Πέμπτη, 9 Αυγούστου 2018

Differences in elbow extensor muscle characteristics between resistance-trained men and women

Abstract

Purpose

Muscular strength is suggested to be dependent upon muscle characteristics. Yet, sex-specific relationships of muscle characteristics to strength in the resistance-trained require investigation. Therefore, the purpose was to evaluate sex differences in muscle characteristics and isometric strength in the elbow extensors, as well as their respective associations.

Methods

Resistance-trained men (n = 15, mean ± SD 22 ± 4 years, 87.5 ± 12.8 kg, 16.9 ± 2.9% body fat) and women (n = 15, mean ± SD 25 ± 5 years, 59.3 ± 7.3 kg, 22.4 ± 4.2% body fat) were tested. B-mode ultrasound images assessed muscle thickness, pennation angle, and echo intensity. Muscle volume and fascicle length were estimated from previously validated equations. Maximal voluntary isometric contraction measured elbow extensors isometric strength. Independent samples t-tests and Fisher's r-to-z test examined differences between sexes.

Results

Sex differences existed in all muscle characteristics (p < 0.05). Men's absolute strength (27.86 ± 3.55 kg) was significantly greater than women (16.15 ± 3.15 kg), but no differences were noted when controlling for muscle volume (men 0.069 ± 0.017, women 0.077 ± 0.022 kg/cm3). Sex differences did not exist in the relationships of muscle characteristics to strength with muscle size having the largest correlations. However, the relationship between echo intensity and body fat was different in men (r = − 0.311) and women (r = 0.541, p = 0.0143).

Conclusions

Sex differences in isometric elbow extensor strength are eliminated when expressed relative to muscle volume. Relationships of echo intensity and body fat were different between men and women and may be indicative of greater adipose infiltration in women.



from Physiology via xlomafota13 on Inoreader https://ift.tt/2MarunC
via IFTTT

Efficient and fast identification of differentially methylated regions using whole-genome bisulfite sequencing data

Publication date: Available online 9 August 2018

Source: Journal of Genetics and Genomics

Author(s): Dinh Diep, Kun Zhang



from Genetics via xlomafota13 on Inoreader https://ift.tt/2KG1QSb
via IFTTT

Anti-MAG neuropathy: role of IgM antibodies, the paranodal junction and juxtaparanodal potassium channels

Although the neuropathy associated with IgM antibodies against myelin-associated glycoprotein (MAG) has characteristic clinical, immunological and pathological features, there remains a gap in understanding the functional alterations underlying nerve dysfunction. Clinically, anti-MAG neuropathy is typically associated with a distal acquired demyelinating symmetric (DADS) phenotype characterised by a progressive predominantly sensory, distal neuropathy with distally accentuated conduction slowing seen on neurophysiology (Steck et al., 2006).

from Physiology via xlomafota13 on Inoreader https://ift.tt/2OR0RBT
via IFTTT

Should we set-up routine screening for primary sclerosing cholangitis in all IBD patients?



from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2vyqnno
via IFTTT

Prognostic factors in esophageal cancer treated with curative intent

The overall prognosis of patients with esophageal cancer has improved in recent decades due to surgical and medical progress, but overall survival remains poor. Better patient selection and tailored treatment are needed. Different prognostic factors linked with the patient, tumoral characteristics and treatment with curative intent have been identified and are the purpose of this review. Tumor detection at an earlier stage, the advent of new molecules and therapeutic combinations, and the centralization of management in high-volume centers should help to improve the prognosis of esophageal cancer.

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2MxaqnO
via IFTTT

Unmet needs of Italian physicians managing patients with Inflammatory Bowel Disease

Little is known about the unmet needs of physicians caring for patients with inflammatory bowel disease (IBD).

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2vycvto
via IFTTT

Should we set-up routine screening for primary sclerosing cholangitis in all IBD patients?



from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2vyqnno
via IFTTT

Prognostic factors in esophageal cancer treated with curative intent

The overall prognosis of patients with esophageal cancer has improved in recent decades due to surgical and medical progress, but overall survival remains poor. Better patient selection and tailored treatment are needed. Different prognostic factors linked with the patient, tumoral characteristics and treatment with curative intent have been identified and are the purpose of this review. Tumor detection at an earlier stage, the advent of new molecules and therapeutic combinations, and the centralization of management in high-volume centers should help to improve the prognosis of esophageal cancer.

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2MxaqnO
via IFTTT

Unmet needs of Italian physicians managing patients with Inflammatory Bowel Disease

Little is known about the unmet needs of physicians caring for patients with inflammatory bowel disease (IBD).

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2vycvto
via IFTTT

Exoskeleton assistance symmetry matters: unilateral assistance reduces metabolic cost, but relatively less than bilateral assistance

Many gait impairments are characterized by asymmetry and result in reduced mobility. Exoskeletons could be useful for restoring gait symmetry by assisting only one leg. However, we still have limited understan...

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2AU49Bu
via IFTTT

Homeostatic balance of histone acetylation and deconstruction of repressive chromatin marker H3K9me3 during adipocyte differentiation of 3T3-L1 cells

Abstract

Background Adipocyte differentiation is completed by changing gene expression. Chromatin is closely related to gene expression. Therefore, its structure might be changed for adipocyte differentiation. Mouse 3T3-L1 preadipocytes have been used as a cell model to study molecular mechanisms of adipogenesis. Objective To examine changes of chromatin modification and expression of histone modifying enzymes during adipocyte differentiation. Methods Microscopic analysis and Oil Red O staining were performed to determine distinct phenotype of adipocyte differentiation. RT-PCR and Western blot analysis were used to examine expression levels of histone modifying enzymes during adipocyte differentiation. Histone modifications were examined by immunostaining analysis. Results Expression levels of P300 and cbp were increased during adipocyte differentiation. However, acetylation of histones was not quantitatively changed postdifferentiation of 3T3-L1 cells compared to that at pre-differentiation. RT-PCR and Western blot analyses showed that expression levels of hdac2 and hdac3 were increased during adipocyte differentiation, suggesting histone acetylation at chromatin level was homeostatically controlled by increased expression of both HATs and HDACs. Tri-methylation level of H3K9 (H3K9me3), but not that of H3K27me3, was significantly decreased during adipocyte differentiation. Decreased expression of setdb1 was consistent with reduced pattern of H3K9me3. Knock-down of setdb1 induced adipocyte differentiation. This suggests that setdb1 is a key chromatin modifier that modulates repressive chromatin. Conclusion These results suggest that there exist extensive mechanisms of chromatin modifications for homeostatic balance of chromatin acetylation and deconstruction of repressive chromatin during adipocyte differentiation.



from Genetics via xlomafota13 on Inoreader https://ift.tt/2vTq0mL
via IFTTT

Plasma mtDNA Analysis Aids in Predicting Pancreatic Necrosis in Acute Pancreatitis Patients: A Pilot Study

Abstract

Background

Specific plasma biomarkers in predicting pancreatic necrosis (PNec) are needed in treating acute pancreatitis (AP).

Aims

To investigate the prognostic value of plasma mitochondrial DNA fragments (mtDNA) in patient with AP for PNec.

Methods

AP patients with symptoms onset within 72 h were prospectively enrolled from June 2015 through June 2017 and were assessed for PNec using contrast-enhanced CT scan. Plasma mtDNA concentration (specific mitochondrial gene ND1) was measured using qRT-PCR.

Results

Of the 74 AP patients included, significant higher median level of plasma mtDNA was found in severe AP patients than in mild AP patients and healthy controls, but not in moderately severe AP patients. Patients with PNec had higher level of plasma mtDNA than those without PNec (774.2 [IQR 397.6–2205.0] vs. 169.5 [IQR 73.6–683.4] pg/ml, P < 0.05). The area under the receiver operator characteristic curve (ROC-AUC) of mtDNA for predicting PNec was higher than that of CRP (0.813 [95% CI 0.705–0.895] vs. 0.678 [95% CI 0.558–0.783]). Using a cutoff value of 302.5 pg/ml, the sensitivity and specificity for diagnosing PNec were 90.9 and 68.3%, respectively. Finally, plasma mtDNA levels decreased significantly after continuous renal replacement therapy (717.7 [IQR 307.00–1370.00] vs. 237.5 [IQR 117.20–464.80] pg/ml, P < 0.01).

Conclusions

Elevated plasma mtDNA content in AP patients may be used as a more accurate early predictor of PNec in contrast to traditional CRP.



from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KF9GeP
via IFTTT

Optimal Omeprazole Dosing and Symptom Control: A Randomized Controlled Trial (OSCAR Trial)

Abstract

Background

Proton pump inhibitors (PPIs) are potent inhibitors of acid secretion and are the mainstay of therapy for gastroesophageal reflux disease (GERD). Initially designed to be taken 30 min before the first daily meal, these agents are commonly used suboptimally, which adversely affects symptom relief. No study to date has assessed whether correcting dosing regimens would improve symptom control. The objective of this study was to determine whether patients with persistent GERD symptoms on suboptimal omeprazole dosing experience symptomatic improvement when randomized to commonly recommended dosing regimen and to evaluate the economic impact of suboptimal PPI dosing in GERD patients.

Methods

Patients with persistent heartburn symptoms ≥ 3 times per week treated with omeprazole 20 mg daily were enrolled and randomized to commonly recommended dosing or continued suboptimal dosing of omeprazole. The primary outcomes were changes in symptom, frequency, and severity, as determined using the Gastroesophageal Reflux Disease Symptom Assessment Scale (GSAS) 4 weeks after the intervention was administered. In secondary analysis, an alternative measure of symptom load was used to infer potential costs.

Results

Sixty-four patients were enrolled. GSAS symptom, frequency, and severity scores were significantly better when dosing was optimized for overall and heartburn-specific symptoms (P < 0.01 for all parameters). Cost savings resulting from reduced medical care and workplace absenteeism were estimated to be $159.60 per treated patient, with cost savings potentially exceeding $4 billion annually in the USA.

Discussion

Low-cost efforts to promote commonly recommended PPI dosing can dramatically reduce GERD symptoms and related economic costs.

ClinicalTrials.gov, number: NCT02623816.



from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2M8Fcar
via IFTTT

Case study: How a group of Pittsburgh firefighters got a better handle on patient lifting

Binder Lift lets rescuers move more weight with fewer people.

from EMS via xlomafota13 on Inoreader https://ift.tt/2nnz8MD
via IFTTT

FOXP2 tells a cautionary tale

FOXP2 tells a cautionary tale

<i>FOXP2</i> tells a cautionary tale, Published online: 09 August 2018; doi:10.1038/s41576-018-0046-6

A study in Cell challenges the existing notion of the evolution of FOXP2 as a human-specific language gene.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2vQtDd3
via IFTTT

Lessons from 1 million genomes

Lessons from 1 million genomes

Lessons from 1 million genomes, Published online: 09 August 2018; doi:10.1038/s41576-018-0047-5

A Nature Genetics study reports the findings of a genome-wide associationstudy of educational attainment in 1.1 million individuals.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2vOkMIU
via IFTTT

Sleep Disturbances Are Commonly Reported Among Patients Presenting to a Gastroenterology Clinic

Abstract

Background

Poor sleep quality is common among patients with gastrointestinal (GI) disorders. However, few studies have assessed the presence of insomnia or reported circadian preferences and none have directly compared sleep between common GI conditions.

Aims

To compare clinical sleep characteristics in patients presenting to a tertiary care GI clinic for irritable bowel syndrome (IBS), functional dyspepsia (FD), inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), and celiac disease (CD).

Methods

Validated sleep measures were administered to consecutive patients if they were diagnosed with IBS, IBD in clinical remission, CD, FD, or GERD. Healthy Controls (HCs) with no reported GI diagnoses or symptoms were also recruited.

Results

A total of 212 eligible respondents completed this survey, 161 GI clinic patients (IBS (n = 48), GERD (n = 29), IBD in clinical remission (n = 44), CD (n = 40)), and 41 HCs. Only, 10 respondents had a diagnosis of FD, and these were excluded. The IBS group had the highest frequency of poor sleep (72%) followed by CD (61%), GERD (60%), IBD (54%), and HC (39%). IBS patients also had the highest frequency of clinical insomnia (51%), followed by GERD (37%), CD (35%), IBD (27%), and HC (18%). 40% of IBS patients reported taking sleep medications at least once per week, compared to 32% of GERD, 23% IBD, 13% CD, and 15% HC.

Conclusions

Patients presenting to a tertiary care GI clinic report poorer sleep than healthy controls. In general, patients with IBS report the highest rates of sleep difficulties compared to patients with other diagnoses.



from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2OUBBut
via IFTTT

Similar Sustained Virologic Response in Real-World and Clinical Trial Studies of Hepatitis C/Human Immunodeficiency Virus Coinfection

Abstract

Background

Clinical trials evaluating efficacy of direct-acting antiviral (DAA) therapies demonstrate sustained virologic response (SVR) rates greater than 90% in patients infected with hepatitis C (HCV) and human immunodeficiency virus (HIV). However, generalizability of this data to real-world coinfected populations is unknown.

Aim

We aim to compare efficacy data from clinical trials to effectiveness data of real-world observational studies that evaluate oral interferon-free HCV treatment regimens in patients infected with HIV and HCV.

Methods

We included English-language studies on PubMed and MEDLINE databases from inception until October 2017. Eight clinical trials and 11 observational studies reporting on efficacy data and effectiveness data, respectively, of interferon-free oral DAA regimens in HCV/HIV coinfected patients, were included.

Results

Of patients in the eight clinical trials evaluated, 93.1% (1218/1308) achieved SVR12; of the 11 real-world observational studies, 90.8% (2269/2499) achieved SVR12. Relative risk between those treated in clinical trials versus observational studies was 0.98. Patients with genotype 1 infection, African-American patients, cirrhotic patients, and patients with prior HCV treatment experience had similar rates of SVR in real-world and clinical trial cohorts.

Conclusion

SVR among real-world HCV/HIV coinfected populations treated with DAA regimens is similar to SVR of patients studied in clinical trials. Historically negative predictors of achieving SVR during the era of interferon-based treatments, such as those with cirrhosis, prior HCV treatment failure, GT1 infection, and African-American race, are not associated with a significantly lower SVR in real-world populations treated with various DAA regimens.



from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2MuWM4t
via IFTTT

Swimming versus running: effects on exhaled breath condensate pro-oxidants and pH

Abstract

Purpose

The respiratory redox-state of swimmers can be affected by chronic exposures to chlorinated pools, and the effects of different exercises on it are unknown. Our aim was to compare two exercises performed at high-intensity and under habitual environmental conditions (swimming indoor vs. running outdoor) on the production of pro-oxidants (hydrogen peroxide and nitrite) and pH in exhaled breath condensate (EBC) and spirometry parameters in competitive swimmers chronically exposed to chlorinated pools.

Methods

Seventeen men and women (mean age ± SD = 21 ± 2 years) swam 3.5 km in an indoor pool treated with Cl2, and after 2-weeks, they ran 10 km outdoors. The pHEBC, [H2O2]EBC, [NO2]EBC, [NO2]EBC/[NO2]Plasma and spirometry parameters were analyzed pre-exercise and 20 min and 24 h after exercise ended.

Results

Two mixed models were applied to compare EBC parameters between swimming and running. Lower levels of [H2O2]EBC and [NO2]EBC (p = 0.008 and p = 0.018, respectively) were found 24-h post-swimming, and the same trend was observed for [NO2]EBC/[NO2]Plasma (p = 0.062). Correlations were found in both exercises between pre-exercise levels of pHEBC, [H2O2]EBC, [NO2]EBC, and [NO2]EBC/[NO2]Plasma and their changes (Δ) after 24-h as well as between [H2O2]EBC and [NO2]EBC for basal levels and for changes after 24 h. A relationship was also found for running exercise between pulmonary ventilation and changes after 24 h in [H2O2]EBC. Spirometry data were unaffected in both types of exercise.

Conclusion

In competitive swimmers, at 24-h acute post-exercise follow-up, swimming decreased and running increased pro-oxidant biomarkers of pulmonary origin, without changes in lung function.



from Physiology via xlomafota13 on Inoreader https://ift.tt/2M6OK5Y
via IFTTT

Effect of supplemental simethicone for bowel preparation on adenoma detection during colonoscopy: A meta-analysis of randomized controlled trials

Journal of Gastroenterology and Hepatology

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2AXYLx6
via IFTTT

Risk factors for early and late procedure-related adverse events in percutaneous endoscopic gastrostomy: A single center, retrospective study

Journal of Gastroenterology and Hepatology

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2vu6iyw
via IFTTT

Liver stiffness measured by transient elastography as predictive of prognoses following portosystemic shunt occlusion

Journal of Gastroenterology and Hepatology

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2AXYbiU
via IFTTT

Clinical, endoscopic and histological differentiation between celiac disease and tropical sprue: A systematic review

Journal of Gastroenterology and Hepatology

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2OWeorQ
via IFTTT

Endoscopic prediction of advanced histology in diminutive and small colorectal polyps

Journal of Gastroenterology and Hepatology

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2ASvN1K
via IFTTT

Metabolic effects of betaine: A randomized clinical trial of betaine supplementation in prediabetes

Journal of Clinical Endocrinology & Metabolism

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2vu6gGU
via IFTTT

Identification of risk factors for postoperative recurrent Hirschsprung associated enterocolitis

Journal of Pediatric Surgery

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2AX1HtX
via IFTTT

Physical Activity Patterns and Correlates of 9-Month-Old Chinese Infants in the Macau Population

Abstract

Objectives Many obesity-related chronic diseases originate from unhealthy childhood habits. The aim of this study was to describe 9-month-old infants' physical activity levels and patterns and to examine the correlates. Understanding these factors is necessary for improving the effectiveness of physical activity intervention programs for infants. Methods In total, 143 infant–mother dyads from Macau, SAR China, participated in this study. Physical activity (PA) was assessed by using the Actigraph GT3X+ accelerometer and the demographic variables were collected by questionnaires. Results The most important findings were that: (1) infants had more screen time during weekdays (p = .044); (2) infants and mothers were least active at 8 a.m. (both weekdays and weekends) in the morning and most active at 7 p.m. (weekdays) and 8 p.m. (weekends) in the evening; (3) infants' PA levels significantly correlated with their mothers' PA intensities during the weekends (r = .192, p = .036), especially the mothers' lower intensities in the mornings and evenings; (4) maternal BMI predicted the PA levels of the 9-month-old infants' (R2 = .06, β = 29.188, p = .009). Conclusions for Practice Physical activity promotion programs for infants should be time-specific starting from early infancy. This study was one of the first to examine 9-month-old infants' PA levels, patterns and correlates. The results may be helpful in improving the effectiveness of future healthy lifestyle intervention programs for infants in Macau and in the region in general.



from Health via xlomafota13 on Inoreader https://ift.tt/2OT8R5b
via IFTTT

Influence of Obesity and Metabolic Abnormalities on the Risk of Developing Colorectal Neoplasia

Abstract

Background

Obesity and metabolic syndrome are risk factors for colorectal neoplasia (CRN). However, the association between metabolically healthy obese (MHO) or metabolically unhealthy non-obese (MUNO) status and the risk of CRN remains unclear.

Aims

We aimed to elucidate the association between MHO or MUNO status and the risk of CRN.

Methods

A total of 139,023 asymptomatic subjects who underwent a primary screening colonoscopy were categorized into 4 groups according to obesity and metabolic status: metabolically healthy non-obese (MHNO), MHO, MUNO, and metabolically unhealthy obese (MUO).

Results

Mean participant age was 41.0 years, and the proportion of men was 65.3%. Among men, the risk of overall CRN increased in MHO (adjusted odds ratio [AOR] 1.22, 95% confidence intervals [CI] 1.12–1.33), MUNO (AOR 1.25, 95% CI 1.18–1.31), and MUO groups (AOR 1.47, 95% CI 1.40–1.54) compared with the MHNO group, whereas the risk of advanced CRN (ACRN) increased in MUNO (AOR 1.16, 95% CI 1.002–1.33) and MUO groups (AOR 1.49, 95% CI 1.31–1.70), but not in the MHO group (AOR 0.92, 95% CI 0.70–1.21). Moreover, among non-obese men, the risk of overall CRN and ACRN linearly increased with an increasing number of metabolic abnormalities. However, among women, only the MUO group had an increased risk of overall CRN (AOR 1.34, 95% CI 1.21–1.47) and no other significant associations were observed.

Conclusions

Poor metabolic health, regardless of obesity, is an independent risk factor for CRN in men. Our results suggest that men with metabolic abnormalities should be considered as a high-risk group for colorectal cancer, even if they are not obese.



from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KFKnZV
via IFTTT

Influence of Ambulatory Triglyceride Levels on Risk of Recurrence in Patients with Hypertriglyceridemic Pancreatitis

Abstract

Background and Aims

To evaluate impact of ambulatory triglyceride levels on risk of recurrent pancreatitis in patients with hypertriglyceridemic pancreatitis.

Methods

We conducted a longitudinal retrospective cohort study of patients with serum triglyceride level ≥ 500 mg/dL during index hospitalization for acute pancreatitis within a regional integrated healthcare system between 2006 and 2013 (follow-up through 2015). Cases were identified based on combination of diagnosis codes and serum amylase/lipase. We used multivariable robust Poisson regression to determine independent effect of baseline (first outpatient) triglyceride measurement on risk of recurrent pancreatitis. Ambulatory triglyceride levels were categorized as normal (0–200 mg/dL), moderately elevated (201–500 mg/dL), and highly elevated (> 500 mg/dL). We further assessed factors related to likelihood of normalization of serum triglycerides (< 200 mg/dL) in the outpatient setting.

Results

One hundred and fifty-one patients met study inclusion criteria with median follow-up of 3 years. Overall, 45 (29.8%) patients experienced at least 1 recurrent attack with 25 (16.6%) experiencing multiple episodes. In multivariable analysis, patients that continued to have moderately elevated ((adjusted rate ratio RR 5.47 (95% CL 1.80, 16.65)) as well as highly elevated (RR 8.45 (2.55, 27.96)) triglycerides were at increased risk of disease recurrence compared to patients that achieved normalization. Patients with triglyceride measurement performed within 30 days from discharge were more likely to achieve normalization, 40 versus 26%, p = 0.03.

Conclusions

For patients with hypertriglyceridemic pancreatitis, even modest elevation in subsequent triglyceride levels was associated with increased risk of recurrence. Future efforts should focus on ensuring timely care in the outpatient setting with a goal of normalizing triglycerides.



from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2M8NHlf
via IFTTT

Case–Control Study of Inflammatory Bowel Disease Patients with and without Clostridium difficile Infection and Poor Outcomes in Patients Coinfected with C. difficile and Cytomegalovirus

Abstract

Background and Aims

Clostridium difficile infection (CDI) incidence and risk factors in patients with inflammatory bowel disease (IBD) have been extensively studied. However, data describing CDI in Chinese patients with IBD are limited. We investigated the cumulative incidence, risk factors, and outcomes of CDI in Chinese IBD patients.

Methods

We conducted a retrospective, case–control study of patients hospitalized with IBD and CDI at Peking Union Medical College Hospital from January 2010 to December 2015. CDI was diagnosed based on the presence of active symptoms and positive enzyme immunoassay-based stool test results for C. difficile toxin A or B (CDAB). Controls were selected from CDAB-negative patients with IBD and matched by age, gender, phenotypes of IBD and the same time period of CDAB testing at a 1:2 or 1:3 ratio.

Results

We identified 60 (7.41%) cases of CDI among 810 patients with IBD, and 137 control cases were selected. Univariate analysis revealed that IBD patients with CDI had higher rates of concurrent corticosteroid use, proton pump inhibitor, antibiotic use, recent hospitalization, parenteral nutrition support, and cytomegalovirus (CMV) coinfection (P < 0.05). Multivariate analysis revealed that concurrent corticosteroid use (odds ratio [OR] = 6.803, 95% confidence interval [CI] = 2.901–15.954, P < 0.001) and hospitalization within 1 month (OR = 3.028, 95% CI = 1.225–7.480, P = 0.016) were associated with CDI. CMV and C. difficile coinfection (hazard ratio [HR] = 4.185, 95% CI = 1.492–11.736, P = 0.007) as well as disease severity (HR 2.070, 95% CI = 1.006–4.261, P = 0.048) were independently associated with colectomy following CDI.

Conclusions

IBD patients with concurrent corticosteroid use and recent hospitalization are at a higher risk of CDI. CMV and C. difficile coinfection is associated with poorer outcomes.



from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KEnWEo
via IFTTT

Lessons from 1 million genomes



from Genetics via xlomafota13 on Inoreader https://ift.tt/2M7X6tO
via IFTTT

FOXP2 tells a cautionary tale



from Genetics via xlomafota13 on Inoreader https://ift.tt/2Okbn3k
via IFTTT

Author’s Reply to Goulet: Comment on: “Drinking Strategies: Planned Drinking Versus Drinking to Thirst’’



from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2MxjoBF
via IFTTT

Comment on “Drinking Strategies: Planned Drinking Versus Drinking to Thirst’’



from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2OXiNuK
via IFTTT

Looking further when symptoms are disproportionate to physical findings

A 36 year-old male presents with left ulnar-side wrist pain during an ice hockey game that prevented him from playing hockey or golf. There was no acute mechanism of injury. The usual clinical examination revealed only minimal tenderness and minimal pain with resisted wrist extension. Careful attention to precipitating factors led to testing resisted wrist extension with the forearm fully supinated, which reliably reproduced the intensity of the patient's symptoms, and a diagnosis of extensor carpi ulnaris tendinopathy. A literature review suggested three additional special tests (two were positive) and management. However, a standard of care has yet been established as neither the tests nor the management has been properly validated through research, thus leaving the management of this condition as an art. Corresponding Author: Ian Shrier MD, PhD, Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Cote Sainte-Catherine Road, Montreal, QC H3T 1E2, Canada. Email: ian.shrier@mcgill.ca. Tel: 1-514-340-7563; Fax: 1-514-340-7564 The authors have no conflict of interests to report. This report was unfunded. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. The results of the present study do not constitute endorsement by ACSM. Accepted for Publication: 26 July 2018 © 2018 American College of Sports Medicine

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2AWqVsp
via IFTTT

Normobaric Hypoxia Reduces V˙O2 at Different Intensities in Highly Trained Runners

Introduction We sought to determine the effect of low and moderate normobaric hypoxia on oxygen consumption and anaerobic contribution during interval running at different exercise intensities. Methods Eight runners (age: 25 ± 7 years, V˙O2max: 72.1 ± 5.6 ml.kg-1.min-1) completed three separate interval sessions at threshold (4 x 5 min, 2 min recovery), V˙O2max (8 x 90 s, 90 s recovery), and race pace (10 x 45 s, 1 min 45 s recovery) in each of; normoxia (elevation: 580 m, FiO2: 0.21), low (1400 m, 0.195) or moderate (2100 m, 0.18) normobaric hypoxia. The absolute running speed for each intensity was kept the same at each altitude to evaluate the effect of FiO2 on physiological responses. Expired gas was collected throughout each session, with total V˙O2 and accumulated oxygen deficit calculated. Data were compared using repeated measures ANOVA. Results There were significant differences between training sessions for peak and total V˙O2, and anaerobic contribution (p

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2vqhEUf
via IFTTT

Demographic-specific Validity of the Cancer Prevention Study-3 Sedentary Time Survey

PURPOSE This study examined the one-year test-re-test reliability and criterion validity of sedentary time survey items in a subset of participants from a large, nationwide prospective cohort. METHODS Participants included 423 women and 290 men aged 31-72 years in the Cancer Prevention Study-3 (CPS-3). Reliability was assessed by computing Spearman correlation coefficients between responses from pre- and post-study surveys. Validity was assessed by comparing survey-estimated sedentary time with a latent variable representing true sedentary time estimated from the seven-day diaries, accelerometry, and surveys through the method of triads. Sensitivity analyses were restricted to 566 participants with an average of 14+ hours of diary and accelerometer data per day for seven days per quarter. RESULTS Reliability estimates for total sitting time were moderate or strong across all demographic strata (Spearman ρ≥0.6), with significant differences by race (p=0.01). Reliability estimates were strongest for the TV-related sedentary time item (Spearman ρ=0.74, 95% CI: 0.70, 0.77). The overall validity coefficient (VC) for survey-assessed total sedentary time was 0.62 (95% CI: 0.55, 0.69), although VCs varied by age group and activity level (p

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2AQY2xA
via IFTTT

Supraspinal Fatigue and Neural-evoked Responses in Lowlanders and Sherpa at 5050 m

Purpose At high-altitude, Lowlanders exhibit exacerbated fatigue and impaired performance. Conversely, Sherpa (native Highlanders) are known for their outstanding performance at altitude. Presently, there are no reports comparing neuromuscular fatigue and its etiology between Lowlanders and native Sherpa at altitude. Methods At 5050 m, nine age-matched Lowlanders and Sherpa (31±10 vs. 30±12 years, respectively) completed a 4-minute sustained isometric elbow flexion at 25% maximal voluntary (MVC) torque. Mid-minute, stimuli were applied to the motor cortex and brachial plexus to elicit a motor evoked potential (MEP) and maximal compound muscle action potential (Mmax), respectively. Supraspinal fatigue was assessed as the reduction in cortical voluntary activation (cVA) from pre- to post-fatigue. Cerebral haemoglobin concentrations and tissue oxygenation index (TOI) were measured over the prefrontal cortex by near-infrared spectroscopy. Results Pre-fatigue, MVC torque and cVA were significantly greater for Lowlanders than Sherpa (79.5±3.6 vs. 50.1±11.3N·m, and 95.4±2.7 vs. 88.2±6.6%, respectively). With fatigue, MVC torque and cVA declined similarly for both groups (~24-26% and ~5-7%, respectively). During the task, MEP area increased more and sooner for Lowlanders (1.5min) than Sherpa (3.5min). Mmax area was lower than baseline throughout fatigue for Lowlanders but unchanged for Sherpa. TOI increased earlier for Lowlanders (2min) than Sherpa (4min). Total haemoglobin increased only for Lowlanders (2min). Mmax was lower while TOI and total haemoglobin were higher for Lowlanders than Sherpa during the second half of the protocol. Conclusion Although neither MVC torque loss nor development of supraspinal fatigue was different between groups, neural evoked responses and cerebral oxygenation indices were less perturbed in Sherpa. This represents an advantage for maintenance of homeostasis, presumably due to bequeathed genotype and long-term altitude adaptations. Correspondence: Dr. Chris McNeil, School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia – Okanagan Campus, 133-1147 Research Road, Kelowna, British Columbia, Canada, V1V 1V7. E-mail: chris.mcneil@ubc.ca. Tel.: +1-250-807-9664, Fax: +1-250-807-9865 This work was supported by the Natural Sciences and Engineering Research Council of Canada (DG 435912-2013) and the Canada Foundation for Innovation / British Columbia Knowledge Development Fund (32260). The authors declare they have no conflict of interest. The results of this study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation and do not constitute endorsement by the American College of Sports Medicine. Accepted for Publication: 27 July 2018. © 2018 American College of Sports Medicine

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2OPgdH3
via IFTTT

Fat-free Mass Characteristics of Muscular Physique Athletes

Purpose Simple body composition models, such as two-compartment models, employ assumptions which may be violated in specific athletic populations (e.g. the constancy of fat-free mass density [DFFM] and hydration [TBW:FFM]). The present analysis examined FFM characteristics of muscular physique athletes. Methods Twenty-six athletes (16 M: 94.5±9.9 kg, 12.2±4.2 %fat; 10 F: 63.8±5.7 kg, 19.7±4.9 %fat) completed duplicate assessments of dual-energy x-ray absorptiometry (DXA), bioimpedance spectroscopy (BIS), and single- and multi-frequency bioelectrical impedance analysis (SFBIA; MFBIA). FFM was calculated via 5-compartment (5C) model, and FFM characteristics (i.e. DFFM, TBW:FFM, FFM mineral, FFM protein) were compared between sexes and between the sample and reference values (RV) from cadaver analysis. TBWBIS:FFM5C was designated as the reference TBW:FFM model, and alternate models were produced using BIS, MFBIA, SFBIA, impedance-based equations, and DXA output. Results Males had lower TBW:FFM and FFM mineral, but higher FFM protein than females (p

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2AWqAG9
via IFTTT

Peak Ventilation Reference Standards from Exercise Testing: From the FRIEND Registry

Purpose Cardiopulmonary exercise testing (CPX) provides valuable clinical information, including peak ventilation (VEpeak), which has been shown to have diagnostic and prognostic value in the assessment of patients with underlying pulmonary disease. This report provides reference standards for VEpeak derived from CPX on treadmills in apparently healthy individuals. Methods Nine laboratories in the United States experienced in CPX administration with established quality control procedures contributed to the Fitness Registry and the Importance of Exercise National Database from 2014 to 2017. Data from 5232 maximal exercise tests from men and women without cardiovascular or pulmonary disease were used to create percentiles of VEpeak for both men and women by decade between 20-79 years. Additionally, prediction equations were developed for VEpeak using descriptive information. Results VEpeak was found to be significantly different between men and women and across age groups (p

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2vyA7hi
via IFTTT

Individual and Environmental Determinants of Late-Life Community Disability for Persons Aging With Cardiovascular Disease

Objective To estimate the prevalence of late-life community disability for adults aged 65 and older with cardiovascular disease vs. those without. This study also investigated the contributions of environmental and individual risk factors on late-life community disability for persons with cardiovascular disease. Design Secondary data analysis of the 2016 round of the National Health and Aging Trends Study. The study sample included community-dwelling Americans with cardiovascular disease (n=1,490) and without (n=4,819). Logistic regression was used to estimate associations between individual risk factors, environmental factors, and community disability for those with CVD. Results Individuals with cardiovascular disease had a significantly higher prevalence of late-life community disability than those without (44.8% vs. 29.0%). For persons with CVD, lack of transportation, home modification, and needing assistance with mobility increased the odds of community disability. Younger age and lower comorbidity were associated with decreased odds of community disability. When accounting for environmental factors in multivariate analyses, sex, race, and education were not significantly associated with community disability. Conclusion Late-life community disability is highly prevalent for persons aging with cardiovascular disease. Intervention strategies to deter late-life community disablement should focus on improving access to transportation and improving the community environment in which older adults live. Correspondence: Tamra Keeney, PhD, DPT, CCS, 36 1st Avenue, Boston, MA 02129, Phone: 314-401-8701. Email: TKeeney1@partners.org. Author Disclosures: The authors have no competing interests or financial benefits related to this work. Funding Source: none Previous Presentation: This work was submitted for review as a poster presentation at the forthcoming Gerontological Society of America 2018 Annual Scientific Meeting. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2OjS8XN
via IFTTT

Correction to: The Effect of Acute Caffeine Ingestion on Endurance Performance: A Systematic Review and Meta-Analysis

Caffeine is a widely used ergogenic aid with most research suggesting it confers the greatest effects during endurance activities. Despite the growing body of literature around the use of caffeine as an ergogenic aid, there are few recent meta-analyses which quantitatively assess the effect of caffeine on endurance exercise.



from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2On2IwW
via IFTTT

Physical Activity Questionnaires for Pregnancy: A Systematic Review of Measurement Properties

Abstract

Background

In order to assess physical activity (PA) during pregnancy, it is important to choose the instrument with the best measurement properties.

Objectives

To systematically summarize, appraise, and compare the measurement properties of all self-administered questionnaires assessing PA in pregnancy.

Methods

We searched PubMed, Embase, and SPORTDiscus with the following inclusion criteria: (i) the study reported at least one measurement property (reliability, criterion validity, construct validity, responsiveness) of a self-administered questionnaire; (ii) the questionnaire intended to measure PA; (iii) the questionnaire was evaluated in healthy pregnant women; and (iv) the study was published in English. We evaluated results, quality of individual studies, and quality of evidence using a standardized checklist (Quality Assessment of Physical Activity Questionnaires [QAPAQ]) and the GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach.

Results

Seventeen articles, reporting 18 studies of 11 different PA questionnaires (17 versions), were included. Most questionnaire versions showed insufficient measurement properties. Only the French and Turkish versions of the Pregnancy Physical Activity Questionnaire (PPAQ) showed both sufficient reliability and construct validity. However, all versions of the PPAQ pooled together showed insufficient construct validity. The quality of individual studies was usually high for reliability but varied considerably for construct validity. Overall, the quality of evidence was very low to moderate.

Conclusions

We recommend the PPAQ to assess PA in pregnancy, although the pooled results revealed insufficient construct validity. The lack of appropriate standards in data collection and processing criteria for objective devices in measuring PA during pregnancy attenuates the quality of evidence. Therefore, research on the validity of comparison instruments in pregnancy followed by consensus on validation reference criteria and standards of PA measurement is needed.



from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2vYhTWb
via IFTTT

Pyogenic granuloma of the ampulla of Vater: unexpected cause of gastrointestinal bleeding

Abstract

We describe the case of a previously healthy 8-year-old girl presenting with a 1-year history of iron deficiency anemia. There was no report of hematemesis, abdominal pain or melena. Laboratory work-up excluded iron malabsorption as the underlying cause. Therefore, endoscopic evaluation was performed to exclude gastrointestinal blood loss, which revealed the presence of a 7 mm reddish lesion located within the ampulla of Vater. Capsule endoscopy excluded alternative diagnoses and concomitant lesions. Histopathological examination confirmed the diagnosis of pyogenic granuloma. The young age of the child and the benign nature of this lesion along with the absence of complications favored conservative management. Pyogenic granuloma is a benign vascular lesion that presents as a polypoid red mass. In the gastrointestinal tract, it is a rare condition and occurs more commonly in the elderly. The most common sites are the small intestine, esophagus, and colon, but they can occur throughout the entire gastrointestinal tract with a propensity to bleed that may cause iron deficiency anemia. In pediatric age patients, there are few reports of gastrointestinal pyogenic granulomas, most of which occur in the colon and rectum. Its identification and location in the ampulla of Vater is an exceptional finding.



from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2AUvt2q
via IFTTT