Functional interferon-epsilon gene polymorphisms and sexually transmitted infections of the endometrium

PROBLEM

Interferon-epsilon (IFNε) is the only type I IFN constitutively expressed in the female reproductive tract and fluctuates across the menstrual cycle in humans. Mouse models show that IFNε protects against Chlamydia trachomatis, Herpes Simplex Virus, HIV, and Zika in mice, but human studies are limited. Bacterial sexually transmitted infections (STI) can ascend to the upper genital tract and cause pelvic inflammatory disease (PID) and subsequent infertility. However, the host immunological mechanisms that play a role in the ascension and infection of the endometrium in individuals with clinically suspected PID are not elucidated.

METHOD OF STUDY

This pilot investigation determined if IFNε gene variants are associated with bacterial vaginosis (BV) and endometrial infection with C. trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium using biospecimens from 154 self-report Black individuals who participated in the PID Evaluation and Clinical Health (PEACH) study.

RESULTS

The T allele for rs2039381 was associated with endometrial STI infection (OR 2.7, 95% CI: 1.0-7.1) and the C allele for rs1125488 was inversely associated with BV (OR: .2, 95% CI: .05-.8).

CONCLUSIONS

Few studies have examined IFNε gene variants, our study raises the possibility that IFNε gene variants may be a potential host contributor to STI pathogenesis.

Sexually transmitted infections and risk of hypertensive disorders of pregnancy

Hypertensive disorders of pregnancy (HDP) result in maternal morbidity and mortality but are rarely examined in perinatal studies of sexually transmitted infections. We examined associations between common sexually transmitted infections and HDP among 38,026 singleton pregnancies. Log-binomial regression calculated relative risk (RRs) and 95% confidence intervals (CIs) for associations with gestational hypertension, preeclampsia with severe features, mild preeclampsia, and superimposed preeclampsia. All models were adjusted for insurance type, maternal age, race/ethnicity, and education. Additional adjustments resulted in similar effect estimates. Chlamydia was associated with preeclampsia with severe features (RR_adj. 1.4, 95% CI 1.1, 1.9). Effect estimates differed when we examined first prenatal visit diagnosis only (RR_adj. 1.3, 95% CI 0.9, 1.9) and persistent or recurrent infection (RR_adj. 2.0, 95% CI 1.1, 3.4). For chlamydia (RR_adj. 2.0, 95% CI 1.3, 2.9) and gonorrhea (RR_adj. 3.0, 95% CI 1.1, 12.2), women without a documented treatment were more likely to have preeclampsia with severe features. Among a diverse perinatal population, sexually transmitted infections may be associated with preeclampsia with severe features. With the striking increasing rates of sexually transmitted infections, there is a need to revisit the burden in pregnant women and determine if there is a link between infections and hypertensive disorders of pregnancy.

Patient Risk Factors for Violent Restraint Use in a Children's Hospital Medical Unit

BACKGROUND AND OBJECTIVES

To inform efforts to reduce violent restraint use, we examined risk factors for restraint use among hospitalized children with known behavior concerns.

METHODS

We conducted a retrospective cross-sectional study of restraint events in all hospitalizations from 2017 to 2019 on a 10-bed medical-surgical unit with dedicated mental health clinician support. We examined characteristics of restraint events, used adjusted logistic regression models to identify independent risk factors for restraint use, and used an adjusted Poisson regression model to determine the adjusted rate of restraint events per hospital day.

RESULTS

The sample included 1507 hospitalizations representing 1235 patients. Among included hospitalizations, 48% were for a psychiatric indication awaiting transfer to an inpatient psychiatric unit, and 52% were for a primary medical or surgical problem. Sixteen percent had a restraint event. Patient demographic characteristics were not associated with risk of a restraint event. Having a psychiatric indication for hospitalization was an independent risk factor for restraint use (odds ratio: 2.85; 95% confidence interval: 2.06-3.94). Rate of restraint use per day decreased as length of stay increased; hospitalizations lasting 9 days or longer had a 58% lower rate of restraint use per day than 1- to 2-day hospitalizations (P < .001).

CONCLUSIONS

Interventions to reduce restraint use may benefit from incorporating information about a patient's psychiatric risk factors, including type and number of diagnoses and reason for hospitalization. Future efforts could investigate whether providing enhanced behavior supports during the first several days of a patient's hospitalization reduces violent restraint use.

There are many Mediterranean diets

Interest in Mediterranean diet began 30 years ago, when Ancel Keys published the results of the famous Seven Countries Study, Since 1945, almost 1.3 million people have come to Australia from Mediterranean countries as new settlers. There are 18 countries with coasts on the Mediterranean sea: Spain, southern France, Italy, Malta, Croatia, Bosnia, Albania, Greece, Cyprus, Turkey, Syria, Lebanon, Egypt, Libya, Malta, Tunisia, Algeria and Morocco. This study from which this report derives aims to investigate the influence of the food habits of immigrants from Mediterranean countries on Australian food intake. Here we look at the 'traditional' food habits of the above Mediterranean countries as told by 102 people we interviewed in Sydney, who came from 18 Mediterranean countries to Sydney. Most of the informants were women, their age ranged from 35 to 55 years. The interview was open-ended and held in the informant's home. It usually lasted around 1 1/2 hours. The interview had three parts. Personal information was obtained, questions relating to the food habits of these people back in their original Mediterranean countries and how their food intake and habits have changed in Australia were also asked. From the interviews, we have obtained a broad picture of 'traditional' food habits in different Mediterranean countries. The interview data was checked with books of recipes for the different countries. While there were similarities between the countries, there are also important differences in the food habits of the Mediterranean countries. Neighbouring countries' food habits are closer than those on opposite sides of the Mediterranean Sea. We suggest that these food habits can be put into four groups. The data here refer to food habits in Mediterranean countries 20 or 30 years ago, as they were recovering from the Second World War. There is no single ideal Mediterranean diet. Nutritionists who use the concept should qualify the individual country and the time in history of their model Mediterranean diet.