Self-reported gastrointestinal disorders among veterans with gulf war illness with and without posttraumatic stress disorder

BACKGROUND

Gulf War Illness (GWI) is a chronic, multi-symptom disorder affecting 25%-32% of Gulf War veterans. Veterans with GWI disproportionately suffer from gastrointestinal (GI) disorders. Given the increasing evidence supporting a gut-brain axis, we explore the relationship between post-traumatic stress disorder (PTSD), GWI, and self-reported GI disorders among GW veterans.

METHODS

Veterans from the Gulf War Era Cohort and Biorepository responded to a mail-based survey (N = 1058). They were stratified by GWI (Centers for Disease Control definition) and PTSD status. This yielded three groups: GWI-, GWI+/PTSD-, and GWI+/PTSD+. Multivariable logistic regression adjusting for demographic and military characteristics examined associations between GWI/PTSD groups and GI disorders. Results were expressed as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).

KEY RESULTS

The most frequently reported GI disorders were irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and colon polyps (CP). The GWI+/PTSD+ group had a higher odds of these disorders than the GWI+/PTSD- group (aOR_IBS  = 3.12, 95% CI: 1.93-5.05; aOR_GERD  = 2.04, 95% CI: 1.44-2.90; aOR_CP  = 1.85, 95% CI: 1.23-2.80), which had a higher odds of these disorders than the GWI- group (aOR_IBS  = 4.38, 95% CI: 1.55-12.36; aOR_GERD  = 2.51 95% CI: 1.63-3.87; aOR_CP  = 2.57, 95% CI: 1.53-4.32).

CONCLUSIONS & INFERENCES

GW veterans with GWI and PTSD have significantly higher odds of specific self-reported GI disorders than the other groups. Given the known bidirectional influences of the gut and brain, these veterans may benefit from a holistic healthcare approach that considers biopsychosocial contributors to the assessment and management of disease.

Mothers and fathers in the criminal justice system and children's child protective services involvement

BACKGROUND

Parental criminal justice system (CJS) involvement is a marker for child protective services (CPS) involvement.

OBJECTIVE

To document how parental criminal case processing affects children's CPS involvement.

PARTICIPANTS AND SETTING

Participants included mothers and fathers with a serious criminal charge (mothers = 78,882; fathers = 165,070) and without any criminal charge (mothers = 962,963; fathers = 743,604) between 2008-2012. Statewide North Carolina records on court proceedings, births, CPS assessments/investigations, and foster care placements were used.

METHODS

The observational unit was an individual's first charge date of a year. Outcomes were CPS assessment/investigation and foster care entry within six months and alternatively three years following the charge. Key explanatory variables were whether the charges resulted in prosecution, conviction following prosecution, and an active sentence conditional on conviction. An instrumental variables approach was used.

RESULTS

Parents charged with a criminal offense had higher rates of having a CPS assessment/investigation during the three years preceding the charge than parents who were not charged. Among mothers who were convicted, CPS assessment/investigation increased 8.1 percent (95 % CI: 2.2, 13.9) and 9.5 percent (95 % CI: 1.3, 17.6) 6 months and 3 years following the charge. An active sentence increased CPS assessment/investigations by 21.6 percent (95 % CI: 6.4, 36.7) within 6 months. For fathers, active sentence increased foster care placement by 1.6 percent (95 % CI: 0.24, 2.9) within 6 months of the criminal charge.

CONCLUSIONS

Changing parental incarceration rates would change CPS caseloads substantially. The criminal justice and CPS systems work with overlapping populations, data and services sharing should be considered a high priority.

Risk factors for biopsy-proven advanced non-alcoholic fatty liver disease in the Veterans Health Administration

BACKGROUND

With its increasing incidence, nonalcoholic fatty liver disease (NAFLD) is of particular concern in the Veterans Health Administration (VHA).

AIMS

To evaluate risk factors for advanced fibrosis in biopsy-proven NAFLD in the VHA, to identify patients at risk for adverse outcomes.

METHODS

In randomly selected cases from VHA databases (2005-2015), we performed a retrospective case-control study in adults with biopsy-defined NAFLD or normal liver.

RESULTS

Of 2091 patients reviewed, 399 met inclusion criteria. Normal controls (n = 65) had normal liver function. The four NAFLD cohorts included: NAFL steatosis (n = 76), nonalcoholic steatohepatitis (NASH) without fibrosis (n = 68), NAFLD/NASH stage 1-3 fibrosis (n = 82), and NAFLD/NASH cirrhosis (n = 70). NAFLD with hepatocellular carcinoma (HCC) was separately identified (n = 38). Most patients were older White men. NAFLD patients with any fibrosis were on average severely obese (BMI>35 kg/m² ). Diabetes (54.4%-79.6%) and hypertension (85.8%-100%) were more common in NAFLD with fibrosis or HCC. Across NAFLD, 12.3%-19.5% were enrolled in diet/exercise programs and 0%-2.6% had bariatric surgery. Hispanics exhibited higher rates of NASH (20.6%), while Blacks had low NAFLD rates (1.4%-11.8%), particularly NAFLD cirrhosis and HCC (1.4%-2.6%). Diabetes (OR 11.8, P < .001) and BMI (OR 1.4, P < .001) were the most significant predictors of advanced fibrosis.

CONCLUSIONS

In the VHA, diabetes and severe obesity increased risk for advanced fibrosis in NAFLD. Of these patients, only a small proportion (~20%) had enrolled in diet/exercise programs or had bariatric surgery (~2%). These results suggest that providers should focus/tailor interventions to improve outcomes, particularly in those with diabetes and severe obesity.

Are oestrous feral pigs, Sus scrofa, useful as trapping lures?

Eight feral pigs (two boars, four sows and two piglets) were caught in traps using oestrous sows as lures during a control program on a remnant pig population in part of Namadgi National Park during spring, 1990. The program was mostly based on aerial baiting with warfarin. No pigs were caught in traps containing anoestrous sows or in traps containing bait only. Seven unmarked pigs (caught seven days after the cessation of baiting) did not appear to have eaten any warfarin bait. In an earlier pilot trial, two boars were caught at a trap containing an oestrous sow, one of these again in a trap baited only with fermented grain, but no pigs were caught at a trap containing an anoestrous sow. Although not cost-effective as a general technique, this method could be useful in specific circumstances, such as eradication campaigns on islands, if the last few pigs are, or have become bait shy, or are impossible to cull by other methods.

Murine recessive hereditary spherocytosis, sph/sph, is caused by a mutation in the erythroid alpha-spectrin gene

INTRODUCTION

Spectrin, a heterodimer of alpha- and beta-subunits, is the major protein component of the red blood cell membrane skeleton. The mouse mutation, sph, causes an alpha-spectrin-deficient hereditary spherocytosis with the severe phenotype typical of recessive hereditary spherocytosis in humans. The sph mutation maps to the erythroid alpha-spectrin locus, Spna1, on Chromosome 1.

MATERIALS AND METHODS

Scanning electron microscopy, osmotic gradient ektacytometry, cDNA cloning, RT-PCR, nucleic acid sequencing, and Northern blot analyses were used to characterize the wild type and sph alleles of the Spna1 locus.

RESULTS

Our results confirm the spherocytic nature of sph/sph red blood cells and document a mild spherocytic transition in the +/sph heterozygotes. Sequencing of the full length coding region of the Spna1 wild type allele from the C57BL/6J strain of mice reveals a 2414 residue deduced amino acid sequence that shows the typical 106-amino-acid repeat structure previously described for other members of the spectrin protein family. Sequence analysis of RT-PCR clones from sph/sph alpha-spectrin mRNA identified a single base deletion in repeat 5 that would cause a frame shift and premature termination of the protein. This deletion was confirmed in sph/sph genomic DNA. Northern blot analyses of the distribution of Spna1 mRNA in non-erythroid tissues detects the expression of 8, 2.5 and 2.0 kb transcripts in adult heart.

CONCLUSION

These results predict the heart as an additional site where alpha-spectrin mutations may produce a phenotype and raise the possibility that a novel functional class of small alpha-spectrin isoforms may exist.

Temporal, spatial and individual variation in the diet of red foxes (Vulpes vulpes) in central New South Wales

This study describes temporal, spatial and individual variation in the diet of 255 red foxes (Vulpes vulpes) collected from agricultural land in central New South Wales from July 1994 to November 1996. Rabbits (Oryctolagus cuniculus), sheep (Ovis aries), eastern grey kangaroos (Macropus giganteus) and invertebrates were the most important food items overall. Significant seasonal variations, and sex and age differences between foxes occurred in the consumption of some food types. Some temporal synchrony was also evident, with different individuals often eating similar foods on the same night. This may have been related to moonlight. On full moon nights, foxes ate rabbits and small mammals significantly less often than during other moon phases. The management implications of variation in diet are discussed.

An alternative first exon in the distal end of the erythroid ankyrin gene leads to production of a small isoform containing an NH2-terminal membrane anchor

Mouse erythroid ankyrin is encoded by the Ank1 gene on Chromosome 8. The best studied isoform is 210 kDa and contains three large functional domains. We have recently reported a small Ank1 isoform (relative mobility 25 kDa) that localizes to the M and Z lines in skeletal muscle. Analyses of cDNA and genomic clones show that three transcripts of 3.5, 2.0, and 1.6 kb code for this protein. The different transcript sizes are due to their 3'-untranslated regions. They are encoded by a new first exon located in intron 39 of the Ank1 gene and three previously described Ank1 exons (40, 41, and 42). The 5'-flanking region contains a putative muscle-specific promoter. The sequence of the first 72 amino acids is novel and is predicted to form a transmembrane helix at the NH2-terminus. Functional testing of the putative transmembrane segment indicates that it acts as a membrane anchor, suggesting that the new Ank1 isoform may play an important role in organizing the contractile apparatus within the cell.

The ‘Judas’ Pig Technique: a Method that Could Enhance Control Programmes against Feral Pigs, Sus scrofa

The successful ‘Judas’ goat technique has been adapted for use with feral pigs. The ‘Judas’ goat technique involves releasing radio-collared goats into a control area and, after a sufficient period to allow them to join other goats, tracking them down and culling the other individuals associated with them. Trials with the technique on feral pigs in Namadgi National Park, ACT, indicated that it worked best with sows captured in the same area. Each of these sows established contact with 1–8 other pigs in the area within 1–7 days of release and was located with at least one other pig on 67–100% of occasions. In contrast, sows and boars from outside the study area took longer to come into contact with ‘local’ pigs and associated with them much less frequently. A subsequent control exercise in Namadgi, using ‘Judas’ pigs to indicate where to lay warfarin baits from a helicopter, resulted in a 75% reduction in the low-density population still present after a larger control exercise two years earlier. Since then, the technique has been used to eradicate a small colony of feral pigs in central Australia and is proving successful for control of feral pigs and other ungulates in other parts of Australia and New Zealand.

Seasonal Patterns in Bait Consumption by Feral Pigs (Sus Scrofa) in the Hill Country of South-Eastern Australia

Both fermenting wheat and bran/pollard pellets were readily accepted as bait throughout the year by feral pigs (Sus scrofa) in Namadgi National Park, Australian Capital Territory. Birds mainly ate wheat bait, particularly during winter. Other animals occasionally fed on both types of bait, mainly during autumn and winter. Covering baits with forest-floor litter did not significantly affect their discovery and consumption by pigs or by other animals. The proximity of the pigs to the bait line and their appetite for bait appeared to be the main factors responsible for seasonal differences in bait consumption. Trail-baiting campaigns against pigs in similar hill country areas are likely to be more effective during late autumn than other seasons because more pigs are likely to be close to the trails then and more quickly find and eat greater quantities of bait.

Secondary Poisoning Hazards Associated With 1080-Treated Carrot-Baiting Campaigns Against Rabbits, Oryctolagus Cuniculus

The conc. of 1080 (sodium monofluoroacetate) in dry muscle, organs, and stomach contents of rabbits poisoned by eating baited carrots ranged from 0.004 to 0.423 mg/g. Stomach contents (mainly masticated carrot bait) and livers contained the highest concn., followed by stomach tissue, kidneys, heart, and muscle. The total 1080 content in rabbits ranged from 0.01 to 4.88 mg. The risk of secondary poisoning in animals eating rabbits poisoned by 1080 was evaluated using 2 methods. Foxes, dingos, dogs and cats probably face the greatest risk of secondary poisoning. The extent to which other carrion-eating animals, particularly birds and small dasyurids, are at risk depends on their feeding habits and wheter they are able to vomit or develop an aversion to the taste and smell of 1080. Secondary poisoning can be minimized by using the minimum effective concn. of 1080 in baits and by removing the dead animals from the treated area.

Effects on non-target animal populations of a rabbit trail-baiting campaign with 1080 poison

Populations of non-target birds and mammals on a semi-cleared grazing property near Braidwood, New South Wales, did not appear to be affected by a trail-baiting campaign against rabbits, Oryctolagus cuniculus, using pellet bait and 1080 poison. Rabbit numbers were reduced by about 90% and those of the fox, Vulpes vulpes, another exotic pest, by about 75%. Populations of both pest species began recovering soon after the campaign, indicating the need for continued control measures.

The Effect of Rainfall and Blowfly Larvae on the Toxicity of '1080'-Treated Meat Baits Used in Poisoning Campaigns Against Wild Dogs

Meat baits injected with '1080' poison (sodium monofluoroacetate) according to the method recommended by the Department of Agriculture, New South Wales, Australia, for preparing baits for poisoning compaigns against wild dogs (Canis f. familiaris) and dingoes (C. f. dingo), began to lose their toxicity from the moment of preparation onwards, particularly after different rainfall treatments and when inhabited by calliphorid larvae. The main or most likely reasons for the loss of fluoroacetate were consumption by maggots (mainly larvae of Calliphora augur and C. stygia plus some C. hilli and C. tibialis) and their subsequent disappearance from the baits, leaching by rainfall, defluorination of the fluoroacetate by micro-organisms, and leakage from the baits after injection and during their decomposition. During this study the baits remained toxic to dogs, despite different rainfall treatments, for over 32 days during winter when maggots were absent, and for 6-31 days during summer, when they were present. Under the same conditions the baits contained an LD50 for an average-sized tiger quoll (Dasyurus maculatus) for 4-15 days and 2-4 days, respectively.

The Effect on Wild Dogs, Canis-F-Familiaris, of 1080-Poisoning Campaigns in Kosciusko-National-Park, Nsw

Nine wild dogs, Canis f. familiaris, radio-tracked over periods of 28-61 days in Kosciusko National Park, N.S.W., occupied home ranges of 220-5420 ha (mean 2193 ha). These home ranges were similar in size to those observed for dingoes, C. f. dingo, in other areas of south-eastern Australia. The maximum distance that any of the nine dogs moved between successive daily locations was 11.2 km. On the basis of this information and that obtained by others, we suggest that the control of wild dogs on Crown Land in south-eastern Australia should be confined to those areas adjacent to private grazing land. Furthermore, a control zone 12-20 km wide should be adequate. Two successive trail-baiting campaigns with 1080 poison in March and April 1982 killed only two (22%) of the nine wild dogs carrying radio transmitters. Traps, in comparison, caught 15 out of 27 (56%) of the dogs known to be in the area. The main factors which reduced the success of the poisoning campaign were the rapid loss of toxicity of the baits after their distribution, the rapid rate at which they were removed by other animals, particularly foxes Vulpes vulpes and birds, and the dogs' apparent preference for natural prey.

Effects on Nontarget Animal Populations of Wild Dog Trail-Baiting Campaigns With 1080 Poison

Populations of birds and small mammals in a mountain forest area of New South Wales were not significantly affected by two trail-baiting campaigns involving 1080 poison that were carried out against wild dogs, Canis familiaris, during the winters of 1980 and 1981. Factors which probably minimized the effect on the non-target species were the sparse distribution of baits, the placement of the baits in habitats not favoured by small mammals, their initially rapid rate of removal by foxes, Vulpes vulpes, the dietary preferences of the non-target animals and the low risk they would face if they did consume a bait.