Effect of Probiotic “L.Reuteri” Association on the Reduction of Serum Bilirubin in Neonatal Jaundice

Objective: Evaluate the effect of probiotics association in reducing the total bilirubin level in the serum of neonates with jaundice. Methods: 69 neonates with indirect hyperbilirubinemia were divided randomly into two groups: control and treatment. The control group was treated using phototherapy and the treatment group was treated using phototherapy plus L.Reuteri probiotic. Inclusion criteria: all term newborns admitted for phototherapy for unconjugated hyperbilirubinemia. Exclusion criteria: septic or ill newborn, phenobarbital therapy, transfusion and parents ‘refusal to enter the study. Baseline bilirubin level was obtained prior to initiating phototherapy and then daily for an average of 3 days. Results: Before treatment, the level of bilirubin was similar in the two groups (p>0.05). We noted a more significant difference in bilirubin at day 1 (p=0.000), day 2 (=0.000) and day 3 (p=0.000) during treatment in the probiotic group when compared to the control group. We also noticed a more significant decrease in bilirubin between day 1 and day 2 (p=0.000) and between day 2 and day 3 (p=0.000) in the probiotic group when compared to the control group. Conclusion: The decrease of bilirubin in neonates with jaundice is more rapid and more significant in the group receiving probiotics as an adjuvant to phototherapy in case of presence of incompatibility or not

Evidence That Two ATP-Dependent (Lon) Proteases in Borrelia burgdorferi Serve Different Functions

The canonical ATP-dependent protease Lon participates in an assortment of biological processes in bacteria, including the catalysis of damaged or senescent proteins and short-lived regulatory proteins. Borrelia spirochetes are unusual in that they code for two putative ATP-dependent Lon homologs, Lon-1 and Lon-2. Borrelia burgdorferi, the etiologic agent of Lyme disease, is transmitted through the blood feeding of Ixodes ticks. Previous work in our laboratory reported that B. burgdorferi lon-1 is upregulated transcriptionally by exposure to blood in vitro, while lon-2 is not. Because blood induction of Lon-1 may be of importance in the regulation of virulence factors critical for spirochete transmission, the clarification of functional roles for these two proteases in B. burgdorferi was the object of this study. On the chromosome, lon-2 is immediately downstream of ATP-dependent proteases clpP and clpX, an arrangement identical to that of lon of Escherichia coli. Phylogenetic analysis revealed that Lon-1 and Lon-2 cluster separately due to differences in the NH2-terminal substrate binding domains that may reflect differences in substrate specificity. Recombinant Lon-1 manifested properties of an ATP-dependent chaperone-protease in vitro but did not complement an E. coli Lon mutant, while Lon-2 corrected two characteristic Lon-mutant phenotypes. We conclude that B. burgdorferi Lons -1 and -2 have distinct functional roles. Lon-2 functions in a manner consistent with canonical Lon, engaged in cellular homeostasis. Lon-1, by virtue of its blood induction, and as a unique feature of the Borreliae, may be important in host adaptation from the arthropod to a warm-blooded host

Exome genotyping arrays to identify rare and low frequency variants associated with epithelial ovarian cancer risk

Rare and low frequency variants are not well covered in most germline genotyping arrays and are understudied in relation to epithelial ovarian cancer (EOC) risk. To address this gap, we used genotyping arrays targeting rarer protein-coding variation in 8,165 EOC cases and 11,619 controls from the international Ovarian Cancer Association Consortium (OCAC). Pooled association analyses were conducted at the variant and gene level for 98,543 variants directly genotyped through two exome genotyping projects. Only common variants that represent or are in strong linkage disequilibrium (LD) with previously-identified signals at established loci reached traditional thresholds for exome-wide significance (P < 5.0 × 10 (−) (7)). One of the most significant signals (P(all histologies )=( )1.01 × 10 (−) (13);P(serous )=( )3.54 × 10 (−) (14)) occurred at 3q25.31 for rs62273959, a missense variant mapping to the LEKR1 gene that is in LD (r(2 )=( )0.90) with a previously identified ‘best hit’ (rs7651446) mapping to an intron of TIPARP. Suggestive associations (5.0 × 10 (−) (5 )>( )P≥5.0 ×10 (−) (7)) were detected for rare and low-frequency variants at 16 novel loci. Four rare missense variants were identified (ACTBL2 rs73757391 (5q11.2), BTD rs200337373 (3p25.1), KRT13 rs150321809 (17q21.2) and MC2R rs104894658 (18p11.21)), but only MC2R rs104894668 had a large effect size (OR = 9.66). Genes most strongly associated with EOC risk included ACTBL2 (P(AML )=( )3.23 × 10 (−) (5); P(SKAT-o )=( )9.23 × 10 (−) (4)) and KRT13 (P(AML )=( )1.67 × 10 (−) (4); P(SKAT-o )=( )1.07 × 10 (−) (5)), reaffirming variant-level analysis. In summary, this large study identified several rare and low-frequency variants and genes that may contribute to EOC susceptibility, albeit with possible small effects. Future studies that integrate epidemiology, sequencing, and functional assays are needed to further unravel the unexplained heritability and biology of this disease

Isolated and stable gallbladder perforation in a 5 year old child after blunt abdominal trauma

Isolated gallbladder injury, secondary to a blunt abdominal trauma, is a rare finding in children.The presence of vague symptoms and the unknown dynamic of the trauma may increase the diagnostic challenge especially in pediatrics.A conservative management has been proposed in some particular cases in adults, but remains controversial in children.We report a case of a 5 year old boy who presented an isolated gallbladder lesion secondary to a blunt abdominal trauma.The surgical treatment was delayed for non-medical reasons, which gave us the possibility to try a conservative approach. Keywords: Isolated, Gallbladder injury, Blunt trauma, Conservative approac

Hypoxia-induced carbonic anhydrase mediated dorsal horn sensory neuron activation and induction of neuropathic pain

Neuropathic pain such as that seen in diabetes mellitus, results in part from central sensitisation in the dorsal horn. However, the mechanisms responsible for such sensitisation remain unclear. There is evidence that disturbances in the integrity of the spinal vascular network can be causative factors in the development of neuropathic pain. Here we show that reduced blood flow and vascularity of the dorsal horn leads to the onset of neuropathic pain. Using rodent models (type 1 diabetes and an inducible endothelial specific vascular endothelial growth factor receptor 2 knockout mouse) that result in degeneration of the endothelium in the dorsal horn we show that spinal cord vasculopathy results in nociceptive behavioural hypersensitivity. This also results in increased hypoxia in dorsal horn neurons, depicted by increased expression of hypoxia markers hypoxia inducible factor

The role of maternal obesity in infant outcomes in polycystic ovary syndrome—a systematic review, meta-analysis, and meta-regression

Polycystic ovary syndrome (PCOS) is associated with worsened pregnancy and infant outcomes, higher body mass index (BMI), and longitudinal weight gain. Despite most of the clinical features of PCOS being risk factors for worsened infant outcomes in the general population, their impact on infant outcomes in PCOS is unknown. We aimed to investigate the association of PCOS with infant outcomes considering maternal adiposity, other known risk factors, and potential confounders. The meta-analyses included 42 studies in 7041 women with PCOS and 63 722 women without PCOS. PCOS was associated with higher gestational weight gain (GWG) and with higher preterm birth and large for gestational age and with lower birth weight with this association varying by geographic continent, PCOS phenotypes, and study quality. However, PCOS was associated with none of these outcomes on BMI-matched studies. Gestational diabetes was significantly associated with an increased preterm birth on meta-regression. We report for the first time that GWG is higher in PCOS. Infant outcomes vary by geographic continent and study quality but are similar in BMI-matched women with and without PCOS. This suggests that infant outcomes in PCOS may be related to maternal obesity. These novel findings warrant future studies in PCOS investigating screening and management of infant outcomes with consideration of maternal obesity.Mahnaz Bahri Khomami, Anju E. Joham, Jacqueline A. Boyle, Terhi Piltonen, Chavy Arora, Michael Silagy, Marie L. Misso, Helena J. Teede, Lisa J. Mora

Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—a systematic review, meta-analysis, and meta-regression

Polycystic ovary syndrome (PCOS) is associated with an increased risk of maternal pregnancy and delivery complications. However, the impact of clinical features of PCOS and other potential risk factors in PCOS is still unknown. We aimed to investigate the association of PCOS with maternal pregnancy and delivery complications with consideration of risk factors and potential confounders. The meta-analysis included 63 studies. PCOS was associated with higher miscarriage, gestational diabetes mellitus, gestational hypertension, pre-eclampsia, induction of labour, and caesarean section. The association of PCOS with these outcomes varied by geographic continent, PCOS phenotypes, and study quality. Pre-eclampsia and induction of labour were not associated with PCOS on body mass index-matched studies. No outcome was associated with PCOS on assisted pregnancies. Age was significantly associated with higher miscarriage on meta-regression. There were no studies assessing perinatal depression. We confirm that PCOS is associated with an increased risk of maternal pregnancy and delivery complications. The association of PCOS with the outcomes is worsened in hyperandrogenic PCOS phenotypes, in specific geographic continents, and in the highest quality studies but disappears in assisted pregnancies. Future studies in PCOS are warranted to investigate proper timing for screening and prevention of maternal pregnancy and delivery complications with consideration of clinical features of PCOS.Mahnaz Bahri Khomami, Anju E. Joham, Jacqueline A. Boyle, Terhi Piltonen, Michael Silagy, Chavy Arora, Marie L. Misso, Helena J. Teede, Lisa J. Mora