Does the low FODMAP diet improve symptoms of radiation-induced enteropathy? A pilot study.

RATIONALE: Patients with radiation-induced enteropathy (RE) after cancer treatment show similar symptoms as patients with irritable bowel syndrome (IBS). The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet (LFD) is a widespread management strategy for IBS. We aimed to investigate if there may be a positive effect of LFD on symptoms and health-related quality of life (HRQOL) in patients with RE. METHODS: In an open non-controlled pilot study, 11 patients (all female) with RE-related IBS symptoms were recruited largely based on own initiative. All followed LFD for four weeks. IBS Severity Scoring System (IBS-SSS) and IBS Symptom Questionnaire (IBS-SQ) were used to assess symptoms. Short Form Nepean Dyspepsia Index (SF-NDI) and 12-item Short Form Health Survey (SF-12) evaluated HRQOL. A three day food record was used to estimate baseline intake of FODMAPs and to reveal dietary changes. RESULTS: FODMAP intake was successfully reduced, although LFD was found a burdensome intervention. IBS symptoms improved significantly based on mean total score of IBS-SSS and IBS-SQ, which changed from 310.2 ± 60.7 to 171.4 ± 107.2 (p = .001) and 27.4 ± 4.1 to 15.7 ± 10.1 (p = .002). HRQOL improved based on SF-NDI total score (30.5 ± 9.4 to 18.3 ± 8.2, p = .001) and based on mental (p = .047) and physical (p = .134) score of SF-12. Main additional dietary changes were reduced intake of energy, carbohydrates, and fiber. CONCLUSION: Our findings from this small-scaled pilot study indicate that the LFD may alleviate symptoms and improve HRQOL in patients with RE. Further controlled studies with larger sample size should be conducted to verify our results and hopefully enable implementation of LFD as a future part of the management strategy for RE.

Differential expression of a virulence factor in pathogenic and non-pathogenic mycobacteria.

The pathogenicity of mycobacterial infections depends on virulence factors that mediate survival inside host macrophages. These virulence factors are generally believed to be specific for pathogenic species and absent or mutated in non-pathogenic strains. The serine/threonine protein kinase G (PknG) mediates survival of mycobacteria within macrophages by blocking lysosomal delivery. Here we describe a gene of the non-pathogenic species Mycobacterium smegmatis that is 78% identical with pknG of Mycobacterium tuberculosis and M. bovis bacillus Calmette-Guérin (BCG). When cloned into expression vectors, the M. smegmatis pknG orthologue produced an active kinase and performed the same function as its M. bovis BCG counterpart in intracellular survival. In addition, similar levels of pknG transcripts were found in M. bovis BCG and M. smegmatis. However, virtually no translation product of chromosomal pknG could be detected in M. smegmatis both after in vitro growth and after macrophage infection. This lack of efficient translation was shown to be caused by regulatory elements in the upstream region of the M. smegmatis gene. The data reveal dramatically increased translational efficiency of a virulence gene in a pathogenic mycobacterium compared with a non-pathogenic mycobacterium suggesting that changes in expression levels may underlie evolution of pknG and other pathogenicity genes in mycobacterium.

Psychosocial work environment and intention to leave the nursing profession: results from the longitudinal Chinese NEXT study.

AIMS: A shortage of nurses happens not only in developed countries, but also in developing countries, such as in China, but the nurse turnover here makes the situation worse. Why do Chinese nurses want to leave the nursing profession? Our hypothesis is that unfavourable psychosocial work environment could predict nurses' intention to leave (ITL). METHODS: Collaborating with the EU NEXT study (Nurses' Early eXit sTudy), the longitudinal study was conducted in China, and the psychosocial work environment was measured with the Copenhagen Psychosocial Questionnaire (COPSOQ). A total of 3,088 registered female nurses working in hospitals were eligible for the baseline analyses by multivariate logistic regression, and 1,521 for the one-year follow-up analyses by multivariate Poisson regression. RESULTS: A wide range of psychosocial factors at work--in particular, increased emotional demands, decreased meaning of work, decreased commitment to the workplace, and decreased job satisfaction--were associated with ITL in both baseline analyses and prospective analyses after adjusting for numerous confounders. CONCLUSIONS: The findings suggest that unfavourable psychosocial work environment predicts ITL in Chinese nurses. Improvements in the psychosocial work environment may be helpful in retention of the nursing workforce.

Characterization of drug-chitosan interaction by 1H NMR, FTIR and isothermal titration calorimetry.

Electrostatic interaction between opposite charge of drugs (insulin and benzoic acid) and chitosan was studied by 1H NMR, FTIR and isothermal titration calorimetry (ITC). No ionic interaction between the carboxyl group of benzoic acid and the amine group of chitosan could be detected. There was a minor change in the FTIR spectra of insulin-chitosan microparticles made of different concentrations of insulin. Exothermic heat of reaction between insulin and chitosan was obtained by ITC. However, the measured interaction enthalpy change (delta H) was possibly due to the conformational changes and the adsorption phenomena of insulin onto the surfaces of the particles but not to a binding interaction. The binding of tripolyphosphate, a widely used cross-linking agent, to pH 3.3 and pH 5 chitosan was also studied by ITC. The interaction enthalpy change of the binding between tripolyphosphate and chitosan indicated that tripolyphosphate provided a stronger interaction to pH 5 chitosan than to pH 3.3 chitosan. However, it can be stated that the electrostatical interaction forces between the tested molecules insulin, benzoic acid, and tripolyphosphate and chitosan are found to be very weak.

Chitosan drug binding by ionic interaction.

Three model drugs (insulin, diclofenac sodium, and salicylic acid) with different pI or pKa were used to prepare drug-chitosan micro/nanoparticles by ionic interaction. Physicochemical properties and entrapment efficiencies were determined. The amount of drug entrapped in the formulation influences zeta potential and surface charge of the micro/nanoparticles. A high entrapment efficiency of the micro/nanoparticles could be obtained by careful control of formulation pH. The maximum entrapment efficiency did not occur in the highest ionization range of the model drugs. The high burst release of drugs from chitosan micro/nanoparticles was observed regardless of the pH of dissolution media. It can be concluded that the ionic interaction between drug and chitosan is low and too weak to control the drug release.

Association of eukaryotic translation initiation factor eIF2B with fully solubilized CXCR4.

Chemokine receptors are key regulators of leukocyte trafficking but also have an important role in development, tumor growth, and metastasis. Among the chemokine receptors, CXCR4 is the only one that leads to perinatal death when genetically ablated in mice, indicating a more-widespread function in development. To identify pathways that are activated downstream of CXCR4, a solubilization protocol was elaborated, which allows for the isolation of the endogenous receptor from human cells in its near-native conformation. Solubilized CXCR4 is recognized by the conformation-sensitive monoclonal antibody 12G5 and retains the ability to bind CXCL12 in solution, which was abolished in the presence of receptor antagonists. Mass spectrometry of CXCR4 immunoprecipitates revealed a specific interaction with the pentameric eukaryotic translation initiation factor 2B. The observation that the addition of CXCL12 leads to the dissociation of eukaryotic translation initiation factor 2B from CXCR4 suggests that stimulation of the receptor may trigger the local protein synthesis required for efficient cell movement.

Inhaled nitric oxide therapy in adults: European expert recommendations.

BACKGROUND: Inhaled nitric oxide (iNO) has been used for treatment of acute respiratory failure and pulmonary hypertension since 1991 in adult patients in the perioperative setting and in critical care. METHODS: This contribution assesses evidence for the use of iNO in this population as presented to a expert group jointly organised by the European Society of Intensive Care Medicine and the European Association of Cardiothoracic Anaesthesiologists. CONCLUSIONS: Expert recommendations on the use of iNO in adults were agreed on following presentation of the evidence at the expert meeting held in June 2004.

Knowledge retrieval from PubMed abstracts and electronic medical records with the Multiple Sclerosis Ontology.

BACKGROUND: In order to retrieve useful information from scientific literature and electronic medical records (EMR) we developed an ontology specific for Multiple Sclerosis (MS). METHODS: The MS Ontology was created using scientific literature and expert review under the Protégé OWL environment. We developed a dictionary with semantic synonyms and translations to different languages for mining EMR. The MS Ontology was integrated with other ontologies and dictionaries (diseases/comorbidities, gene/protein, pathways, drug) into the text-mining tool SCAIView. We analyzed the EMRs from 624 patients with MS using the MS ontology dictionary in order to identify drug usage and comorbidities in MS. Testing competency questions and functional evaluation using F statistics further validated the usefulness of MS ontology. RESULTS: Validation of the lexicalized ontology by means of named entity recognition-based methods showed an adequate performance (F score = 0.73). The MS Ontology retrieved 80% of the genes associated with MS from scientific abstracts and identified additional pathways targeted by approved disease-modifying drugs (e.g. apoptosis pathways associated with mitoxantrone, rituximab and fingolimod). The analysis of the EMR from patients with MS identified current usage of disease modifying drugs and symptomatic therapy as well as comorbidities, which are in agreement with recent reports. CONCLUSION: The MS Ontology provides a semantic framework that is able to automatically extract information from both scientific literature and EMR from patients with MS, revealing new pathogenesis insights as well as new clinical information.

Analyser-based tomography images of cartilage.

Analyser-based imaging expands the performance of X-ray imaging by utilizing not only the absorption properties of X-rays but also the refraction and scatter rejection (extinction) properties. In this study, analyser-based computed tomography has been implemented on imaging an articular cartilage sample, depicting substructural variations, without overlay, at a pixel resolution of 3.6 microm.