We studied the effects of caffeine ingestion during pregnancy. A total number of 9,921 healthy pregnant women with a gestational age after 24 weeks were subjected to the study. The women who drank more than 5 cups of coffee per day had a high incidence of impending abortion, premature labor, and fetuses small for gestational age. The heavy coffee drinkers among the pregnant women had high rates of spontaneous abortion, chromosomal abnormality and congenital multi-anomalies. However, we would like to stress that the multiple socioeconomic variables might be more important than any direct effect of caffeine.
BackgroundMalnutrition is frequently observed in patients with pulmonary tuberculosis (TB). The present study aimed to examine the relationship between nutritional status using Malnutrition Universal Screening Tool (MUST) and the mortality of patients with pulmonary TB.MethodsFifty-seven patients with pulmonary TB were analyzed. Nutrition assessment was carried out using MUST. The Cox proportional hazard model was applied to assess the ability of MUST to predict prognosis. Receiver operating characteristic curve analysis was used to assess MUST score as a prognostic indicator in pulmonary TB patients. To obtain optimal cut-off values for MUST score for prognostic assessment in TB patients, we used the maximum Youden Index.ResultsFor predicting the risk of mortality, the optimal cut-off value for MUST score was 3.5. Univariate and multivariate analyses identified age and MUST score ≥ 4 as significant independent prognostic factors for survival. The patients with MUST score ≤ 3 had a median survival of 481 days (95% CI: 453 to 510) and that for the patients with MUST score ≥ 4 was 304 days (95% CI: 214 to 394); the difference was statistically significant (P = 0.001).ConclusionMUST appears to be a reliable tool for nutritional risk assessment of patients with pulmonary TB. In addition, MUST may be a useful prognostic indicator of survival in patients with pulmonary TB.
Herpesviral haematopoietic necrosis (HVHN), caused by cyprinid herpesvirus-2 (CyHV-2), has affected the commercial production of the goldfish Carassius auratus and gibelio carp Carassius auratus gibelio. High water temperature treatments are reported to reduce the mortality rate of infected goldfish and elicit immunity in the survivors. To define the mechanism by which this intervention induces resistance, clonal ginbuna Carassius auratus langsdorfii, which is closely related to both species and has been used in fish immunology, may represent a promising model species. In this study, we investigated the susceptibility of clonal ginbuna strains to CyHV-2 and the effect of high water temperature treatment on infected ginbuna and goldfish. Experimental intraperitoneal infection with CyHV-2 at 25 °C caused 100% mortality in ginbuna strains, which was accompanied by histopathological changes typical of HVHN. Both infected ginbuna S3n strain and goldfish, exposed to high temperature for 6 days [shifting from 25 °C (permissive) to 34 °C (non-permissive)], showed reduced mortalities after the 1st inoculation, and subsequent 2nd virus challenge to 0%, indicating induction of immunity. It was concluded that ginbuna showed a similar susceptibility and disease development in CyHV-2 infection compared to goldfish, suggesting that ginbuna can be a useful fish model for the study of CyHV-2 infection and immunity.
Ependymoma is a glioma with differentiation toward ependymal cells that usually arises in the central nervous system. Ovarian ependymoma is extremely rare, and the treatment strategies for this disease have not been established. This is the first report of a patient with advanced ovarian ependymoma who received fertility-sparing surgery and is now alive without disease. A 23-year-old Japanese woman, gravida 0, presented with a chief complaint of lower abdominal distension and weight loss. She underwent left salpingo-oophorectomy for suspected ovarian cancer. Microscopic examination revealed a highly cellular tumor composed of small cells with hyperchromatic, round-to-oval nuclei and scanty cytoplasm. Perivascular pseudorosettes, ependymal rosettes, and extensive necrosis were observed. After thorough pathologic examination, she was diagnosed as having stage IIIC ovarian ependymoma. Postoperatively, she received adjuvant chemotherapy and underwent secondary cytoreductive surgery that preserved the uterus and right ovary. Her menstrual cycle has resumed, and she is alive without evidence of disease 16 months after the start of treatment. Although rare, primary ovarian ependymoma must be kept in mind in the differential diagnosis of ovarian tumors, especially in young women. Administration of etoposide-based chemotherapy along with cytoreductive surgery is a potential standard treatment for advanced ovarian ependymoma.
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