An exploratory study on the effect of choline and folate deficiency on levels of vascularization proteins and transcription factors in first trimester trophoblast HTR-8/SVneo cells

Aims: We studied the effect of choline and folate deficiencies on levels of predetermined placental proteins during early development. Methods: We incubated HTR-8/SVneo cells under choline and folate deficiency conditions and measured levels of some placental proteins using ELISA methods. Results: Concentrations of LRP2 protein in cell lysates were higher in cells incubated in choline and folate deficient media compared to the control media (mean [SD] = 2.95 [1.30] vs. 1.65 [0.27] ng/mg protein, p = 0.004). The levels of LRP2 protein in lysates of cells incubated in choline and folate deficient media were significantly higher than the concentrations in lysates of cells incubated in choline deficient but folate sufficient media (1.96 [0.28] ng/mg protein) or those incubated in choline sufficient but folate deficient media (1.77 [0.24] ng/mg protein) (p < 0.05 for both). The cellular levels of CDX2 protein were significantly higher in cells incubated in choline and folate deficient media compared to the control media (1.78 [0.60] vs. 0.99 [0.42] pg/mg protein, p = 0.002); and compared to CDX2 levels in cells incubated in choline deficient but folate sufficient media (0.87 [0.13] pg/mg protein, p < 0.001) or in choline sufficient but folate deficient media (0.96 [0.16] pg/mg protein, p < 0.001). The levels of sFLT-1 and IGF1 in culture media and that of EOMES in HTR-8/ SVneo cell lysates remained unchanged under all deficiency conditions. Discussion: LRP2 and CDX2 are likely to be molecular targets for early choline and folate deficiencies in human trophoblast cells. The results should be confirmed in animal models and in other models of placental cells

Protective effect of antioxidative vitamins against lipid eroxidation in liver ischemia and reperfusion

Ischemia and reperfusion (I/R) leads to oxidative stress with free radical formation. With respect to liver surgery and transplantation this can lead to deleterious clinical effects. Protection of the liver against I/R injury is of major concern. Thus, in this study, we examined the effect of an antioxidant vitamin solution (vitamin E, C and ß-carotene) on warm I/R injury. Twelve pigs of the German landrace (7 animals in the vitamin group and 5 untreated controls) were examined in this animal model. Twenty-four hours before laparotomy, the vitamin group was initiated with a single intravenous infusion of the vitamin cocktail. The duration of complete warm ischemia of the liver was 4 hours. Serum liver enzyme levels (AST and ALT) and with thiobarbituric acid reacting substances (TBARS) in liver tissue were measured. Furthermore, immunohistochemical staining of oxidative products (oxidized proteins and 4-hydroxy-nonenal = 4-HNE) in liver tissue was made. The maximum accumulation of oxidized proteins was seen six days postoperatively in the controls whereas in the vitamin group only small amounts were seen. 4-HNE showed a marked accumulation in the controls but was almost not detectable in the vitamin group. TBARS were lower in the vitamin group compared to controls. Although the emulsifier necessary for the vitamin solution leads to increased liver enzyme levels in the vitamin group, the values returned to normal more rapidly. Antioxidant vitamins are able to improve warm I/R liver injury. Oxidative stress is directly verifiable at the tissue level. Future animal experiments as well as clinical trials are necessary to explore the optimization of the combination of antioxidative vitamins for the maximum protection from I/R injury

The impact of a cancer Survivorship Care Plan on gynecological cancer patient and health care provider reported outcomes (ROGY Care): study protocol for a pragmatic cluster randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>There is a need for improvement of information provision and post-treatment care for cancer survivors. A Survivorship Care Plan (SCP) is recommended by the American Institute of Medicine and the Dutch Health Council, which is a summary of patients' course of treatment as a formal document, and includes recommendations for subsequent cancer surveillance, management of late effects, and strategies for health promotion. Until now, evidence on the effects of implementing the SCP in clinical practice is lacking. The rationale and study design of a pragmatic cluster randomized trial, aiming to assess the impact of SCP care in routine clinical practice, is presented.</p> <p>Methods/Design</p> <p>A web-based patient registration system 'Registrationsystem Oncological GYnecology' (ROGY) is used by gynecologists in the South of the Netherlands since 2006. A personalized SCP can automatically be generated out of ROGY. In this pragmatic cluster randomized controlled trial, 12 hospitals are randomized to either 'usual care' or 'SCP care'. In patients with 'usual care', the gynecologist provides care as usual. In patients with 'SCP care', information about the tumor stage and treatment is personally discussed with the patient and a document is handed to the patient. Prospectively, all patients diagnosed with endometrial or ovarian cancer in the participating hospitals will be approached for study participation. Patients will complete questionnaires after surgery, and before additional treatment, and after 6, 12, 18 and 24 months. In addition, health care providers will be asked their opinion about implementation of SCP care. Primary outcome is defined as patient satisfaction with information provision and care. Secondary outcomes are illness perception, health-related quality of life, health care use, prevalence, course and referral rate of survivors with psychosocial distress, and health care providers' evaluation of SCP care.</p> <p>Discussion</p> <p>The ROGY Care trial will help to gain insight into the impact of SCP care on patient reported outcomes, and on the evaluation of cancer survivors and health care providers of the different elements of the SCP. Therefore, results will contribute to efforts to improve quality of care for cancer survivors.</p> <p>Trial registration</p> <p>Trial Registration: <url>http://www.ClinicalTrials.gov</url>. Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01185626">NCT01185626</a></p> <p>Medical Research Ethics Committee Reference Number: NL33429.008.10 Grant Reference Number: UVT2010-4743</p

Bestämning av biocidspridning vid sanering av bottenfärg från fritidsbåtar

Spridning av biocider från sanering av båtbottenfärg bestämdes experimentellt genom  att sanera båtar med sex olika metoder och mäta den spridda andelen bottenfärg.  Metoderna är vanligt förekommande i fritidsbåtshamnar och utförs vanligen av  båtägaren, dessutom utvärderades fackmannamässig blästring. Resultaten från de  olika  scenariona visar att det går att utföra sanering med många av de vanliga  metoderna slipning, skrapning, gelupplösning samt blästring och uppnå insamling av  mer än 98 % av färgen. Metoderna skiljer sig åt i andelen spridd färg men även i  svårighetsgrad i utförande samt hur robust de kan utföras med bibehållen låg spridning.  Faktorer som utförande, båt och färgtyp varierar stort vid implementering på det svenska båtbeståndet, vilket ger att det sannolikt är viktigare med rätt  riskminskningsmetoder än att rangordna saneringsmetoderna. Metoder som bildar torra  små partiklar vid borttagande av färgen är känsliga för att dessa färgpartiklar sprids  med vinden. Beräkningar av partiklars vindtransport visar att de partikelstorlekar som  bildas vid tex slipning och skrapning med lätthet kan spridas utanför en skyddande  marktäckning till den yttre miljön. Spridningen i ett sådant saneringsfall kan vara  mycket högt och kan i det närmaste bli fullständig om inte skyddsåtgärder vidtas.  Hantering av denna risk bör göras genom att, såsom i vissa av de utförda  experimenten, samla in partiklarna med sug, ha kontroll över vindhastigheten samt  kravställa utförandet, alternativt förbjuda metodiken.Undersökningen har initierats av Transportstyrelsen och samverkansgruppen Skrovmålet  med ett tiotal deltagande myndigheter. Syftet är att få ett tekniskt underlag som kan bidra  till beslut om metodik för sanering av fritidsbåtar med biocidinnehållande bottenfärg.  Undersökningen har finansierats av Transportstyrelsen, avdelningen för sjö- och luftfart  samt delvis av Havs och Vattenmyndighetens anslag 1:11 -åtgärder för havs-och  vattenmiljön.</p

Grape Seed Extract Positively Modulates Blood Pressure and Perceived Stress: A Randomized, Double-Blind, Placebo-Controlled Study in Healthy Volunteers

It is well established that maintaining healthy blood pressure is fundamental in order to avoid disorders to the heart and blood vessels. In prevention, and alongside pharmacological therapy, the use of natural substances has been proven to be extremely helpful for pre- and mild hypertensive subjects. Our study was therefore focused on the effects, both in vitro and in humans, of a grape seed extract, Enovita (GSEe), a highly standardized extract in polyphenols of Vitis vinifera L. The in vitro human umbilical vein endothelial cells (HUVEC) model was chosen to explore the extract properties related to vascular inflammation/vasodilation. A significant reduction of both soluble Inter-Cellular Adhesion Molecule-1 (sICAM) and endothelin-1 secretion/release was induced by GSEe in HUVEC cells. A randomized, double-blind, placebo-controlled clinical study in healthy volunteers was further performed to investigate GSEe benefits. In healthy volunteers, both supplementations significantly modulated blood pressure, with a pronounced effect after GSEe tablets (300 mg/day for 16 weeks) in respect to placebo. In the male gender subgroup, no placebo effect was observed as it was for the female group. As an additional outcome, an overall GSEe positive modulation emerged on mood related to stress perception. Thus, GSEe resulted in a benefit of modulating endothelial functionality and blood pressure. It was noteworthy that GSEe relieved the perceived stress, promising new future perspectives on mood comfort

Effects of Survivorship Care Plans on patient reported outcomes in ovarian cancer during 2-year follow-up: The ROGY care trial

Objective: The aim of this study was to assess the long-term impact of an automatically generated Survivorship Care Plan (SCP) on patient reported outcomes in ovarian cancer in routine clinical practice. Outcome measures included satisfaction with information provision and care, illness perceptions and health care utilization. Methods: In this pragmatic cluster randomized trial, twelve hospitals in the South of the Netherlands were randomized to 'SCP care' or 'usual care'. All newly diagnosed ovarian cancer patients in the 'SCP care' arm received an SCP that was automatically generated by the oncology provider, by clicking a button in the web-based Registrationsystem Oncological GYnecology (ROGY). Ovarian cancer patients (N=174, mean age 63.3, SD=11.4; all stages) completed questionnaires directly after initial treatment and after 6, 12 and 24months. Results: First questionnaires were returned from 61 (67%) ovarian cancer patients in the 'SCP care' arm and 113 (72%) patients in the 'usual care' arm. In the 'SCP care' arm, 66% (N=41) of the patients reported receipt of an SCP. No overall differences were observed between the trial arms on satisfaction with information provision, satisfaction with care or health care utilization. Regarding illness perceptions, patients in the 'SCP care' arm had lower beliefs that the treatment would help to cure their disease (overall, 6.7 vs. 7.5, P<0.01). Conclusions: SCPs did not increase satisfaction with information provision or care in ovarian cancer patients. Our trial results suggest that ovarian cancer patients may not benefit from an SCP