Association Between Obesity and Migraine in Women

Abstract


Purpose of Review

Migraine is a common and highly disabling condition that is particularly prevalent among women and especially women of reproductive age. The tremendous rise in adiposity in the Western world has led to an epidemic of obesity in women. The particular effects of obesity on women with migraine of various ages are the focus of this review.


Recent Findings

Conflicting findings from various studies with different approaches and populations have made challenging definitive conclusions about associations between migraine and obesity. While the association between obesity and migraine frequency has been consistently demonstrated and obesity is considered a risk factor for progression from episodic to chronic migraine, the association between obesity and migraine prevalence is still somewhat debated and appears to be dependent on gender and age, with the most consistent effects observed in women younger than 55 years of age.


Summary

Association between migraine and obesity is most commonly observed in women of reproductive age. The multimodal changes associated with age and hormonal change in women likely play a role in this relationship, as obesity does not appear to be related to migraine in women over 55 years of age. Future studies focusing on the migraine-obesity relationship in women should examine the effects of age, endogenous hormonal state, and exogenous hormones on migraine and obesity.

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The Multifaceted Personality of Intestinal CX3CR1+ Macrophages

Publication date: Available online 24 August 2017
Source:Trends in Immunology
Author(s): Mari Regoli, Eugenio Bertelli, Massimo Gulisano, Claudio Nicoletti
Intestinal macrophages expressing the fraktalkine receptor (CX3CR1+) represent a cell population that plays a variety of roles ranging from maintaining intestinal immune homeostasis at steady state to controlling antigen access by extending transepithelial dendrites (TEDs) to capture luminal microbes and shuttle them across the epithelium to initiate immune responses. However, recent evidence shows that very early during infection, pathogen-capturing CX3CR1+ macrophages migrate to the lumen of the small intestine, therefore preventing pathogens from traversing the epithelium. Here we discuss the complexity of the at-times seemingly opposing roles played by these cells and propose that CX3CR1-mediated pathogen exclusion is part of a defensive strategy against infections that includes multiple effector mechanisms acting synergistically at the intestinal mucosa.

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Specific mutations of penicillin-binding protein 1A in 77 clinically acquired amoxicillin-resistant Helicobacter pylori strains in comparison with 77 amoxicillin-susceptible strains

Abstract

Background

Amoxicillin (Amx) is one of the most important antibiotics for eradication of Helicobacter pylori (H. pylori). Main determinants of genetically stable Amx resistance are mutations in the C-terminus of penicillin-binding protein 1A (pbp1A). However, contribution of individual mutation remains unclear.

Methods

77 Amx-resistant (AmxR) and 77 Amx-susceptible (AmxS) H. pylori strains were isolated from gastric tissues, and DNA sequencing was performed to compare C-terminus sequences of pbp1A gene between AmxR and AmxS strains. Natural transformation of these mutated genes into amoxicillin-susceptible strains was performed.

Results

Among many mutations in pbp1A, D479E (OR: 37.4, 95% CI: 5.53-252.49, < .001), and T593 mutation (OR: 32.0, 95% CI: 4.04-252.86, < .001) independently contributed to Amx resistance in H. pylori strains. In the transformation experiment, T593 mutations were identified in their transformants showing Amx resistance. However, PCR product of D479E was not inserted into recipient (ATCC 43504) resulting in transformation failure.

Conclusion

Amx resistance is associated with various substitutions in pbp1A and T593 mutation contributes to Amx resistance of H. pylori.

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Incidence of bifid uvula and its relationship with submucous cleft palate and a family history of oral cleft in the Brazilian population

Publication date: Available online 24 August 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Sizina Aguiar G. Sales, Maria Luiza Santos, Renato Assis Machado, Verônica Oliveira Dias, Jairo Evangelista Nascimento, Mario Sérgio Oliveira Swerts, Hercílio Martelli Júnior, Daniella Reis Barbosa Martelli
IntroductionBifid uvula is a frequently observed anomaly in the general population and can be regarded as a marker for submucous cleft palate.ObjectiveIn this study aimed to determine the frequency of bifid uvula and submucous cleft palate and their relationship with oral clefts in a Brazilian population.MethodsWe conducted a transversal, descriptive and quantitative study of 1206 children between August 2014 and December 2015. A clinical examination of the children was conducted by means of inspection of the oral cavity with the aid of a tongue depressor and directed light. After the clinical examination in children, parents answered a questionnaire with questions about basic demographic information and their family history of oral clefts in their first-degree relatives. After application of the questionnaires, the information collected were archived in a database and analyzed by the statistical program SPSS® version 19.0, by applying Chi-Square tests. Values with p<0.05 were considered statistically significant.ResultsOf the 1206 children included in this study, 608 (50.40%) were female and 598 (49.60%) were male (p=0.773). The average age of children was 3.75 years (standard deviation±3.78 years). Of the 1206 children studied, 6 (0.5%) presented with bifid uvula. Submucosal cleft palate was not found in any child. When the family histories of children were examined for the presence of nonsyndromic cleft lip and/or cleft palate, no first degree relatives presented with the congenital anomaly.ConclusionThis study revealed that the incidence of bifid uvula and submucous cleft palate in this population was quite similar to previously reported incidence rates. Our study suggests an intensification of new reviews, with broader and diverse populations, seeking to associate the occurrence of bifid uvula, submucous cleft palate and oral clefts.

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Multidimensional effects of voice therapy in patients affected by unilateral vocal fold paralysis due to cancer

Publication date: Available online 24 August 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Camila Barbosa Barcelos, Paula Angélica Lorenzon Silveira, Renata Lígia Vieira Guedes, Aline Nogueira Gonçalves, Luciana Dall’Agnol Siqueira Slobodticov, Elisabete Carrara-de Angelis
IntroductionPatients with unilateral vocal fold paralysis (UVFP) may demonstrate different degrees of voice perturbation depending on the position of the paralyzed vocal fold. Understanding the effectiveness of voice therapy in this population may be an important coefficient to define the therapeutic approach.ObjectiveTo evaluate the voice therapy effectiveness in the short, medium and long-term in patients with UVFP and determine the risk factors for voice rehabilitation failure.MethodsProspective study with 61 patients affected by UVFP enrolled. Each subject had voice therapy with an experienced speech pathologist twice a week. A multidimensional assessment protocol was used pre-treatment and in three different times after voice treatment initiation: short-term (1–3 months), medium-term (4–6 months) and long-term (12 months); it included videoendoscopy, maximum phonation time (MPT), GRBASI scale, acoustic voice analysis and the portuguese version of the voice handicap index (VHI).ResultsMultiple comparisons for GRBASI scale and VHI revealed statistically significant differences, except between medium and long term (p<0.005). The data suggest that there is vocal improvement over time with stabilization results after 6 months (medium term). From the 28 patients with permanent UVFP, 18 (69.2%) reached complete glottal closure following vocal therapy (p=0.001). The logistic regression method indicated that the Jitter entered the final model as a risk factor for partial improvement. For every unit of increased jitter, there was an increase of 0.1% (1.001) of the chance for partial improvement, which means an increase on no full improvement chance during rehabilitation.ConclusionVocal rehabilitation improves perceptual and acoustic voice parameters and voice handicap index, besides favor glottal closure in patients with UVFP. The results were also permanent during the period of 1 year. The Jitter value, when elevated, is a risk factor for the voice therapy success.

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The Voiced Oral High-frequency Oscillation Technique’s Immediate Effect on Individuals With Dysphonic and Normal Voices

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Publication date: Available online 24 August 2017
Source:Journal of Voice
Author(s): Thais Lenharo Saters, Vanessa Veis Ribeiro, Larissa Thaís Donalonso Siqueira, Beatriz Dantas Marotti, Alcione Ghedini Brasolotto, Kelly Cristina Alves Silverio
ObjectiveThe aim of this study was to verify the effect of the voiced oral high-frequency oscillation (VOHFO) on voice quality in acoustic voice symptoms and self-reported sensations in individuals with voice complaints and dysphonic voices, and in individuals with normal voices.MethodsThe participants, which included 60 individuals from 18 to 45 years of age, both genders, were divided into two groups: G1, 30 individuals without voice complaints and normal voices; and G2, 30 individuals with voice complaints and dysphonic voices. We used the following measures: acoustic analysis, voice and larynx symptom investigation, and phonation time before and after 3 minutes of performing the VOHFO technique. The sensations were reported only after the VOHFO technique. Data were analyzed using the Wilcoxon test (P ≤ 0.05), paired t test (P ≤ 0.05), and the Mann-Whitney test (P ≤ 0.05).ResultsAfter the VOHFO, in G1, there was an increased fundamental frequency (both genders), a higher voice turbulence index, and a decrease in dryness symptoms (women); in G2, there was a decrease in the following symptoms: strong voice, dryness and lump in the throat, sensitive throat (women), and roughness and weak voice (men). The phonation measures and sensations did not present differences. The soft phonation index decreased in G1 and increased in G2 (women), in addition to a significant decrease in strong voice and sensitive throat (women) and roughness (men) in G2.ConclusionsThe VOHFO technique improves the source-filter relationship and the severity of voice and larynx symptoms in dysphonic and normal individuals. Women improved more in terms of larynx symptoms, whereas men improved more in terms of voice symptoms.

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The Voiced Oral High-frequency Oscillation Technique’s Immediate Effect on Individuals With Dysphonic and Normal Voices

Publication date: Available online 24 August 2017
Source:Journal of Voice
Author(s): Thais Lenharo Saters, Vanessa Veis Ribeiro, Larissa Thaís Donalonso Siqueira, Beatriz Dantas Marotti, Alcione Ghedini Brasolotto, Kelly Cristina Alves Silverio
ObjectiveThe aim of this study was to verify the effect of the voiced oral high-frequency oscillation (VOHFO) on voice quality in acoustic voice symptoms and self-reported sensations in individuals with voice complaints and dysphonic voices, and in individuals with normal voices.MethodsThe participants, which included 60 individuals from 18 to 45 years of age, both genders, were divided into two groups: G1, 30 individuals without voice complaints and normal voices; and G2, 30 individuals with voice complaints and dysphonic voices. We used the following measures: acoustic analysis, voice and larynx symptom investigation, and phonation time before and after 3 minutes of performing the VOHFO technique. The sensations were reported only after the VOHFO technique. Data were analyzed using the Wilcoxon test (P ≤ 0.05), paired t test (P ≤ 0.05), and the Mann-Whitney test (P ≤ 0.05).ResultsAfter the VOHFO, in G1, there was an increased fundamental frequency (both genders), a higher voice turbulence index, and a decrease in dryness symptoms (women); in G2, there was a decrease in the following symptoms: strong voice, dryness and lump in the throat, sensitive throat (women), and roughness and weak voice (men). The phonation measures and sensations did not present differences. The soft phonation index decreased in G1 and increased in G2 (women), in addition to a significant decrease in strong voice and sensitive throat (women) and roughness (men) in G2.ConclusionsThe VOHFO technique improves the source-filter relationship and the severity of voice and larynx symptoms in dysphonic and normal individuals. Women improved more in terms of larynx symptoms, whereas men improved more in terms of voice symptoms.

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Complement as a regulator of adaptive immunity

Abstract

The complement system is an ancient and evolutionarily conserved effector system comprising in mammals over 50 circulating and membrane bound proteins. Complement has long been described as belonging to the innate immune system; however, a number of recent studies have demonstrated its key role in the modulation of the adaptive immune response. This review does not set out to be an exhaustive list of the numerous interactions of the many complement components with adaptive immunity; rather, we will focus more precisely on the role of some complement molecules in the regulation of antigen presenting cells, as well as on their direct effect on the activation of the core adaptive immune cells, B and T lymphocytes. Recent reports on the local production and activation of complement proteins also suggest a major role in the control of effector responses. The crucial role of complement in adaptive immunity is further highlighted by several examples of dysregulation of these pathways in human diseases.

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