Maternal plasma cortisol's effect on offspring birth weight: a Mendelian Randomisation study.

BACKGROUND: Observational studies and randomized controlled trials have found evidence that higher maternal circulating cortisol levels in pregnancy are associated with lower offspring birth weight. However, it is possible that the observational associations are due to residual confounding. METHODS: We performed two-sample Mendelian Randomisation (MR) using a single genetic variant (rs9989237) associated with morning plasma cortisol (GWAS; sample 1; N = 25,314). The association between this maternal genetic variant and offspring birth weight, adjusted for fetal genotype, was obtained from the published EGG Consortium and UK Biobank meta-analysis (GWAS; sample 2; N = up to 406,063) and a Wald ratio was used to estimate the causal effect. We also performed an alternative analysis using all GWAS reported cortisol variants that takes account of linkage disequilibrium. We also tested the genetic variant's effect on pregnancy cortisol and performed PheWas to search for potential pleiotropic effects. RESULTS: The estimated effect of maternal circulating cortisol on birth weight was a 50 gram (95% CI, -109 to 10) lower birth weight per 1 SD higher log-transformed maternal circulating cortisol levels, using a single variant. The alternative analysis gave similar results (-33 grams (95% CI, -77 to 11)). The effect of the cortisol variant on pregnancy cortisol was 2-fold weaker than in the original GWAS, and evidence was found of pleiotropy. CONCLUSIONS: Our findings provide some evidence that higher maternal morning plasma cortisol causes lower birth weight. Identification of more independent genetic instruments for morning plasma cortisol are necessary to explore the potential bias identified.

Maternal and fetal genetic contribution to gestational weight gain.

BACKGROUND: Clinical recommendations to limit gestational weight gain (GWG) imply high GWG is causally related to adverse outcomes in mother or offspring, but GWG is the sum of several inter-related complex phenotypes (maternal fat deposition and vascular expansion, placenta, amniotic fluid and fetal growth). Understanding the genetic contribution to GWG could help clarify the potential effect of its different components on maternal and offspring health. Here we explore the genetic contribution to total, early and late GWG. PARTICIPANTS AND METHODS: A genome-wide association study was used to identify maternal and fetal variants contributing to GWG in up to 10 543 mothers and 16 317 offspring of European origin, with replication in 10 660 mothers and 7561 offspring. Additional analyses determined the proportion of variability in GWG from maternal and fetal common genetic variants and the overlap of established genome-wide significant variants for phenotypes relevant to GWG (for example, maternal body mass index (BMI) and glucose, birth weight). RESULTS: Approximately 20% of the variability in GWG was tagged by common maternal genetic variants, and the fetal genome made a surprisingly minor contribution to explain variation in GWG. Variants near the pregnancy-specific beta-1 glycoprotein 5 (PSG5) gene reached genome-wide significance (P=1.71 × 10-8) for total GWG in the offspring genome, but did not replicate. Some established variants associated with increased BMI, fasting glucose and type 2 diabetes were associated with lower early, and higher later GWG. Maternal variants related to higher systolic blood pressure were related to lower late GWG. Established maternal and fetal birth weight variants were largely unrelated to GWG. CONCLUSIONS: We found a modest contribution of maternal common variants to GWG and some overlap of maternal BMI, glucose and type 2 diabetes variants with GWG. These findings suggest that associations between GWG and later offspring/maternal outcomes may be due to the relationship of maternal BMI and diabetes with GWG.

[Comparison of two surgical techniques for the treatment of superior oblique palsy]. / Comparaison de deux techniques chirurgicales dans le traitement de la paralysie du muscle oblique supérieur.

AIM: To compare two surgical techniques for the treatment of superior oblique palsy. PATIENTS AND METHODS: Retrospective study involving 32 patients operated on at the Rouen Teaching Hospital for superior oblique palsy. Group 1 patients were treated by surgical reinforcement of the superior oblique muscle and group 2 patients were treated by surgical loosening (or weakening) of the antagonist muscles. One-year follow-up explored head tilt, diplopia, vertical deviation and cyclotorsion. RESULTS: Functional results (presence of diplopia or stiff neck) were positive in both groups but better in group 1. Only 12.5% of patients required a second operation. Cyclotorsion amounted to less than 2% in group 1 and was still greater than 8% in group 2; on the other hand, vertical deviation had improved more in group 2, where it decreased to 2.1 diopters versus 3.1 in group 1. DISCUSSION: and conclusion: Only reinforcing the superior oblique adequately corrects cyclotorsion, which is the main cause of asthenopia and diplopia, despite an often insufficient height correction that is otherwise clinically well tolerated. We suggest reinforcing the superior oblique as a first intent rather than weakening hyperactive muscles, and in case of excessive postoperative height, we would carry out additional treatment of one of the hyperactive muscles later.

TGFbeta-mediated activation of Smad1 in B-cell non-Hodgkin's lymphoma and effect on cell proliferation.

We have previously reported an overexpression of Smad1 in follicular lymphoma (FL) cells, which are characterized by the t(14;18) bcl2/IgH translocation. Smad1 is commonly involved in bone morphogenetic protein but not in tumor-transforming growth factor beta (TGFbeta) signaling pathways. This study focuses on Smad1 signaling pathway in non-Hodgkin lymphoma cells including follicular or large-cell lymphoma cells. Our results support the notion that phosphorylation of Smad1 is mediated by TGFbeta present in the microenvironment and occurs in FL in vivo. Using an in vitro coculture system mimicking interactions between stroma cells and FL cells, we found that both the cell partners release TGFbeta at a sufficient concentration to activate Smad pathways in the malignant cells. This Smad1 activation involves TGFbetaRII but not ALK-1 receptors, and does not compete with the Smad2 pathway. Moreover, proliferation assays performed on lymphoma cells expressing wild-type or mutated Smad1, or in which endogenous Smad1 level was decreased by gene silencing, strongly supported that overexpression and activation of Smad1 modifies the biological response of lymphoma B cells to TGFbeta family members. This work opens new insights into aberrant Smad pathways and their pathophysiological role in FL and in other non-Hodgkin lymphomas.

[Morphology and characteristics of the cingulum of the permanent maxillary central incisors]. / Morphologie et particularités du cingulum des incisives centrales maxillaires permanentes.

This study constitutes a synthesis of the main cingular morphologies of the permanent maxillary central incisors. The descriptions concern the teeth of one or other of the left or right hemi-dental arches. In complement was realised a statistical study on a sample of 102 people, between 16 and 38 years old, men and women belonging to diverse ethnic groups. The results are interesting, as indicative, of the proportions of the different cingular morphologies inside the diverse ethnic groups (west Europeans, Melano-africans, Maugrabins).

'Is anybody listening?' The experiences of widowhood for older Australian women.

This paper discusses preliminary findings from participants in the baseline survey of the Australian Longitudinal Study on Women's Health (Women's Health Australia: WHA) who reported their marital status as widowed. A total of 12,624 women, aged 70-75 years, completed a self-administered 260-item questionnaire, and 4335 of these women were widowed. Many of these women provided additional qualitative comments about their health, social and financial circumstances after the death of their spouse. This paper presents a thematic analysis of the qualitative comments and builds on the findings of the quantitative analysis of baseline data. The aims of this part of the study are to examine the short- and long-term effects of widowhood on the health and wellbeing of older women and to explore the process of change they experience after the death of a spouse. Preliminary findings suggest that, as a key life event, widowhood has an initial negative impact on the health and wellbeing of older women, but in the long term it may be accompanied by a positive shift into a new life phase.

Social awareness of air quality information.

In the UK, air quality information is made available through a range of media. However, limited attention has been paid to ensuring that the information is provided to the public in a format that is understandable and relevant to their needs. This research has begun the task of determining the nature and extent of public air quality requirements by performing a social survey (using a postal questionnaire) to provide a basic snapshot of the public's views and by determining the views of information providers and interested professionals. The paper identifies the main shortcomings in current public air quality information provision. The social survey and workshop results demonstrate that current information provision and dissemination does not match public requirements; the depth and breadth of local information needs to be enhanced. Local authorities need to improve their co-ordination and collaboration, the role of the mass-media needs to be considered carefully, air quality needs to be better described and its implications for individuals spelled out and certain public groups need special consideration. In addition, local authorities need more guidance on communicating air quality, possibly through a best practice guide. Further research is required to identify the best descriptors for air quality, to improve the effectiveness of public advice during episodes of poor air quality and to use public air quality information to effect behavioral changes.

Local air quality management: a practical approach to air quality assessment and emissions audit.

This paper reviews the results of the practical application of national UK tools of air quality management on a local scale, to show their usefulness and application. Such tools include an urban emissions inventory, dispersion modelling and the review and assessment guidance procedures of the National Air Quality Strategy.

Monitoring children's personal exposure to airborne particulate matter in London, UK--method development and study design.

The paper outlines the methodology selected for identifying the personal exposure of children to airborne particulate matter in a UK urban environment.

Patient preference for waxed or unwaxed dental floss.

The purpose of this study was to discover patient preference for waxed or unwaxed dental floss, and to learn more about individual flossing habits. One hundred patients randomly presenting for routine dental examinations volunteered to sample a brand of similar-appearing waxed and unwaxed dental floss. After flossing an anterior and a posterior contact area with both types, the patients indicated whether they preferred the waxed or unwaxed floss. The patients also answered questions concerning their flossing habits. Waxed floss was found to be preferred after sampling by 79% and unwaxed by 21%. An additional 50 patients sampled a different brand of waxed and unwaxed floss in a similar manner. In this group 78% preferred the waxed and 22% the unwaxed type. A final group of 50 patients compared mint flavored waxed floss with plain waxed floss of the same brand. In this group 56% preferred the mint flavored waxed floss, 24% the plain waxed floss, and 20% had no preference. A combined total of only 29.5% of the patients claimed to floss daily, 53.5% floss irregularly but at least once a week, while 17% do not floss even once a week. Waxed floss was purchased for home use by a combined patient total of 57.5%, unwaxed by 32%, and neither type by 10.5%. An unsubstantiated belief in the superiority of unwaxed floss has persisted to the present time.(ABSTRACT TRUNCATED AT 250 WORDS)

Retrieval of a swallowed casting 6 weeks after ingestion. A case report.

An inadequately retained gold multiple-unit fixed prosthesis was accidently swallowed, ingested into the gastrointestinal tract, and recovered naturally after a delay of 6 weeks. Correct procedures were followed and documented by the providers involved, allowing for a successful conservative resolution of the mishap.

Relative resistance of long junctional epithelial adhesions and connective tissue attachments to plaque-induced inflammation.

This study compared the resistance to periodontal disease of the long junctional epithelial adhesion and the naturally occurring dentogingival junction. Two groups were used, each containing three young male beagle dogs with all permanent teeth erupted. Periodontitis was induced around maxillary and mandibular premolars in the experimental dogs over a 42-day period, using subgingival ligatures and a soft diet. Fourteen days after ligature removal, flaps were reflected, granulation tissue was removed and the roots were planed to the alveolar crest. Reference grooves were placed in the root surfaces at the level of the alveolar bone, the flaps were positioned over the alveolar crests, and sutures were placed. A 60-day period permitted healing with formation of long junctional epithelial adhesions. During this 116-day period control dogs were maintained in gingival health by daily brushing and by prophylaxis every 14 days. Both groups had a high level of health (GI scores of 0) at the beginning of the 20-day combined disease phase. Inflammation was induced in both groups by subgingival ligature placement and a plaque-promoting diet. Right and left sides of both groups represented separate time intervals within the 20-day period. Block sections were secured at time of killing and the tissues were prepared for light and fluorescent microscopic evaluation. Mean GI scores and mean probing depths increased similarly in both groups. Tagge index scores of gingival inflammation were higher at the longer time periods in the experimental animals. However, they displayed an intact long junctional epithelial adhesion throughout the study, while control animals frequently showed ulceration of the sulcular epithelium. Neither group showed significant changes in location of the apical cells of the attachment epithelium. Crestal osteoblastic activity, confirmed with Procion labeling, predominated in the experimental animals, while osteoclastic activity predominated in the control. Under the conditions of this study, there appeared to be no appreciable difference in resistance to disease between a long junctional epithelial adhesion and a true connective tissue attachment.