The role of brain territorial involvement and infection/inflammation in the long-term outcome of neonates with arterial ischemic stroke: A population-based cohort study

BACKGROUND

Neonatal arterial ischemic stroke (NAIS) carries the risk of significant long-term neurodevelopmental burden on survivors.

AIMS

To assess the long-term neurodevelopmental outcome of term neonates diagnosed with NAIS and investigate the associations among brain territorial involvement on MRI, clinical risk factors and neurodevelopmental outcomes.

STUDY DESIGN

Population-based cohort study.

SUBJECTS

Seventy-nine term neonates with NAIS confirmed by MRI born between 2007 and 2017.

OUTCOME MEASURES

Long-term neurodevelopmental outcome assessed using the Bayley Scales of Infant Development-II, the Brunet-Lézine test and the Binet Intelligence scales-V.

RESULTS

Follow-up was available in 70 (89%) of the subjects enrolled, at a median age of 60 months [IQR: 35-84]. Normal neurodevelopmental outcome was found in 43% of the patients. In a multivariable model, infants with main MCA stroke had an increased risk for overall adverse outcome (OR: 9.1, 95% CI: 1.7-48.0) and a particularly high risk for cerebral palsy (OR: 55.9, 95% CI: 7.8-399.2). The involvement of the corticospinal tract without extensive stroke also increased the risk for cerebral palsy/fine motor impairment (OR: 13.5, 95% CI: 2.4-76.3). Multiple strokes were associated with epilepsy (OR: 9.5, 95% CI: 1.0-88.9) and behavioral problems (OR: 4.4, 95% CI: 1.1-17.5) and inflammation/infection was associated with cerebral palsy (OR: 9.8, 95% CI: 1.4-66.9), cognitive impairment (OR: 9.2, 95% CI: 1.8-47.8) and epilepsy (OR: 10.3, 95% CI: 1.6-67.9).

CONCLUSIONS

Main MCA stroke, involvement of the corticospinal tract, multiple strokes and inflammation/infection were independent predictors of adverse outcome, suggesting that the interplay of stroke territorial involvement and clinical risk factors influence the outcome of NAIS.

Effects of extremely low frequency electromagnetic fields on turkeys

Several studies have examined the potential biological effects of electromagnetic fields (EMF) on birds; however, little attention has been paid to the extremely low frequency (ELF; 0-300 Hz; 0-50 μT) radiation found in an urbanized environment. For monitoring the effects of ELF EMF, we used a turkey (Meleagris gallopavo) model, because the nucleated erythrocytes of turkeys contain β-adrenoceptors, and norepinephrine- (NE-) activated β-adrenoceptors have an important role in physiological and behavioral processes. Our aims were the following: 1) to investigate the intracellular mechanisms; 2) to compare the intracellular mechanisms in the treated and control groups over time, considering inter-individual differences and intra-subject correlations; 3) and to study the reversible nature of the response. The turkeys in the treatment group were treated in vivo with ELF EMF (50 Hz; 10 μT) for 3 wk after a 1-wk-long adaptation period. The animals were not exposed to ELF EMF during the regeneration period (5 wk following the exposure). The NE-activated β-adrenoceptor function was detected by measuring the amount of 3΄5΄-cyclic-adenosine-monophosphate (cAMP), and the biochemical enzyme parameters were defined. Repeated measurements of cAMP levels were analyzed using marginal models and a piecewise linear mixed model to compare treatment and control groups over time. According to our results, NE-activated β-adrenoceptor function was decreased in the treated birds in a time-dependent manner, while there were no differences between toxicological parameters in the serum, compared to the normal ranges. The decreased NE-dependent β-adrenoceptor function could be compensated by the homeostatic complex during the 5-wk regeneration period. Extended experimental periods and more sophisticated analysis methods may help prevent harmful environmental effects on birds; furthermore, these findings could affect public health and the economy.

The Role of Uron and Chlorobenzene Derivatives, as Potential Endocrine Disrupting Compounds, in the Secretion of ACTH and PRL

Uron herbicides polluting the environment represent a serious concern for environmental health and may be regarded as endocrine-disrupting compounds (EDCs), which influence the regulation of human homeostasis. We aimed to investigate the effect of EDC urons (phenuron: PU, monuron: MU, and diuron: DU) and chlorobenzenes on the basal release of the adrenocorticotropic hormone (ACTH), which is a part of the adenohypophysis-adrenocortical axis. Hormone secretion in the presence of EDC was studied in two cell types: normal adenohypophysis cells (AdH) and cells of prolactinomas (PRLOMA). PRLOMA was induced in female Wistar rats by subcutaneously injecting them with estrone acetate for 6 months. AdH and PRLOMA were separated from treated and untreated experimental animals, dissociated enzymatically and mechanically in order to create monolayer cell cultures, which served as an experimental in vitro model. We investigated the effects of ED agents separately and in combination on ACTH and prolactin (PRL) release through the hypophyseal-adrenal axis. Hormone determination was carried out by the luminescent immunoassay and the radioimmunoassay methods. Our results showed that (1) uron agents separately did not change ACTH and PRL release in AdH culture; (2) ACTH secretion in arginine vasopressin- (AVP-) activated AdH cells was significantly increased by EDC treatment; (3) ED agents increased the basal hormone release (ACTH, PRL) in PRLOMA cells; and (4) EDC exposure increased ACTH release in AVP-activated PRLOMA cells. We conclude that the herbicides PU, MU, and DU carry EDC effects and show human toxicity potential.

The use of regression methods for the investigation of trends in suicide rates in Hungary between 1963 and 2011

PURPOSE

Suicide rates in Hungary have been analyzed from different aspects in recent decades. However, only descriptive rates have been reported. The aim of our epidemiological study was to characterize the pattern of annual rates of suicide in Hungary during the period 1963-2011 by applying advanced statistical methods.

METHODS

Annual suicide rates per 100,000 population (>6 years) for gender, age group and suicide method were determined from published frequency tables and reference population data obtained from the Hungarian Central Statistical Office. Trends and relative risks of suicide were investigated using negative binomial regression models overall and in stratified analyses (by gender, age group and suicide method). Joinpoint regression analyses were additionally applied to characterize trends and to find turning points during the period 1963-2011.

RESULTS

Overall, 178,323 suicides (50,265 females and 128,058 males) were committed in Hungary during the investigated period. The risk of suicide was higher among males than females overall, in all age groups and for most suicide methods. The annual suicide rate exhibited a significant peak in 1982 and remained basically constant after 2006. Different segmented patterns were observed for the suicide rates in the various age groups.

CONCLUSIONS

Suicide rates revealed segmented linear pattern. This is the first detailed trend analysis with risk estimates obtained via joinpoint and negative binomial regression methods simultaneously for age-specific suicide frequencies in Hungary.