The dynamic transcriptomic response of the goldfish brain under chronic hypoxia.

Oxygen is essential to fuel aerobic metabolism. Some species evolved mechanisms to tolerate periods of severe hypoxia and even anoxia in their environment. Among them, goldfish (Carassius auratus) are unique, in that they do not enter a comatose state under severely hypoxic conditions. There is thus significant interest in the field of comparative physiology to uncover the mechanistic basis underlying hypoxia tolerance in goldfish, with a particular focus on the brain. Taking advantage of the recently published and annotated goldfish genome, we profile the transcriptomic response of the goldfish brain under normoxic (21 kPa oxygen saturation) and, following gradual reduction, constant hypoxic conditions after 1 and 4 weeks (2.1 kPa oxygen saturation). In addition to analyzing differentially expressed protein-coding genes and enriched pathways, we also profile differentially expressed microRNAs (miRs). Using in silico approaches, we identify possible miR-mRNA relationships. Differentially expressed transcripts compared to normoxia were either common to both timepoints of hypoxia exposure (n = 174 mRNAs; n = 6 miRs), or exclusive to 1-week (n = 441 mRNAs; n = 23 miRs) or 4-week hypoxia exposure (n = 491 mRNAs; n = 34 miRs). Under chronic hypoxia, an increasing number of transcripts, including those of paralogous genes, was downregulated over time, suggesting a decrease in transcription. GO-terms related to the vascular system, oxidative stress, stress signalling, oxidoreductase activity, nucleotide- and intermediary metabolism, and mRNA posttranscriptional regulation were found to be enriched under chronic hypoxia. Known 'hypoxamiRs', such as miR-210-3p/5p, and miRs such as miR-29b-3p likely contribute to posttranscriptional regulation of these pathways under chronic hypoxia in the goldfish brain.

The efficacy of aerobic training on the pulmonary functions of hemophilic A patients: a randomized controlled trial.

OBJECTIVE: The present study investigated the efficacy of a program of aerobic exercise on pulmonary functions in adult males with hemophilia A (HA). PATIENTS AND METHODS: 40 patients with HA who met the eligibility criteria (40 HA; age range: 20-39 years) were invited to participate in the study. The patients were divided into two groups, 20 per each. Participants in the study group (A) underwent selected physical therapy program, along with aerobic training sessions on a cycle ergometer (50-60% heart rate reserve, moderate intensity), while the control group (B) underwent a selected physical therapy program only. The pulmonary functions (FVC, FEV1, FEV1/FVC, PEF, PIF, and MVV) were measured before and after treatment program. RESULTS: There were noteworthy statistical differences between pre- and post-measurements in the study group in all measured variables (p < 0.05). There were also significant statistical differences between the study and control groups in all measured variables post treatment (p < 0.05). CONCLUSIONS: This study has demonstrated that hemophilic A patients' pulmonary functions have improved significantly following aerobic exercise training. As a result, aerobic exercise can be used in addition to medical treatment for hemophilic A patients.

Contractile function of the excised hagfish heart during anoxia exposure.

Pacific hagfish, Eptatretus stoutii, can recover from 36 h of anoxia and their systemic hearts continue to work throughout the exposure. Recent work demonstrates that glycogen stores are utilized in the E. stoutii heart during anoxia but that these are not sufficient to support the measured rate of ATP production. One metabolic fuel that could supplement glycogen during anoxia is glycerol. This substrate can be derived from lipid stores, stored in the heart, or delivered via the blood. The purpose of this study was to determine the effect of glycerol on the contractile function of the excised E. stoutii heart during anoxia exposure. When excised hearts, perfused with metabolite free saline (mf-saline), were exposed to anoxia for 12 h, there was no difference in heart rate, pressure generation (max-dP), rate of contraction (max-dP/dtsys), or rate of relaxation (max-dP/dtdia) compared to hearts perfused with mf-saline in normoxia. However, hearts perfused with saline containing glycerol (gly-saline) in anoxia had higher max-dP, max-dP/dtsys, and max-dP/dtdia than hearts perfused with mf-saline in anoxia. Tissue levels of glycerol increased when hearts were perfused with gly-saline in normoxia, but not when perfused with gly-saline in anoxia. Anoxia exposure did not affect the activities of triglyceride lipase, glycerol kinase, or glycerol-3-phosphate dehydrogenase. This study suggests that glycerol stimulates cardiac function in the hagfish but that it is not derived from stored lipids. How glycerol may stimulate contraction is not known. This could be as an energy substrate, as an allosteric factor, or a combination of the two.

Assessment of health literacy among outpatient clinics attendees at Ain Shams University Hospitals, Egypt: a cross-sectional study.

OBJECTIVES: The aim of conducting this study is to measure health literacy (HL) and to investigate the factors associated with inadequate HL in a sample of outpatient clinics attendees (i.e. patients and companions) at Ain Shams University (ASU) Hospitals. STUDY DESIGN: It is a cross-sectional study. METHODS: The study was conducted on 805 attendees of the outpatient clinics at El-Demerdash University Hospital of ASU Hospitals. The Arabic versions of the Swedish Functional Health Literacy Scale and the European Health Literacy Survey Questionnaire-short version-were used to assess HL. The level of HL and factors influencing it were analyzed using correlation and binary logistic regression tests. RESULTS: It was found that 81% of the participants had limited comprehensive health literacy (CHL; 34.3% inadequate and 46.7% problematic), while only 18.9% had sufficient CHL. Regarding functional health literacy (FHL), it was found that 84% had limited FHL (50.6% inadequate and 33.4% problematic), while only 16.1% had sufficient FHL. Females were more likely to have inadequate FHL. On the other hand, males, individuals with low educational levels, and attendees identified as patients as well as participants with inadequate FHL were more likely to have inadequate CHL. CONCLUSION: The majority of our study population has limited HL. Extensive research is warranted to explore the extent of the problem on multi-institutional and national levels and to investigate more explanatory factors.

Epidemiology and medical cost of hospitalization due to rotavirus gastroenteritis among children under 5 years of age in the central-east of Tunisia.

Data on the economic burden of rotavirus infection in Tunisia are needed to inform the decision to include rotavirus in routine childhood immunizations. This study aimed to describe the epidemiological profile of rotavirus disease in central-east Tunisia and to estimate its hospital cost. In the first stage - the prospective collection of epidemiological data - we enrolled all patients < 5 years old who were hospitalized for acute diarrhoea at 5 university paediatric departments in central-east Tunisia during the period 2009-2011. Rotavirus was responsible for 65 (23.3%) of the 279 cases enrolled. In the second stage, cost data were collected retrospectively using an activity-based costing method from the medical records of the children who were positively diagnosed with rotavirus. The average cost of care per child was TD 433 (SD 134). This is a significant economic burden in Tunisia, where a safe and effective vaccine is available but not yet introduced to the immunization schedule.

Epidemiology and medical cost of hospitalization due to rotavirus gastroenteritis among children under 5 years of age in the central-east of Tunisia

Data on the economic burden of rotavirus infection in Tunisia are needed to inform the decision to include rotavirus in routine childhood immunizations. This study aimed to describe the epidemiological profile of rotavirus disease in central-east Tunisia and to estimate its hospital cost.In the first stage - the prospective collection of epidemiological data - we enrolled all patients < 5 years old who were hospitalized for acute diarrhoea at 5 university paediatric departments in central-east Tunisia during the period 2009-2011. Rotavirus was responsible for 65 [23.3%] of the 279 cases enrolled. In the second stage, cost data were collected retrospectively using an activity-based costing method from the medical records of the children who were positively diagnosed with rotavirus. The average cost of care per child was TD 433 [SD 134]. This is a significant economic burden in Tunisia, where a safe and effective vaccine is available but not yet introduced to the immunization schedule

Des données sur le fardeau économique de l'infection à rotavirus en Tunisie sont nécessaires pour décider ou non d'inclure le rotavirus dans les vaccinations infantiles systématiques. La présente étude visait à décrire le profil épidémiologique de l'infection à rotavirus dans le centre-est de la Tunisie et l'estimation de son coût hospitalier. Lors de la première phase, à savoir le recueil prospectif de données épidémiologiques, nous avons recruté tous les patients de moins de cinq ans ayant été hospitalisés pour une diarrhée aiguë dans cinq services pédiatriques universitaires du centre-est de la Tunisie entre 2009 et 2011. Le rotavirus était responsable de 65 cas sur 279 recrutés [23,3 %]. Lors de la deuxième phase, des données sur les coûts ont été recueillies rétrospectivement à partir des dossiers médicaux des enfants qui étaient positifs au rotavirus, en utilisant une méthodologie de gestion des coûts par activité.Le coût moyen des soins par enfant était de 433 dinars tunisiens [ET 134]. Ce montant représente un fardeau économique important en Tunisie, où un vaccin sûr et efficace existe mais n'est pas encore intégré dans le programme de vaccination

Neuromyelitis optica in a patient with pemphigus foliaceus.

Neuromyelitis optica (NMO, also eponymously known as Devic's disease) is an immune-mediated demyelinating disease of the central nervous system that can lead to significant disability. Pediatric NMO is a rare disorder often reported after an infection. The authors report a 16 year-old female patient with pemphigus foliaceus who developed subacute optic neuritis followed by cervical transverse myelitis. Restricted distribution of the lesions in the optic nerve and spinal cord was confirmed by ophthalmological evaluation and magnetic resonance imaging of the brain and spinal cord. She was started on intravenous methylprednisolone and then given a maintenance oral prednisone. Subsequently, she was treated with a nonsteroidal immunosuppressant, mycophenolate mofetil, with a target dose of 1000 mg twice a day. Over the course of months, patient noted significant recovery of previous deficits and resolution of the cervical cord enhancement, expansion and cystic dilatation that was previously seen. This case is noteworthy for being the first patient reported with neuromyelitis optica associated with pemphigus foliaceus.