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Tufa TH, Abubeker FA, Prager S, Tolu LB, Grentzer J, Surur F, Bell JD. The role of advanced training in family planning and reproductive health in a low-income country; the experience of Ethiopia. Contraception 2022; 110:1-5. [PMID: 35217091 DOI: 10.1016/j.contraception.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 11/18/2022]
Abstract
Low- and middle-income countries continue to experience high fertility rates and unsafe abortion. Increased access to safe abortion services and family planning are cost-effective ways to reduce maternal morbidity and mortality. With a vision of improving the reproductive health workforce of the country, St. Paul's Hospital Millennium Medical College, in partnership with a university in the United States (U.S.), launched the first family planning and reproductive health fellowship program in Ethiopia. As the premier program in the country, the fellowship has introduced several new initiatives and skills to the existing reproductive health care training options. This program is a stirring example of successful collaboration between a U.S. university and a college in a low- or middle-income country. We have summarized the process of establishing the fellowship program as the first experience in Ethiopia and East Africa.
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Affiliation(s)
- T H Tufa
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
| | - F A Abubeker
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - S Prager
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia; Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, United States
| | - L B Tolu
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - J Grentzer
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - F Surur
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - J D Bell
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, United States
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Bell SG, Rowe M, Kobernik EK, McKee K, LeBar W, Bell JD. Using ThinPrep Papanicolaou test samples to evaluate sexually transmitted infection screening practices. J Am Soc Cytopathol 2021; 10:571-576. [PMID: 34548251 DOI: 10.1016/j.jasc.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/22/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION We sought to evaluate the use of Papanicolaou samples as a screening tool for sexually transmitted infections (STIs). METHODS Retrospective chart review analyzing Papanicolaou samples for STI. Samples were processed and results compared to clinical data to assess this technique's viability. Cases and controls were matched by sample date. Characteristics of women with STI testing were compared in bivariate analyses. RESULTS We analyzed 50 STI-positive and 50 date-matched samples. Thirteen (26.0%) of the STI-positive patients were not screened at their visit. Women without STI screening were older (39.5 vs. 30.0 years, P = 0.001); non-Hispanic White (65.9% vs. 46.4%, P = 0.05); and married (60.0% vs. 26.9%, P = 0.005) than women with STI screening. Fifty-eight were offered and accepted STI testing at their visit; 37 samples were STI-positive: 17 (29.3%) Mycoplasma genitalium (Mgen), 10 (17.2%) chlamydia, 6 (10.3%) trichomoniasis, 1 (1.7%) gonorrhea, and 3 (5.2%) had two STIs. Among the 42 patients without STI testing, 12 (28.6%) had positive samples: 6 (14.3%) chlamydia, 5 (12.0%) Mgen, and 1 (2.4%) trichomoniasis. CONCLUSIONS Over one-quarter of STI-positive patients were not screened; though low-risk by current screening criteria, a significant number may harbor untreated STIs; using Papanicolaou samples may allow for increased screening in this population.
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Affiliation(s)
- Sarah G Bell
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
| | - Meghan Rowe
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Emily K Kobernik
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Kimberly McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - William LeBar
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Jason D Bell
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
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Tolu LB, Tufa TH, Abas F, Kahn C, MacAfee L, Prager S, Bell JD. Intra-cardiac lidocaine administration to induce fetal demise before late second-trimester abortion: Retrospective review. Int J Gynaecol Obstet 2020; 153:125-129. [PMID: 33043458 DOI: 10.1002/ijgo.13419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/15/2020] [Accepted: 10/09/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To determine the efficacy and safety of intra-cardiac lidocaine administration to induce fetal demise before second-trimester medication abortion in a teaching hospital in Addis Ababa, Ethiopia. METHODS We performed a retrospective chart review to collect selected sociodemographic and clinical information. All patients who received fetal intra-cardiac lidocaine between January 1, 2019 and April 30, 2019 were included in the study. Fetal demise was considered successful if achieved within 24 hours after fetal intra-cardiac lidocaine administration. We analyzed the data using SPSS version 20. We used frequency tables to describe the data and performed a multivariable analysis to determine associations between variables. RESULTS A total of 80 fetuses were given intra-cardiac lidocaine.The mean gestational age was 23+1 weeks (range 21+0 -27+5 weeks). Twenty-four hours after lidocaine administration 76 (95%) pregnancies showed negative fetal cardiac activity. Fetuses at gestational ages of 21-23+6 weeks were five times more likely to have negative cardiac activity compared with those with gestational ages between 24 and 28 weeks (P=0.001). Two women developed nausea, vomiting, and a metallic taste, but no serious adverse events were reported. CONCLUSIONS Intra-cardiac lidocaine is effective at inducing fetal demise before late second-trimester medication abortion with no associated serious adverse events or complications.
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Affiliation(s)
- Lemi Belay Tolu
- Department of Obstetrics & Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Tesfaye H Tufa
- Department of Obstetrics & Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ferid Abas
- Department of Obstetrics & Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Chavi Kahn
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Lauren MacAfee
- Department of Obstetrics, Gynecology and Reproductive Science, University of Vermont, Burlington, VT, USA
| | - Sarah Prager
- Department of Obstetrics & Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.,Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, USA
| | - Jason D Bell
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
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McKee KS, Carter KA, Bassis C, Young VB, Reed B, Harper DM, Ruffin MT, Bell JD. The vaginal microbiota, high-risk human papillomavirus infection, and cervical cytology: results from a population-based study. Gynecol Pelvic Med 2020; 3. [PMID: 35252846 PMCID: PMC8896808 DOI: 10.21037/gpm-20-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: The relationship between the vaginal microbiota, high-risk human papillomavirus infection, and abnormal cervical cytology has not been well characterized. Our objective was to characterize the vaginal microbiota in a stratified random sample of women from a population-based study in Appalachia. Methods: We analyzed a random sample of 308 women in the Community Access, Resources and Education: Project 3 study across 16 clinics in Ohio and West Virginia. Using Illumina MiSeq sequencing of 16S rRNA gene amplicons, we characterized the vaginal microbiota among (I) 109 women randomly chosen with abnormal cervical cytology (i.e., the majority were atypical squamous cells of undetermined significance (n=55) and low-grade squamous intraepithelial lesions (n=45) while n=6 were high-grade squamous intraepithelial lesions and n=3 were atypical glandular cells); (II) 110 high-risk human papillomavirus infection only without cytologic abnormality; and (III) 89 women from a stratified random sample without cytologic abnormalities (negative for intraepithelial lesion or malignancy or any human papillomavirus infection). Among the women with abnormal cervical cytology (n=109), 80 had human papillomavirus infection, the majority of which were positive for a high-risk type (n=61). Results: Nearly all of the women were non-Hispanic White (94.5%), and the mean age was 26 (IQR=21–39) years. Women with abnormal cervical cytology or who were HPV+ were more likely to have a diverse vaginal microbiota characterized by higher Gardnerella vaginalis relative abundance, compared to women without cytologic abnormalities whose communities were more likely to be Lactobacillus spp. dominant (P<0.04). Women without cytologic abnormalities had a higher prevalence of L. iners dominated communities than women with abnormal cervical cytology and HR HPV+ respectively (P<0.04), and L. gasseri relative abundance was differentially greater among these women compared to women with abnormal cervical cytology or who were high-risk HPV+ (Linear discriminant analysis effect size =4.17; P=0.0009). After adjustment for age, white race, current smoking, and ≥2 male partners in the last year, however, we did not detect differences in the vaginal microbiota community states across the three outcome groups. Conclusions: Compared to women without cytologic abnormalities, the vaginal microbiota of women with abnormal cervical cytology or who were high-risk HPV+ were characterized by a diverse community with increased relative abundance of G. vaginalis and reduced relative abundance of L. gasseri. However, these differences were attenuated after adjustment for other factors. Further study and validation of these differences for prognostic use is warranted.
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Affiliation(s)
- Kimberly S. McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Kayla A. Carter
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Christine Bassis
- Department of Internal Medicine/Division of Infectious Diseases, University of Michigan, Ann Arbor, MI, USA
| | - Vincent B. Young
- Department of Internal Medicine/Division of Infectious Diseases, University of Michigan, Ann Arbor, MI, USA
| | - Barbara Reed
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Diane M. Harper
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Mack T. Ruffin
- Department of Family and Community Medicine, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Jason D. Bell
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
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Abstract
Type 2 diabetes is more common in non-Europeans and starts at a younger age and at lower BMI cut-offs. This review discusses the insights from genetic studies about pathophysiological mechanisms which determine risk of disease with a focus on the role of adiposity and body fat distribution in ethnic disparity in risk of type 2 diabetes. During the past decade, genome-wide association studies (GWAS) have identified more than 400 genetic variants associated with the risk of type 2 diabetes. The Eurocentric nature of these genetic studies has made them less effective in identifying mechanisms that make non-Europeans more susceptible to higher risk of disease. One possible mechanism suggested by epidemiological studies is the role of ethnic difference in body fat distribution. Using genetic variants associated with an ability to store extra fat in a safe place, which is subcutaneous adipose tissue, we discuss how different ethnic groups could be genetically less susceptible to type 2 diabetes by developing a more favourable fat distribution.
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Affiliation(s)
- H Yaghootkar
- From the, Genetics of Complex Traits, University of Exeter Medical School, Royal Devon & Exeter Hospital, Exeter, UK.,School of Life Sciences, College of Liberal Arts and Science, University of Westminster, London, UK.,Division of Medical Sciences, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - B Whitcher
- School of Life Sciences, College of Liberal Arts and Science, University of Westminster, London, UK
| | - J D Bell
- School of Life Sciences, College of Liberal Arts and Science, University of Westminster, London, UK
| | - E L Thomas
- School of Life Sciences, College of Liberal Arts and Science, University of Westminster, London, UK
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Hocking DP, Marx FG, Parker WMG, Rule JP, Cleuren SGC, Mitchell AD, Hunter M, Bell JD, Fitzgerald EMG, Evans AR. Inferring diet, feeding behaviour and causes of mortality from prey-induced injuries in a New Zealand fur seal. Dis Aquat Organ 2020; 139:81-86. [PMID: 32351238 DOI: 10.3354/dao03473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
New Zealand fur seals Arctocephalus forsteri are the most abundant of the 4 otariid (eared seal) species distributed across Australasia. Analyses of stomach contents, scats and regurgitates suggest a diet dominated by bony fish and squid, with cartilaginous species (e.g. sharks and rays) either absent or underrepresented because of a lack of preservable hard parts. Here we report on a subadult specimen from south-eastern Australia, which was found ashore emaciated and with numerous puncture wounds across its lips, cheeks, throat and the inside of its oral cavity. Fish spines embedded in the carcass revealed that these injuries were inflicted by chimaeras and myliobatiform rays (stingrays and relatives), which matches reports on the diet of A. forsteri from New Zealand, but not South Australia. Shaking and tearing of prey at the surface may help to avoid ingestion of the venomous spines, perhaps contributing to their absence from scats and regurgitates. Nevertheless, the number and severity of the facial stab wounds, some of which led to local necrosis, likely affected the animal's ability to feed, and may account for its death. Despite their detrimental effects, fish spine-related injuries are difficult to spot, and may be a common, albeit cryptic, type of trauma. We therefore recommend that stranded seals be systematically examined for this potentially life-threatening pathology.
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Affiliation(s)
- D P Hocking
- School of Biological Sciences, Monash University, Clayton, Victoria 3800, Australia
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Hughey KL, Bell JD, Mullan PB, Rana GK, Wagenschutz HM, Skye EP, Kolars JC, Mangrulkar RS, Williams BC. Scaling Up a Global Health and Disparities Path of Excellence Pilot Program at the University of Michigan Medical School. Acad Med 2019; 94:1733-1737. [PMID: 31094724 DOI: 10.1097/acm.0000000000002783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PROBLEM Transforming medical school curricula to train physicians to better address society's needs is a complex task, as students must develop expertise in areas other than clinical medicine. APPROACH In 2010, the University of Michigan Medical School (UMMS) launched the Global Health and Disparities (GHD) Path of Excellence as part of a larger curriculum transformation. The GHD Path is a co-curriculum with the goal of ameliorating health disparities in the United States and abroad. It was developed iteratively based on student and faculty feedback. Student feedback emphasized the value of the relationships with faculty and other students, the capstone project, and exposure to role models and professional networks. Faculty described the joy of interacting with students and the desire for recognition by their departments for their role as an advisor. OUTCOMES Informed by the GHD Path experience, UMMS embraced the Path model, which emphasized professional relationships, career development, and high-impact scholarly work, making it different from the traditional medical curriculum, and the school implemented 7 other Paths between 2013 and 2018. Elements common to all Paths include a capstone project, a longitudinal advisor separate from the capstone advisor, exposure to role models and leaders, and the dissemination of scholarly work to promote networking. NEXT STEPS Next steps for the Paths of Excellence include developing methods to systematically monitor students' progress, facilitating mentoring skills in and recognizing faculty advisors, and measuring the long-term impact of the Paths on students and society.
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Affiliation(s)
- Katherine L Hughey
- K.L. Hughey is assistant director, Global Health and Disparities Path of Excellence, and assistant professor of family medicine, University of Michigan Medical School, Ann Arbor, Michigan. J.D. Bell is associate director, Global Health and Disparities Path of Excellence, and assistant professor of obstetrics and gynecology, University of Michigan Medical School, Ann Arbor, Michigan. P.B. Mullan is professor of learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. G.K. Rana is global health coordinator, Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan. H.M. Wagenschutz is director of curriculum services, University of Michigan Medical School, Ann Arbor, Michigan. She was codirector, Paths of Excellence, from 2014 to 2017. E.P. Skye is clinical associate professor of family medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. He was codirector, Paths of Excellence, from 2014 to 2017. J.C. Kolars is senior associate dean for education and global initiatives, Josiah Macy, Jr., Professor of Health Professions Education, and professor of internal medicine, University of Michigan Medical School, Ann Arbor, Michigan. R.S. Mangrulkar is Marguerite S. Roll Professor of Medical Education, associate dean for medical student education, and associate professor of internal medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. B.C. Williams is director, Global Health and Disparities Path of Excellence, and professor of internal medicine, University of Michigan Medical School, Ann Arbor, Michigan
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Kasi Ganeshan T, Bell JD, Chong NW. P4463The pineal hormone melatonin inhibits doxorubicin-induced mitochondrial dysfunction and apoptosis in cardiomyocytes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Heart failure (HF) is a major end-point of cardiovascular diseases (CVD). The pathogenesis of HF is mostly unresolved but involves metabolic alterations. Treatment of animals and cardiomyocytes with β-adrenergic receptor agonists induces HF. Mitochondrial dysfunction and HF are common complications of anticancer drugs such as doxorubicin (DOX). Melatonin synthesis dramatically decreases with age and in patients with CVD.
Purpose
The aim of this study was to investigate whether DOX-induced cardiac dysfunction can be attenuated by melatonin.
Methods
The Seahorse XF analyser was utilised (with the XFp Cell Energy Phenotype kit) to measure oxygen consumption rate [OCR; oxidative phosphorylation (OXPHOS)] and extracellular acidification rate (ECAR; glycolysis) in living rat cardiomyocyte-derived H9c2 cell line. Mono-layers of cells were treated with cardiotoxic drugs [isoproterenol (ISO, 100μM) or DOX (0.1μM)] for 24hr with and without melatonin co-treatment (MEL, 1μM). Cyan ADP flow cytometry was used to examine the anti-apoptotic properties of MEL (1μM) on DOX-treatment (0.5μM, 24hr). Data are given as mean±SEM (n=separate experiments) and analysis was performed using ANOVA and two-tail unpaired Student's T-test, as applicable.
Results
Isoproterenol-treatment increased peak OCR of H9c2 cells by ∼30% which was inhibited by MEL [CON, 384±17; ISO, 496±33; ISO+MEL, 412±31pmol/min; n=3 (six replicates); CON vs. ISO, p<0.05; ISO vs. ISO+MEL, p<0.05; CON vs. ISO+MEL, p>0.05]. Doxorubicin-treatment decreased OCR by ∼40% which was reversed by MEL [CON, 934±69; DOX, 554±52; DOX+MEL, 858±97pmol/min; n=3 (six replicates); CON vs. DOX, p<0.05; DOX vs. DOX+MEL, p<0.05; CON vs. DOX+MEL, p>0.05]. ISO and DOX significantly increased (∼30%) and decreased (∼25%) ECAR respectively (n=3, p<0.05) which was not inhibited by MEL. Melatonin alone had no significant effect on OCR and ECAR. Melatonin inhibited DOX-induced apoptosis in H9c2 cells [CON, 6.3±0.8%; DOX, 22±1.8%; DOX+MEL, 11±1.7%, n=4 (two replicates); CON vs. DOX, p<0.001; DOX vs. DOX+MEL, p<0.004; CON vs. DOX+MEL, p>0.05].
Conclusions
ISO and DOX-treatment induced mitochondrial dysfunction in H9c2 cells by alteration of OXPHOS and glycolysis; changes in OXPHOS were prevented by MEL. These data indicate that DOX-induced apoptosis in cardiac cells may be mediated, at least in part, by OXPHOS dysfunction which was attenuated by MEL treatment.
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Affiliation(s)
- T Kasi Ganeshan
- University of Westminster, School of Life Sciences, London, United Kingdom
| | - J D Bell
- University of Westminster, School of Life Sciences, London, United Kingdom
| | - N W Chong
- University of Westminster, School of Life Sciences, London, United Kingdom
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Eastman AJ, Bergin IL, Chai D, Bassis CM, LeBar W, Oluoch GO, Liechty ER, Nyachieo A, Young VB, Aronoff DM, Patton DL, Bell JD. Impact of the Levonorgestrel-Releasing Intrauterine System on the Progression of Chlamydia trachomatis Infection to Pelvic Inflammatory Disease in a Baboon Model. J Infect Dis 2019; 217:656-666. [PMID: 29253201 DOI: 10.1093/infdis/jix545] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/09/2017] [Indexed: 11/14/2022] Open
Abstract
Background Understanding the relationship between the levonorgestrel (LNG)-releasing intrauterine system (IUS) and sexually transmitted infections (STIs) is increasingly important as use of the LNG-IUS grows to include women at higher risk for STIs. This study assessed the impact of the LNG-IUS on development of Chlamydia trachomatis pelvic inflammatory disease, using a baboon model. Methods Baboons with and those without the LNG-IUS were cervically inoculated with C. trachomatis and monitored daily, and cervical and fallopian tube swab specimens were collected weekly for C. trachomatis quantitation by nucleic acid amplification testing and culture. Vaginal swab specimens were collected for cytokine analysis, and serum samples were obtained for detection of C. trachomatis antibodies. Results The LNG-IUS resulted in an increased C. trachomatis burden in the cervix, with the bacterial burden in the LNG-IUS group diverging from that in the non-LNG-IUS group by 6 weeks after infection. One of 7 baboons in the non-LNG-IUS group and 2 of 6 in the LNG-IUS group developed pelvic inflammatory disease, while 3 animals in each group met criteria suggestive of pelvic inflammatory disease. LNG-IUS increased baseline interleukin 8 levels but failed to further upregulate interleukin 8 during infection. In LNG-IUS recipients, early perturbations in the interleukin 1β axis corresponded to decreased C. trachomatis clearance and increased T-helper type 2 immune responses. Conclusion LNG-IUS use results in delayed clearance of C. trachomatis and might alter the reproductive tract immune environment.
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Affiliation(s)
- Alison J Eastman
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
| | - Ingrid L Bergin
- Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor
| | - Daniel Chai
- Institute of Primate Research, National Museum of Kenya, Karen
| | - Christine M Bassis
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor
| | - William LeBar
- Department of Pathology, University of Michigan, Ann Arbor
| | - George O Oluoch
- Institute of Primate Research, National Museum of Kenya, Karen
| | - Emma R Liechty
- Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor
| | - Atunga Nyachieo
- Institute of Primate Research, National Museum of Kenya, Karen
| | - Vincent B Young
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor
| | - David M Aronoff
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Dorothy L Patton
- Department of Obstetrics and Gynecology, University of Washington, Seattle
| | - Jason D Bell
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
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Mojtahed A, Kelly CJ, Herlihy AH, Kin S, Wilman HR, McKay A, Kelly M, Milanesi M, Neubauer S, Thomas EL, Bell JD, Banerjee R, Harisinghani M. Reference range of liver corrected T1 values in a population at low risk for fatty liver disease-a UK Biobank sub-study, with an appendix of interesting cases. Abdom Radiol (NY) 2019; 44:72-84. [PMID: 30032383 PMCID: PMC6348264 DOI: 10.1007/s00261-018-1701-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose Corrected T1 (cT1) value is a novel MRI-based quantitative metric for assessing a composite of liver inflammation and fibrosis. It has been shown to distinguish between non-alcoholic fatty liver disease (NAFL) and non-alcoholic steatohepatitis. However, these studies were conducted in patients at high risk for liver disease. This study establishes the normal reference range of cT1 values for a large UK population, and assesses interactions of age and gender. Methods MR data were acquired on a 1.5 T system as part of the UK Biobank Imaging Enhancement study. Measures for Proton Density Fat Fraction and cT1 were calculated from the MRI data using a multiparametric MRI software application. Data that did not meet quality criteria were excluded from further analysis. Inter and intra-reader variability was estimated in a set of data. A cohort at low risk for NAFL was identified by excluding individuals with BMI ≥ 25 kg/m2 and PDFF ≥ 5%. Of the 2816 participants with data of suitable quality, 1037 (37%) were classified as at low risk. Results The cT1 values in the low-risk population ranged from 573 to 852 ms with a median of 666 ms and interquartile range from 643 to 694 ms. Iron correction of T1 was necessary in 36.5% of this reference population. Age and gender had minimal effect on cT1 values. Conclusion The majority of cT1 values are tightly clustered in a population at low risk for NAFL, suggesting it has the potential to serve as a new quantitative imaging biomarker for studies of liver health and disease.
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Affiliation(s)
- A Mojtahed
- Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, USA.
| | | | | | - S Kin
- Perspectum Diagnostics, Oxford, UK
| | - H R Wilman
- Perspectum Diagnostics, Oxford, UK
- Department of Life Sciences, University of Westminster, London, UK
| | - A McKay
- Perspectum Diagnostics, Oxford, UK
| | - M Kelly
- Perspectum Diagnostics, Oxford, UK
| | | | - S Neubauer
- Perspectum Diagnostics, Oxford, UK
- Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, UK
| | - E L Thomas
- Department of Life Sciences, University of Westminster, London, UK
| | - J D Bell
- Department of Life Sciences, University of Westminster, London, UK
| | | | - M Harisinghani
- Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, USA
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Abstract
BACKGROUND Low-carbohydrate diets are becoming increasingly popular, although their dietary quality outside of clinical studies is unknown. A previous study analysed the dietary intake in people consuming a reduced-carbohydrate diet (<40% calories). However, it is not clear what foods people consume when carbohydrate is reduced to below 26% of total calories. METHODS In the present cross-sectional study, the dietary and nutrient intake collected via up to five consecutive 24-h dietary recalls and a food frequency questionnaire of 444 individuals (aged 46-79 years) consuming <26% of calories from carbohydrate (LCHO) was compared with that of 131 897 individuals consuming ≥45% calories from carbohydrate (NCHO) using the UK Biobank Dataset. Absolute cut-offs to define the low-carbohydrate group (<130 g day-1 ; n = 1953 versus ≥225 g day-1 , n = 113 036) were also used. RESULTS Both NCHO (>45% calories and ≥225 g) groups consumed significantly more high-sugar, high-fat snacks [median 6.0, interquartile range (IQR) = 2.0-11.0 and median 6.0, IQR = 3.0-11.8, respectively) compared to the LCHO (<26% calories and <130 g) groups (median 0, IQR = 0-2.8 and median 1, IQR = 0-3.8, respectively) (P < 0.0001). Both LCHO groups reported consuming significantly more red meat, oily fish, nuts and seeds but fewer fruits, vegetables and pulses compared to the NCHO groups. In general, the consumption of oily fish, nuts, seeds and pulses was low across the whole cohort and differences in intake between the LCHO and NCHO groups were small. After adjusting for socio-economic status, most differences remained. CONCLUSIONS Carbohydrate restriction is associated with both beneficial and potentially deleterious dietary changes compared to a normal carbohydrate intake.
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Affiliation(s)
- M Shafique
- Division of Diabetes and Nutritional Sciences, Kings College London, London, UK
| | - S Russell
- Division of Diabetes and Nutritional Sciences, Kings College London, London, UK
| | - S Murdoch
- Division of Diabetes and Nutritional Sciences, Kings College London, London, UK
| | - J D Bell
- Department of Life Sciences, Research Centre for Optimal Health, University of Westminster, London, UK
| | - N Guess
- Division of Diabetes and Nutritional Sciences, Kings College London, London, UK.,Department of Medicine, Imperial College London, London, UK
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12
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Abstract
OBJECTIVES There have been conflicting reports of altered vaginal microbiota and infection susceptibility associated with contraception use. The objectives of this study were to determine if intrauterine contraception altered the vaginal microbiota and to compare the effects of a copper intrauterine device (Cu-IUD) and a levonorgestrel intrauterine system (LNG-IUS) on the vaginal microbiota. STUDY DESIGN DNA was isolated from the vaginal swab samples of 76 women using Cu-IUD (n=36) or LNG-IUS (n=40) collected prior to insertion of intrauterine contraception (baseline) and at 6 months. A third swab from approximately 12 months following insertion was available for 69 (Cu-IUD, n=33; LNG-IUS, n=36) of these women. The V4 region of the bacterial 16S rRNA-encoding gene was amplified from the vaginal swab DNA and sequenced. The 16S rRNA gene sequences were processed and analyzed using the software package mothur to compare the structure and dynamics of the vaginal bacterial communities. RESULTS The vaginal microbiota from individuals in this study clustered into 3 major vaginal bacterial community types: one dominated by Lactobacillus iners, one dominated by Lactobacillus crispatus and one community type that was not dominated by a single Lactobacillus species. Changes in the vaginal bacterial community composition were not associated with the use of Cu-IUD or LNG-IUS. Additionally, we did not observe a clear difference in vaginal microbiota stability with Cu-IUD versus LNG-IUS use. CONCLUSIONS Although the vaginal microbiota can be highly dynamic, alterations in the community associated with the use of intrauterine contraception (Cu-IUD or LNG-IUS) were not detected over 12 months. IMPLICATIONS We found no evidence that intrauterine contraception (Cu-IUD or LNG-IUS) altered the vaginal microbiota composition. Therefore, the use of intrauterine contraception is unlikely to shift the composition of the vaginal microbiota such that infection susceptibility is altered.
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Affiliation(s)
- Christine M Bassis
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109.
| | - Jenifer E Allsworth
- Department of Biomedical & Health, University of Missouri - Kansas City School of Medicine, Kansas City, MO 64108; Department of Obstetrics & Gynecology, University of Missouri - Kansas City School of Medicine, Kansas City, MO 64108.
| | - Heather N Wahl
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109.
| | - Daniel E Sack
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109.
| | - Vincent B Young
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109; Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI 48109.
| | - Jason D Bell
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109.
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13
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Shao A, Drewnowski A, Willcox DC, Krämer L, Lausted C, Eggersdorfer M, Mathers J, Bell JD, Randolph RK, Witkamp R, Griffiths JC. Optimal nutrition and the ever-changing dietary landscape: a conference report. Eur J Nutr 2017; 56:1-21. [PMID: 28474121 PMCID: PMC5442251 DOI: 10.1007/s00394-017-1460-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The field of nutrition has evolved rapidly over the past century. Nutrition scientists and policy makers in the developed world have shifted the focus of their efforts from dealing with diseases of overt nutrient deficiency to a new paradigm aimed at coping with conditions of excess-calories, sedentary lifestyles and stress. Advances in nutrition science, technology and manufacturing have largely eradicated nutrient deficiency diseases, while simultaneously facing the growing challenges of obesity, non-communicable diseases and aging. Nutrition research has gone through a necessary evolution, starting with a reductionist approach, driven by an ambition to understand the mechanisms responsible for the effects of individual nutrients at the cellular and molecular levels. This approach has appropriately expanded in recent years to become more holistic with the aim of understanding the role of nutrition in the broader context of dietary patterns. Ultimately, this approach will culminate in a full understanding of the dietary landscape-a web of interactions between nutritional, dietary, social, behavioral and environmental factors-and how it impacts health maintenance and promotion.
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Affiliation(s)
- A Shao
- Herbalife Nutrition, Los Angeles, CA, USA
| | | | - D C Willcox
- Okinawa International University, Ginowan, Japan
| | - L Krämer
- Technische Universität Braunschweig, Brunswick, Germany
| | - C Lausted
- Institute for Systems Biology, Seattle, WA, USA
| | | | - J Mathers
- Newcastle University, Newcastle upon Tyne, UK
| | - J D Bell
- University of Westminster, London, UK
| | | | - R Witkamp
- Wageningen University, Wageningen, The Netherlands
| | - J C Griffiths
- Council for Responsible Nutrition-International, Washington, DC, USA.
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14
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Savage JL, Maturen KE, Mowers EL, Pasque KB, Wasnik AP, Dalton VK, Bell JD. Sonographic diagnosis of partial versus complete molar pregnancy: A reappraisal. J Clin Ultrasound 2017; 45:72-78. [PMID: 27696434 DOI: 10.1002/jcu.22410] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/27/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE To assess the prospective sonographic diagnosis of molar pregnancy and compare sonographic features of complete versus partial molar pregnancy. METHODS This institutional review board--approved retrospective chart review conducted between 2001 and 2011 identified 70 women with a histopathologic diagnosis of molar pregnancy and with available sonograms. Clinical data, images, and reports were reviewed, and features enumerated by radiologists blinded to the final diagnosis. RESULTS Mean age of patients was 30.5 ± 7.0 (SD) years (range, 16-49 years) with a mean gravidity of 3.2 ± 2.3 (SD) (range 1-11). Mean gestational age was 74.0 ± 19.1 day (range 39-138) and serum β-human chorionic gonadotropin was 131 ± 156 mIU/ml (range 447-662,000). Pathologic results showed 48 partial and 22 complete molar pregnancies. Sonographically, partial moles more commonly showed a yolk sac (56.3% versus 0%, p < 0.0001), fetal pole (62.5% versus 4.6%, p < 0.0001), fine septa within the sac (25.0% versus 4.6%, p = 0.05), and normal (31.3% versus 0%, p = 0.002) or minimally cystic placenta (27.1% versus 4.6%, p = 0.49), while complete moles had larger gestational sacs (612 versus 44 mm, p = 0.005), were more often avascular on color Doppler imaging (45.5% versus 18.8%, p = 0.02), had more often abnormal tissue in the uterus (82.6% versus 20.8%, p < 0.0001) and placental masses (86.9% versus 16.7%, p < 0.0001), and were more often diagnosed prospectively (86.4% versus 41.7%, p = 0.0005). CONCLUSIONS Complete molar pregnancy is associated with marked cystic changes and mass formation and is often diagnosed sonographically. Partial molar pregnancy often presents with minor cystic changes of the placenta and remains underdiagnosed sonographically. However, correct prospective diagnosis was made more frequently in this study than in older reports, perhaps due to improved spatial resolution of sonographic equipment. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:72-78, 2017.
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Affiliation(s)
- Julia L Savage
- Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109
| | - Katherine E Maturen
- Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109
- Department of Obstetrics and Gynecology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109
| | - Erika L Mowers
- Department of Obstetrics and Gynecology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109
| | - Katherine B Pasque
- Department of Obstetrics and Gynecology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109
| | - Ashish P Wasnik
- Department of Obstetrics and Gynecology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109
| | - Vanessa K Dalton
- Department of Obstetrics and Gynecology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109
| | - Jason D Bell
- Department of Obstetrics and Gynecology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109
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15
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Bailey EG, Jensen J, Nelson J, Wiberg HK, Bell JD. Weekly Formative Exams and Creative Grading Enhance Student Learning in an Introductory Biology Course. CBE Life Sci Educ 2017; 16:16/1/ar2. [PMID: 28130269 PMCID: PMC5332045 DOI: 10.1187/cbe.16-02-0104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 08/30/2016] [Accepted: 10/03/2016] [Indexed: 05/03/2023]
Abstract
First-year students often become discouraged during introductory biology courses when repeated attempts to understand concepts nevertheless result in poor test scores. This challenge is exacerbated by traditional course structures that impose premature judgments on students' achievements. Repeated testing has been shown to benefit student ability to recognize and recall information, but an effective means to similarly facilitate skill with higher-order problems in introductory courses is needed. Here, we show that an innovative format that uses a creative grading scheme together with weekly formative midterm exams produced significant gains in student success with difficult items requiring analysis and interpretation. This format is designed to promote tenacity and avoid discouragement by providing multiple opportunities to attempt demanding problems on exams, detailed immediate feedback, and strong incentives to retain hope and improve. Analysis of individual performance trajectories with heat maps reveals the diversity of learning patterns and provides rational means for advising students.
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Affiliation(s)
- E G Bailey
- Department of Biology, Brigham Young University, Provo, UT 84602
| | - J Jensen
- Department of Biology, Brigham Young University, Provo, UT 84602
| | - J Nelson
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
| | - H K Wiberg
- Department of Statistics, Brigham Young University, Provo, UT 84602
| | - J D Bell
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84602
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16
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Chai D, Bassis CM, Bergin IL, Bell JD, Nyachieo A, Gathumbi PK. Prevalence and geographical distribution of Papio hamadryas papillomavirus 1 (PhPV1) in Kenyan baboons. J Med Primatol 2016; 46:13-15. [PMID: 27726166 DOI: 10.1111/jmp.12247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 11/29/2022]
Abstract
Papio hamadryas papillomavirus (PhPV) 1, 2, and 3, are Alphapapillomaviruses that have been detected in Kenyan Olive baboons but the distribution is unknown. Therefore, cervical screening for PhPV1 was performed in baboons from various areas in Kenya using a nested polymerase chain reaction. The prevalence rate was 33%.
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Affiliation(s)
- Daniel Chai
- Department of Animal Sciences, Institute of Primate Research, National Museums of Kenya, Karen, Nairobi, Kenya.,Faculty of Veterinary Medicine, Department of Veterinary Pathology, Microbiology and Parasitology, University of Nairobi, Kangemi, Kenya
| | - Christine M Bassis
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ingrid L Bergin
- Unit for Laboratory Animal Medicine, University of Michigan Medical School, North Campus Research Complex, Ann Arbor, MI, USA
| | - Jason D Bell
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Atunga Nyachieo
- Department of Reproductive Health and Biology, Institute of Primate Research, National Museums of Kenya, Karen, Nairobi, Kenya
| | - Peter K Gathumbi
- Faculty of Veterinary Medicine, Department of Veterinary Pathology, Microbiology and Parasitology, University of Nairobi, Kangemi, Kenya
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17
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Liechty ER, Bergin IL, Bassis CM, Chai D, LeBar W, Young VB, Bell JD. The levonorgestrel-releasing intrauterine system is associated with delayed endocervical clearance of Chlamydia trachomatis without alterations in vaginal microbiota. Pathog Dis 2015; 73:ftv070. [PMID: 26371177 DOI: 10.1093/femspd/ftv070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2015] [Indexed: 12/11/2022] Open
Abstract
Progestin-based contraception may impact women's susceptibility to sexually transmitted infection. We evaluated the effect of the levonorgestrel intrauterine system (LNG-IUS) on cervical persistence of Chlamydia trachomatis (CT) in a baboon model. Female olive baboons (Papio anubis) with or without an LNG-IUS received CT or sham inoculations. CT was detected in cervical epithelium with weekly nucleic acid amplification testing (NAAT) and culture. Presence of the LNG-IUS was associated with prolonged persistence of CT. Median time to post-inoculation clearance of CT as detected by NAAT was 10 weeks (range 7-12) for animals with an LNG-IUS and 3 weeks (range 0-12) for non-LNG-IUS animals (P = 0.06). Similarly, median time to post-inoculation clearance of CT by culture was 9 weeks (range 3-12) for LNG-IUS animals and 1.5 weeks (range 0-10) for non-LNG-IUS animals (P = 0.04). We characterized the community structure of the vaginal microbiota with the presence of the LNG-IUS to determine if alterations in CT colonization dynamics were associated with changes in vaginal commensal bacteria. Vaginal swabs were collected weekly for microbiome analysis. Endocervical CT infection was not correlated with alterations in the vaginal microbiota. Together, these results suggest that LNG-IUS may facilitate CT endocervical persistence through a mechanism distinct from vaginal microbial alterations.
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Affiliation(s)
- Emma R Liechty
- Unit for Laboratory Animal Medicine, University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Ingrid L Bergin
- Unit for Laboratory Animal Medicine, University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Christine M Bassis
- Department of Internal Medicine Division of Infectious Diseases, University of Michigan, Ann Arbor, MI 48109, USA
| | - Daniel Chai
- Institute for Primate Research, Nairobi, Kenya
| | - William LeBar
- Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Vincent B Young
- Department of Internal Medicine Division of Infectious Diseases, University of Michigan, Ann Arbor, MI 48109, USA Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jason D Bell
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
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18
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Liechty ER, Bergin IL, Bassis CM, Chai D, LeBar W, Young VB, Bell JD. O15.6 Impact of the lng-ius on cervical persistence of chlamydia trachomatisand vaginal microbiota in a baboon model. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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20
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Liechty ER, Wang DY, Chen E, Chai D, Bell JD, Bergin IL. The influence of quarantine on reproductive cycling in wild-caught Baboons (Papio anubis). J Med Primatol 2015; 44:390-2. [PMID: 26308947 DOI: 10.1111/jmp.12189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2015] [Indexed: 11/27/2022]
Abstract
Stress impacts nonhuman primate menstrual cycle length but the impact of quarantine is unknown. A retrospective analysis was performed on cycle data from 31 wild-caught baboons during and following quarantine. Cycling initiated in 94 days (19-181) and length normalized within 4-6 cycles. Quarantine significantly impacts menstrual cycle length.
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Affiliation(s)
- Emma R Liechty
- Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Diane Y Wang
- College of Literature, Science and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - Emily Chen
- Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Chai
- Institute for Primate Research, Karen, Kenya
| | - Jason D Bell
- Program on Women's Healthcare Effectiveness Research, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Ingrid L Bergin
- Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, MI, USA
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21
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Vinekar KS, Vahratian A, Hall KS, West BT, Caldwell A, Bell JD, Dalton VK. Cervical Cancer Screening, Pelvic Examinations, and Contraceptive Use Among Adolescent and Young Adult Females. J Adolesc Health 2015; 57:169-73. [PMID: 26026477 PMCID: PMC4580912 DOI: 10.1016/j.jadohealth.2015.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 04/06/2015] [Accepted: 04/06/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of this study was to characterize the association between pelvic examination and adolescent contraceptive method use in two time periods in the 2006-2010 National Survey of Family Growth (NSFG). METHODS Using data from the 2006-2010 NSFG, we used descriptive statistics and multivariable regression models to examine the association between pelvic examination and/or Pap smear and use of effective or highly effective contraceptive methods during two time periods (2006-2008 and 2008-2010). We used the design characteristics of the NSFG to produce population estimates. RESULTS More than half (57.3%) of our target population reported that they had a pelvic examination and/or Pap smear in the preceding 12 months. After considering health service use, pregnancy history, and demographic characteristics, receipt of pelvic/Pap remained significantly associated with use of effective or highly effective methods of contraception. Adjusted odds ratio = 1.86; 95% confidence interval (CI), 1.17-2.97. When we examined the relationship between pelvic/Pap and use of effective or highly effective methods within time periods, we found that the odds of effective contraception use were higher among adolescents who had received a Pap/pelvic examination in Period 1 (June 2006-May 2008) but not in Period 2 (June 2008-May 2010). Odds ratio = 3.05; 95% CI, 1.53-6.03 and odds ratio = 1.52; 95% CI, .88-2.62, Periods 1 and 2 respectively. CONCLUSIONS This finding provides some reassurance that although indications for pelvic examination and Pap smear among adolescents have decreased, the previously documented association between pelvic examination and effective or highly effective contraception appears to have decreased.
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Affiliation(s)
- Kavita S. Vinekar
- Program on Women’s Healthcare Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women’s’ Hospital, University of Michigan Medical School, Ann Arbor, MI 48109
| | - Anjel Vahratian
- Program on Women’s Healthcare Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women’s’ Hospital, University of Michigan Medical School, Ann Arbor, MI 48109
| | - Kelli Stidham Hall
- Program on Women’s Healthcare Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women’s’ Hospital, University of Michigan Medical School, Ann Arbor, MI 48109
- Institute for Social Research, Population Studies Center, University of Michigan, P.O. Box 1248, 426 Thompson St., Ann Arbor, MI 48106-1248
| | - Brady T. West
- Survey Research Center and Center for Statistical Consultation and Research, The University of Michigan, 3550 Rackham, 915 E. Washington St., Ann Arbor, MI 48109-1070
| | - Amy Caldwell
- Program on Women’s Healthcare Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women’s’ Hospital, University of Michigan Medical School, Ann Arbor, MI 48109
| | - Jason D. Bell
- Program on Women’s Healthcare Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women’s’ Hospital, University of Michigan Medical School, Ann Arbor, MI 48109
| | - Vanessa K. Dalton
- Program on Women’s Healthcare Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women’s’ Hospital, University of Michigan Medical School, Ann Arbor, MI 48109
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22
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Abstract
Appropriate animal modeling is vital for the successful development of novel contraceptive devices. Advances in reproductive biology have identified novel pathways for contraceptive intervention. Here we review species-specific anatomic and physiologic considerations impacting preclinical contraceptive testing, including efficacy testing, mechanistic studies, device design, and modeling off-target effects. Emphasis is placed on the use of nonhuman primate models in contraceptive device development.
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Affiliation(s)
| | | | - Jason D Bell
- Program on Women's Health Care Effectiveness Research, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
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23
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Ourgaud M, Ruitton S, Bell JD, Letourneur Y, Harmelin JG, Harmelin-Vivien ML. Response of a seagrass fish assemblage to improved wastewater treatment. Mar Pollut Bull 2015; 90:25-32. [PMID: 25499183 DOI: 10.1016/j.marpolbul.2014.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/20/2014] [Accepted: 11/24/2014] [Indexed: 06/04/2023]
Abstract
We compared the structure of a seagrass fish assemblage near a sewage outlet before and after improvements to wastewater treatment. To determine whether responses by the fish assemblage were due to changes in water quality or to other factors, comparisons were made with the structure of a fish assemblage from a nearby site unaffected by sewage effluent. Total species richness, density and biomass of fish, decreased at both sites over the 30-year period. An increase in mean trophic level near the sewage outlet following improvements in water quality indicated that wastewater treatment had another important effect. This result is consistent with the reductions in food webs supporting pelagic and benthic fishes that typically accompany decreases in nutrient inputs. Although improvements to wastewater treatment explained much of the variation in the structure of the fish assemblage at PC, our results also suggest that fishing and climate change, at both sites.
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Affiliation(s)
- M Ourgaud
- Mediterranean Institute of Oceanography (MIO), Aix-Marseille Université, CNRS, Toulon Université, IRD, MIO UM 110, 13288 Marseille Cedex 09, France.
| | - S Ruitton
- Mediterranean Institute of Oceanography (MIO), Aix-Marseille Université, CNRS, Toulon Université, IRD, MIO UM 110, 13288 Marseille Cedex 09, France
| | - J D Bell
- Australian National Centre for Ocean Resources and Security, University of Wollongong, NSW 2522, Australia
| | - Y Letourneur
- Université de la Nouvelle Calédonie, Laboratoire LIVE and LABEX «Corail», BP R4, 98851 Nouméa Cedex, New Caledonia
| | - J G Harmelin
- GIS Posidonie & Mediterranean Institute of Oceanography (MIO), Aix-Marseille Université, Station Marine d'Endoume, 13007 Marseille, France
| | - M L Harmelin-Vivien
- Mediterranean Institute of Oceanography (MIO), Aix-Marseille Université, CNRS, Toulon Université, IRD, MIO UM 110, 13288 Marseille Cedex 09, France
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24
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Smith L, Thomas EL, Bell JD, Hamer M. The association between objectively measured sitting and standing with body composition: a pilot study using MRI. BMJ Open 2014; 4:e005476. [PMID: 24916091 PMCID: PMC4067859 DOI: 10.1136/bmjopen-2014-005476] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 05/23/2014] [Accepted: 05/27/2014] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To investigate the association between objectively measured sitting and standing, using a postural allocation technique, with MRI-assessed body composition. DESIGN The present study was a cross-sectional pilot study. SETTING Participants were examined at one centre located in London, UK. PARTICIPANTS Normal weight Caucasian women (30.9±6.1 years; body mass index (BMI), 22.9±3.4 kg/m(2)) with desk-bound occupations were recruited to minimise variability in body composition outcomes. A convenience sample of 12 women was recruited in January 2014 from University College London. OUTCOME MEASURES For each participant a number of body composition variables were attained from a single whole-body MRI session. Main outcome variables included: total and liver adiposity, visceral/subcutaneous fat ratio and BMI. Main exposure variables included: average sitting time, standing:sitting ratio and step count. Pearson correlations were carried out to examine associations between different activity categories and body composition variables. RESULTS There were significant correlations between average daily sitting and liver adiposity and visceral/subcutaneous abdominal fat ratio (r=0.66 and 0.64, respectively); standing:sitting ratio was moderately correlated with liver adiposity and visceral/subcutaneous abdominal fat ratio (r=-0.53 and -0.45); average daily step count was moderately correlated with liver adiposity, total adiposity and visceral/subcutaneous abdominal fat ratio (r=-0.45, -0.46 and -0.51, respectively). CONCLUSIONS This pilot study has provided preliminary evidence of relationships between objectively measured sitting and standing and precise measures of body composition.
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Affiliation(s)
- L Smith
- Department of Epidemiology and Public Health, University College London, London, UK
| | - E L Thomas
- Metabolic and Molecular Imaging Group, MRC Clinical Sciences Centre, Imperial College London, London, UK
| | - J D Bell
- Metabolic and Molecular Imaging Group, MRC Clinical Sciences Centre, Imperial College London, London, UK
| | - M Hamer
- Department of Epidemiology and Public Health, University College London, London, UK
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Bodinham CL, Smith L, Thomas EL, Bell JD, Swann JR, Costabile A, Russell-Jones D, Umpleby AM, Robertson MD. Efficacy of increased resistant starch consumption in human type 2 diabetes. Endocr Connect 2014; 3:75-84. [PMID: 24671124 PMCID: PMC3987287 DOI: 10.1530/ec-14-0036] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Resistant starch (RS) has been shown to beneficially affect insulin sensitivity in healthy individuals and those with metabolic syndrome, but its effects on human type 2 diabetes (T2DM) are unknown. This study aimed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postprandial metabolites and body fat in T2DM. Seventeen individuals with well-controlled T2DM (HbA1c 46.6±2 mmol/mol) consumed, in a random order, either 40 g of type 2 RS (HAM-RS2) or a placebo, daily for 12 weeks with a 12-week washout period in between. AT THE END OF EACH INTERVENTION PERIOD, PARTICIPANTS ATTENDED FOR THREE METABOLIC INVESTIGATIONS: a two-step euglycemic-hyperinsulinemic clamp combined with an infusion of [6,6-(2)H2] glucose, a meal tolerance test (MTT) with arterio-venous sampling across the forearm, and whole-body imaging. HAM-RS2 resulted in significantly lower postprandial glucose concentrations (P=0.045) and a trend for greater glucose uptake across the forearm muscle (P=0.077); however, there was no effect of HAM-RS2 on hepatic or peripheral insulin sensitivity, or on HbA1c. Fasting non-esterified fatty acid (NEFA) concentrations were significantly lower (P=0.004) and NEFA suppression was greater during the clamp with HAM-RS2 (P=0.001). Fasting triglyceride (TG) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 (P=0.039 and P=0.027 respectively). Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption (P=0.049), postprandial GLP1 excursions during the MTT were significantly greater (P=0.009). HAM-RS2 did not improve tissue insulin sensitivity in well-controlled T2DM, but demonstrated beneficial effects on meal handling, possibly due to higher postprandial GLP1.
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Affiliation(s)
| | | | - E L Thomas
- Metabolic and Molecular Imaging GroupMRC Clinical Sciences Centre, Imperial CollegeLondonUK
| | - J D Bell
- Metabolic and Molecular Imaging GroupMRC Clinical Sciences Centre, Imperial CollegeLondonUK
| | - J R Swann
- Department of Food and Nutritional SciencesUniversity of ReadingWhiteknights Campus, Reading, RG6 6APUK
| | - A Costabile
- Department of Food and Nutritional SciencesUniversity of ReadingWhiteknights Campus, Reading, RG6 6APUK
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Hashway SA, Bergin IL, Bassis CM, Uchihashi M, Schmidt KC, Young VB, Aronoff DM, Patton DL, Bell JD. Impact of a hormone-releasing intrauterine system on the vaginal microbiome: a prospective baboon model. J Med Primatol 2013; 43:89-99. [PMID: 24266633 DOI: 10.1111/jmp.12090] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Use of a levonorgestrel-releasing intrauterine system (LNG-IUS) in humans may alter vaginal microbial populations and susceptibility to pathogens. This study evaluated the time-dependent effects of an LNG-IUS on the vaginal microbiome of the baboon, a useful animal model for reproductive studies. METHODS Levonorgestrel-releasing intrauterine systems were inserted into three reproductively mature, female baboons. The animals were evaluated for 6 months by physical examination and Gram-stained cytology. The vaginal microbiota was characterized at each timepoint by culture-independent analysis of the 16S rRNA-encoding gene. RESULTS Each baboon harbored a diverse vaginal microbiome. Interindividual variation exceeded intra-individual variation. Diversity declined over time in one baboon and showed mild fluctuations in the other two. There were no significant community differences from early to late post-LNG-IUS placement. CONCLUSIONS The baboon vaginal microbiome is unique to each individual and is polymicrobial. In this pilot study, the vaginal microbiome remained stable from early to late post-LNG-IUS placement.
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Affiliation(s)
- S A Hashway
- Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, MI, USA
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Forbes S, Godsland IF, Taylor-Robinson SD, Bell JD, Thomas EL, Patel N, Hamilton G, Parker KH, Marshall I, Gray CD, Bedford D, Caslake M, Walker BR, Johnston DG. A history of previous gestational diabetes mellitus is associated with adverse changes in insulin secretion and VLDL metabolism independently of increased intrahepatocellular lipid. Diabetologia 2013; 56:2021-33. [PMID: 23760677 DOI: 10.1007/s00125-013-2956-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 05/20/2013] [Indexed: 01/01/2023]
Abstract
AIMS/HYPOTHESIS We have previously reported a high prevalence of non-alcoholic fatty liver disease (NAFLD) among women with previous gestational diabetes mellitus (pGDM). We wanted to confirm that intrahepatocellular lipid (IHCL) is associated with pGDM independently of adiposity and determine: (1) if VLDL metabolism is dysregulated; and (2) the extent to which NAFLD and IHCL account for the dysmetabolic phenotype in pGDM. METHODS We analysed data from a cohort of 234 women (114 with pGDM) and identified effects of pGDM on lipid and glucoregulation that were independent of ultrasound-diagnosed NAFLD. We then measured IHCL by MR spectroscopy in a representative subgroup (n = 36) and conducted detailed metabolic studies (IVGTT, VLDL apolipoprotein B [apoB] kinetics and palmitate turnover) and measurement of regional body fat by MRI to demonstrate effects of IHCL that were independent of a history of pGDM. RESULTS pGDM was associated with increased IHCL (p = 0.04) after adjustment for adiposity. Independently of IHCL, pGDM was associated with a lower IVGTT disposition index (p = 0.02) and acute insulin response to glucose (pGDM+/NAFLD-, 50% lower; pGDM+/NAFLD+, 36% lower; effect of pGDM, p = 0.03), increased VLDL apoB pool size (pGDM+/NAFLD-, 3.1-fold higher; pGDM+/NAFLD+, 1.2-fold higher; effect of pGDM, p = 0.02) and, at borderline significance (p = 0.05), increased rate of VLDL apoB synthesis. CONCLUSIONS/INTERPRETATION pGDM is associated with increased IHCL independently of adiposity. The increased liver fat contributes to the phenotype, but pGDM status is independently associated with diminished insulin secretion and (shown for the first time) augmented VLDL metabolism. IHCL with pGDM may compound a dysmetabolic phenotype.
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Affiliation(s)
- S Forbes
- Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
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Thomas EL, Fitzpatrick JA, Malik SJ, Taylor-Robinson SD, Bell JD. Whole body fat: content and distribution. Prog Nucl Magn Reson Spectrosc 2013; 73:56-80. [PMID: 23962884 DOI: 10.1016/j.pnmrs.2013.04.001] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 04/09/2013] [Accepted: 04/23/2013] [Indexed: 06/02/2023]
Abstract
Obesity and its co-morbidities, including type II diabetes, insulin resistance and cardiovascular diseases, have become one of the biggest health issues of present times. The impact of obesity goes well beyond the individual and is so far-reaching that, if it continues unabated, it will cause havoc with the economies of most countries. In order to be able to fully understand the relationship between increased adiposity (obesity) and its co-morbidity, it has been necessary to develop proper methodology to accurately and reproducibly determine both body fat content and distribution, including ectopic fat depots. Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS) have recently emerged as the gold-standard for accomplishing this task. Here, we will review the use of different MRI techniques currently being used to determine body fat content and distribution. We also discuss the pros and cons of MRS to determine ectopic fat depots in liver, muscle, pancreas and heart and compare these to emerging MRI techniques currently being put forward to create ectopic fat maps. Finally, we will discuss how MRI/MRS techniques are helping in changing the perception of what is healthy and what is normal and desirable body-fat content and distribution.
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Affiliation(s)
- E L Thomas
- Metabolic and Molecular Imaging Group, MRC Clinical Sciences Centre, Imperial College London, London, UK.
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Katzmarzyk PT, Shen W, Baxter-Jones A, Bell JD, Butte NF, Demerath EW, Gilsanz V, Goran MI, Hirschler V, Hu HH, Maffeis C, Malina RM, Müller MJ, Pietrobelli A, Wells JCK. Adiposity in children and adolescents: correlates and clinical consequences of fat stored in specific body depots. Pediatr Obes 2012; 7:e42-61. [PMID: 22911903 DOI: 10.1111/j.2047-6310.2012.00073.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 05/22/2012] [Indexed: 12/11/2022]
Abstract
The 2011 Pennington Biomedical Research Center's Scientific Symposium focused on adiposity in children and adolescents. The symposium was attended by 15 speakers and other invited experts. The specific objectives of the symposium were to (i) integrate the latest published and unpublished findings on the laboratory and clinical assessment of depot-specific adiposity in children and adolescents, (ii) understand the variation in depot-specific adiposity and related health outcomes associated with age, sex, maturation, ethnicity and other factors and (iii) identify opportunities for incorporating new markers of abdominal obesity into clinical practice guidelines for obesity in children and adolescents. This symposium provided an overview of important new advances in the field and identified directions for future research. The long-term goal of the symposium is to aid in the early identification of children and adolescents who are at increased health risk because of obesity and obesity-related conditions.
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Affiliation(s)
- P T Katzmarzyk
- Pennington Biomedical Research Center, Baton Rouge, LA 70808-4124, USA.
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Bergin IL, Bell JD, Chen Z, Zochowski MK, Chai D, Schmidt K, Culmer DL, Aronoff DM, Patton DL, Mwenda JM, Wood CE, Burk RD. Novel genital alphapapillomaviruses in baboons (Papio hamadryas anubis) with cervical dysplasia. Vet Pathol 2012; 50:200-8. [PMID: 22446324 DOI: 10.1177/0300985812439725] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Genital Alphapapillomavirus (αPV) infections are one of the most common sexually transmitted human infections worldwide. Women infected with the highly oncogenic genital human papillomavirus (HPV) types 16 and 18 are at high risk for development of cervical cancer. Related oncogenic αPVs exist in rhesus and cynomolgus macaques. Here the authors identified 3 novel genital αPV types (PhPV1, PhPV2, PhPV3) by PCR in cervical samples from 6 of 15 (40%) wild-caught female Kenyan olive baboons (Papio hamadryas anubis). Eleven baboons had koilocytes in the cervix and vagina. Three baboons had dysplastic proliferative changes consistent with cervical squamous intraepithelial neoplasia (CIN). In 2 baboons with PCR-confirmed PhPV1, 1 had moderate (CIN2, n = 1) and 1 had low-grade (CIN1, n = 1) dysplasia. In 2 baboons with PCR-confirmed PhPV2, 1 had low-grade (CIN1, n = 1) dysplasia and the other had only koilocytes. Two baboons with PCR-confirmed PhPV3 had koilocytes only. PhPV1 and PhPV2 were closely related to oncogenic macaque and human αPVs. These findings suggest that αPV-infected baboons may be useful animal models for the pathogenesis, treatment, and prophylaxis of genital αPV neoplasia. Additionally, this discovery suggests that genital αPVs with oncogenic potential may infect a wider spectrum of non-human primate species than previously thought.
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Affiliation(s)
- I L Bergin
- University of Michigan, Ann Arbor, MI 48109, USA.
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Watson RA, Pride NB, Thomas EL, Ind PW, Bell JD. Relation between trunk fat volume and reduction of total lung capacity in obese men. J Appl Physiol (1985) 2011; 112:118-26. [PMID: 21940844 DOI: 10.1152/japplphysiol.00217.2011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Reduction in total lung capacity (TLC) in obese men is associated with restricted expansion of the thoracic cavity at full inflation. We hypothesized that thoracic expansion was reduced by the load imposed by increased total trunk fat volume or its distribution. Using MRI, we measured internal and subcutaneous trunk fat and total abdominal and thoracic volumes at full inflation in 14 obese men [mean age: 52.4 yr, body mass index (BMI): 38.8 (range: 36-44) kg/m(2)] and 7 control men [mean age: 50.1 yr, BMI: 25.0 (range: 22-27.5) kg/m(2)]. TLC was measured by multibreath helium dilution and was restricted (<80% of the predicted value) in six obese men (the OR subgroup). All measurements were made with subjects in the supine position. Mean total trunk fat volume was 16.65 (range: 12.6-21.8) liters in obese men and 6.98 (range: 3.0-10.8) liters in control men. Anthropometry and mean total trunk fat volumes were similar in OR men and obese men without restriction (the ON subgroup). Mean total intraabdominal volume was 9.41 liters in OR men and 11.15 liters in ON men. In obese men, reduced thoracic expansion at full inflation and restriction of TLC were not inversely related to a large volume of 1) intra-abdominal or total abdominal fat, 2) subcutaneous fat volume around the thorax, or 3) total trunk fat volume. In addition, trunk fat volumes in obese men were not inversely related to gas volume or estimated intrathoracic volume at supine functional residual capacity. In conclusion, this study failed to support the hypotheses that restriction of TLC or impaired expansion of the thorax at full inflation in middle-aged obese men was simply a consequence of a large abdominal volume or total trunk fat volume or its distribution.
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Affiliation(s)
- R A Watson
- Faculty of Medicine, National Heart and Lung Institute, Imperial College, Hammersmith Campus, London, UK
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Bell JD, Bergin IL, Harris LH, Chai D, Mullei I, Mwenda J, Dalton VK, Vahratian A, Lebar W, Zochowski MK, Kiulia N, Aronoff DM, Patton DL. The effects of a single cervical inoculation of Chlamydia trachomatis on the female reproductive tract of the baboon (Papio anubis). J Infect Dis 2011; 204:1305-12. [PMID: 21921205 DOI: 10.1093/infdis/jir541] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The baboon (Papio hamadryas anubis) can be transcervically instrumented, facilitating studies of intrauterine contraception and reproductive tract infection. We sought to determine if the baboon could become infected with a single cervical inoculation of Chlamydia trachomatis. METHODS Ten female baboons were randomized and inoculated cervically with C. trachomatis serovar E (or buffer alone). Animals underwent weekly clinical and laparoscopic evaluations for four weeks and at post-inoculation week 8, to monitor upper tract infection. Cervical culture and nucleic acid amplification testing (NAAT) were completed weekly throughout the study. Animals were euthanized at week 16 and the reproductive tracts were examined histologically. RESULTS All inoculated animals developed cervical infection. The average duration of positive NAAT results was 6.8 weeks (range 2-16). Two of eight (25%) animals tested positive from fallopian tube samples. Infected animals showed histological findings consistent with chlamydial infection, such as germinal centers. Five of ten animals seroconverted to C. trachomatis. CONCLUSIONS Baboons cervically inoculated once with C. trachomatis develop infection similar to humans, with a low incidence of upper tract infection. This novel model of Chlamydia infection closely resembles human disease and opens new avenues for studying the pathogenesis of sexually transmitted infections and contraceptive safety.
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Affiliation(s)
- Jason D Bell
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA.
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Bell JD, Bergin IL, Schmidt K, Zochowski MK, Aronoff DM, Patton DL. Nonhuman primate models used to study pelvic inflammatory disease caused by Chlamydia trachomatis. Infect Dis Obstet Gynecol 2011; 2011:675360. [PMID: 21869858 PMCID: PMC3160047 DOI: 10.1155/2011/675360] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Accepted: 06/03/2011] [Indexed: 12/03/2022] Open
Abstract
Pelvic inflammatory disease (PID) is a global health concern that is associated with significant morbidity and is a major cause of infertility. Throughout history animals have been used for anatomical studies and later as models of human disease. In particular, nonhuman primates (NHPs) have permitted investigations of human disease in a biologically, physiologically, and anatomically similar system. The use of NHPs as human PID models has led to a greater understanding of the primary microorganisms that cause disease (e.g., Chlamydia trachomatis and Neisseria gonorroheae), the pathogenesis of infection and its complications, and the treatment of people with PID. This paper explores historical and contemporary aspects of NHP modeling of chlamydial PID, with an emphasis on advantages and limitations of this approach and future directions for this research.
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Affiliation(s)
- Jason D Bell
- Department of Obstetrics & Gynecology, University of Michigan, 1500 East Medical Center Drive, L4510, Ann Arbor, MI 48109, USA.
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Thomas EL, Makwana A, Newbould R, Rao AW, Gambarota G, Frost G, Delafont B, Mishra RG, Matthews PM, Berk ES, Schwartz SM, Bell JD, Beaver JD. Pragmatic study of orlistat 60 mg on abdominal obesity. Eur J Clin Nutr 2011; 65:1256-62. [PMID: 21697820 DOI: 10.1038/ejcn.2011.108] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES It is well established that combining a reduced calorie, low-fat diet with the lipase inhibitor orlistat results in significantly greater weight loss than placebo plus diet. This weight loss is accompanied by changes in adipose tissue (AT) distribution. As 60 mg orlistat is now available as an over-the-counter medication, the primary objective of this study was to determine whether 60 mg orlistat is effective as a weight loss option in a free-living community population with minimal professional input. METHODS AT and ectopic lipid content were measured using magnetic resonance imaging and (1)H MR spectroscopy, respectively, in 27 subjects following 3 months treatment with orlistat 60 mg and a reduced calorie, low-fat diet. RESULTS Significant reductions in intra-abdominal AT (-10.6%, P=0.023), subcutaneous (-11.7% P<0.0001) and pericardial fat (-9.8%, P=0.034) volumes and intrahepatocellular lipids (-43.3%, P=0.0003) were observed. These changes in body fat content and distribution were accompanied by improvements in plasma lipids and decreases in blood pressure and heart rate. CONCLUSION These findings suggest that over-the-counter 60 mg orlistat, in combination with the type of advice a subject could expect to be given when obtaining 60 mg orlistat in a community setting, does indeed result in potentially clinically beneficial changes in body composition and risk factors for metabolic diseases.
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Affiliation(s)
- E L Thomas
- Metabolic and Molecular Imaging Group, MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, UK.
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Dalton VK, Harris LH, Bell JD, Schulkin J, Steinauer J, Zochowski M, Fendrick AM. Treatment of early pregnancy failure: does induced abortion training affect later practices? Am J Obstet Gynecol 2011; 204:493.e1-6. [PMID: 21419385 DOI: 10.1016/j.ajog.2011.01.052] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 12/17/2010] [Accepted: 01/24/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of the study was to examine the relationship between induced abortion training and views toward, and use of, office uterine evacuation and misoprostol in early pregnancy failure (EPF) care. STUDY DESIGN We surveyed 308 obstetrician-gynecologists on their knowledge and attitudes toward treatment options for EPF and previous training in office-based uterine evacuation. RESULTS Sixty-seven percent of respondents reported training in office uterine evacuation, and 20.3% reported induced abortion training. Induced abortion training was associated with strongly positive views toward both office-based uterine evacuation and misoprostol as treatment for EPF compared with those with office uterine evacuation training in other settings (odds ratio [OR], 2.64; P < .004 and OR, 3.22; P < .003, respectively). Furthermore, induced abortion training was associated with the use of office uterine evacuation for EPF treatment compared with those with office evacuation training in other settings (OR, 2.90; P = .004). CONCLUSION Training experiences, especially induced abortion training, are associated with the use of office uterine evacuation for EPF.
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Affiliation(s)
- Vanessa K Dalton
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, 48109, USA.
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Hankir MK, Parkinson JRC, Minnion JS, Addison ML, Bloom SR, Bell JD. Peptide YY 3-36 and pancreatic polypeptide differentially regulate hypothalamic neuronal activity in mice in vivo as measured by manganese-enhanced magnetic resonance imaging. J Neuroendocrinol 2011; 23:371-80. [PMID: 21251093 DOI: 10.1111/j.1365-2826.2011.02111.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Peptide YY (PYY) and pancreatic polypeptide (PP) are two appetite suppressing hormones, released post-prandially from the ileum and pancreas, respectively. PYY(3-36) , the major circulating form of the peptide, is considered to reduce food intake in humans and rodents via high affinity binding to the auto-inhibitory neuropeptide Y receptor Y2R, whereas PP is considered to act through the Y4R. Current evidence indicates the anorexigenic effects of both peptides occur via signalling in the brainstem and arcuate nucleus (ARC) of the hypothalamus. Manganese-enhanced magnetic resonance imaging (MEMRI) has previously been used to track hypothalamic neuronal activity in vivo in response to both nutritional interventions and gut hormone treatment. In the present study, we used MEMRI to demonstrate that s.c. administration of PP results in a significant reduction in signal intensity (SI) in the ARC, ventromedial hypothalamus and paraventricular nucleus of fasted mice. Subcutaneous delivery of PYY(3-36) resulted in a nonsignificant trend towards decreased SI in the hypothalamus of fasted mice. We found no SI change in the area postrema of the brainstem after s.c. injection of either peptide. These differences in hypothalamic SI profile between PP and PYY(3-36) occurred despite both peptides producing a comparable reduction in food intake. These results suggest that separate central pathways control the anorexigenic response for PP and PYY(3-36) , possibly via a differential effect of Y4 receptor versus Y2 receptor signalling. In addition, we performed a series of MEMRI scans at 0-2, 2-4 and 4-6 h post-injection of PYY(3-36) and a potent analogue of the peptide; PYY(3-36) (LT). We recorded a significant reduction in the ARC SI 2-4 h after PYY(3-36) (LT) injection compared to both saline and PYY(3-36) in fasted mice. The physiological differences between PYY(3-36) and its analogue were also observed in the long-term effects on food intake, with PYY(3-36) (LT) producing a more sustained anorexigenic effect. These data suggest that MEMRI can be used to investigate the long-term effects of gut peptide delivery on activity within the hypothalamus and brainstem.
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Affiliation(s)
- M K Hankir
- Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Abstract
AIMS Diets rich in non-viscous fibre are linked to a reduced risk of both diabetes and cardiovascular disease; however, the mechanism of action remains unclear. This study was undertaken to assess whether chronic consumption of this type of fibre in individuals with the metabolic syndrome would improve insulin sensitivity via changes in ectopic fat storage. METHODS The study was a single-blind, randomized, parallel nutritional intervention where 20 insulin resistant subjects consumed either the fibre supplement (resistant starch) (40 g/day) or placebo supplement (0 g/day) for 12 weeks. Insulin sensitivity was measured by euglycaemic-hyperinsulinaemic clamp and ectopic fat storage measured by whole-body magnetic resonance spectroscopy. RESULTS Resistant starch consumption did not significantly affect body weight, fat storage in muscle, liver or visceral depots. There was also no change with resistant starch feeding on vascular function or markers of inflammation. However, in subjects randomized to consume the resistant starch, insulin sensitivity improved compared with the placebo group (P = 0.023). Insulin sensitivity correlated significantly with changes in waist circumference and fat storage in tibialis muscle and to a lesser extent to visceral-to-subcutaneous abdominal adipose tissue ratio. CONCLUSION Consumption of resistant starch improves insulin sensitivity in subjects with the metabolic syndrome. Unlike in animal models, diabetes prevention does not appear to be directly related to changes in body adiposity, blood lipids or inflammatory markers. Further research to elucidate the mechanisms behind this change in insulin sensitivity in human subjects is required.
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Affiliation(s)
- K L Johnston
- Diabetes and Endocrinology, Postgraduate Medical School, University of Surrey, Guildford, UK
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Zeeni N, Nadkarni N, Bell JD, Even PC, Fromentin G, Tome D, Darcel N. Peripherally injected cholecystokinin-induced neuronal activation is modified by dietary composition in mice. Neuroimage 2010; 50:1560-5. [PMID: 20100582 DOI: 10.1016/j.neuroimage.2010.01.065] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Revised: 12/18/2009] [Accepted: 01/18/2010] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to investigate the effect of long-term nutrient intake on the central response to the anorexigenic gut hormone CCK. C57BL/6 mice were fed one of three diets for 6 weeks: standard high carbohydrate (HC), high fat (HF), or high protein (HP). Assessment of brain response to cholecystokinin (CCK) by manganese-enhanced MRI (MEMRI) showed a reduction in neuronal activity both in an appetite-related area (ventromedial nucleus of the hypothalamus) and areas associated with reward (nucleus accumbens and striatum) regardless of diet. When comparing diet effects, while the HF diet did not induce any change in activity, reductions in MEMRI-associated signal were found in the paraventricular nucleus (PVN) and lateral hypothalamic area (LHA) when comparing the HP to the HC diet. In addition, a significant interaction was found between CCK administration and the HF diet, shown by an increased activation in the PVN, which suggests a decrease the inhibiting action of CCK. Our results put forward that the long-term intake of an HP diet leads to a reduction in basal hypothalamic activation while a high-fat diet leads to desensitization to CCK-induced effects in the hypothalamus.
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Affiliation(s)
- N Zeeni
- AgroParisTech, CNRH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, F-75005 Paris, France
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Bell JD, Park E, Ai J, Baker AJ. PICK1-mediated GluR2 endocytosis contributes to cellular injury after neuronal trauma. Cell Death Differ 2009; 16:1665-80. [DOI: 10.1038/cdd.2009.106] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Bell JD, Awonuga AO, Thompson ME, Ray CB, Devoe LD. Infantile scimitar syndrome complicating pregnancy. Int J Gynaecol Obstet 2009; 106:259-60. [PMID: 19426976 DOI: 10.1016/j.ijgo.2009.03.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 03/13/2009] [Accepted: 03/26/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Jason D Bell
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, Georgia, USA.
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Abstract
There is increasing evidence that preterm birth is a risk factor for the development of adiposity associated disease, although the pathophysiological basis is unclear. We have previously shown that preterm infants have increased internal abdominal (visceral) adiposity by term. In adults increased internal adiposity is associated with elevated intrahepatocellular lipid (IHCL). We measured IHCL using (1)H NMR spectroscopy in 26 infants (eight healthy preterm-at-term and 18 term-born) and compared values with a reference group of 32 adults. There was no significant difference between adult and term-born IHCL content. In preterm-at-term infants IHCL was significantly elevated when compared with term-born infants and with adults (IHCL CH2/water median (interquartile range): preterm 1.69 (1.04-3.53), term 0.21 (0-0.54) and adult 0.55 (0.08-1.57).
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Affiliation(s)
- E L Thomas
- Molecular Imaging Group, MRC Clinical Sciences Centre, Imperial College London, London, UK
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Shojaee-Moradie F, Baynes KCR, Pentecost C, Bell JD, Thomas EL, Jackson NC, Stolinski M, Whyte M, Lovell D, Bowes SB, Gibney J, Jones RH, Umpleby AM. Exercise training reduces fatty acid availability and improves the insulin sensitivity of glucose metabolism. Diabetologia 2007; 50:404-13. [PMID: 17149589 DOI: 10.1007/s00125-006-0498-7] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Accepted: 09/06/2006] [Indexed: 12/16/2022]
Abstract
AIMS/HYPOTHESIS It is not known whether the beneficial effects of exercise training on insulin sensitivity are due to changes in hepatic and peripheral insulin sensitivity or whether the changes in insulin sensitivity can be explained by adaptive changes in fatty acid metabolism, changes in visceral fat or changes in liver and muscle triacylglycerol content. We investigated the effects of 6 weeks of supervised exercise in sedentary men on these variables. SUBJECTS AND METHODS We randomised 17 sedentary overweight male subjects (age 50 +/- 2.6 years, BMI 27.6 +/- 0.5 kg/m(2)) to a 6-week exercise programme (n = 10) or control group (n = 7). The insulin sensitivity of palmitic acid production rate (Ra), glycerol Ra, endogenous glucose Ra (EGP), glucose uptake and glucose metabolic clearance rate were measured at 0 and 6 weeks with a two-step hyperinsulinaemic-euglycaemic clamp [step 1, 0.3 (low dose); step 2, 1.5 (high dose) mU kg(-1) min(-1)]. In the exercise group subjects were studied >72 h after the last training session. Liver and skeletal muscle triacylglycerol content was measured by magnetic resonance spectroscopy and visceral adipose tissue by cross-sectional computer tomography scanning. RESULTS After 6 weeks, fasting glycerol, palmitic acid Ra (p = 0.003, p = 0.042) and NEFA concentration (p = 0.005) were decreased in the exercise group with no change in the control group. The effects of low-dose insulin on EGP and of high-dose insulin on glucose uptake and metabolic clearance rate were enhanced in the exercise group but not in the control group (p = 0.026; p = 0.007 and p = 0.04). There was no change in muscle triacylglycerol and liver fat in either group. CONCLUSIONS/INTERPRETATION Decreased availability of circulating NEFA may contribute to the observed improvement in the insulin sensitivity of EGP and glucose uptake following 6 weeks of moderate exercise.
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Affiliation(s)
- F Shojaee-Moradie
- Department of Diabetes, Endocrinology and Internal Medicine, GKT School of Medicine, King's College London, London, UK.
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Bun Navy K, Prem Prey S, Lynen L, Sovanna P, Bell JD, Harwell JI. The first reported cases of disseminated histoplasmosis in Cambodia, complicated by multiple opportunistic infections. Southeast Asian J Trop Med Public Health 2005; 36:1272-4. [PMID: 16438157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Although disseminated histoplasmosis is recognized as a common opportunistic infection in HIV-infected persons living in endemic areas, it is not widely reported in Southeast Asia, and has not been reported in Cambodia. It remains unanswered whether this is secondary to a low disease prevalence, or whether the disease, which is associated with a nonspecific clinical presentation, is under diagnosed. In addition to a review of the literature regarding histoplasmosis in Southeast Asia, we provide a description of two HIV-1 infected patients with documented disseminated histoplasmosis complicating other opportunistic infections in Phnom Penh, Cambodia. These two cases highlight the need for both a high clinical suspicion, and reliable laboratory testing, in a setting where there is likely to be more than one infection complicating the patient's clinical course.
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Affiliation(s)
- K Bun Navy
- University Research Co LLC, Phnom Penh, Cambodia
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Bell JD, Fay MT. Veterinary practice, competition and advertising: 1985-1994. N Z Vet J 2005; 45:239-42. [PMID: 16031997 DOI: 10.1080/00480169.1997.36037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In 1985, members of the veterinary profession and four other professional groups in New Zealand were surveyed to establish their attitudes towards the developing commercialisation of their professions, and particularly towards advertising. This survey was repeated in 1988, and again in 1994. The results of the three surveys are presented in this paper. There was a sharp movement towards acceptance of advertising, and toward a competitive orientation in general, between 1985 and 1988, with a consolidation of these changes during the following 6 years. The acceptance of the idea of an openly competitive profession now has widespread support among veterinarians. Similarly, there is general support for the use of most kinds of informative advertising, with many practitioners viewing advertising as a business building tool, but with the advertising of fees remaining an area over which there is still considerable caution. Although clients are seen as more demanding than in the past, the client-practitioner relationship is still expected to be an enduring one. We suggest that, in view of the relaxed attitudes towards advertising that now exists among members of the veterinary profession, control of advertising should cease to be a concern to the profession.
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Affiliation(s)
- J D Bell
- Department of Marketing, University of Otago, PO Box 56, Dunedin, New Zealand
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Wilson-Ashworth HA, Judd AM, Law RM, Freestone BD, Taylor S, Mizukawa MK, Cromar KR, Sudweeks S, Bell JD. Formation of transient non-protein calcium pores by lysophospholipids in S49 Lymphoma cells. J Membr Biol 2005; 200:25-33. [PMID: 15386157 DOI: 10.1007/s00232-004-0691-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2004] [Revised: 05/12/2004] [Indexed: 10/26/2022]
Abstract
Palmitoyl-lysophosphatidylcholine promotes a transient calcium influx in lymphoma cells. Previously, it was observed that this influx was accompanied by a temporary increase in propidium iodide permeability that appeared linked to calcium entry. Those studies demonstrated that cobalt or nickel could block the response to lysophosphatidylcholine and raised the question of whether the calcium conductance involved specific channels. This communication describes a series of experiments to address that issue. The time dependence and structural specificity of the responses to lysophosphatidylcholine reinforced the hypothesis of a specific channel or transporter. Nevertheless, observations using patch clamp or calcium channel blockers suggested that this "channel" does not involve proteins. Alternative protein-mediated mechanisms such as indirect involvement of the sodium-calcium exchanger and the sodium-potassium ATPase were also excluded. Experiments with extracellular and intracellular calcium chelators suggested a common route of entry for calcium and propidium iodide. More directly, the ability of lysophosphatidylcholine to produce cobalt-sensitive permeability to propidium iodide was reproduced in protein-free artificial membranes. Finally, the transient nature of the calcium time course was rationalized quantitatively by the kinetics of lysophosphatidylcholine metabolism. These results suggest that physiological concentrations of lysophosphatidylcholine can directly produce membrane pores that mimic some of the properties of specific protein channels.
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Abstract
OBJECTIVE To investigate the effect of viral inoculation by adenovirus 5 (Ad5) on body composition in a mouse model. DESIGN Longitudinal monitoring before and after a single injection of virus or saline. SUBJECTS Two groups of CD1 mice, one group given a single intraperitoneal dose of Ad5 and the control group, saline. MEASUREMENTS Bodyweights and food intake were recorded before and up to 21 weeks after inoculation. At the end of the study, whole-body 1H magnetic resonance spectroscopy (MRS) and localised in vivo 1H MRS spectroscopy of the liver was performed to assess whole-body adiposity and intrahepatic lipid content, respectively. RESULTS Ad5-treated animals gained significantly more weight over a period of 21 weeks after inoculation than the controls, 21.8 g (18.8-25.0) and 18.8 g (17.3-19.8) respectively, (P<0.05). The gain in bodyweight in the former animals arises from increased deposition of adipose tissue as measured by whole-body 1H MRS. Adiposity was 6.7% (3.10-11.20%), and 2.40% (0.85-5.65%) for the Ad5-treated and control animals, respectively (P<0.05). No significant difference in intrahepatic lipid content or food intake was observed between the two groups. CONCLUSION The significantly higher percentage of adipose tissue in the Ad5-treated mice suggest viral infection may play a contributory role to a predisposition to obesity, although its contribution relative to other factors remains to be determined.
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Affiliation(s)
- P-W So
- Molecular Imaging Group, Imaging Sciences Department, Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK.
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Chung YL, Rider LG, Bell JD, Summers RM, Zemel LS, Rennebohm RM, Passo MH, Hicks J, Miller FW, Scott DL. Muscle metabolites, detected in urine by proton spectroscopy, correlate with disease damage in juvenile idiopathic inflammatory myopathies. ACTA ACUST UNITED AC 2005; 53:565-70. [PMID: 16082628 DOI: 10.1002/art.21331] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess for novel markers of muscle damage using urinary muscle metabolites by 1H magnetic resonance spectroscopy in patients with juvenile idiopathic inflammatory myopathy (IIM). METHODS Creatine (Cr), choline (Cho), betaine (Bet), glycine (Gly), trimethylamine oxide (TMAO), and several other metabolites were measured in first morning void urine samples from 45 patients with juvenile IIM and from 35 healthy age-matched controls, and correlated with measures of myositis disease activity and damage. Urinary metabolite to age-adjusted creatinine (Cn) ratios were examined. RESULTS Age-adjusted initial Cr:Cn, Cho:Cn, Bet:Cn, Gly:Cn, and TMAO:Cn ratios were higher in patients with juvenile IIM than controls (P < 0.01). Cr:Cn ratios showed significant correlations with physician-assessed global disease damage (Spearman rs = 0.37; P = 0.01), Steinbrocker functional class (rs = 0.35; P = 0.02), serum Cr (rs = 0.72; P = 0.001), and lactate dehydrogenase (rs = 0.34; P = 0.03) levels. Cho:Cn (rs = 0.3; P = 0.05), Gly:Cn (rs = 0.33; P = 0.03), and TMAO:Cn (rs = 0.36; P = 0.02) ratios showed a significant correlation with serum aldolase levels. Cho:Cn ratios also showed a significant correlation with aspartate aminotransferase levels (rs = 0.35; P = 0.02). A linear regression model was used to evaluate the factors influencing urinary Cr:Cn ratios in the 43 patients with data sets available at the initial visit. The regression model explained 73% of the variation in Cr:Cn ratios. The most significant factor was the physician-assessed global disease damage (R2 = 0.50, P = 0.015). CONCLUSION Urinary Cr:Cn, Cho:Cn, Bet:Cn, Gly:Cn, and TMAO:Cn ratios are elevated in juvenile IIM and Cr:Cn correlates strongly with global disease damage. The Cr:Cn ratio may have potential utility as a marker of myositis disease damage.
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Affiliation(s)
- Y-L Chung
- GKT School of Medicine, Imperial College School of Medicine, Hammersmith Hospital Campus, London, United Kingdom.
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Thomas EL, Hamilton G, Patel N, O'Dwyer R, Doré CJ, Goldin RD, Bell JD, Taylor-Robinson SD. Hepatic triglyceride content and its relation to body adiposity: a magnetic resonance imaging and proton magnetic resonance spectroscopy study. Gut 2005; 54:122-7. [PMID: 15591516 PMCID: PMC1774370 DOI: 10.1136/gut.2003.036566] [Citation(s) in RCA: 245] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Hepatic steatosis is associated with obesity and type II diabetes. Proton magnetic resonance spectroscopy (1H MRS) is a non-invasive method for measurement of tissue fat content, including intrahepatocellular lipids (IHCL) and intramyocellular lipids (IMCL). PATIENTS AND METHODS We used 1H MRS and whole body magnetic resonance imaging (MRI) to assess the relationship between IHCL accumulation, total body adipose tissue (AT) content/distribution, and IMCL content in 11 subjects with biopsy proven hepatic steatosis and 23 normal volunteers. RESULTS IHCL signals were detectable in all subjects but were significantly greater in hepatic steatosis (geometric mean (GM) 11.5 (interquartile range (IQR) 7.0-39.0)) than in normal volunteers (GM 2.7 (IQR 0.7-9.3); p=0.02). In the study group as a whole, IHCL levels were significantly greater in overweight compared with lean subjects (body mass index (BMI) >25 kg/m2 (n=23): GM 7.7 (IQR 4.0-28.6) v BMI <25 kg/m2 (n=11): GM 1.3 (IQR 0.3-3.6; p=0.004)). There was a significant association between IHCL content and indices of overall obesity (expressed as a percentage of body weight) for total body fat (p=0.001), total subcutaneous AT (p=0.007), and central obesity (subcutaneous abdominal AT (p=0.001) and intra-abdominal AT (p=0.001)), after allowing for sex and age. No correlation between IHCL content and IMCL was observed. A significant correlation was observed between serum alanine aminotransferase and liver fat content (r=0.57, p=0.006). CONCLUSIONS Our results suggest that hepatic steatosis appears to be closely related to body adiposity, especially central obesity. MRS may be a useful method for monitoring IHCL in future interventional studies.
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Affiliation(s)
- E L Thomas
- Robert Steiner MR Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Du Cane Rd, London W12 0HS, UK
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Abstract
OBJECTIVE To test the hypothesis that dietary factors in the vegan diet lead to improved insulin sensitivity and lower intramyocellular lipid (IMCL) storage. DESIGN Case-control study. SETTING Imperial College School of Medicine, Hammersmith Hospital Campus, London, UK. SUBJECTS A total of 24 vegans and 25 omnivores participated in this study; three vegan subjects could not be matched therefore the matched results are shown for 21 vegans and 25 omnivores. The subjects were matched for gender, age and body mass index (BMI). INTERVENTIONS Full anthropometry, 7-day dietary assessment and physical activity levels were obtained. Insulin sensitivity (%S) and beta-cell function (%B) were determined using the homeostatic model assessment (HOMA). IMCL levels were determined using in vivo proton magnetic resonance spectroscopy; total body fat content was assessed by bioelectrical impedance. RESULTS There was no difference between the groups in sex, age, BMI, waist measurement, percentage body fat, activity levels and energy intake. Vegans had a significantly lower systolic blood pressure (-11.0 mmHg, CI -20.6 to -1.3, P=0.027) and higher dietary intake of carbohydrate (10.7%, CI 6.8-14.5, P<0.001), nonstarch polysaccharides (20.7 g, CI 15.8-25.6, P<0.001) and polyunsaturated fat (2.8%, CI 1.0-4.6, P=0.003), with a significantly lower glycaemic index (-3.7, CI -6.7 to -0.7, P=0.01). Also, vegans had lower fasting plasma triacylglycerol (-0.7 mmol/l, CI -0.9 to -0.4, P<0.001) and glucose (-0.4 mmol/l, CI -0.7 to -0.09, P=0.05) concentrations. There was no significant difference in HOMA %S but there was with HOMA %B (32.1%, CI 10.3-53.9, P=0.005), while IMCL levels were significantly lower in the soleus muscle (-9.7, CI -16.2 to -3.3, P=0.01). CONCLUSION Vegans have a food intake and a biochemical profile that will be expected to be cardioprotective, with lower IMCL accumulation and beta-cell protective.
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Affiliation(s)
- L M Goff
- Nutrition and Dietetic Research Group, Metabolic Medicine, Investigative Science, Faculty of Medicine, Imperial College Hammersmith Hospital Campus, London, UK
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Robson MD, Gatehouse PD, So PW, Bell JD, Bydder GM. Contrast enhancement of short T2 tissues using ultrashort TE (UTE) pulse sequences. Clin Radiol 2004; 59:720-6. [PMID: 15262547 DOI: 10.1016/j.crad.2003.09.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2003] [Revised: 10/21/2003] [Accepted: 11/14/2003] [Indexed: 11/23/2022]
Abstract
AIM To review the effects of contrast administration on tissues with short T2s using a pulse ultrashort echo time (UTE) sequence. MATERIALS AND METHODS Pulse sequences were implemented with echo times of 0.08 ms and three later gradient echoes. A fat-suppression option was used and later echo images were subtracted from the first echo image. Contrast enhancement with gadodiamide (0.3 mmol/kg) was used for serial studies in a volunteer. The images of 10 patients were reviewed for evidence of contrast enhancement in short T2 tissues. RESULTS Contrast enhancement was seen in normal meninges, falx, tendons, ligaments, menisci, periosteum and cortical bone. In addition more extensive enhancement than with conventional pulse sequences was seen in meningeal disease, intervertebral disc disease, periligamentous scar tissue and periosteum after fracture. Subtraction of an image taken with a longer TE from the first image was of value in differentiating enhancement in short T2 tissues from that in long T2 tissues or blood. CONCLUSION Contrast enhancement can be identified in tissues with short T2s using UTE pulse sequences in health and disease.
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Affiliation(s)
- M D Robson
- The Cardiovascular Magnetic Resonance Unit, John Radcliffe Hospital, Oxford, UK
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