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BACKGROUND: Young to middle-aged women are more likely than men to be diagnosed with irritable bowel syndrome (IBS). Immune dysfunction may be present in IBS, however, few studies have tested whether hormonal contraceptive use is linked to inflammatory markers. The purpose of this study was to compare cytokine levels between women (ages 18-45) with and without IBS and with and without hormonal contraceptive use and to examine the relationships of cytokine levels to IBS gastrointestinal (GI) and non-GI symptoms within those using and not using hormonal contraceptives. METHODS: Seventy-three women with IBS and 47 healthy control women completed questionnaires (demographics, hormonal contraceptive use) and kept a 28-day symptom diary. Fasting plasma and LPS-stimulated pro-inflammatory (IL-1β, IL-6, IL-12p40, IL-12p70, IL-8, and TNF-α) and anti-inflammatory (IL-10) cytokines were assayed. RESULTS: No differences were found in plasma or stimulated cytokine levels between IBS and control women. Levels of IL-1β (p = 0.04) and TNF-α (p = 0.02) were higher among women who did not use hormonal contraceptives compared to women who used hormonal contraceptives. Among women with IBS, significant correlations were found between daily psychological distress and plasma IL-10, IL-12p70, IL-1β, IL-6, and IL-8 cytokine levels. CONCLUSIONS: These results suggest that hormonal contraceptive use might reduce IL-1β and TNF-α cytokine levels in women with IBS. The impact of hormonal contraceptive use on innate immune activation among women with IBS requires further research.

Antigen-specific CD4 and CD8 T cells are important components of the immune response to Mycobacterium tuberculosis, yet little information is currently known regarding how the breadth, specificity, phenotype, and function of M. tuberculosis-specific T cells correlate with M. tuberculosis infection outcome in humans. To facilitate evaluation of human M. tuberculosis-specific T cell responses targeting multiple different Ags, we sought to develop a high throughput and reproducible T cell response spectrum assay requiring low blood sample volumes. We describe here the optimization and standardization of a microtiter plate-based, diluted whole blood stimulation assay utilizing overlapping peptide pools corresponding to a functionally diverse panel of 60 M. tuberculosis Ags. Using IFN-γ production as a readout of Ag specificity, the assay can be conducted using 50 μl of blood per test condition and can be expanded to accommodate additional Ags. We evaluated the intra- and interassay variability, and implemented testing of the assay in diverse cohorts of M. tuberculosis-unexposed healthy adults, foreign-born adults with latent M. tuberculosis infection residing in the United States, and tuberculosis household contacts with latent M. tuberculosis infection in a tuberculosis-endemic setting in Kenya. The M. tuberculosis-specific T cell response spectrum assay further enhances the immunological toolkit available for evaluating M. tuberculosis-specific T cell responses across different states of M. tuberculosis infection, and can be readily implemented in resource-limited settings. Moreover, application of the assay to longitudinal cohorts will facilitate evaluation of treatment- or vaccine-induced changes in the breadth and specificity of Ag-specific T cell responses, as well as identification of M. tuberculosis-specific T cell responses associated with M. tuberculosis infection outcomes.

The goal of this correlational study was to explore the relationship between Korean immigrant discipline (e.g., positive, appropriate, and harsh discipline) and children's social competence and behavior problems. Self-report data were collected from 58 mothers and 20 fathers of children aged from 3 to 8 years. Only paternal harsh discipline was positively correlated with children's behavior problems. Among specific discipline strategies, maternal physical affection, correcting misbehaviors, and reasoning were positively correlated with children's social competence. Paternal physical punishment (e.g., spanking, hitting, and raising arms) was positively correlated with children's behavior problems. Immigrant fathers need to learn alternative ways of managing children's misbehaviors.

This study of recidivism among Washington supermax prisoners used a retrospective matched control design, matching supermax prisoners one-to-one with nonsupermax prisoners on mental illness status and up to eight recidivism predictors. Supermax prisoners committed new felonies at a higher rate than nonsupermax controls, but the difference was not statistically significant. Prisoners released directly from supermax to the community, however, showed significantly higher felony recidivism rates than their nonsupermax controls and committed new offenses sooner than supermax prisoners who left supermax 3 months or more before prison release. Limitations, methodological issues, and policy implications are considered. (Contains 5 tables and 7 notes.)

The clinical significance of hypophosphatemia in cardiac surgery has not been investigated extensively. The aim of this study was to evaluate the association of postoperative hypophosphatemia and lactic acidosis in cardiac surgery patients at the time of intensive care unit (ICU) admission. A retrospective cohort study. At a single academic center. Patients who underwent nontransplant cardiac surgery with cardiopulmonary bypass between August 2009 and December 2020. None. Serum phosphate and lactate levels were measured upon ICU admission in patients undergoing nontransplant cardiac surgery with cardiopulmonary bypass. There were 681 patients in the low-phosphate (<2.5 mg/dL) group and 2,579 patients in the normal phosphate group (2.5-4.5 mg/dL). A higher proportion of patients in the low phosphate group (26%; 179 of 681; 95% CI: 23-30) had severe lactic acidosis compared to patients in the normal phosphate group (16%; 417 of 2,579; 95% CI: 15-18). In an unadjusted logistic regression model, patients in the low phosphate group had 1.9-times the odds of having severe lactic acidosis (serum lactate ≥4.0 mmol/L) when compared to patients in the normal phosphate group (95% CI: 1.5-2.3), and still 1.4-times the odds (95% CI: 1.1-1.7) after adjusting for several possible confounders. Hypophosphatemia is associated with lactic acidosis in the immediate postoperative period in cardiac surgery patients. Future studies will need to investigate it as a potential treatment target for lactic acidosis. [ABSTRACT FROM AUTHOR]

The release of the National Institutes of Health report, Oral Health in America: Advances and Challenges, in 2022 identified a pressing concern about oral healthcare and that "the job is far from finished." The High Point University Workman School of Dental Medicine utilized this report as inspiration to facilitate the design of the Clinician‐Advocate‐Researcher‐Entrepreneur Curriculum. The aspiration was to create a novel curriculum and experiential model to prepare learners for the future of dental medicine, including addressing these public oral healthcare needs. This article describes how we conducted this process in three steps: defining the curriculum philosophy, outcomes, and structure. We present this example for those interested in curriculum design and modifications. Our goal is to encourage educators to explore opportunities to enhance dental education as a critical component of the complex system that impacts oral healthcare broadly. [ABSTRACT FROM AUTHOR]

Bloodstream infections (BSIs) are a major cause of illness in HIV-infected persons. A series of studies, most of which were conducted in sub-Saharan Africa during the 1990s, demonstrated a high [...]

Objectives. We examined trends in tuberculosis (TB) cases and case rates among US- and foreign-born children and adolescents and analyzed the potential effect of changes to overseas screening of applicants for immigration to the United States. Methods. We analyzed TB case data from the National Tuberculosis Surveillance System for 1994 to 2007. Results. Foreign-born children and adolescents accounted for 31% of 18659 reported TB cases in persons younger than age 18 years from 1994 to 2007. TB rates declined 44% among foreign-born children and adolescents (20.3 per 10000 to 11.4 per 100000 population) and 48% (2.1 per 100000 to 1.1 per 100000) among those who were born in the United States. Rates were nearly 20 times as high among foreign-born as among US-born adolescents. Among foreign-born children and adolescents with known month of US entry (88%), more than 20% were diagnosed with TB within 3 months of entry. Conclusions. Marked disparities in TB morbidity persist between foreign- and US-born children and adolescents. These disparities and the high proportion of TB cases diagnosed shortly after US entry suggest a need for enhanced pre- and postimmigration screening. (Am J Public Health. 2010;100:1724-1729. doi:10.2105/AJPH.2009.181289)

The study attempts to develop an evidence-based clinical algorithm for people with human immunodeficiency virus (HIV) for tuberculosis screening and diagnosis. The results indicate that screening should include asking questions about the presence or absence of three symptoms and then treatment can be started.

Up to 50% of persons with HIV and a diagnosis of tuberculosis (TB) in Thailand die during TB treatment. In a prospective observational study, a team of physicians ascribed the [...]

The study aims to evaluate the risk of tuberculosis among foreign-born persons in the United States and the impact of adding TB in the overseas screening procedures for foreigners entering the U.S. The results indicate the chances of finding TB are higher among individuals from countries of Sub-Saharan Africa and Southeast Asia.