The influence of psychological stress on total serum protein and patterns obtained in serum protein electrophoresis

Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases

Introduction: Predicting survival time for patients with spinal metastases is important in treatment choice. Generally speaking, six months is a landmark cutoff point. Revised Tokuhashi score (RTS), the most widely used scoring system, lost its accuracy in predicting 6-month survival, gradually. Therefore, a more precise scoring system is urgently needed. Objective: The aim of this study is to create a new scoring system with a higher accuracy in predicting 6-month survival based on the previously used RTS. Methods: Data of 171 patients were examined to determine factors that affect prognosis (reference group), and the remaining (validation group) were examined to validate the reliability of a new score, adjusted Tokuhashi score (ATS). We compared their discriminatory abilities of the prediction models using area under receiver operating characteristic curve (AUC). Results: Target therapy and the Z score of BMI (Z-BMI), which adjusted to the patients’ sex and age, were additional independent prognostic factors. Patients with target therapy use are awarded 4 points. The Z score of BMI could be added directly to yield ATS. The AUCs were 0.760 for ATS and 0.636 for RTS in the validation group. Conclusion: Appropriate target therapy use can prolong patients’ survival. Z-BMI which might reflect nutritional status is another important influencing factor. With the optimization, surgeons could choose a more individualized treatment for patients.

Systemic evaluation of patients with central serous chorioretinopathy: A case-control study

OBJECTIVE

To investigate the systemic associations of central serous chorioretinopathy (CSCR) with help of clinical and biochemical investigations.

DESIGN

Case-control study.

PARTICIPANTS

Eighty seven CSCR patients (case) and 82 Asian-Indian patients with primary non-traumatic rhegmatogenous retinal detachment (control) were recruited between July 2017 and December 2018 at a tertiary eye-care center in North India.

METHODS

The patients underwent ophthalmological examination and systemic evaluation based on history and biochemical investigations. Logistic regression was performed to identify the associations of CSCR.

RESULTS

The age was similar between cases and controls (36.9 ± 7.8 years vs 35.7 ± 10.8 years, p = 0.38). On univariate analysis, the significant factors with higher odds of CSCR were alcohol use (odds ratio, OR: 3.4; 95% confidence interval: 1.36-8.53), sleep disturbance (OR: 5.44; 1.76-16.8), gastroesophageal reflux (OR: 9.34; 1.15-75.50), psychological disorder (OR: 5.78; 1.24-26.97), tuberculosis history (OR: 8.2; 1.0-67.10), serum albumin: globulin ratio (AGR) > 2 (OR: 10.43; 2.33-46.57), and serum hemoglobin (per unit increase; OR: 1.35; 1.14-1.61). Although the mean blood pressure was significantly higher in cases, the distribution among various hypertension categories was not significantly different. Exogenous steroid use and morning 8 am serum cortisol levels were not significantly different between the groups. On multivariable analysis, alcohol use (OR: 4.72; 1.33-16.76), sleep disturbances (OR: 5.04; 1.36-18.70), dysthyroid state (OR: 3.02; 1.04-8.74), serum AGR > 2 (OR: 14.28; 2.33-87.28), and serum hemoglobin (per unit increase; OR: 1.43; 1.13-1.81) were significant independent associations.

CONCLUSION

Other than the previously described associations of CSCR like alcohol use and sleep disturbances, this study reports possible association with deranged serum protein and thyroid hormone profile. Further large-scale prospective studies need to validate these results.

Comprehensive growth performance, immune function, plasma biochemistry, gene expressions and cell death morphology responses to a daily corticosterone injection course in broiler chickens

The massive meat production of broiler chickens make them continuously exposed to potential stressors that stimulate releasing of stress-related hormones like corticosterone (CORT) which is responsible for specific pathways in biological mechanisms and physiological activities. Therefore, this research was conducted to evaluate a wide range of responses related to broiler performance, immune function, plasma biochemistry, related gene expressions and cell death morphology during and after a 7-day course of CORT injection. A total number of 200 one-day-old commercial Cobb broiler chicks were used in this study. From 21 to 28 d of age, broilers were randomly assigned to one of 2 groups with 5 replicates of 20 birds each; the first group received a daily intramuscular injection of 5 mg/kg BW corticosterone dissolved in 0.5 ml ethanol:saline solution (CORT group), while the second group received a daily intramuscular injection of 0.5 ml ethanol:saline only (CONT group). Growth performance, including body weight (BW), daily weight gain (DG), feed intake (FI) and feed conversion ratio (FC), were calculated at 0, 3 and 7 d after the start of the CORT injections. At the same times, blood samples were collected in each group for hematological (TWBC's and H/L ratio), T- and B-lymphocytes proliferation and plasma biochemical assays (total protein, TP; free triiodothyronine hormone, fT3; aspartate amino transaminase, AST; and alanine amino transaminase, ALT). The liver, thymus, bursa of Fabricius and spleen were dissected and weighed, and the mRNA expression of insulin-like growth factor 1 gene (IGF-1) in liver and cell-death-program gene (caspase-9) in bursa were analyzed for each group and time; while the apoptotic/necrotic cells were morphologically detected in the spleen. From 28 to 35 d of age, broilers were kept for recovery period without CORT injection and the same sampling and parameters were repeated at the end (at 14 d after initiation of the CORT injection). In general, all parameters of broiler performance were negatively affected by the CORT injection. In addition, CORT treatment decreased the plasma concentration of fT3 and the mRNA expression of hepatic IGF-1. A significant increase in liver weight accompanied by an increase in plasma TP, AST and ALT was observed with CORT treatment, indicating an incidence of liver malfunction by CORT. Moreover, the relative weights of thymus, bursa and spleen decreased by the CORT treatment with low counts of TWBC's and low stimulation of T & B cells while the H/L ratio increased; indicating immunosuppressive effect for CORT treatment. Furthermore, high expression of caspase-9 gene occurred in the bursa of CORT-treated chickens, however, it was associated with a high necrotic vs. low apoptotic cell death pathway in the spleen. Seven days after termination of the CORT treatment in broilers, most of these aspects remained negatively affected by CORT and did not recover to its normal status. The current study provides a comprehensive view of different physiological modulations in broiler chickens by CORT treatment and may set the potential means to mount a successful defense against stress in broilers and other animals as well.

Effects of corticosterone and dietary energy on immune function of broiler chickens

An experiment was conducted to investigate the effects of dietary energy level on the performance and immune function of stressed broiler chickens (Gallus gallus domesticus). A total of 96 three-day-old male broiler chickens (Ross × Ross) were divided into two groups. One group received a high energy (HE) diet and the other group received a low energy (LE) diet for 7 days. At 5 days of age, the chickens from each group were further divided into two sub-groups and received one of the following two treatments for 3 days: (1) subcutaneous injection of corticosterone, twice per day (CORT group; 2 mg of CORT/kg BW in corn oil) and (2) subcutaneous injection of corn oil, twice per day (Control/Sham treatment group). At 10 days of age, samples of blood, duodenum, jejunum, and ileum were obtained. Compared with the other three groups, the LE group treated with CORT had the lowest average daily gain (ADG) and the poorest feed conversion ratio (FCR, P < 0.05). Furthermore, CORT treatment decreased the relative weight (RW) of the bursa independent of the dietary energy level, but it decreased the RW of the thymus only in the chickens fed the LE diet. By contrast, CORT administration decreased the RW of the spleen only in the chickens fed the HE diet (P < 0.05). The plasma total protein, albumin, tumor necrosis factor alpha, interleukin 2 and immunoglobulin G (IgG) levels were affected by the CORT treatment (P < 0.05); however, these factors were not significantly affected by the dietary energy level. Toll-like receptor-5 mRNA level was down-regulated by CORT injection in the duodenum and ileum (P < 0.05) and showed a trend of down-regulation in the jejunum (P=0.0846). The present study showed that CORT treatment induced immunosuppressive effects on the innate immune system of broiler chickens, which were ameliorated by consumption of higher dietary energy.

Psychobiological correlates of allostatic overload in a healthy population

The concept of allostatic load (AL) represents the cost of the continual adjustment of the internal milieu required by an organism to adapt to different challenges. The majority of studies concerning AL have focused mainly on identifying its biological components. Recently, new criteria for a clinimetric evaluation of AL have been introduced, adding a new definition of allostatic overload (AO). This study aims to identify psychological and biological correlates of AO in a population of blood donors, according to this new definition of AO. Participants included 240 blood donors recruited from May 2007 to December 2009 in 4 different blood Centers. Blood samples from each participant were collected for laboratory analysis and self-rating instruments were administered on the same day. Biological parameters included those usually assessed during blood donation. Individuals were selected based on the criteria for the clinimetric evaluation of AO. Differences in biomarkers between subjects with and without allostatic overload were performed using the GLM with biological measures as dependent variables, AO groups as the fixed factor and specific confounders as covariates. Based on the selection criteria for allostatic overload, 98 subjects have been identified as presenting with AO. Results showed that individuals with allostatic overload presented lower levels of serum proteins, erythrocytes and immune differential count than donors without allostatic overload. Further, greater mean corpuscular volume has been found in persons included in the AO group. The evaluation of the AO correlates, along with a biomarker profile, may help to identify those conditions that, by exceeding individual resources, may constitute a danger to health.

THE EFFECTS OF STRESS ON DNA REPAIR CAPACITY

Research has shown that lymphocytes of high-distress patients have reduced DNA repair relative to that of low-distress patients and healthy controls. Furthermore, deficits in repair are associated with an increased risk of cancer. Using and academic stress model, we hypothesized that students would exhibit lower levels of Nucleotide Excision Repair (NER) during a stressful exam period when compared to a lower stress period. Participants were 19 healthy graduate level students. NER was measured in lymphocytes using the unscheduled DNA synthesis (UDS) assay with slide autoradiography. Contrary to prediction, mean values for NER significantly increased during the higher stress period relative to the lower stress period controlling for background differences in repair. Furthermore, lymphocytes had significantly increased repair of endogenous damage during the higher stress period. Stress appears to directly increase DNA repair. Additionally, stress may increase DNA repair indirectly by increasing damage to DNA.

Decreased serum albumin levels in Taiwanese patients with schizophrenia

Previous papers have reported lower serum albumin levels in patients with schizophrenia. In the present study, the relationships between serum albumin levels and subtypes of schizophrenia, physical violence and suicide attempts were investigated. A review of medical charts over a 1-year period was carried out in a population of 213 Taiwanese psychiatric inpatients that included 106 patients with schizophrenia. The collected data included age, bodyweight, height, serum albumin levels and routine blood biochemistry examinations. These data were compared with data from a healthy control group (n = 32) composed of staff members using analysis of covariance after age adjustment. The statistical results showed significantly lower serum albumin levels in patients with schizophrenia in the acute phase than in the control group. However, no significant differences in serum albumin levels were found between paranoid and non-paranoid schizophrenic patients, between patients who had or had not exhibited physical violence, or between patients who had or had not made a suicide attempt.