence from in utero exposure to either electric blankets (odds ratio (OR) = 0.9, 95% confidence interval (CI) 0.6-1.2) or heated water beds (OR = 0.9, 95% CI 0.6-1.3) was not elevated. Brain cancer risk did not vary by use in any trimester of pregnancy, and children with mothers who reported use throughout their pregnancy had no increased risk. Similar results were observed for exposure to the child, in that no association between brain cancer and use of electric blankets (OR = 1.0, 95% CI 0.6-1.7) or heated water beds (OR = 1.2, 95% CI 0.7-2.0) was observed. Risks did not vary significantly by age, sex, race, socioeconomic status, or histologic category for either in utero exposure or child\u27s exposure. This study provides no evidence to support the hypothesis that there is a relation between brain cancer occurrence in children and 50-/60- Hz magnetic field exposure from the use of electric blankets and heated water beds

Enzyme-linked Immunospot and Tuberculin Skin Testing to Detect Latent Tuberculosis Infection

Rationale: Diagnosis of latent tuberculosis infection (LTBI) is currently based on the tuberculin skin test. The enzyme-linked immunospot assay (ELISPOT) is a new blood test to diagnose LTBI. Objective: To compare the ELISPOT and the tuberculin skin test for detecting LTBI in contacts of patients with tuberculosis. Methods: Prospective study of 413 contacts of patients with tuberculosis. Measurements and Main Results: Because there is no gold standard for LTBI, the sensitivity and specificity of the ELISPOT and tuberculin skin test cannot be directly measured. For each contact, we therefore estimated the likelihood of having LTBI by calculating a contact score that quantified exposure to and infectiousness of the index case. We analyzed the relationship of contact score to ELISPOT and tuberculin skin test results. The likelihood of a positive ELISPOT (p = 0.0005) and a tuberculin skin test (p = 0.01) increased significantly with rising contact scores. The contact score was more strongly related to the ELISPOT than to the tuberculin skin test results, although this difference was not statistically significant. Among U.S.-born persons and those who were not vaccinated with bacille Calmette-Guérin, approximately 30% had positive ELISPOT or tuberculin skin test results. Foreign-born, bacille Calmette-Guérin–vaccinated persons were significantly more likely to have a positive tuberculin skin test than a positive ELISPOT result (p < 0.0001). Conclusions: Compared with the tuberculin skin test, the ELISPOT appears to be at least as sensitive for diagnosis of LTBI in contacts of patients with tuberculosis

Examination of Duct Physiology in the Human Mammary Gland.

BACKGROUND:The human breast comprise several ductal systems, or lobes, which contain a small amount of fluid containing cells, hormones, proteins and metabolites. The complex physiology of these ducts is likely a contributing factor to the development of breast cancer, especially given that the vast majority of breast cancers begin in a single lobular unit. METHODS:We examined the levels of total protein, progesterone, estradiol, estrone sulfate, dehydroepiandrosterone sulfate, and macrophages in ductal fluid samples obtained from 3 ducts each in 78 women, sampled twice over a 6 month period. Samples were processed for both cytological and molecular analysis. Intraclass correlation coefficients and mixed models were utilized to identify significant data. RESULTS:We found that the levels of these ductal fluid components were generally uncorrelated among ducts within a single breast and over time, suggesting that each lobe within the breast has a distinct physiology. However, we also found that estradiol was more correlated in women who were nulliparous or produced nipple aspirate fluid. CONCLUSIONS:Our results provide evidence that the microenvironment of any given lobular unit is unique to that individual unit, findings that may provide clues about the initiation and development of ductal carcinomas