The prevalence of axial spondyloarthritis in the UK: a cross-sectional cohort study

Background: Accurate prevalence data are important when interpreting diagnostic tests and planning for the health needs of a population, yet no such data exist for axial spondyloarthritis (axSpA) in the UK. In this cross-sectional cohort study we aimed to estimate the prevalence of axSpA in a UK primary care population. Methods: A validated self-completed questionnaire was used to screen primary care patients with low back pain for inflammatory back pain (IBP). Patients with a verifiable pre-existing diagnosis of axSpA were included as positive cases. All other patients meeting the Assessment of SpondyloArthritis international Society (ASAS) IBP criteria were invited to undergo further assessment including MRI scanning, allowing classification according to the European Spondyloarthropathy Study Group (ESSG) and ASAS axSpA criteria, and the modified New York (mNY) criteria for ankylosing spondylitis (AS). Results: Of 978 questionnaires sent to potential participants 505 were returned (response rate 51.6 %). Six subjects had a prior diagnosis of axSpA, 4 of whom met mNY criteria. Thirty eight of 75 subjects meeting ASAS IBP criteria attended review (mean age 53.5 years, 37 % male). The number of subjects satisfying classification criteria was 23 for ESSG, 3 for ASAS (2 clinical, 1 radiological) and 1 for mNY criteria. This equates to a prevalence of 5.3 % (95 % CI 4.0, 6.8) using ESSG, 1.3 % (95 % CI 0.8, 2.3) using ASAS, 0.66 % (95 % CI 0.28, 1.3) using mNY criteria in chronic back pain patients, and 1.2 % (95 % CI 0.9, 1.4) using ESSG, 0.3 % (95 % CI 0.13, 0.48) using ASAS, 0.15 % (95 % CI 0.02, 0.27) using mNY criteria in the general adult primary care population. Conclusions: These are the first prevalence estimates for axSpA in the UK, and will be of importance in planning for the future healthcare needs of this population. Trial registration: Current Controlled Trials ISRCTN7687321

A SCN9A gene-encoded dorsal root ganglia sodium channel polymorphism associated with severe fibromyalgia

<p>Abstract</p> <p>Background</p> <p>A consistent line of investigation suggests that autonomic nervous system dysfunction may explain the multi-system features of fibromyalgia (FM); and that FM is a sympathetically maintained neuropathic pain syndrome. Dorsal root ganglia (DRG) are key sympathetic-nociceptive short-circuit sites. Sodium channels located in DRG (particularly Nav1.7) act as molecular gatekeepers for pain detection. Nav1.7 is encoded in gene SCN9A of chromosome 2q24.3 and is predominantly expressed in the DRG pain-sensing neurons and sympathetic ganglia neurons. Several SCN9A sodium channelopathies have been recognized as the cause of rare painful dysautonomic syndromes such as paroxysmal extreme pain disorder and primary erythromelalgia. The aim of this study was to search for an association between fibromyalgia and several SCN9A sodium channels gene polymorphisms.</p> <p>Methods</p> <p>We studied 73 Mexican women suffering from FM and 48 age-matched women who considered themselves healthy. All participants filled out the Fibromyalgia Impact Questionnaire (FIQ). Genomic DNA from whole blood containing EDTA was extracted by standard techniques. The following SCN9A single-nucleotide polymorphisms (SNP) were determined by 5' exonuclease TaqMan assays: rs4371369; rs4387806; rs4453709; rs4597545; rs6746030; rs6754031; rs7607967; rs12620053; rs12994338; and rs13017637.</p> <p>Results</p> <p>The frequency of the rs6754031 polymorphism was significantly different in both groups (<it>P </it>= 0.036) mostly due to an absence of the GG genotype in controls. Interestingly; patients with this rs6754031 GG genotype had higher FIQ scores (median = 80; percentile 25/75 = 69/88) than patients with the GT genotype (median = 63; percentile 25/75 = 58/73; <it>P </it>= 0.002) and the TT genotype (median = 71; percentile 25/75 = 64/77; <it>P </it>= 0.001).</p> <p>Conclusion</p> <p>In this ethnic group; a disabling form of FM is associated to a particular SCN9A sodium channel gene variant. These preliminary results raise the possibility that some patients with severe FM may have a dorsal root ganglia sodium channelopathy.</p

Effect of chitosan essential oil films on the storage-keeping quality of pork meat products

Edible films based on chitosan were prepared, with and without basil or thyme essential oils, with the aim of assessing their protective ability against lipid oxidation and their antimicrobial activity. Chitosan films had good oxygenbarrier properties, which were worsened by essential oil addition, especially when the film equilibrium moisture content increased. Due to the oxygen-barrier effect, all the films effectively protected pork fat from oxidation, in comparison to unprotected samples. In spite of the worsening of the oxygen-barrier properties, the films with essential oils were more effective than those of pure chitosan, which points to the chemical action of specific antioxidant compounds of the oils. Films were effective to control microbial growth in minced pork meat, although the incorporation of essential oils did not improve their antimicrobial activity. Throughout the storage, the films led to colour changes in minced pork meat associated with the conversion of myoglobin into metmyoglobin due to the reduction of the oxygen availability.The authors acknowledge the financial support provided by the Universitat Politecnica de Valencia (PAID-06-09-2834), Generalitat Valenciana (GV/2010/082) and Ministerio de Educacion y Ciencia (AGL2010-20694). Author J. Bonilla is deeply grateful to Generalitat Valenciana for a Santiago Grisolia Grant.Bonilla Lagos, MJ.; Vargas, M.; Atarés Huerta, LM.; Chiralt Boix, MA. (2014). Effect of chitosan essential oil films on the storage-keeping quality of pork meat products. Food and Bioprocess Technology. 7(8):2443-2450. https://doi.org/10.1007/s11947-014-1329-3S2443245078ASTM D3985. (1995). Standard test method for oxygen gas transmission rate through plastic films and sheeting using a coulometric sensor. 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Coli O157:H7 and Listeria monocytogenes by carvacrol and eugenol encapsulated in surfactant micelles. Journal of Food Protection, 68, 2559–2566.Govaris, A., Botsoglou, E., Sergelidis, D., & Chatzopoulou, P. D. (2011). Antibacterial activity of oregano and thyme essential oils against Listeria monocytogenes and Escherichia coli O157:H7 in feta cheese packaged under modified atmosphere. LWT - Food Science and Technology, 44, 1240–1244.Han, J. H., & Gennadios, A. (2005). Edible films and coatings: a review. In J. H. Han (Ed.), Innovations in Food Packaging (pp. 39–262). Oxford: Elsevier Academic.Kim, J., Marshall, M. R., & Wei, C. I. (1995). Antibacterial activity of some essential oil components against five foodborne pathogens. Journal of Agricultural and Food Chemistry, 43, 2839–2845.Labuza, T. P. (1980). The effect of water activity on reaction kinetics of food deterioration. Food Technology, 34, 36–41.Mancini, R. A., & Hunt, M. C. (2005). Current research in meat color. Meat Science, 71, 100–121.Moure, A., Cruz, J. M., Franco, D., Dominguez, J. M., Sineiro, J., Dominguez, H., et al. (2001). Natural antioxidants from residual sources. Food Chemistry, 72, 145–171.Rao, M. S., Chander, R., & Sharma, A. (2005). Development of shelf-stable intermediate moisture meat products using active edible chitosan coating and irradiation. Journal of Food Science, 70, 325–331.Salame, M. (1986). Barrier polymers. In M. Bakker (Ed.), The Wiley encyclopedia of packaging technology (pp. 48–54). New York: Wiley.Sánchez-González, L., González-Martínez, C., Chiralt, A., & Cháfer, M. (2010). Physical and antimicrobial properties of chitosan–tea tree essential oil composite films. Journal of Food Engineering, 98, 443–452.Sánchez-González, L., Vargas, M., González-Martínez, C., Chiralt, A., & Cháfer, M. (2011a). Use of essential oils in bioactive edible coatings. 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Phenoloxidase activity acts as a mosquito innate immune response against infection with semliki forest virus

Several components of the mosquito immune system including the RNA interference (RNAi), JAK/STAT, Toll and IMD pathways have previously been implicated in controlling arbovirus infections. In contrast, the role of the phenoloxidase (PO) cascade in mosquito antiviral immunity is unknown. Here we show that conditioned medium from the Aedes albopictus-derived U4.4 cell line contains a functional PO cascade, which is activated by the bacterium Escherichia coli and the arbovirus Semliki Forest virus (SFV) (Togaviridae; Alphavirus). Production of recombinant SFV expressing the PO cascade inhibitor Egf1.0 blocked PO activity in U4.4 cell- conditioned medium, which resulted in enhanced spread of SFV. Infection of adult female Aedes aegypti by feeding mosquitoes a bloodmeal containing Egf1.0-expressing SFV increased virus replication and mosquito mortality. Collectively, these results suggest the PO cascade of mosquitoes plays an important role in immune defence against arboviruses

Psychological response of family members of patients hospitalised for influenza A/H1N1 in Oaxaca, Mexico

<p>Abstract</p> <p>Background</p> <p>The A/H1N1 pandemic originated in Mexico in April 2009, amid high uncertainty, social and economic disruption, and media reports of panic. The aim of this research project was to evaluate the psychological response of family primary caregivers of patients hospitalised in the Intensive Care Unit (ICU) with suspected influenza A/H1N1 to establish whether there was empirical evidence of high adverse psychological response, and to identify risk factors for such a response. If such evidence was found, a secondary aim was to develop a specific early intervention of psychological support for these individuals, to reduce distress and possibly lessen the likelihood of post-traumatic stress disorder (PTSD) in the longer term.</p> <p>Methods</p> <p>Psychological assessment questionnaires were administered to the family primary caregivers of patients hospitalised in the ICU in the General Hospital of Zone 1 of the Mexican Institute for Social Security (IMSS), Oaxaca, Mexico with suspected influenza A/H1N1, during the month of November 2009. The main outcome measures were ratings of reported perceived stress (PSS-10), depression (CES-D), and death anxiety (DAQ). Data were subjected to simple and multiple linear regression analysis to identify risk factors for adverse psychological response.</p> <p>Results</p> <p>Elevated levels of perceived stress and depression, compared to population normative data, and moderate levels of death anxiety were noted. Levels of depression were similar to those found in comparable studies of family members of ICU patients admitted for other conditions. Multiple regression analysis indicated that increasing age and non-spousal family relationship were significantly associated with depression and perceived stress. Female gender, increasing age, and higher levels of education were significantly associated with high death anxiety. Comparisons with data collected in previous studies in the same hospital ICU with groups affected by a range of other medical conditions indicated that the psychological response reported in this study was generally lower.</p> <p>Conclusions</p> <p>Data indicated that, contrary to widely publicised reports of 'panic' surrounding A/H1N1, that some of those most directly affected did not report excessive psychological responses; however, we concluded that there was sufficient evidence to support provision of limited psychological support to family caregivers.</p

A Mathematical model for Astrocytes mediated LTP at Single Hippocampal Synapses

Many contemporary studies have shown that astrocytes play a significant role in modulating both short and long form of synaptic plasticity. There are very few experimental models which elucidate the role of astrocyte over Long-term Potentiation (LTP). Recently, Perea & Araque (2007) demonstrated a role of astrocytes in induction of LTP at single hippocampal synapses. They suggested a purely pre-synaptic basis for induction of this N-methyl-D- Aspartate (NMDA) Receptor-independent LTP. Also, the mechanisms underlying this pre-synaptic induction were not investigated. Here, in this article, we propose a mathematical model for astrocyte modulated LTP which successfully emulates the experimental findings of Perea & Araque (2007). Our study suggests the role of retrograde messengers, possibly Nitric Oxide (NO), for this pre-synaptically modulated LTP.Comment: 51 pages, 15 figures, Journal of Computational Neuroscience (to appear

Using Evidence in a Highly Fragmented Legislature: The Case of Colombia's Health System Reform

This chapter examines how evidence is used in major policy health policy initiatives in a highly contested political context. Through a case study of legislation proposed in the context of Colombia’s ongoing health systems reformed process, it explores how such use is affected by the specific role played by the legislature within a highly fragmented polity. It draws on an analysis of evidence cited in the drafting of relevant laws in the process of health systems reform. Reflecting the role of the legislature in Colombia’s contested political system, evidence cited in legislative debates was unable to forge consensus amongst relevant policy actors over health system reforms. While scientific research was available and at the disposal of legislators, it was unable to provide the common ground on which to overcome embedded policy positions and form the basis of compromise over the direction of health systems reforms

Left atrial extension of metastatic lung tumor via pulmonary vein: report on the first case of Ewing sarcoma

Extension of metastatic lung tumors into the left atrium via pulmonary veins is rare. Here, we report the first case of Ewing sarcoma exhibiting such extension. A 31-year-old man with pulmonary metastasis from Ewing sarcoma presented with a mass in the left lung, extending to the left atrium through the left inferior pulmonary vein. As the patient was considered to be at risk of tumor embolism, the mass was excised surgically