Comparison of three anti-dsDNA assays: Performance and correlation with systemic lupus erythematosus disease activity

ObjectiveTo investigate the BioPlex 2200 multiplex immunoassay and Farrzyme ELISA assays as alternatives to the established Farr radioimmunoassay for the correlation of anti-dsDNA antibodies in the assessment of disease activity in systemic lupus erythematosus (SLE).Design and methodsStandard protocols were used to verify analytical performance claims. Anti-dsDNA antibody levels in SLE patient specimens (N = 105) were measured and assessed for clinical performance using manufacturer cut-off limits along with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score.ResultsAssay precision, measurable range and normal reference interval met the manufacturers' stated claims. Agreement between Farr and BioPlex assays was moderate (positive agreement = 62%; negative agreement = 85%; kappa = 0.48), as was agreement between Farr and Farrzyme assays (positive agreement = 56%; negative agreement = 91%; kappa = 0.51). Mean SLEDAI-2K scores differed significantly between the anti-dsDNA positive and negative groups for BioPlex (p = 0.0006), but not Farr (p = 0.11) or Farrzyme (p = 0.34). ROC curve analysis showed a similar area under the curve (AUC) for all three assays (0.76, 0.74, and 0.73 for Farr, BioPlex, and Farrzyme, respectively) in the discrimination of clinically active disease. Furthermore, increased anti-dsDNA levels from BioPlex showed significant correlation with active renal disease. However, results suggested a lower cut-off for the Farrzyme assay for assessment of global disease activity.ConclusionsBioPlex and Farrzyme assays had similar overall agreement with the Farr assay, with BioPlex best reflecting disease activity in SLE patients.     

Common genetic variants of the vitamin D binding protein (DBP) predict differences in response of serum 25-hydroxyvitamin D [25(OH)D] to vitamin D supplementation

BackgroundTo determine the effect of vitamin D binding protein (DBP) genotypes on 25-hydroxyvitamin D [25(OH)D] changes with vitamin D supplements, we studied 98 adults receiving 600 or 4000 IU/d vitamin D₃ for one year.MethodsThe DBP functional variant, T436K, was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).ResultsMean 25(OH)D increases were 97% for TT (n = 48), 151% for TK (n = 31) and 307% (n = 6) for KK genotypes (p = .004).ConclusionsAs with baseline 25(OH)D, T436K genotype predicts 25(OH)D changes after long-term vitamin D supplementation.     

Plasma concentrations of Gas6 and soluble Axl correlate with disease and predict mortality in patients with critical limb ischemia

IntroductionCritical limb ischemia (CLI) is a severe peripheral arterial disease, characterized by rest pain, ulcers and gangrene in the legs. Gas6 is a vitamin K-dependent protein, which binds and activates the tyrosine kinase receptor Axl. Gas6-mediated Axl-signaling influences endothelial activation, neointima formation and immune regulation. Axl can be cleaved and soluble Axl (sAxl) is detectable in circulation.Design and methodsWe quantified plasma concentrations of Gas6 and sAxl in 189 CLI patients and 204 controls.ResultsGas6 and sAxl concentrations were increased in the CLI patients (p < 0.0001) and correlated to C-reactive protein, interleukin-6, tumor necrosis factor α and neopterin. Patients who died within 3 years of sampling (n = 84) had increased concentrations of Gas6 and sAxl as compared to survivors (p = 0.0009 and p = 0.0011).ConclusionsPlasma concentrations of Gas6 and sAxl correlate to inflammation and predict survival. This indicates that Gas6 and sAxl have a role in CLI, presumably connected to the inflammatory process.     

BCL2L12: A promising molecular prognostic biomarker in breast cancer

ObjectivesBCL2-like 12 (BCL2L12) is a new member of the BCL2 gene family that was discovered and cloned by members of our group and found to be expressed in the mammary gland. Many genes of the BCL2 family were found to be implicated in breast carcinogenesis and to serve as possible prognostic markers. The aim of the present study was the quantification of BCL2L12 mRNA expression in order to assess its value as a prognostic tissue biomarker in breast cancer (BC).Design and methodsBCL2L12 mRNA levels were determined in a statistically significant sample size of cancerous (N = 108) and adjacent non-cancerous (N = 71) breast tissues using a highly sensitive quantitative real-time polymerase chain reaction (qRT-PCR) method. Relative quantification analysis was conducted using the comparative C_T (2^− ΔΔC_T) method, whereas the association between BCL2L12 expression and clinopathological data, disease-free survival (DFS) and overall survival (OS) were estimated by statistical analysis.ResultsBCL2L12 mRNA expression was decreased in malignant samples compared to the histologically normal counterparts (p = 0.012). Significant relationships between BCL2L12 expression and TNM stages (p = 0.009), metastatic potential (p = 0.012), tumor size (p = 0.04) and age (p = 0.024) were observed. Moreover, Kaplan–Meier and Cox univariate analyses indicated that BCL2L12 expression is associated with longer DFS, whereas multivariate analysis pointed out the independent favorable prognostic value of BCL2L12.ConclusionsAccording to our results, BCL2L12 mRNA expression is a favorable prognostic marker of DFS for BC patients, suggesting its possible application as a novel prognostic indicator of this malignancy.     

Factors influencing preventive behavior against Middle East Respiratory Syndrome-Coronavirus among nursing students in South Korea

BackgroundMiddle East Respiratory Syndrome Coronavirus (MERS-CoV), an emerging infectious disease introduced in South Korea in 2015, spreads quickly through hospitals, and Korea became one of the major areas affected by the disease after the Middle East region. To stop the spread of an emerging disease, it is important to practice prevention guidelines correctly.ObjectivesThe purpose of this study was to investigate factors influencing preventive behavior against MERS-CoV among Korean nursing students.MethodsThis is a cross-sectional study using a questionnaire survey. Data were collected from 429 nursing students from three colleges of nursing in Korea from June 25 to July 3 in 2015.ResultsPreventive behavior against MERS-CoV was affected mostly by attitude (β = .243, p < .001). Such behavior was also high in relation to the variables of perceived risk (β = .232, p < .001), older students (β = .202, p < .001), knowledge level (β = .153, p < .01), and female respondents (β = .115, p < .05).ConclusionPreventive behavior against emerging infectious diseases such as MERS-CoV was found to be affected most significantly by attitude and risk perception. It is crucial to provide nursing students with information or knowledge, but it is also important to help those in nursing education recognize that active preventive behavior can prevent this infectious disease and stop its spread.     

Neuromuscular rate of force development deficit in Parkinson disease

BackgroundBradykinesia and reduced neuromuscular force exist in Parkinson disease. The interpolated twitch technique has been used to evaluate central versus peripheral manifestations of neuromuscular strength in healthy, aging, and athletic populations, as well as moderate to advanced Parkinson disease, but this method has not been used in mild Parkinson disease. This study aimed to evaluate quadriceps femoris rate of force development and quantify potential central and peripheral activation deficits in individuals with Parkinson disease.MethodsNine persons with mild Parkinson Disease (Hoehn & Yahr ≤ 2, Unified Parkinson Disease Rating Scale total score = mean 19.1 (SD 5.0)) and eight age-matched controls were recruited in a cross-sectional investigation. Quadriceps femoris voluntary and stimulated maximal force and rate of force development were evaluated using the interpolated twitch technique.FindingsThirteen participants satisfactorily completed the protocol. Individuals with early Parkinson disease (n = 7) had significantly slower voluntary rate of force development (p = 0.008; d = 1.97) and rate of force development ratio (p = 0.004; d = 2.18) than controls (n = 6). No significant differences were found between groups for all other variables.InterpretationsPersons with mild-to-moderate Parkinson disease display disparities in rate of force development, even without deficits in maximal force. The inability to produce force at a rate comparable to controls is likely a downstream effect of central dysfunction of the motor pathway in Parkinson disease.     

Impact of long distance rowing on biological health: A pilot study

ObjectivesTo determine the impact of long distance rowing (160 km, nonstop) on standard biological parameters and to study the relation between inflammation, myocardial necrosis, lipid profile, heart rate and energy expenditure.MethodsElectrolytes, lipid profile, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), procalcitonin (PCT), high-sensitive troponin T (hs-cTnT), and N-terminal pro-brain natriuretic peptide (NT-proBNP), were measured on non-fasting venous blood samples collected 8 h before and after the rowing race on five healthy competitors. Heart rate and energy expenditure were measured using sporting self-measurement devices.ResultsAfter 16.5 h of race, significant increases in median CRP (+ 25.2 mg/l; p = 0.04), IL-6 (+ 1.85 pg/ml; p = 0.04), TNF-α (+ 1.2 pg/ml; p = 0.04) and NT-proBNP levels (+ 88.8 pg/ml; p = 0.04) were observed, and a close to significant elevation for hs-cTnT(+ 6 ng/l; p = 0.06) and PCT (+ 0.14 μg/l; p = 0.07). On the other hand, significant decrease in median total cholesterol (− 0.5 mmol/l; p = 0.04), triglycerides (− 0.7 mmol/l; p = 0.04) were observed. Furthermore, significant correlations between the maximal heart rate reached during the race and CRP (r = 0.90; p = 0.03), IL-6 (r = 0.90; p = 0.03), and NT-proBNP (r = 0.90; p = 0.03) were observed, whereas no such associations were retrieved with median heart rate, the percentage of time passed over 70% of maximal heart rate or energy expenditure during the race. There was no association between PCT, NT-proBNP, hs-cTnT, inflammatory biomarkers, lipid profile or heart rate parameters.ConclusionsLong distance rowing induces inflammation and myocardial strain related to the maximal effort generated during the race, but has a favourable effect on lipid profile.     

Yoga’s effect on falls in rural,older adults

BackgroundUnintentional falls affect 30% of people over age 65 years. Yoga has been shown to improve balance. We designed this study to examine if yoga reduces falls.MethodsWe conducted 16 sessions of Hatha yoga over 8 weeks. Participants were randomly assigned to practice 10 min of yoga daily at home in addition to 5-min relaxation exercises or relaxation exercises only (control group).ResultsOf the 38 participants completing the intervention, 15 participants reported a total of 27 falls in the 6-months before the study, compared to 13 participants sustaining 14 falls in the 6 months from the start of the study (p < 0.047), without difference between yoga home-exercise and home relaxation-only groups.Compared to baseline scores, all participants improved on the Berg Balance Scale (53–54 out of 56, p = 0.002), the Functional Gait Assessment (22.9–25.8 out of 30 points, p < 0.001), and the Dynamic Gait Index (20.6–22.4 out of 24 points, p < 0.001). Right leg stand time improved from a mean of 13.3 s to 17.1 s (p = 0.020) and standing forward reach distance from 26.0 cm to 29.6 cm (p < 0.001). Without difference between groups.Confidence, with the Activities-specific Balance Confidence Scale, increased in the yoga home-exercise group (88%–93%, p = 0.037) compared to 90% unchanged from pre-intervention in the home relaxation-only group.ConclusionYoga classes reduce self-reported falls and improve balance measures. The addition of home yoga exercises did not enhance benefit over relaxation exercise only.     

Prevalence of gastric parietal cell antibodies and intrinsic factor antibodies in primary biliary cirrhosis

BackgroundWe investigated the prevalence of antibodies against gastric parietal cells (GPA), intrinsic factor antibodies (IFA) and the presence of pernicious anemia in a large cohort of primary biliary cirrhosis (PBC) patients as similar data is missing.Methods157 PBC patients and 357 controls (73 with autoimmune hepatitis (AIH), 35 primary sclerosing cholangitis (PSC), 45 HBV, 37 HCV, 36 alcoholic liver disease (ALD), 35 non-alcoholic fatty liver disease (NAFLD) and 96 healthy) were investigated for IgG-isotype-specific GPA and IFA by ELISAs and vitamin-B₁₂ levels by a microparticle enzyme immunoassay.ResultsThe detection of IgG-GPA was significantly higher in PBC (31.8%) compared to AIH (10.9%; p = 0.001), PSC (0%; p = 0.000), HCV (13.5%; p = 0.01), HBV (13.3%; p = 0.006), ALD (8.3%; p = 0.004), NAFLD (11.4%; p = 0.003) and healthy (10.4%; p = 0.001). IgG-IFA were detected in 12% of GPA-positive PBC patients and in none of the other liver diseases or in healthy (p = 0.001). This reactivity was significantly associated with lower vitamin-B₁₂ levels compared to those with an IFA-negative test (p = 0.025).ConclusionsA significant proportion of PBC patients had IgG-GPA and IFA compared to controls. IgG-IFA were detected only in GPA-positive PBC patients and associated with lower vitamin-B₁₂ levels compared to those with an IFA-negative test.     

Neuroendocrine tumor liver metastases treated with yttrium-90 radioembolization

ObjectiveYttrium-90 (Y-90) radioembolization is an emerging treatment option for unresectable neuroendocrine liver metastases (NELM). However, the data regarding this treatment are currently limited. This study evaluates the efficacy and tolerability of Y-90 radioembolization and identifies prognostic factors for radiographic response and survival.Methods and materialsThirty-eight patients underwent Y-90 radioembolization for NELM at our institution between April 2004 and February 2012. Patients were assessed radiographically (RECIST criteria, enhancement), serologically, and clinically at 1 month, and then at every 3 months after treatment for tumor response, toxicity, and survival outcomes.ResultsMedian length of follow-up was 17.0 months (IQR, 9.0–37.0). Median survival was 29.2 months. Three patients (9%) had a radiographic complete response to treatment, 6 (17%) had a partial response, 21 (60%) had stable disease, and 5 (14%) developed progressive disease. Two factors were significantly associated with a good radiographic response (complete/partial response): islet cell histological subtype (p = 0.043) and hepatic tumor burden ≥ 33% (p = 0.031). Multivariate analysis revealed that patients requiring multiple Y-90 treatments (HR 2.9, p = 0.035) and patients who had previously failed systemic therapy with octreotide/chemotherapy (HR 4.4, p = 0.012) had worse survival. Grade 3 serologic toxicity was observed in 2 patients (5%; hyperbilirubinemia, elevated alkaline phosphatase) after treatment. Grade 3 non-serologic toxicities included abdominal pain (11%), fatigue (11%), nausea/vomiting (5%), ascites (5%), dyspnea (3%), diarrhea (3%), and peripheral edema (3%). No grade 4 or 5 toxicity was reported.ConclusionsY-90 radioembolization is a promising treatment option for inoperable NELM and is associated with low rates of grade ≥ 3 toxicity.     

The angiotensin converting enzyme D allele is an independent risk factor for early onset coronary artery disease

ObjectiveThe role of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in early onset coronary artery disease age < 55 years (ECAD) is controversial. The aim of this study was to further evaluate the role of this ACE(I/D) gene polymorphism on the risk of premature CAD in patients from western Iran.MethodsThe ACE(I/D) genotypes were detected by PCR-RFLP in 323 individuals undergoing their first coronary angiography. Patients were placed into two groups: ECAD and late onset CAD age ≥ 55 years (LCAD).ResultsWe found a statistically significant association of the ACE D allele, as homozygous or ACE ID plus DD genotypes (ID + DD), only in the ECAD subjects OR = 1.35, p = 0.015, OR = 3.27, p = 0.014, and OR = 2.8, p = 0.013, respectively. In addition, there was a significant association after adjustment for the absence of history of diabetes, presence of normolipidemia and absence of history of blood pressure [OR 1.38, p = 0.017 and 2.35, p = 0.02]. Our results indicated that the ACE D allele is a risk factor for early onset of CAD even after correcting for conventional risk factors. The incidence of triple vessel disease was significantly higher in individuals carrying ACE(D/D) genotype in ECAD patients compared to those who carried ACE(I/I) genotype (OR 3.38; p = 0.019; 57.5% vs. 42.5%; p = 0.013).ConclusionThe presence of D allele of ACE can be important independent risk factor in the onset of CAD patients less than 55 years old in a west population of Iran. Larger collaborative studies are needed to confirm these results.     

Shoulder and elbow kinematics during the Mallet score in obstetrical brachial plexus palsy

BackgroundThe physical signs of obstetrical brachial plexus palsy range from temporary upper-limb dysfunction to a lifelong impairment and deformity in one arm. The aim of this study was to analyze the kinematics of the upper limb and to evaluate the contribution of glenohumeral and scapulothoracic joints of obstetrical brachial plexus palsy children.MethodsSix children participated in this study: 2 males and 4 females with a mean age of 11.7 years. Three patients had a C5, C6 lesion and 3 had a C5, C6, C7 lesion. They were asked to perform five tasks based on the Mallet scale and the kinematic data were collected using the Fastrak electromagnetic tracking device.FindingsThe scapulothoracic protraction and posterior tilt were significantly increased in the involved limb during the hand to mouth task (p = 0.006 and p = 0.015 respectively). The scapulothoracic Protraction/glenohumeral Elevation ratio was significantly increased in the involved limb during the hand to neck task (p = 0.041) and the elevation task (p = 0.015). The ratios of scapulothoracic Tilt on the three glenohumeral excursion angles were significantly increased during the hand to mouth task (p ≤ 0.041). The scapulothoracic Mediolateral/glenohumeral Elevation ratio was significantly increased in the involved limb during the elevation task (p = 0.038). The glenohumeral elevation excursion was significantly decreased in the involved limb during the hand to neck task (p < 0.001) and the elevation task (p = 0.0003).InterpretationThis study gives us information about the greater contribution of the scapulothoracic joint to shoulder motion for affected arm of obstetrical brachial plexus palsy patients compared to their unaffected arm. Kinematic analysis could be useful in shoulder motion evaluation during the Mallet score and to evaluate outcomes after surgery.     

Interleukin-1β genotype and circulating levels in cancer patients: Metastatic status and pain perception

ObjectivesProinflammatory cytokines released during inflammation can cause hyperexcitability in pain transmission neurons, leading to hyperalgesia and allodynia. Polymorphisms in interleukin 1 (IL-1) family of genes (IL1A, IL1B) and in IL-1 receptor antagonist (IL-1Ra, coded by IL1RN) may therefore induce alterations in cytokine levels/effects and pain related response. Our purpose was to investigate the influence of polymorphisms in IL1A/B/RN on cytokine serum levels and its correlation with pain intensity, performance status, adverse effects, metastases and breakthrough pain in Caucasian cancer patients.Design and methodsSerum IL-1α/β levels of 74 cancer patients were measured by competitive enzyme immunosorbent assay. All patients were also genotyped for the polymorphisms in IL1A (rs17561), IL1B (rs1143634) and IL1RN (rs419598) with Real-Time PCR. Results were then correlated to the appearance of bone or CNS metastases and several pain-related parameters.ResultsIL-1β rs1143634 homozygous for T allele were associated with lower levels of IL1-β (p = 0.032, Mann–Whitney test) and presented a trend for lower levels of pain (p = 0.06, Fisher's Exact Test). Also, IL1-β levels were related with cancer onset status, since a four-fold increase probability of metastatic disease was observed in high IL-1β individuals (OR = 4.074, p = 0.010, Pearson χ² test). Among the female patients presenting metastatic disease and carriers of the TT genotype we observed a trend to lower levels of IL1-β (p = 0.053, Pearson χ² test).ConclusionsOur results indicate that genetic variation at IL1-β gene may influence serum levels of IL1-β, with proportional consequences in cancer-related pain.     

Effects of a self-management program on patients with early-stage chronic kidney disease: A pilot study

BackgroundWithout intervention, renal function deteriorates in patients with chronic kidney disease (CKD).AimThis pilot study aimed to develop a self-management education program based on self-regulation theory and to evaluate its effects on self-efficacy, self-management behavior, and CKD progression among patients with early-stage CKD.MethodsIn this single-group, pretest–posttest, repeated-measures, longitudinal study, participants underwent baseline pretesting (T₀) and posttesting at 3 (T₁), 6 (T₂), and 12 (T₃) months after a 5-week group-session self-management program.ResultsSelf-efficacy increased significantly at T₂ (χ² = 8.97, p = .02) and T₃ (χ² = 10.71, p = .01) compared with T₀, but self-management behavior did not. A marginally significant decrease in serum creatinine levels was observed from T₀ to T₃ (χ² = 6.29, p = .07) but estimated glomerular filtration rates remained stable throughout the 12-month period.ConclusionsThe results of this empirical study suggest that the theory-based intervention is feasible and has potential efficacy in retarding CKD progression.     

High-level expression of early growth response-1 and association of polymorphism with total IgE and atopy in allergic rhinitis adults

BackgroundEarly growth response-1 (Egr-1) is expressed in human airways and its polymorphisms have been associated with total IgE and atopy in asthmatic patients. We investigated the effects of Chinese-tagging single nucleotide polymorphism (SNP) of Egr-1 and its mRNA expression on allergic rhinitis (AR) traits.MethodsAmong 214 Chinese AR adults and 259 controls, tag SNP ?4071 A → G was genotyped and mRNA expression in peripheral blood was quantified by real-time PCR.ResultsEgr-1 mRNA expression was significantly higher in patients than controls (median of 0.23 vs 0.15 fold GAPDH expression; p < 0.001). Its expression was not associated with ? 4071 polymorphism. However, significant correlations were found between ? 4071 A → G with increased plasma total IgE (p = 0.028) and atopy (p = 0.030) in patients. Logistic regression confirmed the association (p = 0.034) with age and gender adjusted. Patients homozygous for the A allele had a 2.3-fold and 1.9-fold risks, respectively of having increased plasma total IgE and atopy than those G allele carriers.ConclusionsWe showed high levels of Egr-1 mRNA expression and demonstrated a significant association of polymorphism with increased plasma total IgE and atopy in AR patients. It may be useful to explore the pharmacogenetics of Egr-1 inhibitors.     

Plasma high sensitivity C-reactive protein and its relationship with cytokine levels in children with newly diagnosed type 1 diabetes and ketoacidosis

BackgroundHigh-sensitivity C-reactive protein (hs-CRP) and pro-inflammatory cytokines have been suggested as sensitive markers of endothelial dysfunction. Our aim was to monitor plasma hs-CRP levels at different time-points and in different degrees of ketoacidosis severity, its association with cytokine levels and its role as a marker of severe ketoacidosis complications.Patients and methodsWe studied in 38 newly diagnosed children with type 1 diabetes and ketoacidosis, aged 7.7 ± 3.1 years, hs-CRP, white blood cell count (WBC), and plasma levels of cytokines IL-1β (interleukin-1β), IL-2, IL-6, IL-8, IL-10, TNF-α (tumor necrosis factor-α) prior to and during DKA management.ResultsOn admission, the levels of WBC, PMN, IL-6 and IL-10 were elevated, but were all reduced within 120 h after ketoacidosis management. In the group with moderate/severe ketoacidosis, but not in mild ketoacidosis, hs-CRP levels were significantly reduced at 24 h (p = 0.021), WBC and IL-6 at 120 h (p = 0.003), while IL-10 was prematurely reduced at 6–8 h (p = 0.008). Moreover hs-CRP was significantly associated with WBC (p = 0.023) and IL-6 (p = 0.028) on admission, with IL-6 (p = 0.002) and IL-8 (p = 0.014) at 24 h and with IL-10 (p = 0.027) at 120 h. The above were not observed in the group with mild ketoacidosis.ConclusionsIn the children with moderate/severe diabetic ketoacidosis of our study, increased levels of hs-CRP and IL-6 were observed, together with leukocytosis and neutrophilia, without the presence of infection. As hs-CRP was found to be strongly associated with the inflammatory IL-6, the prolonged elevation of hs-CRP levels in children with severe ketoacidosis could serve as a marker for the development of its severe complications.     

Impact of radiotherapy and chemotherapy on biomarkers of oxidative DNA damage in lung cancer patients

ObjectivesTo assess oxidative damage to DNA during lung cancer (LC) treatments.Design and methodsUrinary levels of 8-oxoguanine (8-oxoGua) and levels of 8-oxo-2′-deoxyguanosine (8-oxodG) from urine and whole blood were determined in 36 non-cancer controls and 65 LC patients before any treatments. Samples were also obtained of LC patients during and after radiotherapy (RT, n = 33) and chemotherapy (CT, n = 16).ResultsStage IV LC patients had higher urinary 8-oxoGua and 8-oxodG levels than patients with stage I–III disease (p = 0.044 and p = 0.034, respectively). Urinary 8-oxodG levels increased during the first week of RT (p < 0.001). Nuclear 8-oxodG increased during RT and 3 months after start of RT. Nuclear 8-oxodG levels also rose between the first two CT cycles (p = 0.043), and urinary 8-oxodG levels during the sixth CT cycle (p = 0.009).ConclusionsUrinary DNA damage biomarker levels may be associated with LC stage. Both RT and CT increase the parameters of DNA oxidation.     

Tai Chi with mental imagery theory improves soleus H-reflex and nerve conduction velocity in patients with type 2 diabetes

ObjectivesDiabetes is a disease that leads to damage to the peripheral nerves which may eventually cause balance instability. The purpose of this study was to determine the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on soleus H-reflex and nerve conduction velocity (NCV) of the sural and superficial peroneal nerves in people with diabetes.DesignsQuasi-experimental, one group pretest-posttest design.SettingHuman Research Laboratory.InterventionsA series of Yang style of Tai Chi classes with mental imagery, one hour, two sessions per week for 8 weeks was done.Main outcome measuresThe Activities-specific Balance Confidence (ABC) Scale, Functional Reach Test (FRT), and One Leg Standing Test (OLS) were measured as functional data. Hoffman reflex (H-reflex), and sural and superficial peroneal NCV were measured as main outcomes.ResultsAll functional outcomes measures were significantly improved after the intervention (p < 0.01). In the H-reflex, there was a significant increase in amplitude (μV) after completing 8 weeks of TC exercise (p = 0.02). In the sural nerve, the velocity (p = 0.01), amplitude (p = 0.01), and latency (p = 0.01) were significantly improved between pre and post-test. In the superficial peroneal nerve, significant improvements were observed in (p = 0.02) and latency (p = 0.01), but not in amplitude (μV) (p > 0.05).ConclusionsCombining TC intervention with MI theory showed an improvement in the H-reflex and NCV tests, which suggests improved balance and walking stability.     

Effectiveness of an educational intervention (the Encourage Autonomous Self-Enrichment Program) in patients with chronic kidney disease: A randomized controlled trial

BackgroundSelf-management is an important step toward preventing and impeding the progression of chronic kidney disease. However, patients with chronic kidney disease may have few or no subjective symptoms and therefore might consider self-management to be unnecessary. Effective support and encouragement of self-management in patients with chronic kidney disease is therefore required.ObjectivesThis study tested the effectiveness of the Encourage Autonomous Self-Enrichment patient education program, which supports patient autonomy and intrinsic motivations with the aim of improving self-efficacy and sustaining self-management, on perceived self-efficacy, self-management behaviors, and physiological endpoints (blood pressure and renal function parameters) in patients with chronic kidney disease.DesignThis was a randomized, controlled, single-blind trial with one-to-one allocation into two groups.SettingsThe study was conducted at 13 Japanese clinics or general hospitals that specialize in internal medicine and urology.ParticipantsParticipants included patients who were diagnosed with chronic kidney disease and were not receiving dialysis. Patients were recruited from among those attending follow-up visits at participating institutions.MethodsA total of 65 participants were randomly allocated into the intervention (n = 33) and control (n = 32) groups. The intervention group followed the Encourage Autonomous Self-Enrichment program action plan for 12 weeks. The control group received standard education provided by nurses who distributed leaflets in accordance with physicians’ instructions, provided auxiliary medical services, and answered patients' questions.ResultsExcept for 1 participant who died after 4 weeks, all 33 members of the intervention group continued the Encourage Autonomous Self-Enrichment program for 12 weeks. This program intervention yielded significant improvements in perceived self-efficacy (U = 318.5, p = 0.035, effect size r = 0.27) and self-management behaviors (U = 310.0, p = 0.026, effect size r = 0.29). There were no differences in blood pressure or renal function between the groups; however, serum potassium levels decreased in the intervention group and increased in the control group (t (58) = 1.047, p = 0.299, effect size d = 1.49). No intervention-related adverse events, such as worsening of patients' test results, were observed.ConclusionsThese findings indicate that the Encourage Autonomous Self-Enrichment program yielded improvements in perceived self-efficacy and self-management behaviors in patients with chronic kidney disease not treated with dialysis.     

Mutation -538 T/C in bone morphogenetic protein 4 do not increase the risk in sickle-cell disease with orthopedic complications but strongly associated with increased LDH and uric acid level in Indian patients from Chhattisgarh and Jharkhand states

BackgroundBone morphogenetic protein (BMP) are involved in the various orthopedic complications such as avascular necrosis, osteonecrosis and bone turnover, therefore genes coding for proteins, like BMP4, can be potential candidate for studying orthopedic disorders.MethodsA case–control study was conducted to examine the association between SNP T538C of BMP4 and orthopedic complications in sickling patients by employing PCR-RFLP.ResultsA total of 200 cases and 172 control groups were studied from Indian population. T538C SNP has not been implicated in disease and doesn't increase the risk (OR = 0.89, OR = 0.68). We observed no significant association between the T538C polymorphism and case group in the studied population. However, we observed significantly increased uric acid and LDH level in homowild (TT), heteromutant (TC) and homomutant (CC) in case group compared to control group ( all p = 0.0001) and (p = 0.0001, p = 0.0001, p = 0.015 and p = 0.0001, p = 0.0001, p = 0.0001 respectively) in the studied population.ConclusionsThe T/C polymorphism in BMP4 is not associated with case group and in view of present observation, we suggest that evaluation of LDH and uric acid level and its association with polymorphisms in the BMP4 may be considered to be reliable molecular and biochemical markers, and possess promising rational for diagnostic potential in clinical cases.