Kazuistické sdělení o problémech se stanovením diagnózy u 72letého pacienta s dlouhodobými bolestmi na hrudníku při mnoha zavádějících okolnostech i příznacích, s mnoha komplikacemi během léčby mikčních potíží, stenokardií apod. v anamnéze.
DiagnosisA case-history on problems associated with assessment of the diagnosis in a 72-year-old patient suffering from prolonged pain of the chest associated with many confounding circumstances and symptoms and many complications during treatment of problems with micturition, stenocardia etc. in the history.
- MeSH
- Chest Pain etiology MeSH
- Cholecystitis diagnosis MeSH
- Diagnosis, Differential MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Case Reports MeSH
In previous studies, one of the systolic time intervals - preejection period (PEP) - was used as an index of sympathetic activity reflecting the cardiac contractility. However, PEP could be also influenced by several other cardiovascular variables including preload, afterload and diastolic blood pressure (DBP). The aim of this study was to assess the behavior of the PEP together with other potentially confounding cardiovascular system characteristics in healthy humans during mental and orthostatic stress (head-up tilt test - HUT). Forty-nine healthy volunteers (28 females, 21 males, mean age 18.6 years (SD=1.8 years)) participated in the study. We recorded finger arterial blood pressure by volume-clamp method (Finometer Pro, FMS, Netherlands), PEP, thoracic fluid content (TFC) - a measure of preload, and cardiac output (CO) by impedance cardiography (CardioScreen® 2000, Medis, Germany). Systemic vascular resistance (SVR) - a measure of afterload - was calculated as a ratio of mean arterial pressure and CO. We observed that during HUT, an expected decrease in TFC was accompanied by an increase of PEP, an increase of SVR and no significant change in DBP. During mental stress, we observed a decrease of PEP and an increase of TFC, SVR and DBP. Correlating a change in assessed measures (delta values) between mental stress and previous supine rest, we found that deltaPEP correlated negatively with deltaCO and positively with deltaSVR. In orthostasis, no significant correlation between deltaPEP and deltaDBP, deltaTFC, deltaCO, deltaMBP or deltaSVR was found. We conclude that despite an expected increase of sympathetic activity during both challenges, PEP behaved differently indicating an effect of other confounding factors. To interpret PEP values properly, we recommend simultaneously to measure other variables influencing this cardiovascular measure.
- MeSH
- Blood Pressure physiology MeSH
- Humans MeSH
- Cardiac Output physiology MeSH
- Adolescent MeSH
- Young Adult MeSH
- Stress, Psychological physiopathology psychology MeSH
- Heart Rate physiology MeSH
- Sympathetic Nervous System physiology MeSH
- Stroke Volume physiology MeSH
- Tilt-Table Test methods MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
A sexually dimorphic characteristic, the second to fourth digit ratio (2D:4D ratio), has been shown to reflect the prenatal concentration of sex steroid hormones and to correlate with many personality, physiological, and life history traits. The correlations are usually stronger for the right than the left hand. Most studies have shown that the 2D:4D ratio does not vary with age or postnatal concentration of sex steroid hormones. Recently, a strong association between left hand 2D:4D ratio and infection with a common human parasite Toxoplasma has been reported. We hypothesized that the confounding effect of Toxoplasma infection on left hand 2D:4D ratio could be responsible for the stronger association between different traits and right hand rather than left hand 2D:4D ratio. This confounding effect of toxoplasmosis could also be responsible for the difficulty in finding an association between 2D:4D ratio and age or postnatal steroid hormone concentration. To test this hypothesis, we analyzed the association between sex and age and 2D:4D ratio in a population of 194 female and 106 male students with and without controlling for the confounding variables of Toxoplasma infection and testosterone concentration. Our results showed that the relationship between age and sex and 2D:4D ratio increased sharply when Toxoplasma infection and testosterone concentration were controlled. These results suggest that left hand 2D:4D ratio is more susceptible to postnatal influences and that the confounding factors of Toxoplasma infection, testosterone concentration and possibly also age, should be controlled in future 2D:4D ratio studies. Because of a stronger 2D:4D dimorphism in Toxoplasma-infected than Toxoplasma-free subjects, we predict that 2D:4D ratio dimorphism as well as right hand/left hand 2D:4D ratio dimorphism will be higher in countries with a high prevalence of Toxoplasma infection than in those with a low prevalence. (c) 2008 Wiley-Liss, Inc.
- MeSH
- Child MeSH
- Adult MeSH
- Functional Laterality MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Sex Characteristics MeSH
- Gonadal Steroid Hormones physiology MeSH
- Child, Preschool MeSH
- Antibodies, Protozoan blood MeSH
- Fingers anatomy & histology MeSH
- Saliva chemistry MeSH
- Testosterone metabolism MeSH
- Toxoplasma pathogenicity MeSH
- Toxoplasmosis epidemiology immunology metabolism MeSH
- Animals MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Research Support as Topic MeSH
- Insulin Resistance MeSH
- Humans MeSH
- Polycystic Ovary Syndrome physiopathology MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Review MeSH
Isolation of RNA from whole saliva, a non-invasive and easily accessible biofluid that is an attractive alternative to blood for high-throughput biodosimetry of radiological/nuclear victims might be of clinical significance for prediction and diagnosis of disease. In a previous analysis of 12 human samples we identified two challenges to measuring gene expression from total RNA: (1) the fraction of human RNA in whole saliva was low and (2) the bacterial contamination was overwhelming. To overcome these challenges, we performed selective cDNA synthesis for human RNA species only by employing poly(A)+-tail primers followed by qRT-PCR. In the current study, this approach was independently validated on 91 samples from 61 healthy donors. Additionally, we used the ratio of human to bacterial RNA to adjust the input RNA to include equal amounts of human RNA across all samples before cDNA synthesis, which then ensured comparable analysis using the same base human input material. Furthermore, we examined relative levels of ten known housekeeping genes, and assessed inter- and intra-individual differences in 61 salivary RNA isolates, while considering effects of demographical factors (e.g. sex, age), epidemiological factors comprising social habits (e.g. alcohol, cigarette consumption), oral hygiene (e.g. flossing, mouthwash), previous radiological diagnostic procedures (e.g. number of CT-scans) and saliva collection time (circadian periodic). Total human RNA amounts appeared significantly associated with age only (P ≤ 0.02). None of the chosen housekeeping genes showed significant circadian periodicity and either did not associate or were weakly associated with the 24 confounders examined, with one exception, 60% of genes were altered by mouthwash. ATP6, ACTB and B2M represented genes with the highest mean baseline expression (Ct-values ≤ 30) and were detected in all samples. Combining these housekeeping genes for normalization purposes did not decrease inter-individual variance, but increased the robustness. In summary, our work addresses critical confounders and provides important information for the successful examination of gene expression in human whole saliva.
- MeSH
- RNA, Bacterial MeSH
- Adult MeSH
- Genes, Essential * MeSH
- Gene Expression * MeSH
- DNA, Complementary MeSH
- DNA Contamination MeSH
- Real-Time Polymerase Chain Reaction MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- RNA isolation & purification MeSH
- Saliva metabolism MeSH
- Gene Expression Profiling methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVES: Outdoor air pollution has consistently been shown to predict mortality. The finding that this association is stronger in infants than in children or adults raises the question whether air pollution could also be related to pregnancy outcomes--such as birthweight and stillbirth. The association between outdoor air pollution and stillbirths and low birthweight in the Czech Republic, where air pollution was high, was examined. METHODS: An ecological study was conducted, with routinely collected data on stillbirths and low birthweight (< 2500 g), air pollution (total suspended particulates, sulphur dioxide (SO2), and nitrogen oxides (NOx)), and socioeconomic factors (mean income, car ownership, divorce rate, etc). The analyses were restricted to 45 districts on which data on air pollution were available for the period 1986-8. The effects of exposure variables on frequency of pregnancy outcomes were estimated by logistic regression with district-years as the units of analysis. RESULTS: Stillbirth rate (4.2/1000 births in monitored districts) was not significantly associated with any indicator of air pollution, and was weakly related to mean income and proportion of births outside marriage. Crude prevalence of low birthweight (prevalence 5.5%) showed highly significant associations with several socioeconomic factors; after controlling for these, odds ratios (ORs)/50 micrograms/m3 increase in pollutant were: 1.04 (95% confidence interval (95% CI) 0.96 to 1.12) for total suspended particles, 1.10 (1.02 to 1.17) for SO2, and 1.07 (0.98 to 1.16) for NOx. When all pollutants were included in one model, SO2 remained related to low birthweight (OR 1.10 (1.01 to 1.20), p = 0.033). CONCLUSION: These results are consistent with a recent study in China where birthweight was also associated with total suspended particles and SO2 but ecological studies must be interpreted cautiously. Residual confounding by socioeconomic factors cannot be ruled out. The association between air pollution and birthweight requires further investigation.
- MeSH
- Residence Characteristics MeSH
- Confounding Factors, Epidemiologic MeSH
- Humans MeSH
- Logistic Models MeSH
- Infant, Low Birth Weight * MeSH
- Infant, Newborn MeSH
- Fetal Death epidemiology MeSH
- Prevalence MeSH
- Socioeconomic Factors MeSH
- Pregnancy MeSH
- Air Pollution adverse effects MeSH
- Check Tag
- Humans MeSH
- Infant, Newborn MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
- MeSH
- Confounding Factors, Epidemiologic MeSH
- Coffee adverse effects MeSH
- Cohort Studies MeSH
- Smoking adverse effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Mortality MeSH
- Follow-Up Studies MeSH
- Cause of Death MeSH
- Risk MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Comment MeSH
- Geographicals
- United States MeSH
Sex of the fetus is genetically determined such that an equal number of sons and daughters are born in large populations. However, the ratio of female to male births across human populations varies significantly. Many factors have been implicated in this. The theory that natural selection should favour female offspring under suboptimal environmental conditions implies that pathogens may affect secondary sex ratio (ratio of male to female births). Using regression models containing 13 potential confounding factors, we have found that variation of the secondary sex ratio can be predicted by seroprevalence of Toxoplasma across 94 populations distributed across African, American, Asian and European continents. Toxoplasma seroprevalence was the third strongest predictor of secondary sex ratio, β = -0·097, P < 0·01, after son preference, β = 0·261, P < 0·05, and fertility, β = -0·145, P < 0·001. Our preliminary results suggest that Toxoplasma gondii infection could be one of the most important environmental factors influencing the global variation of offspring sex ratio in humans. The effect of latent toxoplasmosis on public health could be much more serious than it is usually supposed to be.
- MeSH
- Global Health MeSH
- Energy Intake MeSH
- Confounding Factors, Epidemiologic MeSH
- Fertility MeSH
- Humans MeSH
- Marriage statistics & numerical data MeSH
- Young Adult MeSH
- Climate MeSH
- Sex Ratio * MeSH
- Prevalence MeSH
- Income MeSH
- Regression Analysis MeSH
- Socioeconomic Factors MeSH
- Toxoplasmosis epidemiology physiopathology MeSH
- Health Status MeSH
- Check Tag
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
