OBJECTIVE: Despite evidence of hyperresponsive peripheral and central nervous system (CNS) noradrenergic activity in posttraumatic stress disorder (PTSD), direct measures of CNS norepinephrine in ...PTSD have been lacking. The goal of this study was to determine serial CSF norepinephrine levels in patients with PTSD. METHOD: CSF samples were obtained serially over a 6-hour period in 11 male combat veterans with chronic PTSD and eight healthy men through an indwelling subarachnoid catheter. Thus the authors were able to determine hourly CSF norepinephrine concentrations under baseline (unstressed) conditions. Severity of the patients' PTSD symptoms was assessed with the Clinician-Administered PTSD Scale. RESULTS: CSF norepinephrine concentrations were significantly higher in the men with PTSD than in the healthy men. Moreover, CSF norepinephrine levels strongly and positively correlated with the severity of PTSD symptoms. Plasma norepinephrine concentrations showed no significant relationship with the severity of PTSD symptoms. CONCLUSIONS: These findings reveal the presence of greater CNS noradrenergic activity under baseline conditions in patients with chronic PTSD than in healthy subjects and directly link this pathophysiologic observation with the severity of the clinical posttraumatic stress syndrome.
OBJECTIVE: The authors sought to carefully test, by using a technique of continuous CSF sampling, the hypothesis that basal elevations in CSF corticotropin-releasing hormone (CRH) concentrations ...exist in patients with posttraumatic stress disorder (PTSD). They also sought to assess the relationship among PTSD symptoms, adrenocortical activity, and CSF CRH levels. METHOD: CSF was withdrawn by means of a flexible, indwelling subarachnoid catheter over a 6-hour period, and hourly CSF concentrations of CRH were determined for 11 well-characterized combat veterans with PTSD and 12 matched normal volunteers. Twenty-four-hour urinary-free cortisol excretion was also determined. PTSD and depressive symptoms were correlated with the neuroendocrine data. RESULTS: Mean CSF CRH levels were significantly greater in PTSD patients than in normal subjects (55.2 SD=16.4 versus 42.3 pg ml SD=15.6). No correlation was found between CSF CRH concentrations and PTSD symptoms. While there was no significant difference between groups in 24-hour urinary-free cortisol excretion, the correlation between 24-hour urinary-free cortisol excretion and PTSD symptoms was negative and significant. CONCLUSIONS: By using a serial CSF sampling technique, the authors found high basal CSF CRH concentrations and normal 24-hour urinary-free cortisol excretion in combat veterans with PTSD, a combination that appears to be unique among psychiatric conditions studied to date.
Summary Accruing evidence indicates that neuropeptide Y (NPY), a peptide neurotransmitter, is a resilience-to-stress factor in humans. We previously reported reduced cerebrospinal fluid (CSF) NPY ...concentrations in combat-related posttraumatic stress disorder (PTSD) subjects as compared with healthy, non-combat-exposed volunteers. Here we report CSF NPY in combat-exposed veterans with and without PTSD. We quantified NPY concentrations in morning CSF from 11 male subjects with PTSD from combat in Iraq and/or Afghanistan and from 14 combat-exposed subjects without PTSD. NPY-like immunoreactivity (NPY-LI) was measured by EIA. The relationship between CSF NPY and clinical symptoms, as measured by the Clinician-Administered PTSD Scale (CAPS) and Beck Depression Inventory (BDI), was assessed, as was the relationship between combat exposure scale (CES) scores and CSF NPY. As compared with the combat-exposed comparison subjects without PTSD, individuals with PTSD had significantly lower concentrations of CSF NPY mean CSF NPY was 258.6 ± 21.64 pg/mL in the combat trauma-no PTSD group but only 180.5 ± 12.62 pg/mL in PTSD patients ( p = 0.008). After adjusting for CES and BDI scores the two groups were still significantly different with respect to NPY. Importantly, CSF NPY was negatively correlated with composite CAPS score and intrusive (re-experiencing) subscale scores, but did not significantly correlate with CES or BDI scores. Our current findings further suggest that NPY may regulate the manifestation of PTSD symptomatology, and extend previous observations of low CSF NPY concentrations in the disorder. Central nervous system NPY may be a clinically important pharmacotherapeutic target, and/or diagnostic measure, for PTSD.
Infant formulas are useful alternatives to breast milk in many circumstances but may pose health risks to infants and children due to contamination by potentially toxic metals. This study aimed to ...determine the aluminium, arsenic and mercury concentrations and carry out an exposure health risk assessment in commonly consumed infant formulas in Nigeria.
Different brands of both locally manufactured and imported infant formulas were purchased in March 2017 from stores in Port Harcourt, Nigeria. Analysis of metals in the samples was performed by atomic absorption spectrophotometry. The health risk was assessed by comparing estimated daily intake of aluminium, arsenic and mercury with the provisional tolerable daily intake acceptable by the Joint Food and Agricultural Organization/World Health Organization Expert Committee on Food Additives (JECFA).
A total of 26 infant formulas were analysed. The levels of arsenic were higher in cereal-based formulas compared to milk-based formulas, but the difference was not significant (
>0.05). The intake levels of aluminium, arsenic and mercury in infant formulas were found to be 8.02-14.2%, 437.1-771% and 23.7-41.8% of the provisional tolerable daily intake JECFA threshold values, respectively.
Commonly consumed infant formulas in Nigeria may add to the body burden of arsenic in children.
Pregnancy is characterized by important variations in virtually every organ system to accommodate the growing and developing fetoplacental entity. Hence, the objective of this study is to assess the ...effect of pregnancy on hematological profile of female subjects attending a private hospital in Benin City, Edo State, Nigeria using eighty female volunteered individuals comprising sixty pregnant subjects and twenty nonpregnant subjects. The pregnant group was further categorized into three trimesters, each consisting of twenty participants. Results were presented as Mean ± SD and analyzed using GraphPad Prism 5 software (GraphPad Software Inc.), and p < 0.05 was considered statistically significant. Overall, the mean values of lymphocytes, red blood cells, hematocrit, hemoglobin, and platelets were decreased in the pregnant cohort when compared to the nonpregnant cohort, whereas an incremental rise in white blood cell, and granulocytes were observed in the pregnant cohort when compared to the nonpregnant cohort. A statistically significant difference (p < 0.05) in the mean hematocrit and hemoglobin values was observed when comparing the first-trimester participants with the control participants, although white blood cells, granulocytes, lymphocytes, red blood cells, and platelets were not different (p > 0.05). The average values for white blood cells, granulocytes, red blood cells, hematocrit, and hemoglobin between second-trimester individuals and those of nonpregnant individuals exhibited a significant variance (p < 0.05), while the average lymphocyte and platelet counts showed no significance (p > 0.05). the mean white blood cells, granulocytes, lymphocytes, red blood cells, hematocrit, hemoglobin, and platelet counts for the third-trimester subjects were significantly different (p < 0.05) when compared to the control subjects. The study outcome suggests that pregnancy affects hematological indices and may be a risk predictor for pregnancy-associated complications.
Objective. Street-vended foods offer numerous advantages to food security; nevertheless, the safety of street food should be considered. This study has investigated the level of potential toxic metal ...(Pb, Cd, Hg, Sb, Mn, and Al) contamination among street-vended foods in Benin City and Umunede. Methods. Twenty street food samples were purchased from vendors at bus stops. Metals were analyzed with atomic absorption spectrophotometry. The methods developed by the US EPA were employed to evaluate the potential health risk of toxic metals. Results. The concentrations of the toxic metals in mg/kg were in the range of Pb (0.014–1.37), Cd (0.00–0.00017), Hg (0.00–0.00014), Sb (0.00–0.021), Mn (0.00–0.012), and Al (0.00–0.22). All the toxic metals except Pb were below permissible limit set by WHO, EU, and USEPA. The daily intake, hazard quotient, and hazard index of all toxic metals except for Pb in some street foods were below the tolerable daily intake and threshold value of 1, indicating an insignificant health risk. Total cancer risk was within the priority risk level of 1.0E-04 but higher than the acceptable risk level of 1E-06. Conclusion. Consumption of some of these street foods is of public health concern.
Summary The hypothalamic neuropeptide, orexin-A has a number of regulatory effects in humans and pre-clinical evidence suggests a link to neuroendocrine systems known to be pathophysiologically ...related to posttraumatic stress disorder (PTSD). However, there are no reports of central nervous system (CNS) or peripheral orexin-A concentrations in patients with PTSD, or any anxiety disorder. Cerebrospinal fluid (CSF) and plasma levels of orexin-A were serially determined in patients with PTSD and healthy comparison subjects to characterize the relationships between orexin-A (in the CNS and peripheral circulation) and central indices of monoaminergic neurotransmission and to determine the degree to which CNS orexin-A concentrations reflect those in the circulating blood. CSF and plasma samples were obtained serially over a 6-h period in 10 male combat veterans with chronic PTSD and 10 healthy male subjects through an indwelling subarachnoid catheter. Orexin-A concentrations were determined in plasma and CSF and CSF levels of the serotonin metabolite, 5-hydroxyindolacetic acid (5-HIAA), and the dopamine metabolite, homovanillic acid (HVA), were determined over the sampling period. CSF and plasma orexin-A concentrations were significantly lower in the patients with PTSD as compared with healthy comparison subjects at all time points. In addition, CSF orexin-A concentrations strongly and negatively correlated with PTSD severity as measured by the Clinician-Administered PTSD Scale (CAPS) in patients with PTSD. Peripheral and CNS concentrations of orexin-A were correlated in the healthy comparison subjects and peripheral orexin-A also correlated with CNS serotonergic tone. These findings suggest low central and peripheral orexin-A activity in patients with chronic PTSD are related to symptom severity and raise the possibility that orexin-A is part of the pathophysiological mechanisms of combat-related PTSD.
The use of electronic health records (EHRs) has grown significantly in the past decade. Health information databases contain sensitive patient information, including their names and addresses, tests, ...diagnoses, treatment, and medical history. This information should be secured and protected from manipulation and fraudulent use by third parties. EHRs are expected to increase efficiency in healthcare delivery, improve healthcare quality, and relieve increased financial pressure. Despite these expected benefits, EHRs are potentially vulnerable to security concerns that may affect the confidentiality and privacy of patients’ personal information. This paper presents a literature review of EHRs, factors that support the security and safety of health records, potential security breaches, and solutions to inherent security concerns. The study collects data through a systematic review of past studies that have addressed the topic of EHRs and security issues, and other relevant publications on EHR systems, and procedures that help safeguard health records databases. A total of 30 sources are analyzed for all pertinent information regarding security concerns of health records databases. These sources were obtained through an internet search on credible databases, including Google Scholar, PubMed, and CINAHL databases. The results of the current study reveal the perceived vulnerability of EHRs to security concerns, common security issues, the nature of these common security concerns, Health Insurance Portability and Accountability Act rules, provider responsibilities, and recommendations for reducing EHR security risks. This paper also reveals effective strategies such as privacy-protection awareness and staff training to enhance the security of health records databases.
OBJECTIVE: Results of basal peripheral cortisol measures in posttraumatic stress disorder (PTSD) have been variable. The authors' goal was to measure CSF cortisol concentrations, which more ...accurately reflect brain glucocorticoid exposure, in subjects with or without PTSD. METHOD: CSF was withdrawn from a subarachnoid catheter and plasma from a venous catheter, both indwelling, over a 6-hour interval to determine hourly plasma ACTH and cortisol concentrations and hourly CSF cortisol levels in eight well-characterized combat veterans with PTSD and eight matched healthy volunteers. RESULTS: Mean CSF cortisol concentrations were significantly higher in the subjects with PTSD (3.18 ng ml, SD=0.33) than in the normal volunteers (2.33 ng ml, SD=0.50), largely due to higher CSF cortisol concentration nadirs. No group differences were observed in either plasma ACTH or peripheral (plasma or urinary free) cortisol. CSF corticotropin-releasing hormone and CSF cortisol concentrations were positively and significantly correlated. CONCLUSIONS: Despite normal peripheral cortisol indexes in the veterans with PTSD, their CNS exposure to cortisol was greater than that of normal comparison subjects.
This review article explores spinal injuries in athletes participating in various sporting activities. It also highlights the various mechanisms of injuries that contribute to spinal injuries in each ...sport. Electronic databases such as PubMed, Cochrane Library, Web of Science, Embase, MEDLINE Ovid, and Google Scholar were searched for articles from 2000 to 2022 on spine injuries in sports and radiological studies discussing the various injury patterns among athletes. Studies were scoured in accordance with the inclusion criteria, and relevant data such as the number of participants, sporting activities, spine injuries, and outcomes were retrieved. Fifteen articles that met the inclusion criteria were included in the study. Cervical spine injuries are common in athletes who participate in contact sports such as football. Similarly, athletes in collision sports such as football, rugby, and hockey are likely to suffer stingers due to traction and compression injuries. Players engaged in such as soccer, baseball, and swimming, are likely to suffer from spondylolysis. Soccer players are more prone to multiple lesions compared to athletes in sports such as baseball because the sport involves training exercises such as jogging and running without kicking any ball. In swimmers, spondylolysis is common in breaststroke and butterfly styles since they involve repeated flexion and hyperextension of the lumbar spine. CT is essential for diagnosing spondylolysis as it demonstrates the lesions more accurately. Ice hockey is associated with a significant incidence of cervical spine injuries, mostly due to players being constantly checked/pushed from behind. Spine injuries are common in elite athletes across several sports. About 10% of spinal injuries in the United States result from sports activities. In diagnosing spine injuries, imaging modalities such as MRI, CT, or plain radiographs are essential. From a radiologist's perspective, these tests help immensely in deciding which treatment is required for a particular athlete or how the injury can be optimally managed. Achieving recovery from a specific spine injury usually depends on the kind of injury and the rehabilitation process the athletes undergo before returning to play.
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