Prevalence and risk factors of peripheral artery disease in a population with chronic kidney disease in Australia: A systematic review and meta-analysis.

There is a lack of clarity and guidance for screening peripheral artery disease (PAD) in persons with chronic kidney disease (CKD) and end stage kidney disease (ESKD) despite this group being at excess risk of cardiovascular disease (CVD). In this current study, we performed a systematic review and meta-analysis to examine the prevalence and risk factors for PAD in persons with CKD in Australian cohorts. We used the inverse variance heterogeneity meta-analysis with double arcsine transformation to summarize the prevalence of PAD (with 95% CIs). Nine studies and 18 reports from the Australia and New Zealand dialysis and transplant registry with 36 cohorts were included in the review. We found a substantially higher PAD prevalence in cohorts based on an ankle-brachial index (ABI) or toe systolic pressure (TBI) than cohorts based on self-reported history. Higher PAD prevalence was observed in ESKD persons than CKD persons without dialysis (PAD diagnosis based on ABI or TBI: 31% in ESKD persons and 23% in CKD persons, PAD diagnosis based on self-reported history: 17% in ESKD persons and 10% in CKD persons). Older age, Caucasian race, cerebrovascular disease and haemodialysis were associated with the presence of PAD in ESKD persons. Our findings indicated a considerable proportion of PAD in CKD and ESKD persons particularly in those with ESKD. To develop and provide an adequate plan to clinically manage CKD patients with PAD, evidence of cost-effectiveness and clinical benefit of early detection of PAD in persons with CKD in Australia is recommended for future studies.

Protective effects of breastfeeding against acute respiratory tract infections and diarrhoea: Findings of a cohort study.

AIM: The objective of this paper is to identify associations between breastfeeding and acute respiratory tract infections (ARTIs) and diarrhoea. METHODS: A cohort of 458 mothers was recruited at the antenatal clinics at Indira Gandhi Memorial and Abdul Rahman Dhon Kaleyfaanu Hospitals. Mothers were interviewed 'face-to-face' at 36 weeks of gestation and at 1, 3 and 6 months after delivery. The questionnaires included demographic information about parents, infant feeding methods and breastfeeding duration. The number of episodes of ARTIs and diarrhoea was also recorded. Ethics approval was obtained from the National Research Committee of the Maldives and Curtin University Human Research Ethics Committee. Descriptive, univariate, logistic and survival analyses were used to assess the effects of breastfeeding on infant ARTIs and diarrhoea. RESULTS: The partial, predominant and exclusive breastfeeding rates at 1 month were 98.9, 67.6 and 26.9%, respectively. The risk of acquiring ARTIs is significantly reduced when the infants were predominantly breastfed for 3 months (adjusted odds ratio (OR): 0.56, 95% of adjusted OR: 0.34-0.94) and 6 months (adjusted OR: 0.45, 95% of adjusted OR: 0.24-0.84). The risk of getting diarrhoea is significantly reduced even when the babies were partially breastfed for 6 months (adjusted OR): 0.31, 95% of adjusted OR: 0.11-0.90). Kaplan Meier curves demonstrated that the risk lowers with longer duration of breastfeeding. CONCLUSION: Breastfeeding need to be promoted because the risk of infant morbidity is negatively associated with the duration of breastfeeding.

Factors Associated With Maternal Depression in the Maldives: A Prospective Cohort Study.

The aim of the study was to document perinatal depression in mothers in the Maldives and associated factors. A cohort of 458 mothers was recruited at the 2 major hospitals in Malé, the Maldives, and followed from 36 weeks of pregnancy to 3 months after birth. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure maternal depression. Maternal sociodemographic factors and infant's health were also recorded. The prevalence of depressive symptoms (EPDS score ≥13) at 36 weeks of pregnancy and at 1 and 3 months postpartum were 24%, 27%, and 12%, respectively. Having experienced stressful life events is an established risk factor for maternal depression across these time points. Having depressive symptoms during the postpartum period is significantly associated with presence of antenatal depressive symptoms. Future studies may look into effectiveness of strategies that cope with stressors in the management of maternal depression.

Interaction of human and bacterial AlkB proteins with DNA as probed through chemical cross-linking studies.

The Escherichia coli AlkB protein was recently found to repair cytotoxic DNA lesions 1-methyladenine and 3-methylcytosine by using a novel iron-catalyzed oxidative demethylation mechanism. Three human homologs, ABH1, ABH2 and ABH3, have been identified, and two of them, ABH2 and ABH3, were shown to have similar repair activities to E.coli AlkB. However, ABH1 did not show any repair activity. It was suggested that ABH3 prefers single-stranded DNA and RNA substrates, whereas AlkB and ABH2 can repair damage in both single- and double-stranded DNA. We employed a chemical cross-linking approach to probe the structure and substrate preferences of AlkB and its three human homologs. The putative active site iron ligands in these proteins were mutated to cysteine residues. These mutant proteins were used to cross-link to different DNA probes bearing thiol-tethered bases. Disulfide-linked protein-DNA complexes can be trapped and analyzed by SDS-PAGE. Our results show that ABH2 and ABH3 have structural and functional similarities to E.coli AlkB. ABH3 shows preference for the single-stranded DNA probe. ABH1 failed to cross-link to the probes tested. This protein, unlike other AlkB proteins, does not seem to interact with DNA in its E.coli expressed form.