Relationship between physical activity and HDL-cholesterol in healthy older men and women: a cross-sectional and exercise intervention study

Prolactin (PRL) is known to be expressed in the decidualized human endometrium and secreted into amniotic fluid. Although the site of synthesis of endometrial PRL is known to be the decidual cells, the difference in PRL gene expression within each area of decidua, i.e. decidua basalis, decidua parietalis and decidua capsularis, during pregnancy is not clear. We have applied an in situ hybridization histochemistry technique using a radiolabeled RNA probe to compare the difference in expression of PRL gene within each area of the decidualized endometrium. Specific hybridization signals were distributed over the decidual cells in early and term pregnancy. More intense hybridization signals were always detected in the tissues of early pregnancy than in those of term pregnancy. In the decidua capsularis of early pregnancy, labeled cells were concentrated close to the amniotic cavity, whereas cells were concentrated close to the maternal surface of the fetal membrane in term pregnancy. In the decidua parietalis, almost all decidual cells were labeled, but no specific labeling was seen in the endometrial glands or capillary endothelium in both groups. In the decidua basalis, most decidual cells showed hybridization signals whereas no hybridization signal was seen over the trophoblast cells. These results show that there are regional and periodic differences in PRL gene expression in the decidual cells during pregnancy.     

Relationship between free-living daily physical activity and ambulatory measures in older claudicants

The purpose of this study was to determine the relationship between free-living daily physical activity and ambulatory measurements in peripheral arterial occlusive disease (PAOD) patients with intermittent claudication. Thirty-four older, nonsmoking PAOD patients with intermittent claudication (age=69.0 +/- 6.0 years, ankle/brachial index [ABI] =0.63 +/- 0.18) were recruited from the Vascular Clinic at the Baltimore Veterans Affairs Medical Center and from radio and newspaper advertisements. Energy expenditure of physical activity (EEPA) was determined by using doubly labeled water and indirect calorimetry techniques. Patients were also characterized on claudication distances and peak oxygen uptake during a graded treadmill test, 6-minute walking distance, weight, body mass index, and percent body fat. The claudication patients were sedentary, as EEPA was 362 +/- 266 kcal/day. EEPA was related to the 6-minute walk distance (369 +/- 68 meters; r=0.629, P<0.001), to the number of steps taken during 6 minutes (605 +/- 99 steps; r=0.485, P=0.008), to the treadmill distance to maximal claudication (313 +/- 131 meters; r=0.470, P=0.010), and to the time to relief of pain (6:21 +/- 3:57 min:sec; r=-0.417, P=0.017). None of the other ambulatory and body composition measurements were correlated with EEPA. In conclusion, a reduction in free-living daily physical activity was associated with a decrease in ambulatory ability and with more severe intermittent claudication in older PAOD patients.     

Association between marginal bone loss around osseointegrated mandibular implants and smoking habits: a 10-year follow-up study

While many factors are conceivable, occlusal loading and plaque-induced inflammation are frequently stated as the most important ones negatively affecting the prognosis of oral implants. Currently, little is known about the relative importance of such factors. The aim of this study was to analyze the influence of smoking and other possibly relevant factors on bone loss around mandibular implants. The participants were 45 edentulous patients, 21 smokers and 24 non-smokers, who were followed for 10-year period after treatment with a fixed implant-supported prosthesis in the mandible. The peri-implant bone level was measured on intraoral radiographs, information about smoking habits was based on a careful interview, and oral hygiene was evaluated from clinical registration of plaque accumulation. Besides standard statistical methods, multiple linear regression models were constructed for estimation of the relative influence of some factors on peri-implant bone loss. The long-term results of the implant treatment were good, and only three implants (1%) were lost. The mean marginal bone loss around the mandibular implants was very small, about 1 mm for the entire 10-year period. It was greater in smokers than in non-smokers and correlated to the amount of cigarette consumption. Smokers with poor oral hygiene showed greater marginal bone loss around the mandibular implants than those with good oral hygiene. Oral hygiene did not significantly affect bone loss in non-smokers. Multivariate analyses showed that smoking was the most important factor among those analyzed for association with peri-implant bone loss. The separate models for smokers and non-smokers revealed that oral hygiene had a greater impact on peri-implant bone loss among smokers than among non-smokers. This study showed that smoking was the most important factor affecting the rate of peri-implant bone loss, and that oral hygiene also had an influence, especially in smokers, while other factors, e.g., those associated with occlusal loading, were of minor importance. These results indicate that smoking habits should be included in analyses of implant survival and peri-implant bone loss.     

Relationship between plasma aldosterone concentration and plasma potassium in patients with essential hypertension during alprenolol treatment

Plasma aldosterone concentration (PAC), plasma renin concentration (PRC), plasma potassium, plasma sodium and blood pressure (BP) have been measured in 22 patients with essential hypertension before and after treatment for one month with alprenolol. PAC, PRC and BP decreased and plasma potassium increased significantly during treatment. Plasma sodium, however, was unchanged. Changes in PAC were inversely correlated to changes in plasma potassium. No relationship could be demonstrated between PAC and plasma sodium. Mean BP was inversely correlated to PAC during alprenolol treatment, but bot before treatment. No relationship was found between changes in BP and changes in PRC. The results suggest that plasma potassium is an important regulatory factor for aldosterone secretion during alprenolol treatment. Other factors, however, must have a modulating influence and since the renin- angiotensin system is not suppressed to very low values, this system is possibly the most important of these factors. It is suggested that aldosterone secretion is not of primary importance in BP regulation during alprenolol treatment.     

Reciprocal changes in complement activity and immune-complex levels during plasma infusion in a C2-deficient SLE patient

A toxin isolated from the growth medium of Actinobacillus actinomycetemcomitans by ammonium sulfate precipitation was shown to inhibit irreversibly the multiplication of human gingival fibroblasts. DNA histograms from flow cytometric measurements showed that the cells accumulated preferentially in the G2 phase of the cell cycle. Such cells exhibited sheetlike protrusions, and an increased frequency of micronuclei was evident in cells treated with low concentrations of the toxin. Toxin-treated cells were viable for several weeks, as shown by staining with trypan blue and fluorescein diacetate, and the general cell metabolism as measured by oxygen consumption was unimpaired.     

Suicide attempts in a cohort of drug abusers: a 5-year follow-up study

A group of 125 drug abusers admitted consecutively for detoxification and short-term rehabilitation were followed up 5 years after discharge. They were asked about possible suicide attempts in a semi-structured face-to-face interview. Nearly half of the group (45%) reported having attempted suicide at some point in their life. The most common reasons given were the loss of a person whom they loved, and feelings of loneliness. Only three respondents reported using their drug of choice in the attempt(s). The suicide attempters were more often found to have been in child psychiatric treatment earlier, and to have experienced loss of significant others in childhood, than those who did not report attempting suicide. At follow-up the suicide attempters indicated that they experienced more depressive moods and more severe psychological problems than those who had never made a suicide attempt. The importance of assessing the risk of suicide attempts among drug addicts in order to be able to take measures to prevent future suicidal behaviour is emphasized.     

Relationship between changes in factors of nonspecific resistance during traumatic and burn shock

Kaposi's sarcoma (KS) is a common malignancy in patients with acquired immunodeficiency syndrome (AIDS), classically appearing as red to purple plaques containing small papules and nodules. We report our experience with an adolescent orthotopic liver transplant recipient who presented with an unusual presentation of KS. The patient had a protracted multisystem illness that began with hemolytic anemia, fevers, and fatigue and progressed to pancreatitis, sinusitis, lymphadenopathy, and mouth ulcers. The diagnosis was made by a lymph node biopsy that was performed to evaluate for Epstein-Barr virus. The classical subcutaneous nodules characteristic of KS did not become evident until shortly before the patient died. We present this case to emphasize that KS in pediatric liver transplant patients can present as a multisystem disease that progresses to disseminated organ involvement before the characteristic subcutaneous manifestations are evident.     

Physical activity, change in blood pressure and predictors of mortality in older South Africans--a 2-year follow-up study

OBJECTIVE: A 2-year follow-up study of a cohort of 200 historically disadvantaged older South Africans was conducted to: (i) characterise current levels of habitual physical activity; (ii) relate physical activity to current risk factors for chronic disease; and (iii) identify risk factors associated with 2-year mortality. The baseline sample, drawn in 1993, was found to have a high prevalence of hypertension (71.7%). RESEARCH DESIGN: Retrospective cohort study. METHODS: A baseline sample of 200 persons aged > or = 65 years, resident in the Cape Peninsula, was randomly drawn by means of a two-stage cluster design. Baseline measurements included: anthropometry, waist/hip ratio, systolic and diastolic blood pressure, body mass index (BMI), serum albumin, serum ferritin, haemoglobin and fasting plasma glucose levels, plasma lipid profiles, oral glucose tolerance test and self-reported health status. Subjects were revisited after 2 years, at which time an adapted version of the Yale Physical Activity Survey was administered and measurements of blood pressure and anthropometry were repeated. STATISTICAL ANALYSES: Spearman's rank-order correlations were used to describe relationships between various current risk factors and physical activity. Logistic regression was used to determine predictors of 2-year mortality from baseline data. RESULTS: At follow-up, 142 of the subjects (66 men, 76 women) were traced and measurements collected. Thirty-two subjects were reported to have died by relatives living in the same household (22 men, 10 women). Levels of reported physical activity in the survivors were two-thirds lower than those reported in a sample of North Americans of similar age. There was an inverse association between age and physical activity (r = -0.31; P < 0.0005) and a positive association between BMI and physical activity (r = 0.29; P < 0.005). There was, however, no association between physical activity and systolic or diastolic blood pressure. In men, BMI in the lower tertile (P = 0.07) and serum ferritin levels were positively associated with increased mortality. Serum albumin levels were protective over the 2-year follow-up period (OR = 0.85; P < 0.05). In women, being diabetic (OR = 4.88; P = 0.06) and having a waist/hip ratio in the upper tertile (OR = 3.26; P = 0.06) were associated with mortality. CONCLUSIONS: Physical activity levels in this sample of older historically disadvantaged South Africans were habitually low. Simple anthropometric assessments incorporating weight and waist/hip ratio, together with serum albumin measurements, may be useful to screen general health risk for older adults at primary care level and provide indications for social or medical intervention. Further, strategies for earlier detection and effective management of diabetes, particularly in older women, may reduce premature mortality in this population.     

Long-term follow-up of physical activity behavior in older adults.

Objective: To examine the contribution of social-cognitive factors (self-efficacy and affect) in predicting long-term physical activity in a sample of older adults (N = 174). Design: A prospective design assessed physical activity and psychosocial variables at 2 and 5 years following a 6-month randomized, controlled exercise trial. Main Outcome Measures: The primary outcome variable was self-reported physical activity, with previous behavior, self-efficacy, and affect assessed as determinants of physical activity. Results: Covariance modeling analyses indicated that physical activity at Year 2 was the strongest predictor of physical activity at 5-year follow-up. Both self-efficacy and affect at Year 2 were also associated with physical activity at Year 5, as was original treatment condition. Variables accounted for 35% of the variance in Year 5 activity. Conclusion: Older adults with higher levels of physical activity, more positive affect, and higher self-efficacy at Year 2 were more likely to continue to be active at Year 5. This study is one of the longest follow-ups of exercise behavior in older adults and has implications for structuring environments to maximize the maintenance of physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Six-month physical activity and fitness changes in Project Active, a randomized trial

PURPOSE: Project Active is a randomized clinical trial (N = 235) comparing a lifestyle physical activity program with a structured exercise program in changing physical activity (total energy expenditure [kcal.kg-1.d-1]) and cardiorespiratory fitness (VO2peak in mL.kg-1.min-1). METHODS: Sedentary but healthy adults (N = 235) aged 35-60 years received 6 months of intensive intervention. RESULTS: Analysis of covariance (ANCOVA), adjusting for baseline measure, age, gender, body mass index (BMI), cohort, and ethnicity, showed that at 6 months both lifestyle and structured groups significantly increased energy expenditure over baseline (P < 0.001). The mean increases +/- SE, 1.53 +/- 0.19 kcal.kg-1.d-1 for the lifestyle group and 1.34 +/- 0.20 kcal.kg-1 d-1 for the structured group, were not significantly different between groups (P = 0.49). For cardiorespiratory fitness, both groups had significant increases from baseline (P < 0.001). Mean increases +/- SE were 1.58 +/- 0.33 mL.kg-1.min-1 and 3.64 +/- 0.33 mL.kg-1.min-1 for the lifestyle and structured groups, respectively. This was significantly greater in the structured group (P < 0.001). We also studied changes in intensity of physical activity. Both groups significantly increased moderate intensity activity from baseline, but the increase was significantly greater in the lifestyle group than the structured group (P = 0.02). In contrast, the structured group increased its hard activity more than the lifestyle group, but the difference was not significantly different (P = 0.02). In contrast, the structured group increased its hard increased (P < 0.01) for both groups by 0.25 kcal.kg-1.d-1. CONCLUSION: Both intervention approaches are effective for increasing physical activity and fitness over a 6-month period in initially sedentary men and women.     

Relationship between cognitive style and cognitive development: A 2-year longitudinal study.

Examined developmental changes in the relationship between reflection–impulsivity, spatial perspective taking, and conservation behavior in 40 4–8 yr olds. Ss were administered the Matching Familiar Figures Test. Results indicate no relationship between these variables for 4-yr-olds. At 6 and 8 yrs of age, however, moderately strong negative correlations were found between impulsivity and the expression of operative knowledge. Structural regression analyses suggested that the expression of a reflective cognitive style at 6 yrs of age was causally linked to the emergence of operativity at 8 yrs of age. Longitudinal data confirmed a developmental shift from what is seen in perspective-taking tasks to how it is seen. Discussion focuses on the role of cognitive styles in the development and use of cognitive structures and on the nature of perspective-taking development. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between serum angiotensin-converting enzyme activity and plasma plasminogen activator inhibitor activity in patients with recent myocardial infarction

BACKGROUND: An elevated level of angiotensin-converting enzyme (ACE) has been demonstrated to increase the risk of myocardial infarction. Plasminogen activator inhibitor (PAI) is the most important physiological inhibitor of tissue plasminogen activator in plasma. An elevated level of PAI has been reported to be associated with decreased fibrinolytic capacity and to constitute a marker of the risk for recurrent coronary thrombosis. METHODS: We measured the serum ACE activity and plasma PAI activity in 34 patients with recent myocardial infarction, and evaluated the correlation between these two values by linear regression analysis. We also administered captopril (37.5 mg/day) to 17 of these patients and placebo to the other 17 patients at random, and compared the changes in PAI activity and ACE activity in these two groups over a 1-month period. RESULTS: There was a significant correlation between the serum ACE activity and the plasma PAI activity at baseline in the patients (r = 0.498, P < 0.01). The captopril-treated patients showed significantly reduced PAI activity (P < 0.01), and a concomitant decrease in ACE activity. CONCLUSION: These results suggest that elevated ACE activity is associated with impaired fibrinolysis and that treatment with an ACE inhibitor improves the fibrinolytic function in patients with recent myocardial infarction. The results also suggest that the renin-angiotensin system plays a role in the increased risk of ischemic cardiovascular events when it is activated, and in the reduction of risk of recurrent myocardial infarction by ACE inhibition.     

Cardiovascular outcome in white-coat versus sustained mild hypertension: a 10-year follow-up study

BACKGROUND: The aim of this study was to compare the risk conferred by white-coat versus sustained mild hypertension for the development of cardiovascular disease. METHODS AND RESULTS: Patients (n=479) who underwent 24-hour intra-arterial ambulatory blood pressure monitoring on the basis of a persistently elevated clinic systolic blood pressure of 140 to 180 mm Hg were followed up for the development of subsequent cardiovascular events during a 9.1+/-4. 2-year period. White-coat hypertension, defined as a clinic systolic blood pressure of 140 to 180 mm Hg associated with a 24-hour ambulatory systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg, was present in 126 patients, and the remainder had sustained mild hypertension. A subgroup of patients without complications underwent follow-up echocardiography and carotid ultrasound. White-coat hypertensives were younger (44+/-12 versus 52+/-10 years, respectively; P<0.001) and had a significantly lower incidence of cardiovascular events (1.32 versus 2.56 events per 100 patient-years, respectively; P<0.001) than sustained hypertensives. Multivariate analysis revealed age (P=0.002), sex (P=0.007), race (P=0.001), smoking (P=0.005), and the presence of white-coat hypertension (hazard ratio, 0.29; 95% CI, 0.09 to 0.90; P=0.04) to be independent predictors of subsequent cardiovascular events. Subgroup analysis in patients without complications revealed a lower incidence of left ventricular hypertrophy and lesser degrees of carotid hypertrophy in the white-coat group. CONCLUSIONS: These findings indicate a relatively benign outcome in white-coat hypertension compared with sustained mild hypertension.     

The relationship between coping and adjustment after spinal cord injury: A 5-year follow-up study.

Investigated the relationship between coping and adjustment (including psychological distress, acceptance of disability, vocational hours, and medical status) 5 to 6 yrs after spinal cord injury. 28 people who had provided coping data during acute rehabilitation (AR) completed various measures including the SCL-90 (Revised). Results indicate that coping strategies during AR were not associated with long-term adjustment. However, at 5-yr follow-up, cognitive restructuring was positively associated and wish-fulfilling fantasy was negatively associated with acceptance of disability. Self-blame was related to psychological distress during AR but not at 5-yr follow-up. These results suggest that the importance of specific coping strategies to adjustment changes over time and support the belief that coping is a dynamic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Endoscopic pancreaticobiliary procedures in patients with a Billroth II resection: a 10-year follow-up study

PURPOSE: To report uveitis associated with human immunodeficiency virus (HIV) infection and to suggest guidelines for treatment. METHODS: Six HIV-seropositive patients (10 eyes) with anterior or posterior uveitis or both were evaluated. After ineffective prolonged treatment with systemic and topical corticosteroids, specific systemic antiretroviral therapy with zidovudine was initiated in all patients. Aqueous humor was cultured in three eyes of three patients, and vitreous humor was cultured in one eye of one patient. RESULTS: In all 10 eyes of six patients, there was resolution of inflammation in 10 to 42 days after commencement of treatment with zidovudine (600 to 800 mg/day), despite no or minimal response to corticosteroids. Cultures of aqueous humor from three eyes of three patients and culture of vitreous humor from one eye of one patient were positive for HIV; no other organism was isolated. Systemic evaluation disclosed no other identifiable cause for the uveitis in any patient. CONCLUSIONS: Infection with HIV appears to be a cause of uveitis. A trial of zidovudine may be warranted in HIV-seropositive patients with uveitis that is poorly responsive to corticosteroid treatment when no other cause is identified. The efficacy of other retroviral agents was not determined.     

Steroid therapy during the early stage of progressive IgA nephropathy. A 10-year follow-up study

This study was undertaken to clarify the effect of corticosteroids on the long-term clinical course of the early stage of progressive IgA nephropathy. The early stage of progressive IgA nephropathy was defined as having moderate proteinuria between 1 and 2 g/day, creatinine clearance values of 70 ml/min or more, and a histological severity score of 7 or more. The number of patients who fulfilled these three conditions during 12 years from 1972 and then were continuously followed up for 10 years or more in our renal unit was 46. Twenty of them received steroid treatment for an average period of 18 months, and the remaining 26 patients had no steroid treatment. The initial data of proteinuria, creatinine clearance values, frequency of hypertensive cases, and histological scores of 7 or more were not different between the two groups: 1.4 +/- 0.4 vs. 1.3 +/- 0.3 g/day, 85 +/- 14 vs. 88 +/- 13 ml/min, 25 vs. 38%, and 10.7 +/- 2.5 vs. 11.0 +/- 3.0, respectively. During the follow-up period of 10 years, the renal survival rate was significantly different between the two groups (100 vs. 84% 5 years after starting therapy and 80 vs. 34% 10 years later; p < 0.001). The final creatinine clearance values were significantly different between the two groups (54 +/- 35 vs. 20 +/- 29 ml/min; p < 0.005). On the other hand, the patient groups with mild histological changes or decreased renal function due to moderate proteinuria showed no significant differences in the final outcome. These results indicate that corticosteroids are beneficial in stabilizing the renal function for a long time during the early stage of progressive IgA nephropathy, although this study was not a randomized one.     

Social skills training for primary school children: a 1-year follow-up study

OBJECTIVE: To evaluate the effectiveness of the Rochester Social Problem Solving Program to reduce emotional and behavioural problems amongst primary school children. METHODOLOGY: Children in years 3 and 4 at primary school were assessed prior to receiving the program, immediately after the program and 1 year after the program. At each assessment, the functioning of the children who received the program was compared to the functioning of children enrolled in years 3 and 4 at a comparable school who did not receive the program. RESULTS: The program improved the ability of children to cope with potentially difficult social situations. However, the program did not reduce the prevalence of teacher-reported or mother-reported childhood emotional and behavioural problems. CONCLUSIONS: School-based social skills programs may be more effective in reducing childhood emotional and behavioural problems if they include components which focus specifically on childhood behaviour problems as well as components focusing on social skills and peer relationships.     

Mortality of chromium plating workers in Japan--a 16-year follow-up study

Opportunistic infections are common and major causes of morbidity in patients with AIDS. Endemic mycoses pose serious risks for patients in certain parts of the world. Histoplasmosis occurs in 2-5% of patients with AIDS in the Ohio and Mississippi River valleys of the United States and in over 25% of patients from a few cities. Antigen testing has become a highly useful method for diagnosing histoplasmosis rapidly, evaluating the response to treatment and diagnosing relapse. Treatment with amphotericin B or itraconazole is effective (90% or higher) if the patient is not seriously ill at the time of diagnosis but the mortality approaches 50% for those with multiorgan failure. Itraconazole blood levels should be monitored and drugs that impair the absorption or accelerate the metabolism of itraconazole should be avoided. Prophylaxis with itraconazole may be appropriate in areas with an incidence of histoplasmosis. A recently completed study in cities which have unusually high rates of histoplasmosis will provide greater insight into the role of prophylactic antifungal therapy.     

Relationship between insulin secretory function and endogenous hypertriglyceridemia in obese humans with insulin resistance

Eighteen obese inpatients with insulin resistance revealed by i.v. insulin test and expressed in various grades of hyperinsulinemia and hyperglycemia were examined for plasma lipid levels. A significant positive correlation was found to be present between the plasma triglyceride (TG) level and the insulin response to glucose load. A stepwise multiple regression analysis revealed that the insulin secretory response, the plasma cholesterol level and the relative body weight contributed to the level of plasma TG. No difference was found in the grades of insulin resistance between patients with and without elevated TG. The ratio of sum of plasma insulin values to that of blood glucose values during glucose tolerance test was markedly increased in patients with elevated TG. The patients with relatively blunted insulin response and impaired glucose tolerance curves showed only slight slight hypertriglyceridemia. Endogenous hypertriglyceridemia in obesity seems to be more closely correlated with plasma insulin level, and therefore, with insulin action rather than insulin resistance.     

Relationship between serum 1,5-anhydroglucitol and urinary excretion of N-acetylglucosaminidase and albumin determined at onset of NIDDM with 3-year follow-up

A nonsense codon suppression technique was employed to incorporate ortho-nitrobenzyl tyrosine, "caged tyrosine," in place of tyrosine at any of three positions (93, 127, or 198) in the alpha subunit of the muscle nicotinic ACh receptor (nAChR) expressed in Xenopus oocytes. The ortho-nitrobenzyl group was then removed by 1 ms flashes at 300-350 nm to yield tyrosine itself while macroscopic currents were recorded during steady ACh exposure. Responses to multiple flashes showed (1) that each flash decages up to 17% of the tyrosines and (2) that two tyrosines must be decaged per receptor for a response. The conductance relaxations showed multiple kinetic components; rate constants (<0.1 s(-1) to 10(3) s(-1)) depended on pH and the site of incorporation, and relative amplitudes depended on the number of prior flashes. This method, which is potentially quite general, (1) provides a time-resolved assay for the behavior of a protein when a mutant sidechain is abruptly changed to the wild-type residue and (2) will also allow for selective decaging of sidechains that are candidates for covalent modification (such as phosphorylation) in specific proteins in intact cells.