Open Access Short Communication

Vitamin D and Primary Immunodeficiencies

Talita Lemos Paulino, Marina Neto Rafael, Rosangela da Silva, Elisangela Calheiro dos Santos-Valente, Fabíola Isabel Suano de Souza, Roseli Oselka Saccardo Sarni, Beatriz Tavares Costa-Carvalho

Journal of Advances in Medicine and Medical Research, Page 1035-1038
DOI: 10.9734/BJMMR/2015/17469

Some of the recognized actions of vitamin D include immunological effects such as keeping tolerance and to promote protective immunity. These functions are related to the blocking of B cell differentiation and immunoglobulin secretion as well as decreased production of inflammatory cytokines. The aim of this study was to describe the frequency of vitamin D deficiency in patients with primary immunodeficiencies. We studied 31 patients: 14 with Ataxia-telangiectasia (11 male, mean age 13.1±4.9 years) and 17 with Common variable immunodeficiency (8 males, mean age 28.5±11.3 years). Classification of nutritional status and percentage of fat mass were evaluated. 25-hydroxyvitamin D was analyzed by high performance liquid chromatography and deficiency was considered when 25-hydroxyvitamin D< 20 ng/mL. Malnutrition was the most common nutritional disorder: 7/14 (50%) and 4/17 (23.5%) in Ataxia-telangiectasia and Common variable immunodeficiency groups, respectively. We found a high percentage of 25-hydroxyvitamin D deficiency in the Ataxia-telangiectasia group 6/14 (42.8%) and Common variable immunodeficiency group 3/17 (17.6%). There was no association between vitamin D deficiency and high-sensitivity C-reactive protein, lymphocyte count (CD3, CD4 and CD8) and body fat percentage. Considering the frequency of autoimmune diseases and infections in patients with primary immunodeficiencies, strict monitoring of the vitamin levels are recommended with the aim to reduce morbidity.

Open Access Minireview Article

Common High Altitudes Illnesses a Primer for Healthcare Provider

Vahid Mohsenin

Journal of Advances in Medicine and Medical Research, Page 1017-1025
DOI: 10.9734/BJMMR/2015/17501

Exposure to high altitude imposes significant strain on cardiopulmonary system and the brain. As a consequence, sojourners to high altitude frequently experience sleep disturbances, often reporting restless and sleepless nights.
At altitudes above 3,000 meters (9,800 ft) almost all healthy subjects develop periodic breathing especially during NREM sleep.
Sleep architecture gradually improves with increased NREM and REM sleep despite persistence of periodic breathing .
The primary reason for periodic breathing at high altitude is a hypoxic-induced increase in chemoreceptor sensitivity to changes in PaCO2 – both above and below eupnea, leading to periods of apnea and hyperpnea.
Acetazolamide improves sleep by reducing the periodic breathing through development of metabolic acidosis and induced hyperventilation decreasing the plant gain and widening the PCO2 reserve. This widening of the PCOreserve impedes development of central apneas during sleep.
Benzodiazepines and GABA receptor antagonist such as zolpidem improve sleep without affecting breathing pattern or cognitive functions.

Open Access Minireview Article

Synthetic Bone Substitutes in Combination with Growth Factors for Maxillary Sinus Floor Augmentation: A Mini-review

Cleopatra C. Nacopoulos, Ismene Dontas, Efstathios Chronopoulos, Lubna Khaldi, Anna Maria Vesala, Ioannis K. Triantafyllopoulos, Nikolaos Papaioannou

Journal of Advances in Medicine and Medical Research, Page 1026-1034
DOI: 10.9734/BJMMR/2015/15613

Objective: Growth factors have been applied in maxillary sinus augmentation with clinically successful results. The purpose of this article is to evaluate the effectiveness of growth factors in combination with various synthetic scaffolds.
Methods and Materials: A systematic review of studies examining the effects of synthetic materials in combination with growth factors were performed.
Results: Twelve (1 human and 11 animal) studies were eligible for inclusion. Due to the great heterogeneity of the studies regarding design, materials and outcomes, a meta-analysis was not performed. The majority of the studies show a reduction in healing time and enhancement of bone formation within the subantral environment. Bone Morphogenetic Protein-2 and GDF-5 were the two most common osteoinductive factors studied, showing a significant effect on new bone formation. Moreover, initial outcomes of trials with stem cells genetic transformation, that results in increased production of growth factors, are positive and justify further research.
Conclusion: The incorporation of growth factors into the synthetic scaffold may be beneficial regarding the healing process.

Open Access Original Research Article

Retracted: Bioenergetics of Human Cancer Cells and Normal Cells during Proliferation and Differentiation

Nina A. Mikirova

Journal of Advances in Medicine and Medical Research, Page 971-982
DOI: 10.9734/BJMMR/2015/17113

Cancer cells are known to have different metabolic properties than normal cells, particularly their tendency to undergo glycolysis even under aerobic favoring conditions. This has created interest in how mitochondrial function in tumor cells may differ from that in normal cells. Using human malignant cells (SW-620, PC-3, HT-1080, SK-MEL, HL-60, K-562 and MOLT-3), human fibroblast (CCL-153) and human T Cells, we investigated three key parameters that have been typically to describe mitochondrial function: cellular ATP production, mitochondrial potential and cellular cardiolipin levels. On average, tumor cancer cells had more ATP production and greater mitochondrial potentials. For example, ATP levels in malignant cells ranged from 20 to 69 µmole/106 cells, with a cancer cell average of 40±18 µmole/106 cells. For normal cells, the ATP level range went from 9 to 24 µmole/106 cells, for an average of 15±11 µmole/106 cells. Mitochondrial potentials tended to be three times higher in cancer cells, perhaps because overall mitochondrial mass (as measured by relative cardiolipin levels) were twice as high in cancer cells. Higher mitochondrial masses are consistent with proliferation. Proliferating cells in general showed higher mitochondrial function compared to quiescent cells (confluent monolayers), and HL-60 cells showed reductions in all three mitochondrial parameters measured here when the cells were exposed to the differentiating agent TPA. The effects of ATP production inhibitors CCCP and oligomycin on mitochondrial function in normal and cancer cells were also compared. In general, in these experiments, cancer cell mitochondrial inhibition with these agents produced a decrease ATP levels by 30-40% while in normal cells ATP production was reduced by 60%. These results provide evidence of a mitochondrial dysfunction in cancer cells. Cancer cells appear to better withstand interference with ATP synthesis in mitochondria since they rely mainly on glycolysis as an energy producing mechanism.


Retraction Notice: This paper has been retracted from British Journal of Medicine & Medical Research due to the following reason:

‘The paper was submitted to British Journal of Medicine & Medical Research (BJMMR) on 26th Feb 2015 and published in BJMMR on 10th April after peer review and editorial acceptance. It came to our knowledge on 29th June 2015 that the same paper was submitted to the Puerto Rico Health Sciences Journal on October 20, 2014 and authors mutually agreed to retract this paper to avoid copyright related complexities’. We thank all concerned persons for their active cooperation, help and patience during this process.

Open Access Original Research Article

Demographic Variables and Self Image as Predictors of Pornography Viewing and Substance Use among Nigerian Adolescents

M. T. Abiodun, B. F. Akinkunmi, G. E. Okungbowa

Journal of Advances in Medicine and Medical Research, Page 983-990
DOI: 10.9734/BJMMR/2015/16780

Background: Health Risk behavior is a major concern in the society, especially among young people.
Aims: This study evaluated the influence of self-image; socio-demographic factors and low parental supervision on pornography consumption and substance use among Nigerian adolescents.
Methods: This was a cross-sectional observational study. Adolescents’ self-image was measured with Rosenberg Self-Esteem (RSE) scale. Multivariate analysis was used to explore the relationship among demographic variables, self-image, pornography consumption and substance use. A 2-sided p-value < 0.05 was considered significant.
Results: Altogether, 883 street youths participated in the study. The mean ages (years) were 17.6±2.5 and 16.8±2.3 for boys and girls respectively. The overall prevalence of pornography viewing and substance use were 54.5% and 21.5% respectively. Specific prevalence for substance use was highest for Cannabis (10.5%). Self-image significantly influenced both vices, p<0.001. Stepwise logistic regression identified predictors of substance use as follows: male gender, OR = 3.65 (2.44 – 5.47); secondary education: OR = 2.50 (1.51 – 4.13) and living with relatives, OR = 2.77 (1.17-6.52).
Conclusion: Self-image and modifiable demographic features influence pornography viewing and substance use among young people. Adolescent Preventive Services should be made readily available to this high risk group.

Open Access Original Research Article

Role of Actinomyces and Helicobacter pylori in Obstructive Sleep Apne syndrome (OSAS) in Children

Shawky Elmorsy, Shirien Amin Rakha, Noha Tharwat Abou El-khier, Hoda Saleh

Journal of Advances in Medicine and Medical Research, Page 991-998
DOI: 10.9734/BJMMR/2015/17654

Background: Obstructive hyperplasia causing obstructive sleep apnea syndrome (OSAS) is one of the most common conditions indicating tonsillectomy. Actinomycosis and H. pylori were assumed to have a role in tonsillar hyperplasia causing OSAS
Purpose: Study the presence of Actinomyces and H. pylori in tonsils removed in children with OSAS.
Methods: 50 children scheduled for tonsillectomy, all of these children had OSAS ± symptomatic adenoid enlargement. One tonsil, choosed randomly divided with a sterile blade into two parts: one half to be sent to pathology department (pathological examination) and the other half to clinical pathology (Rapid urease test and PCR).
Results: Patients’ age was between 3 and 16 years (mean age was 5.38±2.74 years). 29 (61.7%) patients with Actinomyces in their tonsillar tissue were included in study group and 9 patients (64.7%) with H. pylori in their tonsillar tissue specimens were included in the second group. 3 patients were excluded from the study in whom both Actinomyces and H. pylori.
Conclusion: The size of tonsils was significantly larger among cases with positive results to Actinomyces in comparison to cases to H. pylori. Further studies are needed to assure the role of actinomyces in pediatric tonsillar hypertrophy and whether control of Actinomycyes may reverse the problem or not.

Open Access Original Research Article

Ambulatory Phonation Monitor as an Indicator of Voice Use Profile in a Group of Speech Language Pathologists

Tamer A. Mesallam

Journal of Advances in Medicine and Medical Research, Page 999-1005
DOI: 10.9734/BJMMR/2015/17777

Aim: Speech-language pathologists (SLPs) can be recognized as professional voice users, as their job depends mainly on healthy and intact voices. The purpose of this study was to explore the vocal load characteristics in a group of SLPs compared to a control group consisting of subjects of different professional backgrounds.
Study Design: Prospective study.
Methodology: A group of 13 SLPs and a control group of 7 subjects working in different professions were included in the study. Vocal load during a whole working day was measured for all the participants using Ambulatory Phonation Monitor (APM). The measured parameters include total phonation time (TPT), cycle dose, and distance dose.
Results: The SLPs group demonstrated significantly higher vocal load parameters than the control group including TPT, cycle dose, and distance dose (P. < 0.01).
Conclusions: Vocal load parameters as measured by cycle dose and distance dose appear to be significantly higher in the SLPs group compared to the control subjects who are working in other non-voice demanding occupations.

Open Access Original Research Article

Perceived Sexual Attitudes and HIV/AIDS-Health Seeking Behaviours of People Living in the Fishing Community of Akwa Ibom State, Nigeria

Festus Abasiubong, Alphonsus U. Idung

Journal of Advances in Medicine and Medical Research, Page 1006-1016
DOI: 10.9734/BJMMR/2015/16671

Background: Despite the tremendous efforts made to reduce the burden of HIV/AIDS in many countries, there are still gaps in the control of spread of HIV-infection in Nigeria, especially in the coastal areas due to inappropriate life style and preference for traditional care of people living with the disease.
Aim: The purpose of this study was to assess the sexual attitudes and HIV/AIDS-healthcare seeking behavi ours of people living in the fishing community of Okposo, Akwa Ibom State, Nigeria.
Methods: This was a cross-sectional descriptive study of 600 people living in the fishing community, who were assessed for perceived sexual attitudes and HIV/AID-health care seeking behaviours, using Attitude and Sexual Behaviour Questionnaire.
Results: Of the 600 participants, 339 (56.5%) were males and 261 (43.5%) females. Inspite of the increasing awareness of the existence of HIV/AIDS, sexual attitudes were variable and inimical to the fight against the disease; sexual urge was high; 27.7% males and 15.3% females had at least two or more sexual partners; 13.8% males and 10.8% females hardly used condom during sexual intercourse, while 15.5% males and 18.8% females would not undergo HIV testing. Perception on the cause and mode of transmission of HIV/AIDS were poor. Perceived efficacy, confidentiality, affordability and accessibility were reasons for choice of traditional care; about 61.0% of the participants would not attend to infected individuals because of fear of being infected with the virus.
Conclusion: This study has shown that a lot still need to be done in Nigeria, especially in areas with difficult terrain to reverse the trend of HIV/AIDS. Massive enlightenment campaigns are necessary to serve as continuous efforts to increase and maintain high levels of motivation for lifestyle modification.

Open Access Review Article

Fetal Heart Rate Interpretation in the Second Stage of Labour: Pearls and Pitfalls

Sian McDonnell, Edwin Chandraharan

Journal of Advances in Medicine and Medical Research, Page 957-970
DOI: 10.9734/BJMMR/2015/17022

It is vital to determine whether a fetus is showing a normal physiological response to the stress of labour or if the fetus is exposed to intrapartum hypoxia to ensure timely and appropriate management. Failure to interpret fetal heart rate correctly during second stage of labour may lead to increased maternal and neonatal morbidity due to an unnecessary caesarean section or an instrumental vaginal delivery. Conversely, delay in timely and appropriate intervention can also result in increased perinatal morbidity and mortality.
This review addresses the pathophysiology behind features observed on the CTG trace as well as the types of intrapartum hypoxia during second stage of labour and aims to identify common pitfalls including inadvertent monitoring of maternal heart rate as well as monitoring and interpretation of cardiotocograph of twin pregnancies in the second stage of labour.

Open Access Case Study

An Obturation Technique for Closure of Body Wall Defects

David Y. Johnson, Mark A. Franke, Nancy J. Phillips, Frank E. Johnson

Journal of Advances in Medicine and Medical Research, Page 1039-1043
DOI: 10.9734/BJMMR/2015/16100

Aims: In the vast majority of instances, closure of abdominal wall defects relies on the tensile strength of transposed native tissue and/or prosthetic material. The purpose of this report is to alert clinicians to a different strategy for closure that we have used successfully on several occasions.
Presentation of Case: A 72 year old man had a bulky inguinal nodal metastasis from cutaneous squamous cell carcinoma. He had an extended radical groin dissection including full thickness abdominal wall resection, with primary closure, followed by external beam radiotherapy. After 30 months, he developed an abdominal wall hernia and enterocutaneous fistula at the surgical site. Direct closure and local vascularized flaps were not feasible. Obturation of the defect by omentum was employed, taking advantage of its relative incompressibility rather than its minimal tensile strength. The wound was subsequently covered by a skin graft. The patient survived 10 years with an intact hernia repair and died of unrelated causes.
Discussion: The technique has yielded good results.
Conclusions: This surgical option is valuable for situations in which the abdominal wall defect to be closed is fibrotic, has been radiated, is infected, or is otherwise not suitable for conventional techniques.