Shaping the risk for late-life neurodegenerative disease: A systematic review on prenatal risk factors for Alzheimer's disease-related volumetric brain biomarkers.

Environmental exposures including toxins and nutrition may hamper the developing brain in utero, limiting the brain's reserve capacity and increasing the risk for Alzheimer's disease (AD). The purpose of this systematic review is to summarize all currently available evidence for the association between prenatal exposures and AD-related volumetric brain biomarkers. We systematically searched MEDLINE and Embase for studies in humans reporting on associations between prenatal exposure(s) and AD-related volumetric brain biomarkers, including whole brain volume (WBV), hippocampal volume (HV) and/or temporal lobe volume (TLV) measured with structural magnetic resonance imaging (PROSPERO; CRD42020169317). Risk of bias was assessed using the Newcastle Ottawa Scale. We identified 79 eligible studies (search date: August 30th, 2020; Ntotal=24,784; median age 10.7 years) reporting on WBV (N = 38), HV (N = 63) and/or TLV (N = 5) in exposure categories alcohol (N = 30), smoking (N = 7), illicit drugs (N = 14), mental health problems (N = 7), diet (N = 8), disease, treatment and physiology (N = 10), infections (N = 6) and environmental exposures (N = 3). Overall risk of bias was low. Prenatal exposure to alcohol, opioids, cocaine, nutrient shortage, placental dysfunction and maternal anemia was associated with smaller brain volumes. We conclude that the prenatal environment is important in shaping the risk for late-life neurodegenerative disease.

The effect of patient positioning on adrenal gland linear measurements estimated from computed tomographic images in healthy beagle dogs.

Considering that recumbency can lead to a change in localization, detectability of distinct margins and thus measurement of the organs and reconstruction quality, it is of value to evaluate the effect of positioning on the objective evaluation of abdominal organs in computed tomography (CT). The objective of the present study was to evaluate the effect of patient decubitus on adrenal gland CT biometry. For this purpose, 6 clinically healthy adult beagle dogs underwent CT examination in 4 recumbencies. The various adrenal gland's size measurements were performed by 2 observers. Statistical analyses revealed that repeatability and reproducibility was the highest on the ventral and right lateral recumbencies, respectively. Significant differences were found in the left adrenal gland's length between the different positions (P < 0.001) and the left adrenal gland's width of the cranial pole measured in the dorsal plane (P < 0.04). The measurements on the parasagittal images differed significantly for the left adrenal length (P = 0.01), cranial pole height (P = 0.03), the right adrenal gland's lateral limb's length (P = 0.05) and medial limb's caudal poles height (P < 0.01). The caudal pole height of the right adrenal gland's medial limb was significantly different (P < 0.01) in all positions on the transverse images. In addition, the adrenal position differed significantly, except for the left adrenal gland relative to the nearest renal vessel (P = 0.1). According to these results, it is recommended to perform a CT of adrenal glands always in the same recumbency. If adrenal glands are evaluated on images taken in various recumbencies, we suggest relying on the measurements made on transverse plane images.

Prevalence of polycystic kidney disease in Persian and Persian related-cats referred to Small Animal Hospital, University of Tehran, Iran.

BACKGROUND: Autosomal-dominant polycystic kidney disease (ADPKD) is the most prevalent inherited genetic disease of cats, predominantly affecting Persians and Persian-related cats. AIMS: The purpose of this study was to determine prevalence of polycystic kidney disease (PKD) in Persian cats in Iran, and also to assess the relationships between PKD and gender, age as well as clinical and paracilinical manifestations. METHODS: Sonographic screening examination was performed on all healthy and unhealthy Persian and Persian-related cats referred to Small Animal Hospital of Faculty of Veterinary Medicine, University of Tehran, from April 2014 to May 2015. Cats were classified as positive when at least one anechoic cavity was found in at least one kidney. RESULTS: Of 76 Persian and Persian-related cats submitted for PKD ultrasound screening, 36.8% were found to have the disease and 63.2% were negative. Therefore, the prevalence of PKD was estimated 36.8% in Persian and Persian related cats in Tehran, Iran, which is approximately similar to prevalence in other parts of the world. Furthermore, there was a significant correlation between PKD and age, as in affected cats the detection probability of renal cysts in sonography was increased in older animals. For each year increase in age, the detection probability of PKD in sonography was increased about 2.62 times. CONCLUSION: The prevalence of the PKD amongst Persian cats in Iran is relatively high, and insufficient attention to incidence and prevalence of PKD especially in breeding programs, would spread the disease throughout in Persian cats.

Spirocyclic sulfonamides with carbonic anhydrase inhibitory and anti-neuropathic pain activity.

A novel series of 4-oxo-spirochromane bearing primary sulfonamide group were synthetized as Carbonic Anhydrase inhibitors (CAIs) and tested for their management of neuropathic pain. Indeed, CAs have been recently validated as novel therapeutic targets in neuropathic pain. All compounds, here reported, showed strong activity against hCA II and hCA VII with KI values in the low or sub-nanomolar range. Two compounds (6d and 6l) showed good neuropathic pain attenuating effects and longer duration than drug reference acetazolamide in an animal model of oxaliplatin induced neuropathy.

Effectiveness of regionalization of trauma care services: a systematic review.

OBJECTIVES: Improving trauma systems in various forms has always been an important aspect of health policy. While several papers have reported the implementation of a structured trauma system of care, research evidence on the effectiveness of such regionalization for improvement in trauma outcome is limited. STUDY DESIGN: Systematic review. METHOD: Medline, EMbase, EconLit and Health Management Information Consortium were searched, using sensitive search terms, for interventional studies that reported a trauma regionalization system as their intervention, and compared important outcomes such as mortality and preventable deaths. At least two authors assessed eligibility for inclusion and risk of bias, and extracted data from the included studies. As meta-analysis was not possible for all studies, two controlled before-after studies were included in the meta-analysis, and a narrative analysis was conducted for the other studies. RESULTS: After title and abstract sifting, 66 papers were retrieved. After reading the full texts, a total of 24 studies from the USA, UK, Canada, Australia, and the Netherlands were included in this review. In spite of variation in study specifications, most were before-after studies with a high risk of bias. Although a reduction in mortality was shown in most studies, only two studies were eligible for meta-analysis, and the results showed a significant reduction in mortality after implementation of an organized trauma system (odds ratio 0.840, 95% confidence interval 0.756-0.924; P = 0.00). CONCLUSION: Correlation was found between a regionalized network of trauma care and a reduction in trauma-related mortality, based on studies that did not exclude the effects of other concurrent changes on observed reductions. It is recommended that more studies with robust research designs should be conducted in a more diverse range of countries to assess the effectiveness of regionalization. Despite this limitation, the present findings support the regionalization of trauma care services.

The effectiveness of regionalization of perinatal care services--a systematic review.

BACKGROUND: Several reports recommend the implementation of perinatal regionalization for improvements in maternal and neonatal outcomes, while research evidence on the effectiveness of perinatal regionalization has been limited. The interventional studies have been assessed for robust evidence on the effectiveness of perinatal regionalization on improving maternal and neonatal health outcomes. METHODS: Bibliographic databases of Medline, EMbase, EconLit, HMIC have been searched using sensitive search terms for interventional studies that reported important patient or process outcomes. At least two authors assessed eligibility for inclusion and the risk of biases and extracted data from the included studies. As meta-analysis was not possible, a narrative analysis as well as a 'vote-counting' analysis has been conducted for important outcomes. RESULTS: After initial screenings 53 full text papers were retrieved. Eight studies were included in the review from the USA, Canada and France. Studies varied in their designs, and in the specifications of the intervention and setting. Only three interrupted time series studies had a low risk of bias, of which only one study reported significant reductions in neonatal and infant mortality. Studies of higher risk of bias were more likely to report improvements in outcomes. CONCLUSIONS: Implementing perinatal regionalization programs is correlated with improvements in perinatal outcomes, but it is not possible to establish a causal link. Despite several high profile policy statements, evidence of effect is weak. It is necessary to assess the effectiveness of perinatal regionalization using robust research designs in a more diverse range of countries.