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Early outcome after Glenn shunt and Fontan palliation and the impact of operation during viral respiratory season: analysis of a 19-year multi-institutional experience.

BACKGROUND: This study was done to investigate the impact of season of operation, age at operation, and surgical era on short-term outcome after single ventricle palliation. One small study suggests that operation during viral respiratory season is associated with prolonged pleural effusion and hospitalization. Single-institution studies also find improved outcomes after the Glenn shunt and Fontan over time, despite operation at a younger age. METHODS: The Pediatric Cardiac Care Consortium (PCCC) database for Fontan (n = 2,713) and Glenn shunt (n = 2,239) performed between 1982 and 2000 was utilized. Death during initial hospitalization and length of stay after each procedure were investigated. Viral respiratory season was defined as the interval of November to March. RESULTS: The mortality rate after Fontan was higher during the viral respiratory season (14 versus 11%, p = 0.03) and in children under age 2 years. Glenn shunt mortality was higher with operation before age of 120 days, but was not affected by operation during viral respiratory season. Age at operation for the Fontan procedure has decreased with declines in hospital mortality (14% to 7%, p < 0.0001) and hospital stay (14 to 11 days, p < 0.0001) comparing 1992 to 1995 with 1996 to 2000. CONCLUSIONS: Fontan procedure performed during viral respiratory season is associated with an increased mortality. Short-term mortality and morbidity after the Glenn and Fontan procedures have improved in the recent era. Operation in the youngest age groups may adversely impact mortality.

Cardiac Surgical Procedures↗

Stress reactivity and coping in seasonal and nonseasonal depression.

Stress, stress reactivity, and coping skill use were examined in individuals with seasonal depression, nonseasonal depression, and nondepressed controls. Although participants in the two depressed groups reported using more avoidance coping strategies than controls, only participants in the seasonal depressed group reported using more season-specific coping (i.e., light-related strategies) than participants in the nonseasonal depressed and control groups. Individuals in the seasonal depressed group also reporting using acceptance coping strategies less frequently than individuals in the control group. Only participants in the nonseasonal depressed group, however, exhibited greater psychophysiological arousal in reaction to a laboratory stressor (i.e., unsolvable anagram task) when compared to participants in the seasonal and nondepressed control groups. Participants in both depressed groups reported greater impact of negative life events during the past 6 months than did controls. Similarities and differences in the two types of depression may have implications for the conceptualization and treatment of seasonal depression.

Adaptation, Psychological↗

Seasonal variation in plasma thyroxine concentrations in juvenile alligators (Alligators mississippiensis) from three Florida Lakes.

Circulating concentrations of thyroxine (T(4)) vary seasonally in many vertebrates. This study examined the seasonal variation in plasma concentrations of T(4) in juvenile American alligators (Alligator mississippiensis) from three populations in central Florida, USA. One site, Lake Woodruff National Wildlife Refuge, is considered a reference site whereas the other two lakes, Lake Apopka and Orange Lake, are significantly impacted by human activity. Juvenile American alligators ranging from 75-150 cm in total length were hand-captured at night from November 2000-April 2002. Plasma thyroxine concentrations were analyzed using a radioimmunoassay (RIA) previously validated for alligator plasma. Juvenile American alligators display seasonal variation in circulating T(4) concentrations. Plasma T(4) concentrations decrease from August/September to November and then begin a slow rise until April, at which point they plateau. Sex of juveniles influenced plasma concentrations of T(4) in some months but did not appear to alter the pattern in seasonal variation. The pattern we observed in plasma T(4) concentrations is not directly related to an environmental factor such as ambient temperature but is similar to that seen in plasma sex steroid concentrations during the reproductive cycle of adult alligators. Although the pattern and plasma concentration of T(4) exhibits significant variation among the three lakes studied, the pattern in seasonal variation appears similar. Comparing the seasonal pattern in plasma T(4) with plasma concentrations of sex steroids (testosterone and estradiol-17beta) or corticosterone could provide important information on the peripubescent life stage of the American alligator.

Aging↗

The value of Seasonal Correction Factors in assessing the health risk from domestic radon: a case study in Northamptonshire, UK.

Following an intensive survey of domestic radon levels in the United Kingdom (UK), the former National Radiological Protection Board (NRPB), now the Radiation Protection Division of the Health Protection Agency (HPA-RPD), established a measurement protocol and promulgated Seasonal Correction Factors applicable to the country as a whole. Radon levels in the domestic built environment are assumed to vary systematically and repeatably during the year, being generally higher in winter. The Seasonal Correction Factors therefore comprise a series of numerical multipliers, which convert a 1-month or 3-month radon concentration measurement, commencing in any month of the year, to an effective annual mean radon concentration. In a recent project undertaken to assess the utility of short-term exposures in quantifying domestic radon levels, a comparative assessment of a number of integrating detector types was undertaken, with radon levels in 34 houses on common geology monitored over a 12-month period using dose-integrating track-etch detectors exposed in pairs (one upstairs, one downstairs) at 1-month and 3-month resolution. Seasonal variability of radon concentrations departed significantly from that expected on the basis of the HPA-RPD Seasonal Correction Factor set, with year-end discontinuities at both 1-month and 3-month measurement resolutions. Following this study, monitoring with electrets was continued in four properties, with weekly radon concentration data now available for a total duration in excess of three and a half years. Analysis of this data has permitted the derivation of reliable local Seasonal Correction Factors. Overall, these are significantly lower than those recommended by HPA-RPD, but are comparable with other results from the UK and from abroad, particularly those that recognise geological diversity and are consequently prepared on a regional rather than a national basis. This finding calls into question the validity of using nationally aggregated Seasonal Correction Factors, especially for shorter exposures, and the universal applicability of these corrections is discussed in detail.

Air Pollution, Indoor↗

Seasonal and long-term trends in atmospheric PAH concentrations: evidence and implications.

Atmospheric monitoring data for selected polynuclear aromatic hydrocarbons (PAHs) were compiled from remote, rural and urban locations in the UK, Sweden, Finland and Arctic Canada. The objective was to examine the seasonal and temporal trends, to shed light on the factors which exert a dominant influence over ambient PAH levels. Urban centres in the UK have concentrations 1-2 orders of magnitude higher than in rural Europe and up to 3 orders of magnitude higher than Arctic Canada. Interpretation of the data suggests that proximity to primary sources 'drives' PAH air concentrations. Seasonality, with winter (W) > summer (S), was apparent for most compounds at most sites; high molecular weight compounds (e.g. benzo[a]pyrene) showed this most clearly and consistently. Some low molecular weight compounds (e.g. phenanthrene) sometimes displayed S>W seasonality at some rural locations. Strong W>S seasonality is linked to seasonally-dependent sources which are greater in winter. This implicates inefficient combustion processes, notably the diffusive domestic burning of wood and coal. However, sometimes seasonality can also be strongly influenced by broad changes in meteorology and air mass origin (e.g. in the Canadian Arctic). The datasets examined here suggest a downward trend for many PAHs at some sites, but this is not apparent for all sites and compounds. The inherent noise in ambient air monitoring data makes it difficult to derive unambiguous evidence of underlying declines, to confirm the effectiveness of international source reduction measures.

Agriculture↗

Non-specific immune parameters of brood Indian major carp Labeo rohita and their seasonal variations.

Different non-specific immune parameters and their seasonal changes in brood Indian major carp Labeo rohita reared in two major freshwater aquaculture regions of India viz. West Bengal and Orissa were investigated. It was undertaken for 2 consecutive years and included three main seasons of a year such as summer (March-May), rainy (July-September) and winter (November-January). Total serum protein, albumin and globulin levels were not significantly different throughout the year (p>0.01). Serum lysozyme and myeloperoxidase activities were lower (7.26+/-0.87mg/ml and, 0.54+/-0.11 OD, respectively) in winter as compared to any other season of the year. The bacterial agglutination titer was higher (p<0.01) in the rainy season (8.70+/-1.70) compared to summer and winter seasons (3.40+/-0.60 and 4.00+/-0.89, respectively). Haemagglutination and haemolytic activities did not vary (p>0.01) throughout the year. In blood smears, lymphocyte percentage was higher (75-80%) as compared to those of neutrophil (10-15%) and monocytes (5-10%) but eosinophilic granulocytes were present only in few cases. The differential leucocyte count did not vary significantly (p>0.05) in any season. This study indicated that certain non-specific immune parameters of this species can be modulated at certain times of the year.

Animals↗

Molecular cloning and characterization of the clock gene period2 in the testis of lizard Podarcis sicula and its expression during seasonal reproductive cycle.

Clock genes are known to oscillate with circadian rhythmicity in the central clock structure, the suprachiasmatic nucleus of the hypothalamus, and also in peripheral tissues. Reproduction is a peripheral activity that is strongly influenced by a circadian clock in many organisms. Most mammals that exhibit a seasonal cycle are able to decode the daily changes in light across the year and to translate these in hormonal signals that regulate reproductive cycles. Expression of many clock genes has been revealed in mouse testis, although transcription of these genes seems to be constitutive in 24 h, suggesting that these genes may play in the testis a different role with regard to the central clockwork function. The seasonal breeding lizard Podarcis sicula represents an attractive model for studying some developmental and differentiation phenomena, such as gonadal maturation, since in the adult male the testis shows a spring full activity and a complete summer regression. Experimental data seem to suggest that in lizard the environmental factors, as photoperiod and temperature, affect the endogenous elements, although the interaction mechanisms are unknown. It is known that temperature signals have a direct influence on clock processes such as transcription, translation, protein phosphorylation and degradation. In addition, most data show that the expression of circadian clock genes, such as period2, is affected by length of photoperiod. In this way, the core clockwork may also decode seasonal information. Here we report the cloning, sequencing and bioinformatic analysis of period2 gene, isolated from the testis of lizard P. sicula, and its expression both in the testis and in other tissues during the different phases of the seasonal cycle. RT-PCR assays enlighten the presence of transcript in testis, brain, heart, liver and kidney in all the phases analysed. Moreover, real time quantitative PCR assays detect a peak of per2 testicular expression during gonadal regression. Our preliminary results cannot clearly demonstrate the involvement of per2 gene in seasonal reproductive cycle of male lizard P. sicula, but its presence in the testis may suggest a role of this gene during spermatogenesis. Besides, our work can provide numerous starting points to clarify the role of per2 during seasonal reproductive cycle.

Amino Acid Sequence↗

Acute otitis media and season of birth.

INTRODUCTION: This study examines the question whether season of birth is associated with acute otitis media (AOM) and recurrent AOM (rAOM) and whether season of birth is associated with early age of AOM onset. METHODS: This was done in a population-based survey of 591 unselected Greenlandic children aged 3-5 and 8 years, living in the two largest towns in Greenland. The overall attendance rate was 86%. Information of AOM episodes was obtained from the parents and cross-checked in medical records available for 95% of the children. In total, 67% reported AOM at least once and 30% of those had rAOM. RESULTS: According to season of birth, the frequency of history of AOM in general varied between 63% and 70% lowest for birth in the autumn and highest for birth in the spring but without any significant statistical difference (p=0.51). The similar variation in rAOM according to season of birth was between 21% and 35%, highest for children born in autumn and winter and lowest for children born in the spring (p=0.09). Additionally, there was no difference in age at onset of the first AOM episode according to season of birth. However, AOM children born in the summer and autumn periods have a significantly higher relative risk (RR=1.44, CI=1.04-1.99) of attracting rAOM than AOM children born in the winter and spring periods. This may be due to a higher risk of being quickly reinfected in the late autumn and winter period with another episode of upper respiratory tract infection. CONCLUSION: Season of birth do not seem to be a predictor of AOM episodes or early onset of AOM but children born in the summer and autumn periods who attracts AOM have a higher risk of developing rAOM.

Acute Disease↗

A genome-wide search for quantitative trait loci contributing to variation in seasonal pollen reactivity.

BACKGROUND: Asthma and atopy represent complex traits for which genetic predisposition has been demonstrated. Pollen sensitivity, whether seasonal or chronic, appears to be a major contributor to the asthmatic phenotype. OBJECTIVE: Regions of the genome contributing to skin test reactivity to 5 seasonal allergens are to be identified in a genome-wide scan. These regions may be distinct from those contributing to risk for asthma and/or atopy. METHODS: In the Collaborative Study on the Genetics of Asthma, 4 sites collected 287 families with 2 or more members with asthma. Reactivity to individual pollens were determined on all family members. A genome scan was performed at 9-centiMorgan intervals, and skin test reactivity to 5 seasonal allergens was the focus of nonparametric genetic linkage analysis. RESULTS: Chromosomal regions that exhibited suggestive linkage (logarithm of the odds >1.18; P < .01) to seasonal pollen reactivity were identified on chromosomes 13q34, 20p12, and 21q21. Evidence of ethnic differences in linkage to seasonal allergens was demonstrated, with support for linkage in African American subjects on chromosomes 8, 10, and 12, in European American subjects on chromosomes 14, 19, 20, and 22, and in Hispanics on chromosome 21. In all families, evidence for linkage of skin test reactivity for Betula, Lolium, and Artemisia was strongest in a region on chromosome 21 that contained the candidate gene, A Disintegrin And Metalloprotease domain 33 (ADAM33). CONCLUSION: These results suggest both substantial genetic overlap and extensive heterogeneity in the genetic basis for the allergic response to seasonal allergens.

Adolescent↗

Seasonality of suicides with and without psychiatric illness in Denmark.

This paper studied the seasonality of suicides among persons with and without psychiatric illness in Denmark from 1970 to 1999. A non-homogenous Poisson process was used to examine the data. The seasonality of suicides was shown to be associated with gender and their psychiatric histories with a declining trend of suicide incidence noted over the captured period. A mild seasonal component was reported in the period of the late 70s to early 80s (1975-1984) among females who did not have any psychiatric treatment history, while in the 80s the significant seasonality was mainly contributed by male suicides without a psychiatric history. Another mild possible invoked seasonality in the 90s was in males who suffered from psychiatric illness. The rest could be treated as random events. Apparently, the seasonality among suicides with psychiatric illness exists but its effect could vary in different periods of time and among genders in Denmark.

Analysis of Variance↗

Seasonal variations in bipolar disorder admissions and the association with climate: a population-based study.

OBJECTIVE: Although seasonal influences on bipolar disorder admissions have long been observed, the issues of seasonality on different subtypes of mood episodes and the effects of associated climatic parameters remain controversial. This study sets out to examine seasonal variations in bipolar disorder admissions and the association with climate in Taiwan, a subtropical area with fairly constant weather conditions. METHODS: This retrospective population-based study uses the Taiwan National Health Insurance Research Database for 1999-2003, identifying 15,060 admissions for bipolar disorder, comprising of 8631 manic, 2078 depressive and 4351 mixed/unspecified episodes. The auto-regressive integrated moving average model was applied to examine the presence of seasonality and the association with climate in each subtype of mood episodes. RESULTS: Admission peaks were noted during spring/summer, early winter and early spring, for manic, depressive and mixed/unspecified episodes, respectively, while the associations with climatic parameters varied between the subtypes of mood episodes. CONCLUSIONS: Seasonality in bipolar disorder does exist for all subtypes of mood episodes. The distinct seasonal patterns and various associations with the climatic parameters imply different underlying mechanisms for the onset of each subtype of mood episodes. The association between admission rates and certain climatic variables found in this study is informative and could pave the way for future studies aimed at exploring the influence of climate on the psychopathology of bipolar patients as well as the underlying mechanisms.

Adult↗

How similar are daily and seasonal biological clocks?

Daily and seasonal timing systems in insects have usually been supposed to share similar mechanisms, because both rely in large measure on information from the daily light-dark cycle: daily clocks can ensure that activity coincides with the appropriate time of day, and seasonal time is indicated most reliably by daylength. However, several lines of evidence suggest that the systems are different. For example, receptor features, photosensitive pigments, clocks, and the effectors that mediate responses to information derived from the clock may have different daily, seasonal and general functions and properties, and several different systems are known. There are many different additional elements in the seasonal response. Therefore, these responses may not rely on similar timing mechanisms, despite the long-standing belief that the seasonal clock has circadian components. Such a difference would be consistent with the fact that temporal responses serve a very wide range of purposes, meeting many different ecological needs on different time frames. Consequently, understanding the seasonal relevance of the photoperiodic responses is more important than revealing any possible involvement with circadian systems.

Animals↗

Variation in ischemic stroke frequency in Japan by season and by other variables.

BACKGROUND AND PURPOSE: It is unclear whether acute ischemic stroke exhibits a seasonal pattern in Japan. The aim of the present study was to elucidate seasonal differences in acute ischemic stroke. METHODS: Our study enrolled 12,660 patients with ischemic stroke (7943 men, 4717 women; mean age, 70.1 years, S.D. 11.5; median 70; range 18-107). We divided the year into four parts: spring (March-May); summer (June-August); fall (September-November); and winter (December-February). Time of stroke onset was divided into three subgroups: daytime (08:00-16:00), evening (16:00-24:00), and night (24:00-08:00). We examined the association between clinical characteristics, season, and time of stroke onset. RESULTS: Stroke occurred least frequently in spring (22.9%), followed by winter (25.3%), fall (25.8%), and summer (26.0%) (P<0.001). No differences in age, National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale (m-RS) score, history of stroke/transient ischemic attack (TIA), or risk factors for stroke were observed among the four seasons. Stroke in men (63.8% vs. 62.4%; P<0.01), lacunar stroke (LS) (41.2% vs. 39.4%, P<0.01), atherothrombotic stroke (ATS) (34.0% vs. 32.3%; P<0.01), and nighttime stroke (26.5% vs. 24.8%; P<0.05) were observed more frequently in summer compared to other seasons. This contrasts with the findings for stroke in women (39.0% vs. 36.7%; P<0.05), cardioembolic stroke (CES) (23.4% vs. 20.6%; P<0.05), and daytime stroke (47.4% vs. 45.0%; P<0.05), which were more frequent in winter. CONCLUSIONS: Acute ischemic stroke displays seasonal characteristics according to gender, stroke subtype, and time of stroke onset. These results may have important clinical implications in ischemic stroke prevention.

Adolescent↗

Gene-environment interaction in hyperkinetic conduct disorder (HD + CD) as indicated by season of birth variations in dopamine receptor (DRD4) gene polymorphism.

Recently, an interaction between season of birth and the expression of candidate genes has been suggested. Season of birth variations in tryptophan hydroxylase (TPH), the serotonin transporter (5-HTTLPR) and the dopamine D4 receptor (DRD4) gene polymorphisms are different for affective disorders and schizophrenia. The DRD4 gene has been postulated as a candidate gene for attention-deficit-hyperactivity disorder (ADHD), equivalent to hyperkinetic disorder (HD). The seven-repeat long variant of this gene (DRD4*7) in comparison to the short repeat variants of the DRD4 gene polymorphism, has been found to be associated with ADHD. A seasonal pattern of birth has also been proposed for different subtypes of ADHD. Therefore, in a subgroup of children with HD and conduct disorder (CD) and in healthy controls, we investigated a possible association between the DRD4*7 allele and HD + CD in association with the season of birth. Supporting this hypothesis, we found an interaction between the seasons of birth and the expression of the DRD4 candidate gene in children with HD + CD as well as in controls, which differ significantly from each other. Depending on the season of birth, children carrying the DRD4*7R allele showed different relative risks for developing HD + CD.

Adolescent↗

The role of prolactin and testosterone in mediating seasonal differences in the self-grooming behavior of male meadow voles, Microtus pennsylvanicus.

Self-grooming in response to the odors of conspecifics is a form of olfactory communication among meadow voles. The amount of time meadow voles spend self-grooming when they encounter the odors of conspecifics varies seasonally, with males targeting the odors of reproductively active females only during the breeding season. Other odor related behaviors in male voles such as odor preferences for conspecifics and the attractiveness of their odors to conspecifics vary seasonally as well. For male meadow voles, these behaviors are mediated by seasonal variations in testosterone (T) and prolactin (PRL) titers. The objective of this study was to determine whether seasonal differences in the amount of time male meadow voles self-groom in response to odors of conspecifics are mediated by seasonal rhythms in their circulating T and PRL titers. We tested the hypothesis that high titers of both T and PRL are necessary for reproductively active (long-photoperiod; LP) males and sufficient for reproductively quiescent (short-photoperiod; SP) male voles to spend more time self-grooming in response to odors of LP females than to those of other conspecifics. Results of this study demonstrate that high titers of PRL and T are necessary for LP male meadow vole to self-groom more in response to odors of LP females as compared to those of other conspecifics, but were not sufficient to induce SP males to preferentially self-groom to odors of LP females. The endocrine control of self-grooming by LP males appears to depend upon high titers of both PRL and T, which matches the endocrine mediation of other odor related behaviors in male voles. In contrast, the endocrine tissues that underlie self-grooming in SP male meadow voles appear to be refractory to the effects of LP-equivalent titers of PRL and T.

Animals↗

Estimating depression prevalence from the Beck Depression Inventory: is season of administration a moderator?

The existence of winter seasonal affective disorder (SAD) and its milder population variants implies that depression estimates in a given population may tend to be higher in winter than at other times of the year. The aim of this study was therefore to test whether depression prevalence estimates based on the Beck Depression Inventory (BDI) are systematically moderated by season of administration. Existing information from the screening phase of a multicentre investigation of depression prevalence provided the data for the study. Repeated cross-sectional BDI data from samples in the United Kingdom (n=1299), Finland (n=1352), Norway (n=2711) and Spain (n=1246) were analysed for month- and season-of-administration effects. Whether data were measured continuously or as a dichotomous variable (BDI cutoff >/=13), there was no evidence of a systematic seasonal pattern in depression estimates across the four sites. No seasonal effects reached statistical significance at any single site, and trends in the association between winter and elevated BDI scores were positive in two sites (UK and Norway) and negative in two (Finland and Spain). Although limited by a post hoc analysis of existing data, this study provides the strongest evidence to date that season of administration is not a moderator of depression prevalence as estimated by the BDI.

Adolescent↗

Impact of case fatality on the seasonality of suicidal behaviour.

A number of differences exist between the seasonality of suicide and suicidal behaviour. Case fatality is one index of the relationship between these phenomena. The purpose of this study was to use contemporaneous data to examine the impact of case fatality on the seasonality of suicidal behaviour. All deliberate self-harm (ICD9 E950-58) hospitalisations (DSH) and deaths (suicide) for 1984-93 were extracted from the Western Australia case register (N=22 883). Case fatality was calculated by method of suicide. Data were arranged in time series by standardised month according to case fatality; sex and age and analysed using spectral analysis. We found that DSH involving low case fatal methods is seasonal with a spring peak (95% confidence interval). The explained variance of the seasonal rhythm increases with age. Suicide involving high case fatal methods is not seasonal. The increase in DSH seasonality with age may be related to a parallel increase in case fatality.

Adolescent↗

Effect of season and gonadotropins on the superovulatory response in camel (Camelus dromedarius).

The purpose of the present investigation was to study the extent to which season and the gonadotropin preparation interferes with the superovulatory response in the dromedary. Adult camels were treated for superovulation during the breeding (November to April) and non-breeding season (May to October). Animals were synchronized by daily i.m. injections of progesterone (125 mg/animal/day, Jurox, UK) for 10 to 14 days. Superovulation was induced by 400mg pFSH alone (Follitropin V, Vetrepharm, Canada) administered in eight descending doses at 12h intervals or a combination of PMSG (2000IU, Folligon, Intervet, The Netherlands), injected with last injection of progesterone and 400mg pFSH in eight descending doses. The follicular development was daily assessed by ultrasonography of the ovaries. The donors were classified as per their response to the superovulatory treatment into very good (>10 follicles), good (5-10 follicle), poor (2-4 follicles) or no response (1 or no follicle) on each ovary. Ovulation was induced by injecting 3000 IU hCG (Chorulon, Intervet) at the time of first mating. The donors were mated twice at an interval of 12h when all or most of the follicles reached to a size of about 1.0-1.7 cm. Camels were flushed non-surgically on Day 6 or 7 after the ovulation. The proportion of camels showing very good response during the breeding as well as non-breeding season was higher (P<0.05) when a combination of pFSH and eCG was used compared with pFSH only. There was no difference (P>0.05) in the proportion of donors flushed successfully (embryos recovered) when treated either with a combination of pFSH and eCG or pFSH alone during the breeding and non-breeding season. The rate of recovery of ova/embryos and proportion of transferable embryos was higher (P<0.05) when donors were treated with pFSH+eCG compared with pFSH only during the breeding as well as non-breeding season. The results may indicate that ova/embryo recovery rate of the dromedary is influenced by the gonadotropin preparation but is not appreciably affected by the season.

Animals↗