Increased Incidence of Asthma in Children with Prenatal Opioid Exposure

Prenatal opioid exposure (POE) has increased dramatically in the last 10 years, with nearly 100 babies born daily in the United States with Neonatal Opioid Withdrawal Syndrome (NOWS). The impact on long-term outcomes continues to be investigated. Given the proinflammatory state that results from POE, we hypothesized that infants with POE or NOWS diagnoses during the newborn hospitalization would have an altered immune reactivity that persisted into childhood, defined by asthma diagnosis within the first 8 years. A retrospective cohort design utilizing a comprehensive CERNER HealthFacts U.S. national database was completed, which accesses clinical data from 800 hospitals across the country. ICD-9-CM and ICD-10-CM diagnosis codes were used to identify infants born at term with known POE or NOWS and were compared to healthy control infants with no diagnoses at birth other than normal newborn codes. The incidence of asthma during the first 8 years of life was determined. Descriptive statistics of frequencies and percentages were calculated for all variables. A Chi-Square test was used to examine the association between asthma diagnosis and POE. A total of 3128 infants were included in the analysis. Approximately 41% were identified as male and 38% identified as female; the remainder were not specified with coding. Almost 52% of subjects were identified as Caucasian. Asthma diagnosis differed significantly by group, X2 (3, n = 3,128) = 12.93 with a p \u3c 0.001. These emerging results suggest infants with POE may have altered immune reactivity that not only impacts the newborn period but persists into childhood. Those with POE were more likely to be diagnosed with asthma by 8 years of age than infants in the healthy control group. Additional investigations are needed to further characterize the impact POE has on the immune system, so that potential follow up strategies and/or interventions can be established

Primary thyroid MALToma- a rare diagnosis of an unassuming thyroid nodule.

Primary thyroid lymphoma, although a rare malignancy, can arise in common chronic inflammatory conditions such as Hashimoto\u27s thyroiditis. Incidental finding of a thyroid nodule with chronic thyroid inflammation warrants further investigation. Early detection of malignancy can play a vital role in improved outcomes. We report a case of a 60-year-old male who presented to the clinic for a routine visit. An enlarged, firm, non-tender thyroid gland was appreciated on exam with high thyroid stimulating hormone (TSH) level. Fine needle aspiration of the mass revealed nonspecific atypical lymphocytes. The pathology and immunohistochemical stains were consistent with histologic impression of extra nodal marginal B-cell lymphoma (mucosa-associated lymphoid tissue [MALT] lymphoma) and Hashimoto\u27s thyroiditis. Patient was treated with thyroxine after complete surgical excision of left thyroid lobe and remains in remission with close follow-up with his primary care provider. Primary thyroid MALT lymphoma follows an indolent process and remains asymptomatic in most patients. These are usually found to arise at sites of ongoing chronic inflammation with underlying autoimmune or infectious etiologies. Treatment modalities include surgical excision and/or radiation therapy for localized lesions, with both radiation and chemotherapy indicated for disseminated disease

Neural bases of social feedback processing and self–other distinction in late childhood: The role of attachment and age

Attachment plays a key role in how children process information about the self and others. Here, we examined the neural bases of interindividual differences in attachment in late childhood and tested whether social cognition-related neural activity varies as function of age. In a small sample of 8-year-old to 12-year-old children (n = 21/19), we used functional magnetic resonance imaging to measure neural responses during social feedback processing and self–other distinction. Attachment was assessed using child self-report. The social feedback processing task presented smiling and angry faces either confirming or disconfirming written information about participant performance on a perceptual game. In addition to observing main effects of facial emotion and performance, an increase in age was related to a shift from negative (i.e., angry faces/bad performance) to positive (i.e., smiling faces/good performance) information processing in the left amygdala/hippocampus, bilateral fusiform face area, bilateral anterior temporal pole (ATP), and left anterior insula. There were no effects of attachment on social feedback processing. The self–other distinction task presented digital morphs between children’s own faces and faces of their mother or stranger females. We observed differential activation in face processing and mentalizing regions in response to self and mother faces versus morphed faces. Furthermore, left ATP activity was associated with attachment anxiety such that greater attachment anxiety was related to a shift from heightened processing of self and mother faces to morphed faces. There were no effects of age on self–other distinction. We discuss our preliminary findings in the context of attachment theory and previous work on social evaluation and self–other processing

Prescription audit of antihypertensive drugs used in stroke patients in a tertiary care teaching hospital

Background: Stroke is considered as one of the important reasons of death and disability worldwide. A rational use of medications is needed to prevent the recurrence and the disease related complications.Methods: The current study is a prospective observational study. All stroke cases, with patients above the age of 25 and treated with antihypertensive agents were included in the study. A total of 189 patients were found suitable for inclusion in the study. Using a suitably designed data collection form, all pertinent data such as patient demographics, prescribed medicines, drug interactions and adverse drug reactions were collected from the patient’s case file, nurses’ charts, and medication charts. Prescription pattern of antihypertensive drugs were obtained. The causality of the ADR was assessed using the Naranjo causality assessment scale and reported in the institution where the study was conducted.Results: Majority of patients included in the study were in the age group of 61-70 years. The incidence of stroke in this study was more in males than in the females. Ischemic stroke (72%) was more prevalent when compared to Hemorrhagic stroke. Among the antihypertensive agents, calcium channel blockers (32%) were the most commonly prescribed class of drugs. In our audit, drug related problems were observed in 27% of the cases which included cases with improper dose (3 cases), contraindications (4 cases), major drug interactions (20 cases), and adverse drug reactions (17 cases). Most of the prescriptions were legible. Drug related problems had a great impact on the overall stroketherapy.Conclusions: The drug related problems are a relevant aspect to be considered when treating patients with stroke and it can arise irrespective of adherence to guidelines

Risk factors for wasting among hospitalised children in Nepal

Background: Malnutrition has various adverse effects in children. This study aimed to determine risk factors for malnutrition among hospitalised children, changes in nutritional status at admission and discharge and effects of use of systematic anthropometric measurement in identification of malnutrition.Methods: We enrolled 426 children, aged between 6 months and 15 years, admitted to Siddhi Memorial Hospital, Bhaktapur, Nepal, from November 2016 to June 2017. Anthropometric measurements were performed at the time of admission and discharge. Risk factors were assessed by multivariable logistic regression models.Results: Median age of children was 26 months (IQR: 13–49), and males were 58.7%. The prevalence of wasting was 9.2% (39/426) at admission and 8.5% (36/426) at discharge. Risk factors associated with wasting at admission were ethnic minority (aOR: 3.6, 95% CI 1.2–10.8), diarrhoeal diseases (aOR = 4.0; 95% CI 1.3–11.8), respiratory diseases (aOR: 3.4, 95% CI 1.4–8.1) and earthquake damage to house (aOR = 2.6; 95% CI 1.1–6.3). Clinical observation by care providers identified only 2 out of 112 malnutrition cases at admission and 4 out of 119 cases at discharge that were detected by the systematic anthropometric measurement.Conclusions: Ethnic minority, diarrhoeal diseases, respiratory infections and house damage due to the earthquake were risk factors associated with wasting. Systematic anthropometric examination can identify significantly more malnourished children than simple observation of care providers

Genome-wide association mapping of rust resistance in Aegilops longissima

The rust diseases, including leaf rust caused by Puccinia triticina (Pt), stem rust caused by P. graminis f. sp. tritici (Pgt), and stripe rust caused by P. striiformis f. sp. tritici (Pst), are major limiting factors in wheat production worldwide. Identification of novel sources of rust resistance genes is key to developing cultivars resistant to rapidly evolving pathogen populations. Aegilops longissima is a diploid wild grass native to the Levant and closely related to the modern bread wheat D subgenome. To explore resistance genes in the species, we evaluated a large panel of Ae. longissima for resistance to several races of Pt, Pgt, and Pst, and conducted a genome-wide association study (GWAS) to map rust resistance loci in the species. A panel of 404 Ae. longissima accessions, mostly collected from Israel, were screened for seedling-stage resistance to four races of Pt, four races of Pgt, and three races of Pst. Out of the 404 accessions screened, two were found that were resistant to all 11 races of the three rust pathogens screened. The percentage of all accessions screened that were resistant to a given rust pathogen race ranged from 18.5% to 99.7%. Genotyping-by-sequencing (GBS) was performed on 381 accessions of the Ae. longissima panel, wherein 125,343 single nucleotide polymorphisms (SNPs) were obtained after alignment to the Ae. longissima reference genome assembly and quality control filtering. Genetic diversity analysis revealed the presence of two distinct subpopulations, which followed a geographic pattern of a northern and a southern subpopulation. Association mapping was performed in the genotyped portion of the collection (n = 381) and in each subpopulation (n = 204 and 174) independently via a single-locus mixed-linear model, and two multi-locus models, FarmCPU, and BLINK. A large number (195) of markers were significantly associated with resistance to at least one of 10 rust pathogen races evaluated, nine of which are key candidate markers for further investigation due to their detection via multiple models and/or their association with resistance to more than one pathogen race. The novel resistance loci identified will provide additional diversity available for use in wheat breeding

Preference for Human Papillomavirus–Based Cervical Cancer Screening: Results of a Choice-Based Conjoint Study in Zambia

The objective of this study was to assess the conditions under which Zambia women with a history of cervical cancer screening by visual inspection with acetic acid might switch to HPV-based testing in the future

Associations of occupational standing with musculoskeletal symptoms: A systematic review with meta-analysis

Objective Given the high exposure to occupational standing in specific occupations, and recent initiatives to encourage intermittent standing among white-collar workers, a better understanding of the potential health consequences of occupational standing is required. We aimed to review and quantify the epidemiological evidence on associations of occupational standing with musculoskeletal symptoms. Design A systematic review was performed. Data from included articles were extracted and described, and meta-analyses conducted when data were sufficiently homogeneous. Data sources Electronic databases were systematically searched. Eligibility criteria Peer-reviewed articles on occupational standing and musculoskeletal symptoms from epidemiological studies were identified. Results Of the 11 750 articles screened, 50 articles reporting 49 studies were included (45 cross-sectional and 5 longitudinal; n=88 158 participants) describing the associations of occupational standing with musculoskeletal symptoms, including low-back (39 articles), lower extremity (14 articles) and upper extremity (18 articles) symptoms. In the meta-analysis, 'substantial' (>4 hours/workday) occupational standing was associated with the occurrence of low-back symptoms (pooled OR (95% CI) 1.31 (1.10 to 1.56)). Evidence on lower and upper extremity symptoms was too heterogeneous for meta-analyses. The majority of included studies reported statistically significant detrimental associations of occupational standing with lower extremity, but not with upper extremity symptoms. Conclusions The evidence suggests that substantial occupational standing is associated with the occurrence of low-back and (inconclusively) lower extremity symptoms, but there may not be such an association with upper extremity symptoms. However, these conclusions are tentative as only limited evidence was found from high-quality, longitudinal studies with fully adjusted models using objective measures of standing

Diversity of 16S-23S rDNA Internal Transcribed Spacer (ITS) Reveals Phylogenetic Relationships in Burkholderia pseudomallei and Its Near-Neighbors

Length polymorphisms within the 16S-23S ribosomal DNA internal transcribed spacer (ITS) have been described as stable genetic markers for studying bacterial phylogenetics. In this study, we used these genetic markers to investigate phylogenetic relationships in Burkholderia pseudomallei and its near-relative species. B. pseudomallei is known as one of the most genetically recombined bacterial species. In silico analysis of multiple B. pseudomallei genomes revealed approximately four homologous rRNA operons and ITS length polymorphisms therein. We characterized ITS distribution using PCR and analyzed via a high-throughput capillary electrophoresis in 1,191 B. pseudomallei strains. Three major ITS types were identified, two of which were commonly found in most B. pseudomallei strains from the endemic areas, whereas the third one was significantly correlated with worldwide sporadic strains. Interestingly, mixtures of the two common ITS types were observed within the same strains, and at a greater incidence in Thailand than Australia suggesting that genetic recombination causes the ITS variation within species, with greater recombination frequency in Thailand. In addition, the B. mallei ITS type was common to B. pseudomallei, providing further support that B. mallei is a clone of B. pseudomallei. Other B. pseudomallei near-neighbors possessed unique and monomorphic ITS types. Our data shed light on evolutionary patterns of B. pseudomallei and its near relative species

Формирование эмоциональной культуры как компонента инновационной культуры студентов

Homozygosity has long been associated with rare, often devastating, Mendelian disorders1 and Darwin was one of the first to recognise that inbreeding reduces evolutionary fitness2. However, the effect of the more distant parental relatedness common in modern human populations is less well understood. Genomic data now allow us to investigate the effects of homozygosity on traits of public health importance by observing contiguous homozygous segments (runs of homozygosity, ROH), which are inferred to be homozygous along their complete length. Given the low levels of genome-wide homozygosity prevalent in most human populations, information is required on very large numbers of people to provide sufficient power3,4. Here we use ROH to study 16 health-related quantitative traits in 354,224 individuals from 102 cohorts and find statistically significant associations between summed runs of homozygosity (SROH) and four complex traits: height, forced expiratory lung volume in 1 second (FEV1), general cognitive ability (g) and educational attainment (nominal p<1 × 10−300, 2.1 × 10−6, 2.5 × 10−10, 1.8 × 10−10). In each case increased homozygosity was associated with decreased trait value, equivalent to the offspring of first cousins being 1.2 cm shorter and having 10 months less education. Similar effect sizes were found across four continental groups and populations with different degrees of genome-wide homozygosity, providing convincing evidence for the first time that homozygosity, rather than confounding, directly contributes to phenotypic variance. Contrary to earlier reports in substantially smaller samples5,6, no evidence was seen of an influence of genome-wide homozygosity on blood pressure and low density lipoprotein (LDL) cholesterol, or ten other cardio-metabolic traits. Since directional dominance is predicted for traits under directional evolutionary selection7, this study provides evidence that increased stature and cognitive function have been positively selected in human evolution, whereas many important risk factors for late-onset complex diseases may not have been