Pallean toimintahäiriö ja kuntoutus synnyttäneillä naisilla

Raskaus aiheuttaa merkittäviä fysiologisia ja rakenteellisia muutoksia naisen kehossa. Raskauden aikana pallean asento ja toiminta muuttuvat. Synnytyksen jälkeen muun muassa vauvan kantaminen ja imettäminen vaikuttavat kehon ja pallean asentoon ja siten myös hengitykseen. Mikäli pallea ja sen toiminta jätetään huomiotta synnytyksen jälkeisessä kuntoutuksessa, voi pallean toimintahäiriö ilmetä muun muassa erilaisina hengitystoiminnan häiriöinä tai kipuna kehon eri alueilla. Pallean toiminnan tutkimisen ja sen toimintahäiriön hoidon tulisikin aina kuulua synnytyksen jälkeiseen kuntoutukseen. Tämän opinnäytetyön tarkoituksena on lisätä synnyttäneiden naisten kanssa työskentelevien asiantuntijoiden tietoa ja käytännön taitoja liittyen pallean toimintaan, sen terveydellisiin vaikutuksiin sekä pallean toimintahäiriön kuntoutukseen. Tavoitteena on koota tuorein näyttöön perustuva tieto pallean toiminnasta, toimintahäiriöstä ja sen yleisimmistä ilmenemismuodoista sekä pallean toimintahäiriön kuntoutusmenetelmistä synnyttäneillä naisilla suomen kielellä. Aiheesta ei ole vielä julkaistu suomenkielistä materiaalia. Opinnäytetyön keskeisinä tuloksina lähteenä käytettyyn kirjallisuuteen perustuen pallean toimintahäiriön yleisimmät ilmenemismuodot synnyttäneillä naisilla ovat hyperventilaatio ja pinnallinen rintakehän yläosan hengitys. Opinnäytetyön lopussa on esitetty manuaalisia menetelmiä, Kinetic Control -testiliikkeitä, hengitysmetodeja sekä joogan asentoja pallean toiminnan tutkimiseen ja sen toimintahäiriön kuntoutukseen. Pallean toiminnan tutkimisen ja sen toimintahäiriön hoidon tulisi aina kuulua synnytyksen jälkeiseen kuntoutukseen. Opinnäytetyön toiminnallisena tuotoksena laaditaan koulutusmateriaali työpajan muodossa järjestettävään koulutuspäivään, joka toteutetaan työn tilaajan henkilökunnalle syksyllä 2018. Opinnäytetyön tilaaja on naisten terveyteen keskittyvä yritys FemiHealth Oy. Työn teoreettisen viitekehyksen muodostavat hengitys ja pallean toiminta, pallean toimintahäiriö, raskaus, synnytys ja synnytyksen jälkeinen vaihe sekä fysioterapia.Pregnancy causes significant physiological and structural changes in a woman’s body. During pregnancy, the position and function of the diaphragm changes. Postpartum, for example carrying and breastfeeding the baby affect the posture of the body and the diaphragm and thus breathing. If the diaphragm and its functions are ignored in postpartum rehabilitation, it may lead to diaphragmatic dysfunction manifesting itself in the form of a variety of breathing problems or pain in different parts of the body. Therefore, postpartum rehabilitation should always encompass the examination of diaphragmatic function and treatment of its possible dysfunction. The objective of this thesis is to increase the knowledge and practical skills of experts regarding the function of the diaphragm, its effects on health and the rehabilitation of diaphragmatic dysfunction in postpartum women. In addition, this thesis aspires to present in Finnish the most recent evidence-based knowledge of the function of the diaphragm, its dysfunction and the most common ways the dysfunction appears in postpartum women. Currently, no material about these subjects is available in Finnish. The key finding of this thesis, based on the literature used as reference, is that the most common manifestations of diaphragmatic dysfunction in postpartum women are hyperventilation and thoracic dominant breathing. Manual therapy approaches, Kinetic Control-based dissociation tests, breathing methods and yoga poses to aid in the examination and rehabilitation of diaphragmatic function are proposed at the end of this thesis. The practical product of this thesis is a training material for a training session to be organized in the form of a workshop for the working life partner of the thesis and its staff. The workshop will be organized in autumn 2018. The working life partner of the thesis is FemiHealth Oy, which is a company specializing in promoting women’s health. The theoretical framework of this thesis consists of breathing and the function of the diaphragm, diaphragmatic dysfunction, pregnancy, labour and postpartum phase, and physiotherapy

Transcriptional profiling of rat hypothalamus response to 2,3,7,8-tetrachlorodibenzo-p-dioxin

In some mammals, halogenated aromatic hydrocarbon (HAH) exposure causes wasting syndrome, defined as significant weight loss associated with lethal outcomes. The most potent HAH in causing wasting is 2,3,7,8-tetrachlorodibenzo-rho-dioxin (TCDD), which exerts its toxic effects through the aryl hydrocarbon receptor (AHR). Since TCDD toxicity is thought to predominantly arise from dysregulation of AHR-transcribed genes, it was hypothesized that wasting syndrome is a result of to TCDD-induced dysregulation of genes involved in regulation of food-intake. As the hypothalamus is the central nervous systems' regulatory center for food-intake and energy balance. Therefore, mRNA abundances in hypothalamic tissue from two rat strains with widely differing sensitivities to TCDD-induced wasting syndrome: TCDD-sensitive Long-Evans rats and TCDD-resistant Han/Wistar rats, 23 h after exposure to TCDD (100 mu g/kg) or corn oil vehicle. TCDD exposure caused minimal transcriptional dysregulation in the hypothalamus, with only 6 genes significantly altered in Long-Evans rats and 15 genes in Han/Wistar rats. Two of the most dysregulated genes were Cyp1a1 and Nqo1, which are induced by TCDD across a wide range of tissues and are considered sensitive markers of TCDD exposure. The minimal response of the hypothalamic transcriptome to a lethal dose of TCDD at an early time-point suggests that the hypothalamus is not the predominant site of initial events leading to hypophagia and associated wasting. TCDD may affect feeding behaviour via events upstream or downstream of the hypothalamus, and further work is required to evaluate this at the level of individual hypothalamic nuclei and subregions. (C) 2014 The Authors. Published by Elsevier Ireland Ltd.Peer reviewe

Species distribution and in vitro antimicrobial susceptibility of coagulase-negative staphylococci isolated from bovine mastitic milk

Background: Coagulase-negative staphylococci (CoNS) are the most common bovine mastitis causing bacteria in many countries. It is known that resistance for antimicrobials is in general more common in CoNS than in Staphylococcus aureus but little is known about the antimicrobial resistance of specific CoNS species. In this study, 400 CoNS isolates from bovine mastitic milk samples were identified to species level using ribotyping and MALDI-TOF MS, and their antimicrobial susceptibility was determined using a commercially available microdilution system. The results were interpreted according to the epidemiological cut-off values by the European Committee on Antimicrobial Susceptibility testing. Results: The most common CoNS species were S. simulans, S. epidermidis, S. chromogenes and S. haemolyticus. Penicillin resistance was the most common type of antimicrobial resistance. Staphylococcus epidermidis was the most resistant among the four major species. Almost one-third of our S. epidermidis isolates were resistant to >2 antimicrobials and close to 7 % were multidrug resistant. The majority of S. epidermidis isolates were resistant to benzylpenicillin. On the contrary, only few S. simulans isolates were penicillin-resistant. Phenotypic oxacillin resistance was found in all four main species, and 34 % of the isolates were oxacillin resistant. However, only 21 isolates (5 %) were positive for the mecA gene. Of these, 20 were S. epidermidis and one S. sciuri. mecC positive isolates were not found. Conclusion: Staphylococcus epidermidis differed from the three other major CoNS species as resistance to the tested antimicrobials was common, several isolates were multidrug resistant, and 19 % of the isolates carried the mecA gene encoding methicillin resistance.Peer reviewe

Toxicological characterisation of two novel selective aryl hydrocarbon receptor modulators in Sprague-Dawley rats

The aryl hydrocarbon receptor (AHR) mediates the toxicity of dioxins, but also plays important physiological roles. Selective AHR modulators, which elicit some effects imparted by this receptor without causing the marked toxicity of dioxins, are presently under intense scrutiny. Two novel such compounds are IMA-08401 (N-acetyl-N-phenyl-4-acetoxy-5-chloro-1,2-dihydro-1-methyl-2-oxo-quinoline-3-carboxamide) and IMA-07101 (N-acetyl-N-(4-trifluoromethylphenyl)-4-acetoxy-1,2-dihydro-5-methoxy-1-methyl-2-oxo-quinoline-3-carboxamide). They represent, as diacetyl prodrugs, AHR-active metabolites of the drug compounds laquinimod and tasquinimod, respectively, which are intended for the treatment of autoimmune diseases and cancer. Here, we toxicologically assessed the novel compounds in Sprague-Dawley rats, after a single dose (8.75-92.5 mg/kg) and 5-day repeated dosing at the highest doses achievable (IMA-08401: 100 mg/kg/day; and IMA-07101: 75 mg/kg/day). There were no overt clinical signs of toxicity, but body weight gain was marginally retarded, and the treatments induced minimal hepatic extramedullary haematopoiesis. Further, both the absolute and relative weights of the thymus were significantly decreased. Cyp1a1 gene expression was substantially increased in all tissues examined. The hepatic induction profile of other AHR battery genes was distinct from that caused by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). The only marked alterations in serum clinical chemistry variables were a reduction in triglycerides and an increase in 3-hydroxybutyrate. Liver and kidney retinol and retinyl palmitate concentrations were affected largely in the same manner as reported for TCDD. In vitro, the novel compounds activated CYP1A1 effectively in H4IIE cells. Altogether, these novel compounds appear to act as potent activators of the AHR, but lack some major characteristic toxicities of dioxins. They therefore represent promising new selective AHR modulators. (C) 2017 Elsevier Inc. All rights reserved.Peer reviewe

Semen as a source of Mycoplasma bovis mastitis in dairy herds

Mycoplasma bovis infections are responsible for substantial economic losses in the cattle industry, have significant welfare effects and increase antibiotic use. The pathogen is often introduced into naive herds through healthy carrier animals. In countries with a low prevalence of M. bovis, transmission from less common sources can be better explored as the pathogen has limited circulation compared to high prevalence populations. In this study, we describe how M. bovis was introduced into two closed and adequately biosecure dairy herds through the use of contaminated semen during artificial insemination (AI), leading to mastitis outbreak in both herds. Epidemiological analysis did not reveal an infection source other than semen. In both farms the primary clinical cases were M. bovis mastitis in cows inseminated with the semen of the same bull four weeks before the onset of the disease. One semen straw derived from the semen tank on the farm and other semen lots of this bull were positive for M. bovis. In contrast, semen samples were negative from other bulls that had been used for insemination in previous or later oestrus to those cows with M. bovis mastitis. Furthermore, cgMLST of M. bovis isolates supported the epidemiological results. To our knowledge this is the first study describing the introduction of M. bovis infection into a naive dairy herd via processed semen. The antibiotics used in semen extenders should be re-evaluated in order to provide farms with M. bovis-free semen or tested M. bovis-free semen should be available.Peer reviewe

AHR in energy balance regulation

Recent studies on mice genetically modified at the Ahr locus and fed on high-fat diet have revealed a novel physiological role for the AHR in energy balance. Globally impaired function of the receptor counteracts the development of obesity by increasing energy expenditure, which appears to occur mostly in the skeletal muscle and brown adipose tissue. On the other hand, global and tissue-specific loss of AHR signaling can have opposite effects on liver fat content and their impact on insulin sensitivity is also context-dependent. As tryptophan metabolites are key AHR activators, these findings suggest that the AHR may act as a protein sensor enabling adequate protein intake from low-protein diets by allowing calorie overfeeding without resultant obesity