scholarly journals The Impact of Compulsive Ethanol Consumption on Gut and Brain Neurochemicals (P14-003-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ella Bauer ◽  
Allyse Shoeman ◽  
Karrie Daniels ◽  
Mark Lyte ◽  
Peter Clark
Keyword(s):  
Alcohol Abuse ◽  
Binge Drinking ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The United States ◽  
Ethanol Consumption ◽  
Funding Sources ◽  
The Impact ◽  
Drinking In The Dark ◽  
The Brain

Abstract Objectives Binge drinking is a significant problem costing the United States 191 billion dollars annually and is also a significant risk factor for many dietary (e.g., diabetes) and neurodegenerative diseases (e.g., Alzheimer's and Parkinson's disease). Interestingly, the gut-brain axis has been implicated in the development of neurodegenerative and dietary-related diseases, thus, may mediate the harmful consequences of alcohol abuse on the brain and body. However, the mechanisms are not well understood. We hypothesize that compulsive ethanol consumption will alter the expression of neurochemicals in the mouse gut in a manner that will be correlated to changes in the expression of brain neurochemicals. Methods We examined catecholamines and structurally similar metabolites following repeated bouts of “Drinking in the Dark”- a mouse model of compulsive alcohol-seeking during which mice reliably reach blood ethanol concentrations greater than 100 mg/dL. Adult female and male C57BL/6 J mice received access to either 20% ethanol (n = 12 male, n = 12 female) or water (n = 12 male, n = 12 female) for a two-hour period during the dark cycle over three consecutive days. On the fourth day, mice received access to ethanol or water for four hours, and samples of the intestine, intestinal contents, liver, and brain subregions were analyzed for tissue-specific neurochemical concentrations using UHPLC. Results Ethanol consumption data indicate that binge-drinking female mice consume 36% more ethanol than female water controls and consume 32% more ethanol than binge-drinking male mice on day 4 of the “Drinking in the Dark” protocol. Preliminary neurochemical data indicate compulsive ethanol drinking contributes to trending increases in norepinephrine (17% striatum; 18% hypothalamus) in males whereas females have trending decreases in striatal L-DOPA (15%), 5-HIAA (14%), and 27% more hypothalamic L-DOPA and 5-HIAA when compared with water controls. Conclusions Binge drinking may contribute to region- and sex-specific neurochemical differences in the brain, thus, further neurochemical analyses on the gut could provide insight into the etiology of neurodegenerative and dietary diseases following alcohol abuse. Funding Sources Supported from Iowa State University start-up funds.

scholarly journals 1487. Pneumonia due to Co-Infection in the ICU: Detection and Clinical Significance

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S745-S746
Author(s):  
Casey S Zelus ◽  
Michael Blaha ◽  
Kaeli Samsom ◽  
Jasmine R Marcelin ◽  
Trevor C Van Schooneveld ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Diagnostic Testing ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Categorical Variables ◽  
Chi Square ◽  
Mechanically Ventilated ◽  
Critical Care Units ◽  
Outcomes Measures ◽  
The Impact

Abstract Background Pneumonia is a significant cause of morbidity and mortality, with increasing interest in the detection and clinical significance of co-infection. However, the impact of methodology to obtain lower respiratory samples along with the utility of various microbiological diagnostic testing remains unclear. Methods A single-center retrospective analysis was performed on bronchoalveolar lavage (BAL) samples obtained from mechanically ventilated adults treated in critical care units from August 2012 to December 2017. BAL methodology (bronchoscopic vs blinded), microbiological diagnostic testing, and outcomes measures were obtained. Associations between categorical variables were assessed using Chi-Square or Fisher’s exact tests. Kruskal Wallace tests analyzed differences in distributions of measures between categories based on number of organism types detected. SAS software version 9.4 (SAS Institute Inc., Cary, NC). Results Analysis of the 803 samples that met inclusion criteria found a significant linear association between mortality and number of organism types detected by BAL, with 30 day mortality rates of 43.0%, 47.8%, and 58.3% among those with zero, one, and two or more organisms respectively (p = 0.003). Comparing BALs with at least one organism isolated, the detection of viruses specifically was associated with increased mortality, with the presence and absence of viral organisms corresponding to 56.3% and 46.5% mortality at thirty days (p = 0.03). No association was found between mortality and isolation of acid-fast bacilli, bacteria, or fungi. Co-infection was detected more frequently among bronchoscopic BALs than blinded BALs (26.3% vs 8.6%, p < 0.0001), with more viruses detected bronchoscopic BALs (41.9% vs 13.1%, p < 0.0001), and more bacteria in blinded BALs (41.8% vs 33.0%, p = 0.01). 30 Day Mortality vs Isolation of Specific Organism Types from BAL Number of Organism Types Isolated from BAL Compared to BAL Methodology BAL Methodology vs Isolation of Specific Organism Types Conclusion Co-infection in mechanically ventilated adult patients with pneumonia appears to be a significant risk factor for mortality, with the detection of viral organisms potentially playing an independent role. Within this population, bronchoscopic BALs may have a valuable diagnostic and prognostic methodology. Disclosures All Authors: No reported disclosures

scholarly journals The impact of levothyroxine exposure on delivery outcome in hypothyroid pregnant women (PETAL study): A five-year retrospective cohort study

2021 ◽  
pp. 1753495X2110641
Author(s):  
Diana Oprea ◽  
Nadine Sauvé ◽  
Jean-Charles Pasquier
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Singleton Pregnancy ◽  
Delivery Outcome ◽  
The Impact

Background Hypothyroidism affects 3% of pregnant women, and to date, no studies have addressed the impact levothyroxine-treated hypothyroidism on delivery outcome. Methods This retrospective cohort study was conducted among 750 women with a singleton pregnancy who gave birth between 2015 and 2019. Delivery modes were compared between 250 hypothyroid women exposed to levothyroxine and 500 euthyroid control women. The aim of this study was to determine the impact of levothyroxine exposure on delivery outcome. Results Multiple logistic regression showed no significant association between exposure to levothyroxine and the overall rate of caesarean delivery (aOR 1.1; 95% CI 0.8 to 1.6). Mean TSH concentrations were significantly higher throughout the pregnancy in hypothyroid women despite levothyroxine treatment. Maternal and neonatal outcomes in both groups were not different. Conclusion Hypothyroidism treated with levothyroxine during pregnancy according to local guidelines is not a significant risk factor for caesarean delivery.

scholarly journals Obesity Does Not Increase Mortality after Emergency Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Paula Ferrada ◽  
Rahul J. Anand ◽  
Ajai Malhotra ◽  
Michel Aboutanos
Keyword(s):  
Wound Infection ◽  
Emergency Surgery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Patient Characteristics ◽  
Obese Patients ◽  
Exact Test ◽  
Icu Admission ◽  
Nonobese Patients ◽  
The Impact

Objective.The aim of this study is to evaluate the impact of obesity on patient outcomes after emergency surgery.Methods.A list of all patients undergoing emergent general surgical procedures during the 12 months ending in July 2012 was obtained from the operating room log. A chart review was performed to obtain the following data: patient characteristics (age, gender, BMI, and preexisting comorbidities), indication for surgery, and outcomes (pulmonary embolus (PE), deep venous thrombosis (DVT), respiratory failure, ICU admission, wound infection, pneumonia, and mortality). Obesity was defined as a BMI over 25. Comparisons of outcomes between obese and nonobese patients were evaluated using Fischer’s exact test. Predictors of mortality were evaluated using logistic regression.Results.341 patients were identified during the study period. 202 (59%) were obese. Both groups were similar in age (48 for obese versus 47 for nonobese,P=0.42). Obese patients had an increased incidence of diabetes, (27% versus 7%,P<0.05), hypertension (52% versus 34%,P<0.05), and sleep apnea (0% versus 5%,P<0.05). There was a statistically significant increased incidence of postoperative wound infection (obese 9.9% versus nonobese 4.3%,P<0.05) and ICU admission (obese 58% versus nonobese 42%,P=0.01) among the obese patients. Obesity alone was not shown to be a significant risk factor for mortality.Conclusions.A higher BMI is not an independent predictor of mortality after emergency surgery. Obese patients are at a higher risk of developing wound infections and requiring ICU admission after emergent general surgical procedure.

Abstract TMP82: Increased Intracerebral Hemorrhage During Acute and Chronic Hypertension in Alzheimer's Transgenic Mice

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
David H Cribbs ◽  
Giselle Passos ◽  
Vitaly Vasilevko
Keyword(s):  
Risk Factor ◽  
Transgenic Mice ◽  
Intracerebral Hemorrhage ◽  
Amyloid Precursor Protein ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Chronic Hypertension ◽  
Cerebrovascular System ◽  
The Brain ◽  
Tg2576 Mice

Hypertension is a major risk factor for intracerebral hemorrhage (ICH), and the accumulation of amyloid-beta (Aβ) in the cerebrovascular system, cerebral amyloid angiopathy (CAA), is also a significant risk factor for intracerebral hemorrhage ICH. Currently, there are no animal studies demonstrating a direct involvement of hypertension in the accumulation of Alzheimer’s disease-like pathology. To address this issue we have developed several mouse models that combine hypertension protocols with amyloid precursor protein (APP) transgenic mice (Tg2576), which accumulate significant CAA in the large cerebral vessels and the meninges by 18 months of age. The goal of this study was to determine the effect of acute and chronic hypertension on ICH in wildtype and a transgenic mouse model overexpressing a mutant human amyloid precursor protein (Tg2576 mice) associated with early onset AD and CAA. Fifteen-month-old Tg2576 mice and non-transgenic (nTg) littermates were treated with an angiotensin II (AngII) infusion (1000 ng/kg/min) and L-NAME (100 mg/kg/day) in drinking water to produce chronic hypertension. One week later, transient acute hypertension was induced by daily AngII injections (0.5 μg/g, s.c., twice daily) to produce ICH. A similar increase in mean blood pressure was observed in Tg2576 and nTg mice when evaluated 2 weeks after initiation of treatment. However Tg2576 mice had a higher incidence of signs of stroke compared with nTg littermates (P > 0.05). These data suggest that the accumulation of Aβ in the brain has an important role in development of ICH. Moreover, there was robust glial activation and increase in CAA in the gray matter of Tg2576 mice showing that hypertension may affect gray as well as white matter in the brain. Further studies may provide insights into the hypertension-induced changes in the cerebral vascular system that initiated the increase in CAA. The accumulation of Aβ in the cerebrovascular system is a significant risk factor for intracerebral hemorrhage (ICH), and has been linked to endothelial transport failure and blockage of perivascular drainage. While management of hypertension and atherosclerosis can reduce the incidence of ICH, there are currently no approved therapies for attenuating CAA.

Income and healthcare financing system in the United States: an asymmetric analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mehdi Barati ◽  
Hadiseh Fariditavana
Keyword(s):  
The United States ◽  
Set Covering ◽  
Healthcare Financing ◽  
Financing System ◽  
Data Set ◽  
Content Type ◽  
Funding Sources ◽  
Distributed Lag ◽  
The Impact ◽  
The Relationship

PurposeThe purpose of this study is to first assess how the US healthcare financing system is influenced by income variation. Then, it examines whether or not the impact of income variation is asymmetric.Design/methodology/approachFor the analyses of this paper, the autoregressive distributed lag (ARDL) model is implemented to a data set covering the period from 1960 to 2018.FindingsThe results provide evidence that major funding sources of aggregate healthcare expenditure (HCE) respond differently to changes in income. The results also imply that the effect of income is not always symmetric.Originality/valueMany studies have attempted to identify the relationship between income and HCE. A common feature of past studies is that they have only focused on aggregate HCE, while one might be interested in knowing how major funders of aggregate HCE would be affected by changes in income. Another common feature of past studies is that they have assumed that the relationship between income and HCE is symmetric.

scholarly journals Maternal Obesity and Rectovaginal Group B Streptococcus Colonization at Term

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Shelby M. Kleweis ◽  
Alison G. Cahill ◽  
Anthony O. Odibo ◽  
Methodius G. Tuuli
Keyword(s):  
Risk Factor ◽  
Maternal Obesity ◽  
Management Strategies ◽  
Group B Streptococcus ◽  
Significant Risk ◽  
Positive Culture ◽  
Significant Risk Factor ◽  
Entire Cohort ◽  
Group B ◽  
The Impact

Objective. To test the hypothesis that maternal obesity is an independent risk factor for rectovaginal group B streptococcus (GBS) colonization at term.Study Design. Retrospective cohort study of consecutive women with singleton term pregnancies admitted in labor at Barnes-Jewish Hospital (2004–2008). Maternal BMI ≥ 30 Kg/m2(obese) or <30 Kg/m2(nonobese) defined the two comparison groups. The outcome of interest was GBS colonization from a positive culture. Baseline characteristics were compared using Student’st-test and Chi-squared or Fisher’s exact test. The association between obesity and GBS colonization was assessed using univariable and multivariable analyses.Results. Of the 10,564 women eligible, 7,711 met inclusion criteria. The prevalence of GBS colonization in the entire cohort was relatively high (25.8%). Obese gravidas were significantly more likely to be colonized by GBS when compared with nonobese gravidas (28.4% versus 22.2%,P<0.001). Obese gravidas were still 35% more likely than nonobese women to test positive for GBS after adjusting for race, parity, smoking, and diabetes (adjusted OR 1.35 [95% CI 1.21–1.50]).Conclusion. Maternal obesity is a significant risk factor for GBS colonization at term. Further research is needed to evaluate the impact of this finding on risk-based management strategies.

scholarly journals Television Viewing and Cognitive Dysfunction of Korean Older Adults

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 547
Author(s):  
Mi Sook Jung ◽  
Eunyoung Chung
Keyword(s):  
Older Adults ◽  
Cognitive Dysfunction ◽  
Cognitive Aging ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Later Life ◽  
Significant Risk Factor ◽  
Tv Viewing ◽  
Increased Risk ◽  
The Impact

This study examined the association between television (TV) viewing and cognitive dysfunction in elderly Koreans. Among participants of the 2014 National Survey of Older Koreans, 9644 were considered in this study. To better identify the association between two factors, propensity score (PS) matching with exact method was used. Finally, 168 viewers and non-viewers each were selected based on estimated PS on key variables and eliminating double matches. Multivariate logistic regression analysis was performed when controlling for possible covariates. Viewers were more likely to have cognitive dysfunction than non-viewers, with significant differences in most covariates. After correcting confounding effects of these covariates with PS matching, TV viewing was found to be a significant risk factor of cognitive dysfunction, along with absence of diagnosed hypertension and non-participation in physical leisure activities. TV viewing might be associated with increased risk of cognitive dysfunction in later life. Appropriate education and strategies to minimize TV viewing among older adults should be established to contribute to attenuating cognitive aging. More interventional studies can help older adults, caregivers, and healthcare professionals explore the cognitively beneficial alternatives to TV use considering the impact of socioeconomic factors of selecting TV viewing as a preferred leisure activity.

Comparison of adverse perinatal outcomes after single-needle and double-needle CVS techniques

2017 ◽  
Vol 45 (2) ◽  
Author(s):  
Cenk Gezer ◽  
Atalay Ekin ◽  
Gokhan Goynumer ◽  
Kaan Pakay ◽  
Hicran Acar ◽  
...  
Keyword(s):  
Significant Risk ◽  
Perinatal Outcomes ◽  
Invasive Procedure ◽  
Significant Risk Factor ◽  
Adverse Outcomes ◽  
Control Group ◽  
Needle Technique ◽  
Adverse Perinatal Outcomes ◽  
Chorion Villus ◽  
The Impact

AbstractObjective:To determine the impact of the chorion villus sampling (CVS) technique on adverse perinatal outcomes.Methods:In this case-control study, 412 women who underwent CVS at 11–14 weeks of gestation and 231 women who did not undergo any invasive procedure were retrospectively evaluated. The women in the CVS group were further divided into two groups according to the use of single-needle technique (n=148) vs. double-needle technique (n=264). The adverse outcomes were compared between controls and the two CVS groups, and regression analysis was used to determine the significance of independent contribution.Results:The rate of preeclampsia for the control group was 2.2%, for the double-needle group was 3% and for the single-needle group was 8.1%. CVS with single-needle technique was found to be an independent and statistically significant risk factor for preeclampsia [odds ratio (OR)=2.1, 95% confidence interval (CI); 1.4–2.7, P=0.008].Conclusion:The risk of preeclampsia after CVS appears to be increased with single-needle technique compared with double-needle technique.

scholarly journals Decreasing Incidence of Skin and Soft-tissue Infections in 86 US Emergency Departments, 2009–2014

2018 ◽  
Vol 68 (3) ◽  
pp. 453-459 ◽  
Author(s):  
Ethan Morgan ◽  
Sam Hohmann ◽  
Jessica P Ridgway ◽  
Robert S Daum ◽  
Michael Z David
Keyword(s):  
United States ◽  
Soft Tissue ◽  
Hiv Infection ◽  
Emergency Departments ◽  
Medical Center ◽  
Academic Medical Center ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The United States ◽  
Soft Tissue Infections

Abstract Background The incidence of skin and soft-tissue infections (SSTIs), for which human immunodeficiency virus (HIV) is a significant risk factor, in United States emergency departments (EDs) increased dramatically after 2000 with the emergence of community-associated methicillin-resistant Staphylococcus aureus. Few studies have examined SSTI incidence among HIV-infected and non–HIV-infected patients in the United States after 2010. Methods Data were obtained for patient encounters at all academic medical center EDs affiliated with the Vizient clinical data warehouse assigned an SSTI-associated code based on the International Classification of Diseases, Ninth Revision, between 1 January 2009 and 31 December 2014. The rate was calculated per 1000 ED encounters by year and stratified by SSTI, HIV infection, or both, and by age group, race, payer type, and region of care. Poisson regression was used to assess temporal change over the study period. Results In 2009–2014, a total of 47317 HIV-associated and 820440 SSTI-associated encounters were recorded among 25239781 ED patient encounters. The rate of SSTIs decreased by 8% among all patients and by 14.6%, among those with HIV infection. The SSTI incidence overall decreased from 32.0 to 29.7 per 1000 ED encounters between 2009 and 2014. HIV-infected patients had a significantly higher rate of SSTIs than HIV-uninfected patients (adjusted rate ratio, 1.91; 95% confidence interval, 1.84–1.99). Conclusions The decline in SSTI incidence in US EDs between 2009 and 2014 is a remarkable epidemiologic shift from the increase in SSTIs after 2000, and further research is necessary to assess reasons for this decrease.

scholarly journals United States and Canada Transboundary Oil Spill Liability and Compensation Regimes: An Overview

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
Helkei S. Hemminger
Keyword(s):  
United States ◽  
Natural Resources ◽  
Oil Spill ◽  
Oil Pollution ◽  
The United States ◽  
Coast Guard ◽  
Marine Habitat ◽  
Inland Waterways ◽  
Funding Sources ◽  
The Impact

Abstract # —1141278 — In 2018, the Canadian government purchased the Trans Mountain pipeline, running from Alberta to British Columbia, along with the plans for expansion. The expansion could triple the transport capacity from 300,000 to 890,000 barrels of oil per day, and would increase the tanker traffic in the inland waterways of the Salish Sea, an area known for its sensitive marine habitat, and narrow, difficult to navigate passages. The anticipated increase in tanker traffic in this busy waterway continues to raise concerns about the impact of an oil spill and the financial means to address related injuries, particularly to natural resources. The transboundary nature of any spill further complicates the situation vis-à-vis the applicable liability regimes and response resources. Under the Canada-United States Joint Marine Contingency Plan (“JCP”), the United States Coast Guard and Canadian Coast Guard acknowledge each country's responsibility to fund their own response actions and pursue reimbursement of those costs within their respective jurisdictions. The availability of funding for a response, and to compensate injured parties, however, including the limits of liability of the responsible party, differs under each regime, and could impact the nature and scope of a response. For spills into or posing a substantial threat to the navigable waters of the United States, the Oil Pollution Act of 1990 governs and a national fund, the Oil Spill Liability Trust Fund (“OSLTF”), is immediately available to address an incident, including emergency restoration to natural resources. Canada's Marine Liability Act enables the Ship-source Oil Pollution Fund (“SOPF”) to pay claimants who have incurred damages as a result of oil pollution. Both countries' funds operate under the same principal—the polluter pays—but the compensation structure, and claims processes and procedures are entirely different. This paper provides an overview of these funding sources and claims procedures, comparing and contrasting the different systems. The discussion is meant to provide an overall understanding of potential funding pools available for spill responses under each scheme in order to facilitate transboundary spill planning and discussion.

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