Publications by authors named "Nicole Bender"

56 Publications

Malignancy-associated Sweet syndrome presenting with simultaneous histopathologic and morphologic variants.

JAAD Case Rep 2021 Aug 17;14:104-107. Epub 2021 Jun 17.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.06.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313799PMC
August 2021

Nutrient status and growth in vegan children.

Nutr Res 2021 Jul 18;91:13-25. Epub 2021 May 18.

Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland. Electronic address:

Vegan diets have risen in popularity over the past 9 years. However, few studies have examined nutrient status and the effect of a vegan diet on the growth of children. This study analysed the existing literature on the health impact and growth impact of selected nutrients in vegan children. We assessed the intake of calories and protein, as well as the nutrients iron, calcium, vitamin D, cobalamin and folate. With a small percentage of outliers, vegan children showed normal growth and were less often obese. We found limited evidence that children on a vegan diet can obtain all the examined nutrients. Furthermore, as proper planning and supplementation by caregivers is needed, it is currently unknown how often vegan children follow well-planned diets. Deficiencies in cobalamin, calcium, and vitamin D seem to be the biggest risks associated with a poorly planned vegan diet. For a more definitive assessment, data on the intake and nutrient status of omega-3 fatty acids, zinc, iodine, and selenium in vegan children are needed. Future research should account for demographic shifts in those following a vegan diet, and should discriminate between vegan sub-populations that are open or closed towards scientific approaches, towards health in general, and toward supplementation. Studies should assess the modes and dosages of supplementation and the use of fortified foods or drinks, as well as adherence to the diet itself. Plant ferritin as a source of iron and endogenous cobalamin synthesis warrants further scientific inquiry. In summary, the current literature suggests that a well-planned vegan diet using supplementation is likely to provide the recommended amounts of critical nutrients to provide for normal progression of height and weight in children, and can be beneficial in some aspects. However, data on 5 critical nutrients are still missing, hampering a more definitive conclusion.
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http://dx.doi.org/10.1016/j.nutres.2021.04.005DOI Listing
July 2021

Somatic PIK3R1 variation as a cause of vascular malformations and overgrowth.

Genet Med 2021 May 26. Epub 2021 May 26.

University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.

Purpose: Somatic activating variants in the PI3K-AKT pathway cause vascular malformations with and without overgrowth. We previously reported an individual with capillary and lymphatic malformation harboring a pathogenic somatic variant in PIK3R1, which encodes three PI3K complex regulatory subunits. Here, we investigate PIK3R1 in a large cohort with vascular anomalies and identify an additional 16 individuals with somatic mosaic variants in PIK3R1.

Methods: Affected tissue from individuals with vascular lesions and overgrowth recruited from a multisite collaborative network was studied. Next-generation sequencing targeting coding regions of cell-signaling and cancer-associated genes was performed followed by assessment of variant pathogenicity.

Results: The phenotypic and variant spectrum associated with somatic variation in PIK3R1 is reported herein. Variants occurred in the inter-SH2 or N-terminal SH2 domains of all three PIK3R1 protein products. Phenotypic features overlapped those of the PIK3CA-related overgrowth spectrum (PROS). These overlapping features included mixed vascular malformations, sandal toe gap deformity with macrodactyly, lymphatic malformations, venous ectasias, and overgrowth of soft tissue or bone.

Conclusion: Somatic PIK3R1 variants sharing attributes with cancer-associated variants cause complex vascular malformations and overgrowth. The PIK3R1-associated phenotypic spectrum overlaps with PROS. These data extend understanding of the diverse phenotypic spectrum attributable to genetic variation in the PI3K-AKT pathway.
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http://dx.doi.org/10.1038/s41436-021-01211-zDOI Listing
May 2021

Planned supracervical hysterectomy for surgical management of placenta accreta spectrum: A comparative study.

Eur J Obstet Gynecol Reprod Biol 2021 Jun 30;261:249-251. Epub 2021 Apr 30.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, 90033, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, 90033, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ejogrb.2021.04.039DOI Listing
June 2021

Palmar petechiae in a patient with diabetes mellitus.

JAAD Case Rep 2021 May 27;11:109-111. Epub 2021 Mar 27.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.03.035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081862PMC
May 2021

Reactive angioendotheliomatosis associated with antiphospholipid syndrome.

Dermatol Online J 2021 Mar 15;27(3). Epub 2021 Mar 15.

Department of Dermatology, University of Florida College of Medicine, Gainesville, FlL.

Reactive angioendotheliomatosis (RAE) is an uncommon, benign, antiproliferative condition associated with systemic diseases that may cause occlusion or inflammation of the vascular lumina. A link between antiphospholipid syndrome (APS) and RAE has been reported a few times in the literature. Herein, we present a unique case of RAE diagnosed in a patient with primary APS who was well-managed on warfarin and rituximab with no recent thrombotic events. As RAE can precede or follow a diagnosis of APS, the presence of the condition indicates a need to workup for APS and to ensure those with the condition are adequately anticoagulated. However, as demonstrated in this case, the condition can still occur in patients who are adequately anticoagulated.
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March 2021

Immunofocusing humoral immunity potentiates the functional efficacy of the AnAPN1 malaria transmission-blocking vaccine antigen.

NPJ Vaccines 2021 Apr 6;6(1):49. Epub 2021 Apr 6.

Emerging Pathogens Institute, Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.

Malaria transmission-blocking vaccines (TBVs) prevent the completion of the developmental lifecycle of malarial parasites within the mosquito vector, effectively blocking subsequent infections. The mosquito midgut protein Anopheline alanyl aminopeptidase N (AnAPN1) is the leading, mosquito-based TBV antigen. Structure-function studies identified two Class II epitopes that can induce potent transmission-blocking (T-B) antibodies, informing the design of the next-generation AnAPN1. Here, we functionally screened new immunogens and down-selected to the UF6b construct that has two glycine-linked copies of the T-B epitopes. We then established a process for manufacturing UF6b and evaluated in outbred female CD1 mice the immunogenicity of the preclinical product with the human-safe adjuvant Glucopyranosyl Lipid Adjuvant in a liposomal formulation with saponin QS21 (GLA-LSQ). UF6b:GLA-LSQ effectively immunofocused the humoral response to one of the key T-B epitopes resulting in potent T-B activity, underscoring UF6b as a prime TBV candidate to aid in malaria elimination and eradication efforts.
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http://dx.doi.org/10.1038/s41541-021-00309-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024329PMC
April 2021

Clash of the pandemics - At least 150'000 adults in Switzerland suffer from obesity grades 2 or 3 and are thus at elevated risk for severe COVID-19.

F1000Res 2020 7;9:1413. Epub 2020 Dec 7.

Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.

: Grade 2 and 3 obesity, alongside with other relevant risk factors, are substantially and independently associated with adverse outcomes of coronavirus disease 2019 (COVID-19). However, for Switzerland, due to the lack of synthesis studies, it is currently unknown how many people are affected by obesity at all. This knowledge may help to better estimate the relevance and size of this group at elevated risk, which could be incorporated into strategies to protect risk groups during the still unfolding COVID-19 pandemic. This study aimed to provide a first overall estimation of how many people in Switzerland are currently affected by grade 2 or 3 obesity. : Five representative national population-based studies were accessed which were conducted between 2012 and 2017 and which include data on height and weight of adult men and women in Switzerland. : In Switzerland in 2012-2017, among the 11.20% adults who were obese (body mass index (BMI) ≥30.0kg/m2), 1.76% (95% CI 1.50-2.02) suffered from grade 2 obesity (BMI 35.0-39.9 kg/m2), and 0.58% (95% CI 0.50-0.66) from grade severe 3 obesity (BMI ≥40.0 kg/m2). Converted into estimated absolute population numbers, this corresponds to a total of approximately n=154,515 people who suffer from grade 2 or 3 obesity (n=116,216 and n=38,298, respectively). : This risk group includes many younger people in Switzerland. The number of people with obesity-related risk becomes 3.8 to 13.6 times higher if grade 1 obesity and overweight people are also included in this risk group, for which there are arguments arising in the latest literature. In general, this large group at risk for severe COVID-19 should be given more attention and support. If it is confirmed that obesity plays a major role in severe COVID-19 courses, then every kilo of body weight that is not gained or that is lost in lockdown counts.
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http://dx.doi.org/10.12688/f1000research.27819.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970431PMC
April 2021

Effect of oral contraceptives on total and bioavailable 25-hydroxyvitamin D.

J Steroid Biochem Mol Biol 2021 Jul 20;211:105879. Epub 2021 Mar 20.

Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.

Studies show an increase in circulating levels of 25-hydroxyvitamin D [25(OH)D] in women using combined oral contraceptives (COCs). 25(OH)D is a quantitatively important metabolite and widely used clinical marker of vitamin D status and is regulated by vitamin D binding protein (VDBP). However, studies have not identified the type of formulations used by the women, and there are no data on the effect of progestins on 25(OH)D levels. Our study objective was to compare the effects of two COC formulations [ethinyl estradiol (EE)/norethindrone acetate (NETA) vs. EE/levonorgestrel (LNG)] as well as LNG alone on total and bioavailable (free plus albumin-bound) 25(OH)D levels in serum samples collected at baseline, mid treatment, and end of treatment. Total 25(OH)D and VDBP were measured by immunoassay, and bioavailable 25(OH)D was calculated. The results show that with the EE/NETA formulation, total and bioavailable 25(OH)D and VDBP levels increased non-significantly by 7.4 %, 14.9 %, and 10 %, respectively, from baseline to end of treatment. In contrast, the corresponding changes with EE/LNG showed an increase of 4.4 % in total 25(OH)D but a significant decrease of 18.2 % in bioavailable 25(OH)D and increase of 19.1 % in VDBP. When LNG was administered alone, no significant changes were observed in total and bioavailable 25(OH)D or VDBP levels during the course of treatment. Our findings show considerably different effects on total and bioavailable 25(OH)D levels, as well as VDBP levels, with different oral contraceptive formulations. LNG may have a suppressive effect on VDBP, similar to its well-known androgenic effect on SHBG. Further studies are needed to determine the effect of hormonal contraceptive formulations on vitamin D status and its potential impact on women's health.
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http://dx.doi.org/10.1016/j.jsbmb.2021.105879DOI Listing
July 2021

Sex difference in the immunogenicity of the quadrivalent Human Papilloma Virus vaccine: Systematic review and meta-analysis.

Vaccine 2021 03 24;39(12):1680-1686. Epub 2021 Feb 24.

Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.

Background: Immunological differences between males and females in response to viral vaccines are well known. This the first review to examine them for the Human Papilloma Virus.

Methods: We conducted a systematic review and meta-analysis of the immunogenicity of the Quadrivalent Human Papilloma Virus Vaccine qHPVV. We searched Medline, Embase, and CENTRAL for trials published until September 17, 2019. Inclusion criteria were 3-doses and reporting geometric mean titers (GMTs). We performed random-effects meta-analyses and meta-regression separated by age group and sex.

Results: Our search yielded 1809 unique studies. 334 full texts were screened and data from 18 studies were extracted. Females had higher pooled geometric mean titers than males in all age groups. Log transformed GMTs in male children (<16) years were: against HPV6: 6·62 (95% CI 6·29-6·94; I = 86·0%), against HPV11: 7·07 (95% CI 6·90-7·23; I = 63.1%), against HPV16: 8·53 (95% CI 8·28-8·78; I = 73·0%), and against HPV18 7·21 (95% CI 7·08-7·34; I = 26·4%). In females: against HPV6 7·10 (95% CI 6·79-7·41; I = 96·6%), HPV11: 7·32 (95% CI 7·15-7·50; I = 90·6%), HPV16: 8·71 (95% CI 8·52-8·91; I = 90·2%), and HPV18 7·35 (95% CI 7·11-7·58; I = 92·7%). In the meta-regression, the sexual difference was significant for HPV6 (p = 0·022) with a similar tendency for HPV11 (p = 0·066) and HPV18 (p = 0·079). Immunogenicity was significantly higher in children (<16) than in adults (p < 0·001).

Conclusion: Females have higher antibody titers against HPV after receiving the qHPVV than do males. The difference is bigger in low-risk HPV strains. Adjusting the doses and schedules for each sex should be explored further.
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http://dx.doi.org/10.1016/j.vaccine.2021.02.022DOI Listing
March 2021

COVID-19 sequelae in adults aged less than 50 years: A systematic review.

Travel Med Infect Dis 2021 Mar-Apr;40:101995. Epub 2021 Feb 22.

University of Zurich, Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travel Medicine, Competence Centre for Military Medicine and Biology, Hirschengraben 84, 8001, Zurich, Switzerland.

Background: There is emerging evidence of long-term sequelae in a considerable proportion of COVID-19 patients after recovery and the spectrum and severity of such sequelae should be systematically reviewed. This review aims to evaluate the available evidence of all intermediate and long-term COVID-19 sequelae affecting formerly healthy adults.

Methods: A systematic literature search of Embase, WHO, Scopus, Pubmed, Litcovid, bioRxiv and medRxiv was conducted with a cutoff date of the 17th September 2020 according to PRISMA guidelines and registered in PROSPERO (CRD42020208725). Search terms included "COVID-19", "coronavirus disease 2019", "SARS-CoV-2", "sequelae" and "consequence*". Publications on adult participants, with a confirmed SARS-CoV-2 infection were included. Elderly (>50 years old) and children (<18 years old) were excluded. Bias assessment was performed using a modified Newcastle-Ottawa Scale.

Results: A total of 31 papers were included. Study types included prospective and retrospective cohort studies, cross-sectional studies and case reports. Sequelae persistence since infection spanned 14 days to three months. Sequelae included persistent fatigue (39-73% of assessed persons), breathlessness (39-74%), decrease in quality of life (44-69%), impaired pulmonary function, abnormal CT findings including pulmonary fibrosis (39-83%), evidence of peri-/perimyo-/myocarditis (3-26%), changes in microstructural and functional brain integrity with persistent neurological symptoms (55%), increased incidence of psychiatric diagnoses (5.8% versus 2.5-3.4% in controls), incomplete recovery of olfactory and gustatory dysfunction (33-36% of evaluated persons).

Conclusions: A variety of organ systems are affected by COVID-19 in the intermediate and longer-term after recovery. Main sequelae include post-infectious fatigue, persistent reduced lung function and carditis. Careful follow-up post COVID 19 is indicated to assess and mitigate possible organ damage and preserve life quality.
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http://dx.doi.org/10.1016/j.tmaid.2021.101995DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898978PMC
April 2021

Public Health Interventions, Epidemic Growth, and Regional Variation of the 1918 Influenza Pandemic Outbreak in a Swiss Canton and Its Greater Regions.

Ann Intern Med 2021 04 9;174(4):533-539. Epub 2021 Feb 9.

Institute of Evolutionary Medicine and the Digital Society Initiative, University of Zurich, Zurich, Switzerland (J.F.).

Public health interventions implemented during the coronavirus disease 2019 (COVID-19) pandemic are based on experience gained from past pandemics. The 1918 influenza pandemic is the most extensively researched historical influenza outbreak. All 9335 reports available in the State Archives on 121 152 cases of influenza-like illness from the canton of Bern from 473 of 497 municipalities (95.2%) were collected; the cases were registered between 30 June 1918 and 30 June 1919. The overall incidence rates of newly registered cases per week for the 9 greater regions of Bern for both the first and second waves of the pandemic were calculated. Relative incidence rate ratios (RIRRs) were calculated to estimate the change in the slope of incidence curves associated with public health interventions. During the first wave, school closures (RIRR, 0.16 [95% CI, 0.15 to 0.17]) and restrictions of mass gatherings (RIRR, 0.57 [CI, 0.54 to 0.61]) were associated with a deceleration of epidemic growth. During the second wave, in autumn 1918, cantonal authorities initially reacted hesitantly and delegated the responsibility to enact interventions to municipal authorities, which was associated with a lack of containment of the second wave. A premature relaxation of restrictions on mass gatherings was associated with a resurgence of the epidemic (RIRR, 1.18 [CI, 1.12 to 1.25]). Strikingly similar patterns were found in the management of the COVID-19 outbreak in Switzerland, with a considerably higher amplitude and prolonged duration of the second wave and much higher associated rates of hospitalization and mortality.
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http://dx.doi.org/10.7326/M20-6231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901603PMC
April 2021

The potential for intramuscular depot medroxyprogesterone acetate as a self-bridging emergency contraceptive.

Contracept X 2021 3;3:100050. Epub 2020 Dec 3.

University of Southern California, Department of Obstetrics and Gynecology, Section of Family Planning, 2020 Zonal Ave Room 220, Los Angeles, CA, 90033, United States.

Objective: To examine the rate of ovulatory disruption when intramuscular depot medroxyprogesterone acetate (DMPA) is administered across graded stages of dominant follicle development.

Study Design: We assigned enrolled participants to one of three preassigned dominant follicle size groups: 12-14 mm, 15-17 mm and ≥ 18 mm. We followed dominant follicles via serial transvaginal ultrasound (TVUS) until the follicles reached their assigned size, at which time we administered DMPA. For 5 consecutive days thereafter, we followed the follicles via TVUS to observe follicle rupture and obtained serum luteinizing hormone (LH), estradiol, and progesterone concentrations. In the following 2 weeks, we collected serum progesterone concentrations twice weekly to detect possible ovulatory delay or dysfunction. We also collected serum medroxyprogesterone acetate (MPA) concentrations at 1 and 24 h after DMPA administration to examine against ovulatory outcomes.

Results: Twenty-six of 29 enrolled women completed the study. DMPA suppressed ovulation in 17/26 (65%) and caused ovulatory dysfunction in 1/26 (4%) participants. Larger follicles were more likely to rupture despite DMPA (12-14 mm: 0/10 (0%); 15-17 mm: 3/10 (30%); ≥ 18 mm: 6/6 (100%); p < .01). Pre-DMPA LH concentrations ranged from 13.8 to 93.7 IU/L (mean 49.0 IU/L) in cases of follicle rupture. We observed no cases of follicle rupture when DMPA was administered through cycle day 12. All 24-h MPA concentrations exceeded those needed for ovulation suppression.

Conclusion: DMPA suppressed and additionally disrupted ovulation in 65% and 4% of observed cycles, respectively. DMPA may provide effective emergency contraception as well as ongoing contraception if administered prior to an expected ovulation and specifically before the LH surge.

Implications: DMPA may be an alternative form of emergency contraception that can also self-bridge to ongoing contraception. As ovulation was not observed among any follicles when DMPA was given through cycle day 12, women who initiate DMPA up through cycle day 12 may not require backup contraception.
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http://dx.doi.org/10.1016/j.conx.2020.100050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7749364PMC
December 2020

Violaceous nodules in a patient with endometrial adenocarcinoma.

JAAD Case Rep 2021 Jan 17;7:5-7. Epub 2020 Oct 17.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2020.10.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727286PMC
January 2021

Generalized infantile myofibromatosis with visceral involvement presenting as diffuse hypopigmented macules at birth.

Pediatr Dermatol 2021 Jan 21;38(1):249-252. Epub 2020 Nov 21.

Department of Dermatology, University of Florida, Gainesville, FL, USA.

The initial clinical presentation of infantile myofibromatosis can vary from subtle skin changes to large tumors. Here, we describe a case of congenital generalized infantile myofibromatosis which presented with diffuse hypopigmented macules, some with subtle atrophy and telangiectasia. Further workup revealed visceral involvement which led to treatment with systemic chemotherapy. Awareness of this rare clinical presentation is crucial to expedite workup and treatment given the poor prognosis in infants with visceral involvement.
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http://dx.doi.org/10.1111/pde.14456DOI Listing
January 2021

National guidelines on nutrient reference values for the healthy adult population and for pregnant or lactating women are based on heterogeneous sources of evidence: review of guidelines.

Nutr Rev 2021 03;79(4):462-478

Institute of Evolutionary Medicine, University of Zurich, Switzerland.

Many countries provide dietary guidelines for health practitioners and/or the general population. However, there is no general, international guideline serving as a template for national dietary guidelines, and there is little to no consensus regarding reference values for different nutrients. The present review compared 27 national dietary guidelines for healthy adults as well as for pregnant and/or breastfeeding women, and analysed their quality and the evidence behind their recommendations. The guidelines were evaluated for their quality using the instrument Agree II, and found to be heterogeneous (overall quality score 14%-100%) and often insufficient (quality score < 50%) due to missing information about their methodology and sources of evidence. We analysed the evidence (number of studies, study types and publication years) of reference values of a number of nutrients using the five guidelines that provided the highest scores in the Agree II assessment. The reference values varied among guidelines, were rarely based on up-to-date meta-analyses, and were often based on insufficiently reported evidence (22/27 guidelines with quality score < 50%). We recommend systematic reviews of high quality studies to formulate future guidelines, and to use guidelines on how to write guidelines.
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http://dx.doi.org/10.1093/nutrit/nuaa062DOI Listing
March 2021

Residential Altitude Associates With Endurance but Not Muscle Power in Young Swiss Men.

Front Physiol 2020 23;11:860. Epub 2020 Jul 23.

Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.

Introduction: Physical fitness benefits health. However, there is a research gap on how physical fitness, particularly aerobic endurance capacity and muscle power, is influenced by residential altitude, blood parameters, weight, and other cofactors in a population living at low to moderate altitudes (300-2100 masl).

Materials And Methods: We explored how endurance and muscle power performance changes with residential altitude, Body Mass Index (BMI), hemoglobin and creatinine levels among 108,677 Swiss men aged 18-22 years (covering >90% of Swiss birth cohorts) conscripted to the Swiss Armed Forces between 2007 and 2012. The test battery included a blood test of about 65%, a physical evaluation of about 85%, and the BMI of all conscripts.

Results: Residential altitude was significantly associated with endurance ( < 0.001) but not with muscle power performance ( = 0.858) after adjusting for all available cofactors. Higher BMI showed the greatest negative association with both endurance and muscle power performance. For muscle power performance, the association with creatinine levels was significant. Elevated C-reactive protein (CRP) and hemoglobin levels were stronger contributors in explaining endurance than muscle power performance.

Conclusion: We found a significant association between low to moderate residential altitude and aerobic endurance capacity even after adjustment for hemoglobin, creatinine, BMI and sociodemographic factors. Non-assessed factors such as vitamin D levels, air pollution, and lifestyle aspects may explain the presented remaining association partially and could also be associated with residential altitude. Monitoring the health and fitness of young people and their determinants is important and of practical concern for disease prevention and public health implications.
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http://dx.doi.org/10.3389/fphys.2020.00860DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7390881PMC
July 2020

Multiple measures derived from 3D photonic body scans improve predictions of fat and muscle mass in young Swiss men.

PLoS One 2020 11;15(6):e0234552. Epub 2020 Jun 11.

Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.

Introduction: Digital tools like 3D laser-based photonic scanners, which can assess external anthropometric measurements for population based studies, and predict body composition, are gaining in importance. Here we focus on a) systematic deviation between manually determined and scanned standard measurements, b) differences regarding the strength of association between these standard measurements and body composition, and c) improving these predictions of body composition by considering additional scan measurements.

Methods: We analysed 104 men aged 19-23. Bioelectrical Impedance Analysis was used to estimate whole body fat mass, visceral fat mass and skeletal muscle mass (SMM). For the 3D body scans, an Anthroscan VITUSbodyscan was used to automatically obtain 90 body shape measurements. Manual anthropometric measurements (height, weight, waist circumference) were also taken.

Results: Scanned and manually measured height, waist circumference, waist-to-height-ratio, and BMI were strongly correlated (Spearman Rho>0.96), however we also found systematic differences. When these variables were used to predict body fat or muscle mass, explained variation and prediction standard errors were similar between scanned and manual measurements. The univariable predictions performed well for both visceral fat (r2 up to 0.92) and absolute fat mass (AFM, r2 up to 0.87) but not for SMM (r2 up to 0.54). Of the 90 body scanner measures used in the multivariable prediction models, belly circumference and middle hip circumference were the most important predictors of body fat content. Stepwise forward model selection using the AIC criterion showed that the best predictive power (r2 up to 0.99) was achieved with models including 49 scanner measurements.

Conclusion: The use of a 3D full body scanner produced results that strongly correlate to manually measured anthropometric measures. Predictions were improved substantially by including multiple measurements, which can only be obtained with a 3D body scanner, in the models.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234552PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289400PMC
August 2020

Children's dietary assessment and promotion: The Swiss situation.

Int J Public Health 2020 06 29;65(5):507-509. Epub 2020 May 29.

Bern University of Applied Sciences, Bern, Switzerland.

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http://dx.doi.org/10.1007/s00038-020-01393-4DOI Listing
June 2020

The role of mechanotransduction in heart failure pathobiology-a concise review.

Heart Fail Rev 2021 Jul;26(4):981-995

Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.

This review evaluates the role of mechanotransduction (MT) in heart failure (HF) pathobiology. Cardiac functional and structural modifications are regulated by biomechanical forces. Exposing cardiomyocytes and the myocardial tissue to altered biomechanical stress precipitates changes in the end-diastolic wall stress (EDWS). Thereby various interconnected biomolecular pathways, essentially mediated and orchestrated by MT, are launched and jointly contribute to adapt and remodel the myocardium. This cardiac MT-mediated feedback decisively determines the primary cardiac cellular and tissue response, the sort (concentric or eccentric) of hypertrophy/remodeling, to mechanical and/or hemodynamic alterations. Moreover, the altered EDWS affects the diastolic myocardial properties independent of the systolic function, and elevated EDWS causes diastolic dysfunction. The close interconnection between MT pathways and the cell nucleus, the genetic endowment, principally allows for the wide variety of phenotypic appearances. However, demographic, environmental features, comorbidities, and also the genetic make-up may modulate the phenotypic result. Cardiac MT takes a fundamental and superordinate position in the myocardial adaptation and remodeling processes in all HF categories and phenotypes. Therefore, the effects of MT should be integrated in all our scientific, clinical, and therapeutic considerations.
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http://dx.doi.org/10.1007/s10741-020-09915-1DOI Listing
July 2021

Implementation of multidisciplinary practice change to improve outcomes for women with placenta accreta spectrum.

Eur J Obstet Gynecol Reprod Biol 2020 Mar 13;246:194-196. Epub 2020 Jan 13.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA90033, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA90033, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ejogrb.2020.01.010DOI Listing
March 2020

Rubella Vaccine Persistence Within Cutaneous Granulomas in Common Variable Immunodeficiency Disorder.

Am J Dermatopathol 2020 Jun;42(6):455-457

Departments of Dermatology and Laboratory Medicine & Pathology, Mayo Clinic, Jacksonville, FL.

Common variable immunodeficiency disorder is a primary immunodeficiency disorder characterized by reduced levels of serum immunoglobulins and impaired antibody response. This condition may be associated with development of noninfectious granulomatous dermatitis of the skin which may be disfiguring and destructive. There are no published guidelines for the treatment of cutaneous granulomas in this patient population. In recent studies, rubella virus-positive cells in granulomas were localized to M2 macrophages which have an important role in wound healing and the secretion of immunoregulatory cytokines. We present a case of treatment-refractory, disfiguring common variable immunodeficiency disorder-associated granulomatous dermatitis. Immunofluorescence microscopy of the biopsy specimen confirmed the presence of rubella vaccine capsid proteins in M2 macrophages within the granuloma, a newly recognized phenomenon in this patient population. This knowledge may serve to identify future therapeutic targets or preventative strategies for granulomatous dermatitis in patients with primary immunodeficiency disorder.
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http://dx.doi.org/10.1097/DAD.0000000000001598DOI Listing
June 2020

Body height and waist circumference of young Swiss men as assessed by 3D laser-based photonic scans and by manual anthropometric measurements.

PeerJ 2019 12;7:e8095. Epub 2019 Dec 12.

Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.

Overweight and obesity are considered among the major health concerns worldwide. The body mass index is a frequently used measure for overweight and obesity and is associated with common non-communicable diseases such as diabetes type II, cardiovascular diseases and certain cancers. However, the body mass index does not account for the distribution of body fat and relative fat to muscle mass. 3D laser-based photonic full body scans provide detailed information on various body circumferences, surfaces, and volumes as well as body height and weight (using an integrated scale). In the literature, body scans showed good feasibility, reliability, and validity, while also demonstrating a good correlation with health parameters linked to the metabolic syndrome. However, systematic differences between body scan derived measurements and manual measurements remain an issue. This study aimed to assess these systematic differences for body height, waist circumference, and body mass index using cross-sectional data from a homogenous sample of 52 young Swiss male volunteers. In addition to 3D laser-based photonic full body scans and correlative manual measurements, body fat distribution was assessed through bioelectrical impedance analysis. Overall, an excellent correlation was found between measurements of waist circumference and body mass index, and good correlation between body mass index and total fat mass, as well as between waist circumference and visceral fat mass as assessed by bioelectrical impedance analysis. Volunteers were shorter in height measured by body scan when compared to manual measurements. This systematic difference became smaller when volunteers stood in the scanner in a completely upright position with their feet together. Waist circumference was slightly smaller for manual measurements than for body scan derived values. This systematic difference was larger in overweight volunteers compared to leaner volunteers.
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http://dx.doi.org/10.7717/peerj.8095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6931388PMC
December 2019

Mindful eating and common diet programs lower body weight similarly: Systematic review and meta-analysis.

Obes Rev 2019 11 1;20(11):1619-1627. Epub 2019 Aug 1.

Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.

Common strategies for reducing body weight rely on limiting energy intake and restricting food choices. However, these strategies have often been proven ineffective in achieving long-term and sustainable weight reduction. More recently, mindful eating as an alternative weight management strategy has gained increasing attention, yet systematic reviews on intuitive or mindful eating published so far present contradictory results. We performed a systematic review and meta-analysis on randomized controlled trials on weight loss programs based on mindful or intuitive eating. We analyzed results using meta-regressions. We included a total of 10 studies and found a significant weight loss effect of mindful/intuitive eating strategies compared with nonintervention controls (-0.348 kg, 95% CI: -0.591 to -0.105, P = 0.005). However, there was no difference compared with conventional diet programs (P = 0.99). Reduction of BMI (-0.137 kg/m , 95% CI: -0.365 to 0.091, P = 0.240) or waist circumference (-0.358 cm, 95% CI: -0.916 to 0.200, P = 0.209) were not statistically significant. Mindful/intuitive eating could be a practical approach to weight control. Limitations of this study include the unbalanced sex, origin, place of residence of the participants, and the short duration of interventions. Future research should aim at investigating long-term effects and include a more heterogeneous study population.
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http://dx.doi.org/10.1111/obr.12918DOI Listing
November 2019

Cutaneous metastases of papillary renal cell carcinoma: A case report and review of the literature.

J Cutan Pathol 2019 Dec 13;46(12):960-964. Epub 2019 Aug 13.

Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin.

Papillary renal cell carcinoma (RCC) is an uncommon subtype of RCC that is typically encountered at early stages and has a high survival rate. Histopathology typically shows well-defined papillary architecture with tumor cells lining fibrovascular cores and can be further subdivided into type 1 and type 2 tumors based on cytology and genetic basis. Type 1 tumors have a single layer of basophilic cells and low nuclear atypia, while type 2 tumors have a pseudostratified layer of eosinophilic cells and high nuclear atypia. Some tumors have overlapping features of both types. We present a unique case of cutaneous metastases of papillary RCC with typical papillary architecture in the dermis and review the literature on this rare entity.
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http://dx.doi.org/10.1111/cup.13546DOI Listing
December 2019

Effects of ritonavir-boosted protease inhibitors on combined oral contraceptive pharmacokinetics and pharmacodynamics in HIV-positive women.

Contraception 2019 10 10;100(4):283-287. Epub 2019 Jun 10.

Department of Obstetrics and Gynecology, Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, USA.

Objective: To assess the pharmacokinetics of combined oral contraceptive (COC) components and prevalence of ovulation in HIV-positive women using ritonavir-containing antiretroviral regimens compared to those using regimens previously found not to interact with COCs or not using any antiretrovirals.

Study Design: We conducted a prospective cohort pharmacokinetic pilot study comparing the pharmacokinetics of levonorgestrel (LNG) and ethinyl estradiol (EE) in HIV-positive women taking ritonavir-containing antiretroviral regimens to those in women using non-ritonavir-containing regimens or no antiretrovirals. Participants received COCs containing LNG/EE 150/30 mcg for 21 days. Beginning day 21, we collected serial blood samples over 72 h. The primary outcome was area under the curve (AUC) of LNG, with secondary outcomes including other LNG pharmacokinetic measures, EE pharmacokinetics and ovulation as measured by serum progesterone.

Results: Pharmacokinetic parameters of LNG showed a trend toward increased exposure in women on ritonavir. LNG AUC increased by 32.6% (312±60.9 vs. 243±82.6 ng/mL*h, p=.033, n=5) in women taking ritonavir compared to the control group (n=10). The C (9.68±1.81 vs. 7.62±2.29 ng/mL) and C (4.97±1.15 vs. 3.70±1.29 ng/mL) were also higher in the ritonavir arm. After excluding the inconsistent users (n=2), CL of LNG was reduced in the ritonavir arm (p=.032). EE pharmacokinetic profiles were not different between groups. The progesterone concentrations were similar in women of both groups, and none were consistent with ovulation during the treatment cycle.

Conclusion: Women on ritonavir showed an approximately 30% increase in LNG exposure but no difference in EE exposure.

Implications: The current data suggest that ritonavir does not have a clinically significant impact on oral contraceptive pharmacokinetics.
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http://dx.doi.org/10.1016/j.contraception.2019.06.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778019PMC
October 2019

Pulmonary arterial pressure at rest and during exercise in chronic mountain sickness: a meta-analysis.

Eur Respir J 2019 06 27;53(6). Epub 2019 Jun 27.

Dept of Cardiology and Clinical Research, Inselspital, University of Bern, Bern, Switzerland

Up to 10% of the more than 140 million high-altitude dwellers worldwide suffer from chronic mountain sickness (CMS). Patients suffering from this debilitating problem often display increased pulmonary arterial pressure (PAP), which may contribute to exercise intolerance and right heart failure. However, there is little information on the usual PAP in these patients.We systematically reviewed and meta-analysed all data published in English or Spanish until June 2018 on echocardiographic estimations of PAP at rest and during mild exercise in CMS patients.Nine studies comprising 287 participants fulfilled the inclusion criteria. At rest, the point estimate from meta-analysis of the mean systolic PAP was 27.9 mmHg (95% CI 26.3-29.6 mmHg). These values are 11% (+2.7 mmHg) higher than those previously meta-analysed in apparently healthy high-altitude dwellers. During mild exercise (50 W) the difference in mean systolic PAP between patients and high-altitude dwellers was markedly more accentuated (48.3 36.3 mmHg) than at rest.These findings indicate that in patients with CMS PAP is moderately increased at rest, but markedly increased during mild exercise, which will be common with activities of daily living.
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http://dx.doi.org/10.1183/13993003.02040-2018DOI Listing
June 2019

Have Swiss adult males and females stopped growing taller? Evidence from the population-based nutrition survey menuCH, 2014/2015.

Econ Hum Biol 2019 05 28;33:201-210. Epub 2019 Mar 28.

Institute of Evolutionary Medicine, University of Zurich, Switzerland. Electronic address:

Data from the National Nutrition Survey for adults (menuCH) allow for the assessment of recent trends in measured height by year of birth for adult men and women from a population-based sample. The aim of the present study was to test if - similarly to conscripts and schoolchildren - the Swiss adult population stopped growing taller in recent birth cohorts, and if so, when the change occurred. We found that - when self-reported - height was overestimated on average by about 1 cm in both men and women, with an increasing tendency with older age and with shorter height. Average measured height increased by 4.5-5.0 cm for adult men and women between the birth years 1937-1949 and 1990-1995. However, this increase was not linear, and starting with the 1970s birth years, average height plateaued on a level of about 178 cm for men and 166 cm for women. Being born outside of Switzerland or adjustment for potential shrinkage with increasing age did not change this temporal pattern. We also found shorter average height among participants from the Italian part of Switzerland and those with lower educational level. It remains unclear if the phenomenon of stabilisation affects all subgroups of the Swiss population. Future studies should combine a larger number of population-based surveys to enhance the sample size, for example, for people with a migration background or with different educational levels. Continuing growth monitoring needs to be performed to assess if environmental and demographic changes with an impact on body growth (adverse trends in nutrition, increasing social inequality in health, ethnic composition of the population) positively or negatively influence future trends in average height.
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http://dx.doi.org/10.1016/j.ehb.2019.03.009DOI Listing
May 2019
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