Chromatin remodeling resets the immune system to protect against autoimmune diabetes in mice

Epigenetic alteration of the genome has been shown to provide palliative effects in mouse models of certain human autoimmune diseases. We have investigated whether chromatin remodeling could provide protection against autoimmune diabetes in NOD mice. Treatment of female mice during the transition from prediabetic to diabetic stage (18-24 weeks of age) with the well-characterized histone deacetylase inhibitor, Trichostatin A effectively reduced the incidence of diabetes. However, similar treatment of overtly diabetic mice during the same time period failed to reverse the disease. Protection against diabetes was accompanied by histone hyperacetylation in pancreas and spleen, enhanced frequency of CD4+ CD62L+ cells in the spleen, reduction in cellular infiltration of islets, restoration of normoglycemia and glucose-induced insulin release by beta cells. Activation of splenic T lymphocytes derived from protected mice in vitro with pharmacological agents that bypass the antigen receptor or immobilized anti-CD3 antibody resulted in enhanced expression of Ifng mRNA and protein without altering the expression of Il4, Il17, Il18, Inos, and Tnfa genes nor the secretion of IL-2, IL-4, IL-17, and TNF-α proteins. Consistently, expression of the transcription factor involved in Ifng transcription, Tbet/Tbx21 but not Gata3 and Rorgt, respectively required for the transcription of Il4 and Il17, was upregulated in activated splenocytes of protected mice. These results indicate that chromatin remodeling can lead to amelioration of diabetes by employing multiple mechanisms including differential gene transcription. Thus, epigenetic modulation could be a novel therapeutic approach to block the transition from benign to frank diabetes

Psychosocial and Clinical Profiles of the Cases Visiting the Emergency Department Due to Accidental Self-harm and Suicide Attempts in Doha, Qatar: A Retrospective Study

The aims of this study were to retrospectively assess the profiles of subjects with suicide attempts and self-harm in Doha, Qatar; and whether the available data were complete. We reviewed all the records of fatal and non-fatal suicides together with accidental self-ham cases seen in the major Emergency Department in Doha, over a one-year period. There was 37 completed suicide, mostly male expatriates in mid 30 s who died by hanging. In cases with suicide intent (N = 270), more males were admitted to Psychiatry than women. Overdose was the common method and the majority had mood disorders. In self-harm cases with no suicide intent (N = 150) the majority were not seen by Psychiatry. The profiles of suicide cases in Qatar are similar to those reported internationally. However, there is a major need to establish a comprehensive system to register and assess all self-harm patients in Qatar.Other Information Published in: Community Mental Health Journal License: https://creativecommons.org/licenses/by/4.0See article on publisher's website: http://dx.doi.org/10.1007/s10597-020-00650-3</p

Screening for antenatal depression and its determinants among pregnant women in Qatar: revisiting the biopsychosocial model

Background Screening for antenatal depression and its determinants is highly recommended. However, there is no consensus on a standard conceptual framework to approach pregnant women in a primary health care setting. The prevalence of antenatal depression and significant determinants are unknown in Qatar, a gap that we propose to fill. Methods An analytical cross-sectional study with a probability sampling technique was employed. Enrolling eight-hundred participants from primary health care centers. The screening was performed through a valid and reliable screening instrument ‘Edinburgh Postpartum Depression Scale.’ In addition to the proposed Comprehensive Biopsychosocial Model, participants were asked about their predisposing profile, biological risk, and other suggested modifiable variables. Results Twenty-one percent reported minor depressive episodes (n = 167, 20.9%) at a 95% confidence interval [18.2–23.8]. Previous use of mental health medications, fear of giving birth, concern about appearance, low perceived social support, and low resilience level showed to be associated with antenatal depression. The logistic regression analyses revealed that the Comprehensive Biopsychosocial model forecast 89% of antenatal depression predictors provided Area Under the Receiver Operating Characteristic Curve of 0.89 at a 95% confidence interval [0.85 to 0.92]. Conclusions Antenatal depression is common among pregnant women in Qatar, and preventive interventions must target the determinants revealed. From a clinical perspective, the use of the proposed model may aid in the standardization of the screening process.Other Information Published in: BMC Pregnancy and Childbirth License: http://creativecommons.org/licenses/by/4.0/See article on publisher's website: http://dx.doi.org/10.1186/s12884-021-03793-7</p

Knowledge and Willingness for Organ Donation in the Middle Eastern Region: A Meta-analysis

Medical advancements over the past decades brought organ transplantation as a definitive therapy for different end-stage organ failure. However, non-availability of organs required for transplantation is a major challenge worldwide. We aimed to determine the knowledge and willingness to donate organs in various populations and settings in the Middle Eastern region. Literature searches were conducted on PubMed, MEDLINE, Cochrane, and Google scholar electronic databases. Different combinations of search terms such as “organ donation”; “knowledge”, “awareness”; “beliefs”, “willingness”; and “attitude” along with the country names were used. Additional searches using reference lists of studies and review articles were conducted. Data were extracted using standardized excel form and pilot tested. Three authors independently abstracted the data using a data collection form. Results from different studies were pooled for the analysis when appropriate. The search yielded 1806 articles; 1000 duplicates and review articles were excluded, and a further 792 articles not relevant were excluded. Finally, 14 original studies met the inclusion criteria. Total pooled sample size for assessing knowledge was 6697 and for willingness was 8714. Pooled overall knowledge regarding organ donation was 69% with a 95% CI [64.5, 73.5]. Pooled overall willingness to donate organ was 49.8% with a 95% CI [41.3, 58.4]. Knowledge about organ donation and willingness to donate organs varies in different population and settings in the Middle East. These in fact are linked to multiple social factors ultimately leads to ‘consent’ for donating organs by a potential donor. Family’s influence; religious, traditional and spiritual beliefs; and status of ethnic, minority, and immigrant populace are the important determinants of the decision for organ donation. Understandings on social determinants in organ donation remain crucial and should be addressed while developing policies and organizational developments.Other Information Published in: Journal of Religion and Health License: https://creativecommons.org/licenses/by/4.0See article on publisher's website: http://dx.doi.org/10.1007/s10943-019-00883-x</p

The FASILA Score: A Novel Bio-Clinical Score to Predict Massive Blood Transfusion in Patients with Abdominal Trauma

Background Early identification of patients who may need massive blood transfusion remains a major challenge in trauma care. This study proposed a novel and easy-to-calculate prediction score using clinical and point of care laboratory findings in patients with abdominal trauma (AT). Methods Patients with AT admitted to a trauma center in Qatar between 2014 and 2017 were retrospectively analyzed. The FASILA score was proposed and calculated using focused assessment with sonography in trauma (0 = negative, 1 = positive), Shock Index (SI) (0 = 0.50–0.69, 1 = 0.70–0.79, 2 = 0.80–0.89, and 3 ≥ 0.90), and initial serum lactate (0 ≤ 2.0, 1 = 2.0–4.0, and 2 ≥ 4.0 mmol/l). Outcome variables included mortality, laparotomy, and massive blood transfusion (MT). FASILA was compared to other prediction scores using receiver operating characteristics and areas under the curves. Bootstrap procedure was employed for internal validation. Results In 1199 patients with a mean age of 31 ± 13.5 years, MT, MT protocol (MTP) activation, exploratory laparotomy (ExLap), and hospital mortality were related linearly with the FASILA score, Injury Severity Score, and total length of hospital stay. Initial hemoglobin, Revised Trauma Score (RTS), and Trauma Injury Severity Score (TRISS) were inversely proportional. FASILA scores correlated significantly with the Assessment of Blood Consumption (ABC) (r = 0.65), Revised Assessment of Bleeding and Transfusion (RABT) (r = 0.63), SI (r = 0.72), RTS (r = − 0.34), and Glasgow Coma Scale (r = − 0.32) and outperformed other predictive systems (RABT, ABC, and SI) in predicting MT, MTP, ExLap, and mortality. Conclusions The novel FASILA score performs well in patients with abdominal trauma and offers advantages over other scores.Other Information Published in: World Journal of Surgery License: https://creativecommons.org/licenses/by/4.0See article on publisher's website: http://dx.doi.org/10.1007/s00268-019-05289-0</p

Type of coronary syndrome and mortality in women and men at different age group.

<p>STEMI: ST-Elevation Myocardial Infarction; NSTMI: Non ST-Elevation Myocardial Infarction; UA: Unstable Angina, All values in parenthesis are percentages.</p

Additional file 1 of Association between serum triglycerides and stroke type, severity, and prognosis. Analysis in 6558 patients

Supplementary Material 1

Acute coronary syndrome among Middle Eastern Arab (Men and Women): A: Trend for hospitalization. B: Trend for mortality.

<p>Acute coronary syndrome among Middle Eastern Arab (Men and Women): A: Trend for hospitalization. B: Trend for mortality.</p

Mortality rate in men and women stratified by age.

<p>Mortality rate in men and women stratified by age.</p

Overall and trend of mortality in men and women.

<p>Overall and trend of mortality in men and women.</p