Estrogen receptor 1 gene (TA)n polymorphism is associated with lone atrial fibrillation in men.

AIM: To determine the association between the number of thymine-adenine (TA)n dinucleotide repeats in the promoter region of the gene coding for the estrogen receptor alpha (ESR1) and the prevalence of lone atrial fibrillation (AF) in men. METHODS: We conducted a case-control study involving 89 men with lone AF and 166 healthy male controls. The ESR1 genotype was established by polymerase chain reaction and capillary electrophoresis. To assess the association of ESR1 genotype with AF, logistic regression models were built with AF as outcome. RESULTS: Men with lone AF had significantly greater number of (TA)n repeats of single alleles than controls (mean ± standard deviation, 19.2 ± 4.2 vs 18 ± 4.3, P = 0.010). After adjustment for other factors, a unit-increase in (TA)n repeat number was associated with a significantly greater likelihood of AF (odds ratio 1.069; 95% confidence interval 1.024-1.116, P=0.002). CONCLUSIONS: Our results indicate that a greater number of (TA)n repeats in the promoter region of ESR1 is associated with a significantly increased likelihood of lone atrial fibrillation in men.

Interactions of MinK and e-NOS gene polymorphisms appear to be inconsistent predictors of atrial fibrillation propensity, but long alleles of ESR1 promoter TA repeat may be a promising marker.

Interactions of MinK and e-NOS Gene Polymorphisms Appear to Be Inconsistent Predictors of Atrial Fibrillation Propensity, but Long Alleles of ESR1 Promoter TA Repeat May Be a Promising Marker. We analyzed minK, e-NOS and ESR1 gene polymorphisms in 40 patients with atrial fibrillation (AF) without major structural heart disease compared to 35 healthy controls. A missense polymorphism in the minK gene with A/G substitution at nucleotide 112 causing serine (S) to glycine (G) change, 786 T/C polymorphism in the 5' flanking region of e-NOS gene and TA polymorphism in the regulatory region of estrogen receptor ESR1 gene with long (> or = 19 TA repeats) and short alleles were examined. Only a slight increase in minK G allele frequency, but with marked excess in AG/TT combination of minK and e-NOS polymorphisms was found in the AF group. The interpretation remains tentative due to small groups precluding statistical significance of differences, possible lab flaws and inconsistencies with earlier data. However, ESR1 long allele homozygotes were strikingly more frequent in the AF than in control group, reaching statistical significance surprisingly in males (p < 0.02). Functional activity of estrogen receptors may be more critical in males than in females with abundance of circulating estrogen. Contrasting the intricate complexity of genetic polymorphisms influencing cardiac rhythm with our modest research, we would limit the conclusion to the plea for further research of ESR1 role in AF.

What do grades in clinical subjects depend on? Case study of the Zagreb University School of Medicine.

AIM: To investigate the influence of clinical site, student's and preceptor's sex, and preceptor's academic rank on grading in eight clinical subjects at the Zagreb University School of Medicine between 1999 and 2002. METHODS: We analyzed oral exam grades from five fourth-year clinical courses (radiology, oncology, nuclear medicine, internal medicine, and psychiatry) and three fifth-year clinical courses (surgery; ear, nose and throat diseases (ENT); and pediatrics). Internal medicine course also had a written test, common for all students. We recorded the clinical site where the exams were taken, clinical subjects, grades, number of attempts at passing the exams, student and preceptor gender, and preceptor academic rank. Chi-square test was used for data analysis. RESULTS: Grades from all clinical subjects but internal medicine course significantly differed, depending on clinical site where the exam was taken. There was a significant difference in grades from the internal medicine written exam among teaching sites. Preceptors with higher academic ranks awarded better grades. Male and female students performed equally well. Female preceptors gave significantly lower grades, regardless of the student gender and created a higher failure rate. CONCLUSION: Oral exams are a subjective method of evaluating students' knowledge of clinical subjects and depend on the site of teaching and examination. Written exams and structured clinical skills examinations should be implemented for objective student assessment.