The epidemiology and factors associated with nocturnal enuresis among boarding and daytime school children in southeast of Turkey: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Nocturnal enuresis is an important problem among young children living in Turkey. The purpose of this study was to determine the possible differences in the prevalence of enuresis between children in boarding school and daytime school and the association of enuresis with sociodemographic factors.</p> <p>Methods</p> <p>This was a cross-sectional survey. A total of 562 self-administered questionnaires were distrubuted to parents from two different types of schools. One of them was a day-time school and the other was a boarding school. To describe enuresis the ICD-10 definition of at least one wet night per month for three consecutive months was used. Chi-square test and a logistic regression model was used to identify significant predictive factors for enuresis.</p> <p>Results</p> <p>The overall prevalence of nocturnal enuresis was 14.9%. The prevalence of nocturnal enuresis declined with age. Of the 6 year old children 33.3% still wetted their beds, while the ratio was 2.6% for 15 years-olds. There was no significant difference in prevalence of nocturnal enuresis between boys and girls (14.3% versus 16. 8%). Enuresis was reported as 18.5% among children attending day time school and among those 11.5% attending boarding school (p < 0.05). Prevalence of enuresis was increased in children living in villages, with low income and with positive family history (p < 0.05). After multivariate analysis, history of urinary tract infection (OR = 2.02), age (OR = 1.28), low monthly income (OR = 2.86) and family history of enuresis (OR = 3.64) were factors associated with enuresis. 46.4% of parents and 57.1% of enuretic children were significantly concerned about the impact of enuresis.</p> <p>Conclusion</p> <p>Enuresis was more frequent among children attending daytime school when compared to boarding school. Our findings suggest that nocturnal enuresis is a common problem among school children, especially with low income, smaller age, family history of enuresis and history of urinary tract infection. Enuresis is a pediatric public health problem and efforts at all levels should be made such as preventive, etiological and curative.</p

Disruption of Growth Hormone Receptor Prevents Calorie Restriction from Improving Insulin Action and Longevity

Most mutations that delay aging and prolong lifespan in the mouse are related to somatotropic and/or insulin signaling. Calorie restriction (CR) is the only intervention that reliably increases mouse longevity. There is considerable phenotypic overlap between long-lived mutant mice and normal mice on chronic CR. Therefore, we investigated the interactive effects of CR and targeted disruption or knock out of the growth hormone receptor (GHRKO) in mice on longevity and the insulin signaling cascade. Every other day feeding corresponds to a mild (i.e. 15%) CR which increased median lifespan in normal mice but not in GHRKO mice corroborating our previous findings on the effects of moderate (30%) CR on the longevity of these animals. To determine why insulin sensitivity improves in normal but not GHRKO mice in response to 30% CR, we conducted insulin stimulation experiments after one year of CR. In normal mice, CR increased the insulin stimulated activation of the insulin signaling cascade (IR/IRS/PI3K/AKT) in liver and muscle. Livers of GHRKO mice responded to insulin by increased activation of the early steps of insulin signaling, which was dissipated by altered PI3K subunit abundance which putatively inhibited AKT activation. In the muscle of GHRKO mice, there was elevated downstream activation of the insulin signaling cascade (IRS/PI3K/AKT) in the absence of elevated IR activation. Further, we found a major reduction of inhibitory Ser phosphorylation of IRS-1 seen exclusively in GHRKO muscle which may underpin their elevated insulin sensitivity. Chronic CR failed to further modify the alterations in insulin signaling in GHRKO mice as compared to normal mice, likely explaining or contributing to the absence of CR effects on insulin sensitivity and longevity in these long-lived mice

Histone Variants and Their Post-Translational Modifications in Primary Human Fat Cells

Epigenetic changes related to human disease cannot be fully addressed by studies of cells from cultures or from other mammals. We isolated human fat cells from subcutaneous abdominal fat tissue of female subjects and extracted histones from either purified nuclei or intact cells. Direct acid extraction of whole adipocytes was more efficient, yielding about 100 µg of protein with histone content of 60% –70% from 10 mL of fat cells. Differential proteolysis of the protein extracts by trypsin or ArgC-protease followed by nanoLC/MS/MS with alternating CID/ETD peptide sequencing identified 19 histone variants. Four variants were found at the protein level for the first time; particularly HIST2H4B was identified besides the only H4 isoform earlier known to be expressed in humans. Three of the found H2A potentially organize small nucleosomes in transcriptionally active chromatin, while two H2AFY variants inactivate X chromosome in female cells. HIST1H2BA and three of the identified H1 variants had earlier been described only as oocyte or testis specific histones. H2AFX and H2AFY revealed differential and variable N-terminal processing. Out of 78 histone modifications by acetylation/trimethylation, methylation, dimethylation, phosphorylation and ubiquitination, identified from six subjects, 68 were found for the first time. Only 23 of these modifications were detected in two or more subjects, while all the others were individual specific. The direct acid extraction of adipocytes allows for personal epigenetic analyses of human fat tissue, for profiling of histone modifications related to obesity, diabetes and metabolic syndrome, as well as for selection of individual medical treatments

Needs, Challenges, and Applications of Artificial Intelligence in Medical Education Curriculum

Artificial intelligence (AI) is on course to become a mainstay in the patient’s room, physician’s office, and the surgical suite. Current advancements in health care technology might put future physicians in an insufficiently equipped position to deal with the advancements and challenges brought about by AI and machine learning solutions. Physicians will be tasked regularly with clinical decision-making with the assistance of AI-driven predictions. Present-day physicians are not trained to incorporate the suggestions of such predictions on a regular basis nor are they knowledgeable in an ethical approach to incorporating AI in their practice and evolving standards of care. Medical schools do not currently incorporate AI in their curriculum due to several factors, including the lack of faculty expertise, the lack of evidence to support the growing desire by students to learn about AI, or the lack of Liaison Committee on Medical Education’s guidance on AI in medical education. Medical schools should incorporate AI in the curriculum as a longitudinal thread in current subjects. Current students should understand the breadth of AI tools, the framework of engineering and designing AI solutions to clinical issues, and the role of data in the development of AI innovations. Study cases in the curriculum should include an AI recommendation that may present critical decision-making challenges. Finally, the ethical implications of AI in medicine must be at the forefront of any comprehensive medical education

Effects of insulin and sulphonylureas on insulin-like growth factor-I levels in streptozotocin-induced diabetic rats

WOS: 000180255100012PubMed ID: 12500166OBJECTIVE: Diabetes Mellitus is associated with decreased insulin-like growth factor-I (IGF-I) levels and also, poor growth in diabetes is related with low circulating levels of IGF-I. Insulin acts via an increase of IGF-I synthesis on growth. We studied the effects of insulin and sulphonylureas on serum IGF-I levels and aimed to evaluate the restoration of IGF-I in different therapeutic strategies. DESIGN AND SETTING: Thirty male rats were used in the study and diabetes was induced by a single intraperitoneal injection of streptozotocin (35 mg/kg body weight). After confirmation of hyperglycemia, rats were divided into three groups. The first group was treated with insulin, and second group with glimepiride, third group was not treated (control group). IGF-I levels were measured at basal, after streptozotocin and at the end of the treatment period. RESULTS: Serum IGF-I levels were found to decrease from 577.2 ng/ml to 253.0 ng/ml after streptozotocin (p0.05). CONCLUSIONS: Serum IGF-I levels decrease in diabetes and insulin treatment restores IGF-I depletion significantly. And although less effective, treatment with glimepiride restores IGF-I levels significantly