Ultrasonographic assessment of growth and estimation of birthweight in late gestation fetal sheep

Our aim was to identify which ultrasound parameters can be most accurately measured and best predict ovine fetal weight in late gestation. Singleton pregnancies were established using embryo transfer in 32 adolescent ewes, which were subsequently overnourished to produce fetuses of variable size (1720–6260 g). Ultrasound measurements at 126–133 days gestation were compared with fetal weight/biometry at late-gestation necropsy (n = 19) or term delivery (n = 13). Abdominal circumference (AC) and renal volume (RV) correlated best with physical measurements (r = 0.78–0.83) and necropsy/birth weight (r = 0.79–0.84). Combination of AC + RV produced an estimated fetal weight equation [Log EFW = 2.115 + 0.003 AC + 0.12 RV – 0.005 RV²] with highest adjusted R² (0.72) and lowest mean absolute/percentage prediction error (396–550 g/11.1%–13.2%). In conclusion, AC and RV are parameters of choice for assessment of late-gestation ovine fetal growth and can be used to estimate fetal weight with similar accuracy to human fetuses.     

Differential associations between renal function and “modifiable” risk factors in patients with chronic heart failure

Background  Reduced glomerular filtration rate (GFR) is strongly associated with reduced survival in patients with chronic heart failure (CHF). Our aim was to determine different pathophysiologic markers that are associated with reduced renal function in CHF. Methods and results  We studied 86 patients with CHF (58 ± 12 years, 78% male). GFR and renal blood flow (RBF) were determined by ¹²⁵I-Iothalamate and ¹³¹I-Hippuran clearances. Filtration fraction (FF) was calculated. We determined haemoglobin levels, endothelial function, inflammatory status, plasma renin activity (PRA) and N-terminal pro brain natriuretic peptide (NT-proBNP). Urinay albumin excretion (UAE) was measured in 24 h urine. Mean GFR was 74 ± 28 ml/min/1.73 m². GFR was strongly related to RBF (r = 0.915, P < 0.001), FF (r = 0.546, P < 0.001), but only weakly to endothelial function and PRA. In multivariate analysis, RBF (r = 0.938, P < 0.001), FF (r = 0.786, P < 0.001) and haemoglobin levels (r = −0.520, P < 0.001) were independently associated with GFR. UAE was mainly dependent on RBF (r = −0.401, P < 0.001) and increased exponentially with decreasing RBF. RBF was mainly associated with NT-proBNP (r = −0.561, P < 0.001) and PRA (r = −0.422, P < 0.001). Conclusion  Reduced GFR is mainly dependent of decreased RBF in patients with CHF. Endothelial function and neurohormonal activation showed only mild associations with GFR. NT-proBNP showed a strong relationship with RBF, and may be used as a marker of reduced renal perfusion.     

Relationship between self-efficacy,beliefs, and physical activity in inflammatory arthritis

BackgroundThe benefits of physical activity (PA) in inflammatory arthritis (IA) patients are well-established. However, levels of PA in the IA population are suboptimal and the psychological determinants of PA are poorly understood.ObjectiveThe study aimed to examine the self-reported PA levels and psychological determinants of PA for the IA population.MethodsA cross-sectional study of people with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) was conducted to explore the association between demographic and psychological variables such as self-efficacy and belief about PA, and levels of PA and energy expenditure (EE). PA was recorded using the Yale Physical Activity Survey (YPAS).ResultsA total of 102 participants were included in the study. Participants reported low levels of PA [mean ± standard deviation (SD), 24.3 ± 18.2]. Beliefs about PA, but not self-efficacy, correlated with levels of self-report PA over the past week (r = 0.25, p = 0.01), over the past month (r = 0.21, p = 0.04), and EE (r = 0.31, p = 0.01).ConclusionPeople with IA have decreased levels of PA. Beliefs about PA are associated with levels of self-report PA and EE in this population. These data provide a useful signpost for guiding and designing interventions to improve PA levels in IA populations by altering beliefs about PA.     

Correlation between baropodometric variables,disability, and intensity of low back pain in pregnant women in the third trimester

BackgroundGrowth of uterus, enlargement of breasts and weight gain result from the development and growth of the fetus during pregnancy. The posture and the displacement of the center of gravity change.ObjectiveCorrelate baropodometric variables with low back pain in pregnant women in the third trimester of pregnancy.MethodsThis is a cross-sectional analytical study conducted in São Luís (MA, Brazil). For data collection, we used a form containing sociodemographic and clinical data, Oswestry Disability Questionnaire for disability evaluation of the lumbar spine, Numerical Rating Scale to measure pain intensity, and baropodometric evaluation.ResultsTwenty-five pregnant women took part in the study. There was a significant and positive correlation (r = 0.404, p = 0.045) between functional disability and hindfoot pressure and a significant and negative correlation (r = −0.404, p = 0.045) between functional disability and plantar pressure in the forefoot of the right foot. In addition, there was a positive and significant correlation between the intensity of pain and the contact area on the left (r = 0.504, p = 0.010) and right (r = 0.509, p = 0.009) foot.ConclusionThere is a relation between disability and plantar pressure and between pain intensity and area of contact of feet in pregnant women.     

CpG Methylation Levels in HPA Axis Genes Predict Chronic Pain Outcomes Following Trauma Exposure

Chronic post-traumatic musculoskeletal pain (CPTP) is a common outcome of traumatic stress exposure. Biological factors that influence the development of CPTP are poorly understood, though current evidence indicates that the hypothalamic-pituitary-adrenal (HPA) axis plays a critical role in its development. Little is known about molecular mechanisms underlying this association, including epigenetic mechanisms. Here, we assessed whether peritraumatic DNA methylation levels at 248 5′—C—phosphate—G—3′ (CpG) sites in HPA axis genes (FKBP5, NR3C1, CRH, CRHR1, CRHR2, CRHBP, POMC) predict CPTP and whether identified CPTP-associated methylation levels influence expression of those genes. Using participant samples and data collected from trauma survivors enrolled into longitudinal cohort studies (n = 290), we used linear mixed modeling to assess the relationship between peritraumatic blood-based CpG methylation levels and CPTP. A total of 66 (27%) of the 248 CpG sites assessed in these models statistically significantly predicted CPTP, with the three most significantly associated CpG sites originating from the POMC gene region (ie, cg22900229 [β = .124, P < .001], cg16302441 [β = .443, P < .001], cg01926269 [β = .130, P < .001]). Among the genes analyzed, both POMC (z = 2.36, P = .018) and CRHBP (z = 4.89, P < .001) were enriched in CpG sites significantly associated with CPTP. Further, POMC expression was inversely correlated with methylation levels in a CPTP-dependent manner (6-months NRS<4: r = -.59, P < .001; 6-months NRS ≥ 4: r = -.18, P = .2312). Our results suggest that methylation of HPA axis genes including POMC and CRHBP predict risk for and may contribute to vulnerability to CPTP.PerspectivePeritraumatic blood levels of CpG methylation sites in HPA axis genes, particularly CpG sites in the POMC gene, predict CPTP development. This data substantially advances our understanding of epigenetic predictors and potential mediators of CPTP, a highly common, morbid, and hard-to-treat form of chronic pain.     

Central venous pressure,global end-diastolic index,and the inferior vena cava collapsibility/distensibility indices to estimate intravascular volume status in critically ill children: A pilot study

BackgroundThe assessment of the volume status in critically ill paediatric patients in intensive care units is vitally important for fluid therapy management. The most commonly used parameter for detecting volume status is still central venous pressure (CVP); however, in recent years, various kinds of methods and devices are being used for volume assessment in intensive care units.ObjectivesWe aimed to evaluate the relationship between CVP, the global end-diastolic index (GEDI), and ultrasound measurements of the collapsibility and distensibility indices of the inferior vena cava (IVC) in paediatric patients undergoing Pulse index Contour Cardiac Output (PiCCO) monitoring.MethodsFifteen patients receiving PiCCO monitoring were prospectively included in the study. Forty-nine PiCCO measurements were evaluated, and simultaneous CVP values were noted. After each measurement, IVC collapsibility (in spontaneously breathing patients) and distensibility (in mechanically ventilated patients) indices were measured with bedside ultrasound.ResultsThe mean age was 93.2 ± 61.3 months. Significant and negative correlations of the GEDI were found with the IVC collapsibility index (in spontaneously breathing patients) and the IVC distensibility index (in mechanically ventilated patients) (r = ?0.502, p < 0.001; r = ?0.522, p = 0.001, respectively). A significant and weakly positive correlation was found between the GEDI and CVP (r = 0.346, p = 0.015), and a significant and negative correlation was found between the IVC collapsibility index and CVP (r = ?0.482, p = 0.03). The correlation between the IVC distensibility index and CVP was significant and negative (r = ?0.412, p = 0.04).ConclusionThe use of PiCCO as an advanced haemodynamic monitoring method and the use of bedside ultrasound as a noninvasive method are useful to evaluate the volume status in critically ill paediatric patients in intensive care. These methods will gradually come to the fore in paediatric intensive care.     

Reliability of knee extensor neuromuscular structure and function and functional tests’ performance

IntroductionThe aim of this study was to evaluate the intra and inter-rater and inter-analyzer reliability of neuromuscular variables and functional tests.MethodsCross-sectional crossover design. Two independent raters and analyzers evaluated twenty-two healthy subjects. Knee-extensor strength was assessed from three maximal voluntary isometric contractions. Muscle activation was obtained from the vastus lateralis (VL), rectus femoris (RF), and vastus medialis (VM) muscles. VL and RF muscles’ architecture [fascicle length (FL), pennation angle (PA), muscle thickness (MT)] was obtained at rest by ultrasound. The time from five sit-to-stand (STS) trials, and the distance from the 6-min walk test (6MWT) were obtained. Intraclass correlation coefficient was determined and classified as strong (r = 0.75–1.00), moderate (r = 0.40–0.74), and weak (r < 0.40).ResultsStrong intra-rater reliability values were observed for strength (r = 0.97), muscle activation [VL (r = 0.91); RF (r = 0.92); VM (r = 0.80)], VL [FL (r = 0.90); PA (r = 0.94); MT (r = 0.99)] and RF [MT (r = 0.85)] muscle architecture, STS (r = 0.95), and 6MWT (r = 0.98). Inter-rater reliability also presented strong values for strength (r = 0.97), muscle activation [VL (r = 0.94); RF (r = 0.79); VM (r = 0.78)], muscle architecture VL [PA (r = 0.81) and MT (r = 0.88)] and RF [MT (r = 0.80)], STS (r = 0.93), and 6MWT (r = 0.98). A moderate correlation VL muscle architecture [FL (r = 0.69)]. Inter-analyzer muscle architecture reliability presented strong VL [FL (r = 0.77); PA (r = 0.76); MT (r = 0.91)] and RF [MT (r = 0.99)].ConclusionThe high intra and inter-rater and inter-analyzer reliability values for most variables is evidence that they can be used for clinical evaluation. Muscle architecture might need a longer training period by different raters and analyzers to increase reliability.     

Cardiorespiratory and metabolic demand of the 6-minute pegboard and ring test in healthy young adults

ObjectiveTo determine the cardiorespiratory and metabolic demand of the Six-Minute Pegboard and Ring Test (6PBRT) in healthy young adults and its association with maximal arm cycle ergometer test (arm CET).MethodsVolunteers were randomized to performed the 6PBRT test or arm CET. The second test was performed after 48 h. Oxygen consumption (VO₂), heart rate (HR), dyspnea and upper limb fatigue were assessed during the tests. Demographic data, body composition, level of physical activity, arm strength and endurance were also evaluated.ResultsDuring 6PBRT, VO₂ values increased from 5.8 to 11.1 mL kg⁻¹.min⁻¹ (p < 0.001). VO_2peak, HR _Mean and HR_max at 6PBRT were 47.2% and close to 65% respectively of those achieved during the arm CET. There was a positive correlation between the score on 6PBRT and VO_2mean and VO_2peak achieved at arm CET (r = 0.268; p = 0.003 and r = 0.247; p = 0.046 respectively). No correlation was found between the HR_mean, HR_peak, level of physical activity or strength with 6PBRT (p > 0.05). Handgrip endurance had a positive correlation with score on 6PBRT (r = 0.237; p = 0.054). Body Mass Index, body fat and fat mass were negatively correlated with the score on 6PBRT (r = 0.301; p = 0.014, 0.329; p = 0.007 and r = 0.427; p = 0.001).ConclusionsThe 6PBRT test showed a moderate cardiorespiratory and metabolic demand in healthy individuals in comparison of arm CET. BMI, body fat and fat mass correlated with the score on 6PBRT.     

Association of oxidative stress with clinical characteristics in patients with rheumatoid arthritis

Background

Few studies examining the association between oxidative stress and clinical parameters or disease activity in patients with rheumatoid arthritis (RA) are available. Therefore, the objective of this study was to test whether oxidative stress has any association with clinical parameters and disease activity in patients with RA.

Materials and methods

In this post hoc cross‐sectional study, 45 patients with RA treated with traditional disease‐modifying antirheumatic drugs (DMARDs) ± low‐dose glucocorticoids ± nonsteroidal analgesics for at least 3 months were analysed. Oxidative stress parameters were malondialdehyde (MDA), superoxide dismutase (SOD), antioxidant potential (AOP) and nonenzymatic superoxide radical scavenger activity (NSSA). Clinical parameters were pain, patient global assessment, physician global assessment, Health Assessment Questionnaire (HAQ), and disease activity score (DAS28).

Results

Plasma NSSA levels were significantly inversely correlated with tender joints count (r = ?.304; P = .042), swollen joints count (r = ?.342; P = .021) and DAS28 (r = ?.396; P = .009). There were no significant correlations between MDA/SOD/AOP and any of clinical parameters or DAS28 (P > .05 for all). Multiple regression analysis revealed that NSSA was an independent variable of DAS28 (β=?.243, P = .016).

Conclusion

The preliminary results demonstrate that plasma NSSA levels were inversely correlated with tender and swollen joints count and DAS28 and that NSSA was independently associated with DAS28, in patients with RA treated with traditional DMARDs; and provide initial support that NSSA may be used as a biomarker of disease activity in patients with RA.     

Effect of CGRP and sumatriptan on the BOLD response in visual cortex

To test the hypothesis that calcitonin gene-related peptide (CGRP) modulates brain activity, we investigated the effect of intravenous CGRP on brain activity in response to a visual stimulus. In addition, we examined if possible alteration in brain activity was reversed by the anti-migraine drug sumatriptan. Eighteen healthy volunteers were randomly allocated to receive CGRP infusion (1.5 μg/min for 20 min) or placebo. In vivo activity in the visual cortex was recorded before, during and after infusion and after 6 mg subcutaneous sumatriptan by functional magnetic resonance imaging (3 T). 77% of the participants reported headache after CGRP. We found no changes in brain activity after CGRP (P = 0.12) or after placebo (P = 0.41). Sumatriptan did not affect brain activity after CGRP (P = 0.71) or after placebo (P = 0.98). Systemic CGRP or sumatriptan has no direct effects on the BOLD activity in visual cortex. This suggests that in healthy volunteers both CGRP and sumatriptan may exert their actions outside of the blood–brain barrier.     

The lognormal perfusion model for disruption replenishment measurements of blood flow: in vivo validation

Dynamic contrast enhanced ultrasound (DCE-US) is evolving as a promising tool to noninvasively quantify relative tissue perfusion in organs and solid tumours. Quantification using the method of disruption replenishment is best performed using a model that accurately describes the replenishment of microbubble contrast agents through the ultrasound imaging plane. In this study, the lognormal perfusion model was validated using an exposed in vivo rabbit kidney model. Compared against an implanted transit time flow meter, longitudinal relative flow measurement was (×3) less variable and correlated better when quantification was performed with the lognormal perfusion model (Spearman r = 0.90, 95% confidence interval [CI] = 0.05) vs. the prevailing mono-exponential model (Spearman r = 0.54, 95% CI = 0.18). Disruption-replenishment measurements using the lognormal perfusion model were reproducible in vivo to within 12%.     

Total and free thyroxine and triiodothyronine: Measurement discrepancies,particularly in inpatients

ObjectiveWe compared the performance of tandem mass spectrometry versus immunoassay for measuring thyroid hormones in a diverse group of inpatients and outpatients.MethodsThyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3) were measured by liquid chromatography tandem mass spectrometry and immunoassay in 100 patients and the two assays were compared.ResultsT4 and T3 values measured by the two different assays correlated well with each other (r = 0.91–0.95). However, the correlation was less good at the extremes (r = 0.51–0.75). FT4 and FT3 concentrations measured by the two assays correlated less well with each other (r = 0.75 and 0.50 respectively). The studied analytes had poor inverse correlation with the log-transformed TSH values (r = -0.22 – 0.51) in the population as a whole. The strongest correlations were seen in the groups of outpatients (r = − 0.25−0.61). The weakest degree of correlation was noted in the inpatient group, with many correlations actually being positive.ConclusionThe worst between-assay correlation was demonstrated at low and high hormone concentrations, in the very concentration ranges where accurate assay performance is typically most clinically important. Based on the lesser susceptibility of mass spectrometry to interferences from conditions such as binding protein abnormalities, we speculate that mass spectrometry better reflects the clinical situation. In this mixed population of inpatients and outpatients, we also note failure of assays to conform to the anticipated inverse linear relationship between thyroid hormones and log-transformed TSH.     

Validity of mHealth devices for counting steps in individuals with Parkinson's disease

BackgroundStep quantification is a good way to characterize the mobility and functional status of individuals with some functional disorder. Therefore, a validation study may lead to the feasibility of devices to stimulate an increase in the number of steps and physical activity level of individuals with Parkinson's Disease (PD).AimTo investigate the validity of mHealth devices to estimate the number of steps in individuals with PD and compare the estimate with a standard criterion measure.MethodAn observational study in a university laboratory with 34 individuals with idiopathic PD. The number of steps was measured using mHealth devices (Google Fit, Health, STEPZ, Pacer, and Fitbit INC®), and compared against a criterionstandard measure during the Two-Minute Walk Test using habitual speed.ResultsOur sample was 82% men with a Hoehn and Yahr mean of 2.3 ± 1.3 and mean walking speed of 1.2 ± 0.2 m/s. Positive and statistically significant associations were found between Google Fit (r = 0.92; p < 0.01), STEPZ (r = 0.91; p < 0.01), Pacer (r = 0.77; p < 0.01), Health (r = 0.54; p < 0.01), and Fitbit Inc® (r = 0.82; p < 0.01) with the criterion-standard measure.ConclusionsGoogleFit, STEPZ, Fitbit Inc.®, Pacer, and Health are valid instruments to measure the number of steps over a given period of time with moderate to high correlation with the criterion-standard in individuals with PD. This result shows that technology such as smartphone applications and activity monitor can be used to assess the number of steps in individuals with PD, and allows the possibility of using this technology for assessment and intervention purposes.     

Effects of mental practice on mobility of individuals in the early subacute post-stroke phase: A randomized controlled clinical trial

IntroductionOnly a small number of clinical trials were designed to investigate Mental Practice (MP)'s use for gait rehabilitation in individuals in the early subacute post-stroke phase. This trial aims to investigate the effect of mental practice on mobility rehabilitation in the early subacute phase after a stroke in comparison to a control group.MethodsRandomized controlled clinical trial with 16 individuals diagnosed with a stroke between 50 and 80 years of age. Mobility was evaluated using Timed Up and Go and the Five-Minute Walk Test. In addition, lower extremity muscular strength, Timed Up and Go Assessment of Biomechanical Strategies, quality of life, and depression were evaluated.ResultsBefore and after intervention (within-subjects), mental practice group showed improved mobility in Timed Up and Go (p = 0.01,r = 0.59), muscular strength for bending the right hip (p = 0.04, r = 0.50), for right knee bending (p = 0.03,r = 0.53), and in biomechanical performance of Timed Up and Go Assessment of Biomechanical Strategies(p = 0.01,r = 0.63). Control group showed improvement in neither mobility nor in muscular strength after intervention. Comparing the scores between the groups after intervention (between-subjects), no differences were found for any of the study's outcomes. In the analysis of deltas (gains), it was observed that mental practice group volunteers had a reduction in Timed Up and Go (p = 0.27,r = 0.29) and an increase in total Timed Up and Go Assessment of Biomechanical Strategies scores (p = 0.14,r = 0.36).ConclusionMental Practice was not associated with mobility, muscular strength, mental health, and quality of life improvement for patients in the early subacute post-stroke phase as compared to a control group.     

Serum and salivary oxidative analysis in Complex Regional Pain Syndrome

Although both inflammatory and neural mechanisms have been suggested as potential contributors to Complex Regional Pain Syndrome type I (CRPS-I), the pathogenesis of the syndrome is still unclear. Clinical trials have shown that free radical scavengers can reduce signs and symptoms of CRPS-I, indirectly suggesting that free radicals and increased oxidative stress are involved in the pathogenesis of CRPS-I. This study investigated this premise by determining the levels of antioxidants in the serum and saliva of 31 patients with CRPS-I and in a control group of 21 healthy volunteers. Serum lipid peroxidation products (MDA) and all antioxidative parameters analyzed were significantly elevated in CRPS-I patients: median salivary peroxidase and superoxide dismutase (SOD) activity values, uric acid (UA) concentration and total antioxidant status (TAS) values were higher in CRPS-I patients by 150% (p = 0.01), 280% (p = 0.04), 60% (p = 0.0001), and 200% (p = 0.0003), respectively, as compared with controls. Similar although not as extensive pattern of oxidative changes were found in the serum: mean serum UA and MDA concentrations and TAS value in the CRPS-I patients were higher by 16% (p = 0.04), 25% (p = 0.02), and 22% (p = 0.05), respectively, than in the controls. Additionally, median salivary albumin concentration and median salivary LDH activities in the patients were 2.5 times (p = 0.001) and 3.1 (p = 0.004) times higher than in the controls. The accumulated data show that free radicals are involved in the pathophysiology of CRPS-I, which is reflected both in serum and salivary analyses. These data could be used for both diagnostic and therapeutic purposes in CRPS-I patients.     

Awareness that cocaine can contain fentanyl among nightclub and festival attendees in New York City, 2018–2022

People who attend nightclubs and dance festivals—particularly those that feature electronic dance music (EDM), are at high risk for use of cocaine and other party drugs. Given that cocaine is now sometimes adulterated with fentanyl, this study examines trends in people's knowledge about such risk of adulteration to inform prevention and harm reduction efforts. Adults were surveyed entering randomly selected EDM events (including dance festivals) in New York City in 2018, 2019, 2021, and 2022 (n = 2107). They were asked whether they agree that some dealers sell cocaine containing fentanyl, and trends in agreement were estimated. Prevalence of agreement that cocaine can be adulterated increased from 42.1% (95% CI: 36.8–47.6) in 2018 to 65.6% (95% CI: 54.1–75.4) in 2022—a 55.8% increase (p < .001). Between 2018 and 2022, particular increases occurred among those not reporting past-year cocaine use (by 61.6%, p < .001), among White individuals (by 68.1%, p < .001), those with some college (by 68.5%, p = .021), and those age ≥26 (by 83.8%, p = .001). Awareness that cocaine can contain fentanyl is increasing in this high-risk population. Continued education is needed for high-risk populations regarding both opioid overdose response and test strips that can test drugs for the presence of fentanyl.     

The effect of smartphone addiction on physical activity level in sports science undergraduates

BackgroundSmartphones are thought to have many negative effects on interpersonal relationships, physical-mental health, and general functionality as well as bring many conveniences to our daily lives. This study aimed to determine the effect of smartphone addiction on physical activity level in sports science undergraduates. Secondly, comparing the physical activity level in students by gender was aimed.MethodA total of 300 (134 female, 166 male) healthy university students were included in this study. The mean age of the subjects was 21.36 ± 2.33 years. The universe of the study consisted of volunteer students (Coaching Education, Physical Education and Sports Teaching, Sports Management, Recreation Departments) at the Faculty of Sport Sciences. Participants' demographic information was obtained and their physical activity levels were questioned with International Physical Activity Questionnaires (IPAQ) and smartphone addictions with the Smartphone Addiction Scale- Short Version (SAS-SV). The significance level was accepted as p < .05 in statistical evaluations.ResultsAccording to IPAQ scores, physical activity levels of the participants were as follows; 65.3% were adequate, 32.7% low and 2% inactive. One-hundred and twenty-six participants (42%) were smartphone addicts according to the SAS-SV results. When the departments were examined within themselves, it was found that IPAQ and SAS-SV scores were negatively correlated for Physical Education and Sports Teaching (r = - 0.262; p = .021) and Sports management (r = - 0.295; p = .01).     

Visual and haptic verticality misperception and trunk control within 72 h after stroke

IntroductionStroke patients often exhibit an altered perception of verticality, but there are no studies evaluating verticality perception in the first 72 h after stroke and its relationship with trunk control. Therefore, this study aimed to analyze visual and haptic verticality in the acute phase of stroke.MethodsThis was a cross-sectional study conducted with two groups: (a) 13 individuals with stroke and (b) 12 healthy participants. We assessed verticality via the subjective visual vertical (SVV) and the subjective haptic vertical (SHV); and we measured trunk control with the Trunk Impairment Scale (TIS). We performed t-tests to compare the SVV and SHV between groups. Pearson correlation was performed between verticality tests with National Institutes of Health Stroke Scale (NIHSS) and the TIS.ResultsParticipants with recent stroke presented higher true and absolute SVV deviation values than did the control group. There was significant negative correlation between absolute (r = −0.57; p = 0.02) and true SVV (r = −0.54; p = 0.01) with TIS scores There was also significant positive correlation between absolute (r = 0.63; p = 0.009) and true SVV (r = 0.61; p = 0.003) with NIHSS. A significant negative correlation between NIHSS and TIS scores also was found (r = −0.80; p = 0.005).ConclusionIndividuals with acute stroke presented larger variability in their perceptions of visual verticality than did healthy controls, and verticality perceptions were positively correlated with trunk impairment.     

Serum paraoxonase‐I activity is unaffected by short‐term administration of simvastatin,bezafibrate, and their combination in type 2 diabetes mellitus

Background The high‐density lipoprotein (HDL)‐associated anti‐oxidative and anti‐inflammatory enzyme, paraoxonase‐I, has been found previously to be lower in type 2 diabetes mellitus. We studied whether statin and fibrate treatment, alone and in combination, affect serum paraoxonase‐I activity in conjunction with changes in HDL cholesterol in diabetic patients. Subjects and methods A placebo‐controlled crossover study was carried out in 14 type 2 diabetic patients to test the effect of 8 weeks of active treatment with simvastatin (40 mg daily), bezafibrate (400 mg daily), and their combination on serum paraoxonase‐I activity, measured as its activity towards arylesterase and paraoxon. Serum paraoxonase‐I activity was also compared between these diabetic patients and 49 non‐diabetic control subjects. Results Serum arylesterase activity was lower in type 2 diabetic patients compared to control subjects (P < 0·001), but the difference in paraoxonase activity was not significant (P = 0·22). Neither arylesterase (P = 0·24) nor paraoxonase activity (P = 0·37) was increased in response to treatment, despite higher HDL cholesterol and apolipoprotein A‐I during combination therapy (P < 0·05 for both). Conclusion Short‐term administration of simvastatin and bezafibrate, even when combined, is ineffective in raising serum paraoxonase‐I activity in type 2 diabetes.     

Coronary wall MR Imaging in patients with rapid heart rates: a feasibility study of black-blood steady-state free precession (SSFP)

We assessed the hypothesis that black-blood steady-state free precession (SSFP) would provide coronary wall images comparable to images from TSE and have better performance than TSE under conditions of fast heart rate. With IRB approval, thirty participants without a history of coronary artery disease (19 men, 11 women, 26–83 y/o) were scanned with a 1.5 T MR scanner. Cross-sectional black-blood images of the proximal portions of coronary arteries were acquired with a two-dimensional (2D), double inversion recovery (DIR) prepared TSE sequence and a 2D DIR SSFP sequence on the same planes. Image quality (ranked with a 4-point system, scored from 0 to 3), vessel wall area and thickness, signal-to-noise ratio (SNR) of the wall and contrast-to-noise ratio (CNR, wall to lumen) were compared between SSFP and TSE with SPSS software (v 13.0). Totally 28 scans were completed. For SSFP and TSE, there was no difference in image quality. SSFP had a higher SNR (23.7 ± 10.1 vs. 14.4 ± 5.2, P < 0.001) and wall–lumen CNR (8.8 ± 4.5 vs. 6.7 ± 3.2, P = 0.001). Good agreements between measured wall area (r = 0.701, P < 0.001) and thickness (r = 0.560, P < 0.001) were found. For 10 participants with heart rate more than 80 beats/min, the image quality of SSFP was higher than TSE (P = 0.016). SSFP provided image quality and measurement accuracy that was comparable to TSE. With its higher performance under fast heart rate conditions, SSFP may break through the existing thresholds for heart rate and extend clinical applicability of coronary wall MR imaging to a larger population.