Effects of active commuting on cardiovascular risk factors: GISMO—a randomized controlled feasibility study

A sedentary lifestyle is a major modifiable risk factor for many chronic diseases. Lifestyle modification in order to increase exercise capacity is key in the prevention and rehabilitation of chronic diseases. This could be achieved by active commute. The aim of this study was to assess the effects of daily active commuting on physical activity (PA) and exercise capacity. Seventy-three healthy hospital employees (age: 46 ± 9 years, 38% male), with a predominantly passive way of commuting, were randomly assigned to two parallel groups, a control group (CG, N = 22) or an intervention group (IG, N = 51), which was further split into public transportation/active commuting (IG-PT, N = 25) and cycling (IG-C, N = 26). Both intervention groups were asked to reach 150 min/wk of moderate- to vigorous-intensity exercise during their commute for 1 year. CG maintained a passive commuting mode. All participants underwent assessment of anthropometry, risk factor stratification, and exercise capacity by a medical doctor at the Institute of Sports Medicine, Prevention and Rehabilitation. Weekly physical activity, using the International Physical Activity Questionnaire and commuting behavior, using an online diary, were used to assess physical activity. At the end of the study, the change in exercise capacity did significantly differ between IG and CG (P = .003, ES = 0.82). Actively covered distances through commuting significantly differed between groups (walking P = .026; cycling P < .001). Therefore, active commuting improves exercise capacity and can be recommended to the working population to increase exercise capacity .     

Physical activity and cardiovascular disease prevention in women: how much is good enough?

Epidemiologic data suggest that 30 min x d(-1) of brisk walking can reduce cardiovascular disease incidence in women and men. In a sedentary society, public health initiatives that promote moderate increases in physical activity may represent the optimal balance between efficacy, feasibility, and safety to achieve the desired cardioprotective effect.     

Ischaemic heart disease incidence and mortality in an extended cohort of Mayak workers first employed in 1948–1982

Objective:

Incidence and mortality from ischaemic heart disease (IHD) was studied in an extended cohort of 22,377 workers first employed at the Mayak Production Association during 1948–82 and followed up to the end of 2008.

Methods:

Relative risks and excess relative risks per unit dose (ERR/Gy) were calculated based on the maximum likelihood using Epicure software (Hirosoft International Corporation, Seattle, WA). Dose estimates used in analyses were provided by an updated “Mayak Worker Dosimetry System—2008”.

Results:

A significant increasing linear trend in IHD incidence with total dose from external γ-rays was observed after having adjusted for non-radiation factors and dose from internal radiation {ERR/Gy = 0.10 [95% confidence interval (CI): 0.04 to 0.17]}. The pure quadratic model provided a better fit of the data than did the linear one. No significant association of IHD mortality with total dose from external γ-rays after having adjusted for non-radiation factors and dose from internal alpha radiation was observed in the study cohort [ERR/Gy = 0.06 (95% CI: <0 to 0.15)]. A significant increasing linear trend was observed in IHD mortality with total absorbed dose from internal alpha radiation to the liver after having adjusted for non-radiation factors and dose from external γ-rays in both the whole cohort [ERR/Gy = 0.21 (95% CI: 0.01 to 0.58)] and the subcohort of workers exposed at alpha dose <1.00 Gy [ERR/Gy = 1.08 (95% CI: 0.34 to 2.15)]. No association of IHD incidence with total dose from internal alpha radiation to the liver was found in the whole cohort after having adjusted for non-radiation factors and external gamma dose [ERR/Gy = 0.02 (95% CI: not available to 0.10)]. Statistically significant dose effect was revealed in the subcohort of workers exposed to internal alpha radiation at dose to the liver <1.00 Gy [ERR/Gy = 0.44 (95% CI: 0.09 to 0.85)].

Conclusion:

This study provides strong evidence of IHD incidence and mortality association with external γ-ray exposure and some evidence of IHD incidence and mortality association with internal alpha-radiation exposure.

Advances in knowledge:

It is the first time the validity of internal radiation dose estimates has been shown to affect the risk of IHD incidence.     

Association between FDG uptake, CSF biomarkers and cognitive performance in patients with probable Alzheimer’s disease

Purpose  Brain imaging of FDG uptake and cerebrospinal fluid (CSF) concentration of amyloid-beta 1–42 (Aβ_1-42) or tau proteins are promising biomarkers in the diagnosis of Alzheimer’s disease (AD). There is still uncertainty regarding any association between decreased FDG uptake and alterations in CSF markers. Methods  The relationship between FDG uptake, CSF Aβ_1-42 and total tau (T-tau), as well as the Mini-Mental State Examination (MMSE) score was investigated in 34 subjects with probable AD using step-wise linear regression. FDG uptake was scaled to the pons. Results  Scaled FDG uptake was significantly reduced in the probable AD subjects compared to 17 controls bilaterally in the precuneus/posterior cingulate area, angular gyrus/inferior parietal cortex, inferior temporal/midtemporal cortex, midfrontal cortex, and left caudate. Voxel-based single-subject analysis of the probable AD subjects at p < 0.001 (uncorrected) revealed a total volume of significant hypometabolism ranging from 0 to 452 ml (median 70 ml). The total hypometabolic volume was negatively correlated with the MMSE score, but it was not correlated with the CSF measures. VOI-based step-wise linear regression revealed that scaled FDG uptake in the precuneus/posterior cingulate was negatively correlated with CSF Aβ_1-42. Scaled FDG uptake in the caudate was positively correlated with CSF T-tau. Conclusion  The extent and local severity of the reduction in FDG uptake in probable AD subjects are associated with cognitive impairment. In addition, there appears to be a relationship between local FDG uptake and CSF biomarkers which differs between different brain regions.     

Gorham-Stout disease and generalized lymphatic anomaly—clinical, radiologic, and histologic differentiation

Purpose

Gorham-Stout disease (GSD) is a rare vascular disorder of lymphatic origin characterized by progressive osteolysis. Generalized lymphatic anomaly (GLA) is a multisystem disorder that also commonly affects bone. We hypothesized that Gorham-Stout disease is different from other osseous lymphatic anomalies. We proposed to discriminate these entities by analyzing findings on skeletal imaging.

Methods

Clinical data, imaging studies, and histopathologic findings were retrospectively reviewed in patients presenting to our Vascular Anomalies Center with lymphatic anomalies of bone.

Findings

Within a cohort of 51 patients with lymphatic disorder and radiological evidence of bony involvement, two distinct categories emerged. Nineteen patients met the imaging criteria for GSD: progressive osteolysis with resorption and cortical loss. Thirty-two were categorized as GLA: Discrete radiolucencies and increasing numbers of bone affected over time, but without evidence of progressive osteolysis. The ribs were the most common site in both groups, followed by the cranium, clavicle, and cervical spine in GSD, and thoracic spine, humerus, and femur in GLA. Fewer bones were involved in GSD, with relative sparing of the appendicular skeleton. Associated infiltrative soft tissue abnormality was seen in 18 in GSD, but only six with GLA. Macrocystic lymphatic malformations were identified in 14 with GLA, but none with GSD.

Conclusions

There are significant radiological differences between GSD and GLA, although there are some overlapping features. The major distinguishing characteristic is the progressive osteolysis seen in GSD. Findings suggestive of GLA are more extensive involvement, particularly of the appendicular skeleton, presence of discretemacrocystic lymphatic malformations and visceral organ lesions.     

Correlation between pathology and neuromelanin MR imaging in Parkinson’s disease and dementia with Lewy bodies

Introduction

Direct correlation between neuropathological findings and postmortem neuromelanin MR imaging (NmMRI) was performed in the substantia nigra pars compacta (SNc) to clarify the pathological background of the signal changes in normal, Parkinson’s disease (PD), and dementia with Lewy bodies (DLB) cases.

Methods

NmMRI of 10 % formalin-fixed autopsied midbrains was performed in three cases (normal control, DLB, and PD) with a 3T imaging system, using a 3D gradient echo T1-weighted sequence with a magnetization transfer contrast pulse. Neuropathological examinations of the midbrains were performed, and the density of neuromelanin-positive neurons (number per square millimeter) was determined. The extent of iron deposition in the midbrain was also evaluated using ferritin immunohistochemistry. Furthermore, we directly correlated the contrast signal ratio in the SNc and the density of neuromelanin-containing neurons.

Results

Diffuse hyperintense areas in the SNc reflected well-preserved neuromelanin-containing neurons in the normal control case, whereas an iso-intense area in the SNc showed severe loss of neuromelanin-containing neurons in the DLB and PD cases. Increased signal intensity in the SNc was apparently not influenced by iron deposition. Furthermore, a significant positive correlation between signal intensity and the density of neuromelanin-containing neurons was seen in the SNc.

Conclusion

Based on the direct correlation between postportem NmMRI and neuropathological findings, signal intensity in the SNc is closely related to the quantity of neuromelanin-containing neurons but is not influenced by iron deposition.     

Imaging Intussusception in Children’s Hospitals in the United States: Trends,Outcomes, and Costs

ObjectiveTo describe imaging utilization, outcomes, and cost in the management of intussusception between 2010 and 2017 in pediatric hospitals in the United States.MethodsAll children (under 18 years of age) with a primary diagnosis of intussusception in a large administrative database were identified. Demographics, imaging, and costs were described.ResultsThere were 17,032 children (63.3% boys, 36.7% girls, mean age: 3.2 years) that had 20,655 hospital encounters for intussusception, and 88.5% were <5 years of age. The average length of stay was 2.8 days (median: 1 day), with rates of intensive care unit admission, 3.7%; 90-day readmission, 10.5%; and mortality, 0.2%. The surgical rate was 19.6%, and 93.5% (n = 19,301) of patients underwent imaging: 87.2% (n = 16,822) received ultrasound, 69.1% (n = 13,329) had fluoroscopy, 59% (n = 11,380) had abdominal radiographs, and 8.8% (n = 1,696) had CT. The reduction success rate for fluoroscopy was 77.9%. Surgery was more common in rural patients (26.8% versus 18.7% in urban patients, P < .001). Median encounter costs were $2,675 (interquartile range: $1,637-$5,465). Imaging cost represented a quarter (median $680, interquartile range: $372-1,069) of all costs. Higher costs (median) were associated with longer length of stay (<3 days: $858 versus >3 days: $5,342; use of CT ($4,168 versus $943 in patients without a CT), and surgery ($4,434 versus $860 without surgery).ConclusionThe management of intussusception is mainly nonsurgical, most frequently involving imaging with ultrasound and fluoroscopy, and resulting in excellent outcomes in the great majority of the cases. Despite playing a central role for diagnosis and management, imaging only represents a fraction of total cost.     

Differences in striatal dopamine transporter density between tremor dominant and non-tremor Parkinson’s disease

Purpose

Parkinson’s disease (PD) can manifest with a tremor-dominant or a non-tremor (akinetic-rigid) phenotype. Although the tremor-dominant subtype may show a better prognosis, there is limited information on the phenotypic differences regarding the level of striatal dopamine transmission. The present study investigated striatal dopamine transporter (DAT) binding characteristics in a large sample of patients with and without tremor.

Methods

[¹²³I]FP-CIT SPECT scans of 231 patients with a clinical diagnosis of PD and abnormal FP-CIT binding (157 with tremor, 74 without tremor) and 230 control patients with normal FP-CIT binding (148 with tremor, 82 without tremor) were analysed using an automated region-of-interest analysis of the scans (BRASS). Specific striatal binding ratios were compared between phenotypes and groups using age, sex, and symptom duration, predominant side of symptoms, dopaminergic medications and scanner as covariates.

Results

Patients with PD had 28.1 – 65.0 % lower binding in all striatal regions compared to controls (p?p?Conclusion The motor phenotype is associated with the extent of caudate dopamine terminal loss in PD, as dopamine function is relatively more preserved in tremor patients. Symptom type is related to caudate dopamine function only in association with Parkinsonian dopaminergic degeneration, not in intact dopamine systems in patients with non-PD tremor.     

Reduction in risk factors for cardiovascular diseases and long-lasting walking habit in sedentary male and female subjects following 1 year of guided walking

Aims

To analyze the change in risk factors for cardiovascular diseases in sedentary subjects following 1 year of guided walking and check the maintenance of the walking habit 16 months after the end of the project.

Methods

A total of 650 sedentary subjects (442 women, 208 men) were admitted to the project. Body mass index (BMI), waist circumference, systolic and diastolic blood pressure, and walking speed were determined at enrollment and redetermined after 1 year in the subjects completing the project. Daily groups of guided walking were organized.

Results

In the 326 subjects completing the project, highly significant reduction in body weight, BMI, waist circumference, systolic and diastolic blood pressure and increase in walking speed were documented. Out of the 326 finishers, 266 answered a questionnaire on the minutes of walking they were doing each week, 16 months after the end of the project: 258 declared 170 ± 110 min while eight declared to be back to inactivity.

Conclusion

Guided walking was followed by highly significant reduction in risk factors for cardiovascular diseases and improved walking speed. Seventy-seven percent of the finishers were maintaining the walking practice 16 months after the end of the project, indicating that guided walking programs can be effective in permanently modifying the lifestyle of sedentary subjects.

     

Comparison of sonographically measured bowel wall vascularity, histology, and disease activity in Crohn’s disease

The purposes of this study was to provide a retrospective comparison of semiquantitatively measured bowel wall vascularity by power Doppler sonography, endoscopic-histopathological biopsy findings, and disease activity in patients with confirmed Crohn’s disease. Thirty-two out of 1,332 patients with histologically confirmed Crohn’s disease (18 female, 14 male; mean age 38.8 years) met the inclusion criteria: ileocolonoscopy with biopsy and power Doppler sonographic determination of bowel wall vascularity with assessment of disease activity within a period of 5 days. Sonographic determination of bowel wall vascularity was based on a semiquantitative score. Endoscopic bowel wall biopsy specimens were assessed using a self-developed inflammation score and the disease activity was calculated using Crohn’s disease activity index (CDAI). A significant association (p < 0.05) was shown for results of histology and bowel wall vascularity in the terminal ileum (κ = 0.66; sensitivity 95%; specificity 69%). There was no observed association between CDAI and histology, although there was an association between CDAI and bowel wall vascularity (sensitivity 82%). Increased bowel wall vascularity in the terminal ileum measured by power Doppler ultrasound reflects inflammatory activity in histologically examined bowel wall. Power Doppler ultrasound may be able to monitor activity changes of the bowel wall determined by pharmaceutical treatment. B. H. Drews and T. F. E. Barth contributed equally.     

Dementia in military and veteran populations:a review of risk factors—traumatic brain injury,post-traumatic stress disorder,deployment,and sleep

The military population face a unique set of risk factors that may increase the risk of being diagnosed with dementia.Traumatic brain injury(TBI) and post-traumatic stress disorder(PTSD) have a higher prevalence in this group in comparison to the civilian population. By delving into the individual relationships between TBI and dementia, and PTSD and dementia, we are able to better explore dementia in the military and veteran populations. While there are some inconsistencies in results, the TBI-d...     

Relationships between amyloid levels,glucose metabolism,morphologic changes in the brain and clinical status of patients with Alzheimer’s disease

Annals of Nuclear Medicine - The current study was conducted to improve the understanding of relationships between regional cortical amyloid load, glucose metabolism, cortical morphology (volume),...     

A distant relationship?—investigation of correlations between DNA isolated from backspatter traces recovered from firearms,wound profile characteristics,and shooting distance

In molecular ballistics, where traces originating from the use of firearms against biological targets are investigated, “backspatter” traces are of particular importance. This biological material comprising blood and tissue from the victim is propelled back from the bullet entry site towards the direction of the shooter and can consolidate and persist on the inner and outer surfaces of the firearm, from where it can be collected and analyzed. Thus, a connection between the weapon and the victim can be established solely by molecular biological trace analysis. For the criminalistic investigation of gun-related crimes, the determination of the distance between the weapon and the victim can be of critical importance in reconstructing the circumstances of a crime. In this study, we investigated possible correlations between the shooting distance and the amount of backspatter in/on the used firearm. To this purpose, we employed a previously established skull model and performed shootings in triplicates from various distances up to 50 cm with two types of handguns (pistol and revolver). Backspatter was collected from various sampling locations, and DNA contents were quantified. A post-shooting wound channel evaluation was conducted by optical and radiological evaluation. The obtained DNA yields varied considerably between replicates from the same and from different distances. In contrast, apart from contact shots, no meaningful differences were observable in wound channel evaluations. In summary, no meaningful correlation between backspatter distribution and DNA yields, the shooting distance and the condition of the wound channel could be established.

     

Is marathon running toxic? An observational study of cardiovascular disease prevalence and longevity in 54 male marathon runners

Objectives: Recent literature suggests reduced benefits associated with high intensity (HIT) and or sustained intensity exercise training (SIT). While important, they tend to contrast with other studies of HIT and SIT and may not be representative of all individuals wishing to participate in activities such as marathon running. The purpose of this observational report is to describe a 45-year history of 54 long distance runners, their incidence of death from cardiovascular disease and their ages at death compared to the normal population.

Methods: Data were collected longitudinally on all 54 members of a Southern California mens running club by the author, a cardiologist with 45 years of experience, member of the running club, and personal physician for most of the men for over 40 years. Retrospective and observational data were collected from direct professional and personal contact with the 54 men in the running club.

Results: Closely monitored group of marathon runners with extreme HIT and SIT revealed a low incidence of cardiovascular disease (CVD) with an extended longevity relative to the general population.

Conclusion: The benefits of exercise for reducing risk of chronic disease, including CVD, are well known. Whether these benefits extend to the more intense and prolonged exercise associated with marathon running is unclear. However, as evidenced in the observational data presented here, at least in some populations, years of high-intensity, prolonged exercise may not be as toxic as suggested by others. Whether this is due to self-selection or predisposition is not well understood but merits further study.     

Self-citation: comparison between Radiología, European Radiology and Radiology for 1997–1998

Self-citation, considered as the number of times a paper cites other papers in the same journal, is an important criteria of journal quality. Our objective is to evaluate the self-citation in the official journal of the Spanish Society of Radiology (Radiología), and to compare it with the European Radiology and Radiology journals. Papers published in Radiología, European Radiology, and Radiology during 1997 and 1998 were analyzed. The Self Citation Index, considered as the ratio between self-references and total number of references per article, for the journals Radiología (SCIR), European Radiology (SCIER), and Radiology (SCIRY), were obtained and expressed as percentages. Also, the number of references to Radiología in European Radiology and Radiology papers were calculated. Stratification of the index per thematic area and article type was also performed. Mean SCIR, SCIER, and SCIRY values were compared with the ANOVA and the Student-Newman-Keuls tests. The self-citation index was statistically higher in Radiology (23.2%; p<0.0001) than in Radiología (1.8%) and European Radiology (0.8%). There were no statistically significant differences between SCIR and SCIER indexes ( p=0.25). In the stratification per thematic areas and article type, self-citation in Radiology was statistically higher ( p<0.0001), with the only exception of "Radioprotection" area ( p=0.2), to SCIR and SCIER. Although there were no statistically significant differences, by thematic areas SCIR was always larger than SCIER, with the only exception of the "Genitourinary imaging" area, and by article type SCIR also went greater to SCIER, except in review articles. Radiología, The Spanish official radiological journal, although not included in Index Medicus and its database Medline, had a larger number of self-citing than European Radiology in the period 1997-1998.     

Abnormal changes in functional connectivity between the amygdala and frontal regions are associated with depression in Alzheimer’s disease

Purpose

The aim of the present study was to investigate the functional connectivity (FC) of Alzheimer’s disease patients with depression (D-AD) based on an amygdalar seed using resting-state functional magnetic resonance imaging (rs-fMRI).

Methods

Twenty-one non-depressed AD (nD-AD) patients and 21 D-AD patients underwent rs-fMRI. The Hamilton Depression Rating Scale and Neuropsychiatric Inventory were used to evaluate the severity of depression. The amygdala was used as the seed for FC analysis. The FC differences between the two groups were evaluated by two-sample t tests, and the correlation of FC changes with depressive severity was analyzed by Pearson correlational analysis.

Results

Compared with the nD-AD patients, D-AD patients had increased FC values between the amygdala and orbitofrontal cortex and decreased FC values among the amygdala, medial prefrontal cortex, and inferior frontal gyrus.

Conclusion

These data suggest that abnormal amygdala-prefrontal FC may be an important characteristic of AD patients with depression.

     

Targeting PSMA by radioligands in non-prostate disease—current status and future perspectives

Background

Prostate-specific membrane antigen (PSMA) is the up-and-coming target for molecular imaging of prostate cancer. Despite its name, non-prostate-related PSMA expression in physiologic tissue as well as in benign and malignant disease has been reported in various publications. Unlike in prostate cancer, PSMA expression is only rarely observed in non-prostate tumor cells. Instead, expression occurs in endothelial cells of tumor-associated neovasculature, although no endothelial expression is observed under physiologic conditions. The resulting potential for tumor staging in non-prostate malignant tumors has been demonstrated in first patient studies. This review summarizes the first clinical studies and deduces future perspectives in staging, molecular characterization, and PSMA-targeted radionuclide therapy based on histopathologic examinations of PSMA expression.

Conclusions

The non-exclusivity of PSMA in prostate cancer opens a window to utilize the spectrum of available radioactive PSMA ligands for imaging and molecular characterization and maybe even therapy of non-prostate disease.