Risk factors for marginal ulcer after gastric bypass surgery for obesity:A population-based cohort study

ObjectiveThis study aimed to assess risk factors for developing marginal ulcer (MU) after gastric bypass (GBP) surgery for obesity.BackgroundMU is a common and potentially serious complication of GBP surgery, little is known about its etiology.MethodsThis population-based cohort study of GBP in 2006-2011 evaluated MU in relation to diabetes, hyperlipidemia, hypertension, chronic obstructive pulmonary disease (COPD), ulcer history, use of proton pump inhibitors (PPIs), aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and selective serotonin reuptake inhibitors (SSRIs). Multivariable Cox proportional hazard regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for confounding.ResultsAmong 20,294 GBP patients, diabetes and peptic ulcer history entailed statistically significantly increased risk of MU (HR = 1.26, 95% CI 1.03-1.55 and HR  =  2.70, 95% CI 1.81-4.03), although hyperlipidemia, hypertension, and COPD did not. PPI users had an increased HR of MU (HR  =  1.37, 95% CI 1.17-1.60). Aspirin and NSAID consumption less than or equal to median entailed decreased HRs of MU (HR  =  0.56, 95% CI 0.37-0.86 and HR  =  0.30, 95% CI 0.24-0.38), although aspirin and NSAID users more than median had an increased risk and no association with MU, respectively (HR  =  1.90, 95% CI 1.41-2.58 and HR  =  0.90, 95% CI 0.76-1.87). The use of SSRI less than or equal to median had a decreased risk of MU (HR  =  0.50, 95% CI 0.37-0.67), although use more than median entailed increased HR (HR  =  1.26, 95% CI 1.01-1.56).ConclusionsDiabetes and peptic ulcer history seem to be risk factors for MU, but not hyperlipidemia, hypertension, or COPD. Limited doses of aspirin, NSAIDs, and SSRIs might not increase the risk, although higher doses of aspirin do. The association with PPI could be due to confounding by indication

Antidepressant treatment among social workers, human service professionals, and non-human service professionals : A multi-cohort study in Finland, Sweden and Denmark

Background: Social workers have an elevated risk for mental disorders, but little is known about their antidepressant treatment. Aims: To examine any and long-term antidepressant treatment among social workers in Finland, Sweden and Denmark. Methods: We linked records from drug prescription registers to three prospective cohorts: the Finnish Public Sector study, years 2006-2011, and nation-wide cohorts in Sweden and Denmark, years 2006-2014, including a total of 1.5 million employees in (1) social work, (2) other social and health care professions, (3) education and (4) office work. We used Cox proportional hazards models to estimate hazard ratios for any and long-term (>6 months) antidepressant treatment among social workers compared to the three reference occupational groups and carried out meta-analyses. Results: During follow-up, 25% of social workers had any prescriptions for antidepressants (19-24% reference occupations) and 20% for long-term treatment (14-19% reference occupations). The pooled effects for any and long-term treatment showed that probabilities were 10% higher in social workers compared to other health and social care professionals and 30% higher compared to education and non-human service professionals. Probabilities for any treatment in the three countries were relatively similar, but for long-term treatment social workers in Finland had a greater risk compared with other human service professions. Limitations: There were differences between the cohorts in the availability of data. Specific diagnoses for the antidepressant treatment were not known neither adherence to treatment. Conclusion: Social workers have a higher risk for any and long-term antidepressant treatment than other human and non-human service professionals.Peer reviewe

Gene silencing H-NS paralogue StpA forms a rigid protein filament along DNA that blocks DNA accessibility

Nucleoid-associated proteins are bacterial proteins that are responsible for chromosomal DNA compaction and global gene regulation. One such protein is Escherichia coli Histone-like nucleoid structuring protein (H-NS) which functions as a global gene silencer. Whereas the DNA-binding mechanism of H-NS is well-characterized, its paralogue, StpA which is also able to silence genes is less understood. Here we show that StpA is similar to H-NS in that it is able to form a rigid filament along DNA. In contrast to H-NS, the StpA filament interacts with a naked DNA segment to cause DNA bridging which results in simultaneous stiffening and bridging of DNA. DNA accessibility is effectively blocked after the formation of StpA filament on DNA, suggesting rigid filament formation is the important step in promoting gene silencing. We also show that >1 mM magnesium promotes higher order DNA condensation, suggesting StpA may also play a role in chromosomal DNA packaging

Cas3 is a limiting factor for CRISPR-Cas immunity in Escherichia coli cells lacking H-NS

Background: CRISPR-Cas systems provide adaptive immunity to mobile genetic elements in prokaryotes. In many bacteria, including E. coli, a specialized ribonucleoprotein complex called Cascade enacts immunity by “an interference reaction" between CRISPR encoded RNA (crRNA) and invader DNA sequences called “protospacers”. Cascade recognizes invader DNA via short “protospacer adjacent motif” (PAM) sequences and crRNA-DNA complementarity. This triggers degradation of invader DNA by Cas3 protein and in some circumstances stimulates capture of new invader DNA protospacers for incorporation into CRISPR as “spacers” by Cas1 and Cas2 proteins, thus enhancing immunity. Co-expression of Cascade, Cas3 and crRNA is effective at giving E. coli cells resistance to phage lysis, if a transcriptional repressor of Cascade and CRISPR, H-NS, is inactivated (Δhns). We present further genetic analyses of the regulation of CRISPR-Cas mediated phage resistance in Δhns E. coli cells. Results: We observed that E. coli Type I-E CRISPR-Cas mediated resistance to phage λ was strongly temperature dependent, when repeating previously published experimental procedures. Further genetic analyses highlighted the importance of culture conditions for controlling the extent of CRISPR immunity in E. coli. These data identified that expression levels of cas3 is an important limiting factor for successful resistance to phage. Significantly, we describe the new identification that cas3 is also under transcriptional control by H-NS but that this is exerted only in stationary phase cells. Conclusions: Regulation of cas3 is responsive to phase of growth, and to growth temperature in E. coli, impacting on the efficacy of CRISPR-Cas immunity in these experimental systems

Resultatet av myringoplastikkoperasjoner på barn på Rikshospitalet i Oslo 2003- 2004

The abstract of myringoplasties in children- A retrospective study over two years. C. Sondén and C. Laurent. National hospital, University of Oslo, Oslo, Norway. In this retrospective study over two years 49 children (51 ears; 30 ears of girls and 21 ears of boys) aged 5- 15 years were operated with myringoplasty at The National Hospital, Norway. In total 51 central perforations were operated and followed- up between 1,5 – 18 months after surgery. The over all healing rate was 82 %. The healing rates in perforations after ventilation tubes and revisions were lower, 78 % and 75 % respectively. In children less than 7 years only 1/3 healed, whereas in children over 7 years 90 % healed, irrespective of previous ventilation tubes or not. The hearing improved after surgery in 89 % of the cases and reached < 20 dB in 83 %. Five ears got worse hearing after surgery, maximum 7 dB pure tone average, all of them with healed tympanic membranes. The hearing improved on average 8 dB also in ears with remaining perforations. In conclusion, this retrospective study shows that children 7 years or older have a favorable outcome (90 % healing rate and 89 % improved hearing) after first- time myringoplasty