Digital image analysis of ossification centers in the axial dens and body in the human fetus

Purposes

The detailed understanding of the anatomy and timing of ossification centers is indispensable in both determining the fetal stage and maturity and for detecting congenital disorders. This study was performed to quantitatively examine the odontoid and body ossification centers in the axis with respect to their linear, planar and volumetric parameters.

Methods

Using the methods of CT, digital image analysis and statistics, the size of the odontoid and body ossification centers in the axis in 55 spontaneously aborted human fetuses aged 17–30 weeks was studied.

Results

With no sex difference, the best fit growth dynamics for odontoid and body ossification centers of the axis were, respectively, as follows: for transverse diameter y = ?10.752 + 4.276 × ln(age) ± 0.335 and y = ?10.578 + 4.265 × ln(age) ± 0.338, for sagittal diameter y = ?4.329 + 2.010 × ln(age) ± 0.182 and y = ?3.934 + 1.930 × ln(age) ± 0.182, for cross-sectional area y = ?7.102 + 0.520 × age ± 0.724 and y = ?7.002 + 0.521 × age ± 0.726, and for volume y = ?37.021 + 14.014 × ln(age) ± 1.091 and y = ?37.425 + 14.197 × ln(age) ± 1.109.

Conclusions

With no sex differences, the odontoid and body ossification centers of the axis grow logarithmically in transverse and sagittal diameters, and in volume, while proportionately in cross-sectional area. Our specific-age reference data for the odontoid and body ossification centers of the axis may be relevant for determining the fetal stage and maturity and for in utero three-dimensional sonographic detecting segmentation anomalies of the axis.

     

Morphometric study of the neural ossification centers of the atlas and axis in the human fetus

Purposes

The knowledge of the developing cervical spine and its individual vertebrae, including their neural processes may be useful in the diagnostics of congenital vertebral malformations. This study was performed to quantitatively examine the neural ossification centers of the atlas and axis with respect to their linear, planar and volumetric parameters.

Methods

Using the methods of CT, digital-image analysis and statistics, the size of neural ossification centers in the atlas and axis in 55 spontaneously aborted human fetuses aged 17–30 weeks was studied.

Results

Without any male–female and right–left significant differences, the best fit growth dynamics for the neural ossification centers of the atlas and axis were, respectively, modelled by the following functions: for length: y = ?13.461 + 6.140 × ln(age) ± 0.570 and y = ?15.683 + 6.882 × ln(age) ± 0.503, for width: y = ?4.006 + 1.930 × ln(age) ± 0.178 and y = ?3.054 + 1.648 × ln(age) ± 0.178, for cross-sectional area: y = ?7.362 + 0.780 × age ± 1.700 and y = ?9.930 + 0.869 × age ± 1.911, and for volume: y = ?6.417 + 0.836 × age ± 1.924 and y = ?11.592 + 1.087 × age ± 2.509.

Conclusions

The size of neural ossification centers of the atlas and axis shows neither sexual nor bilateral differences. The neural ossification centers of the atlas and axis grow logarithmically in both length and width and linearly in both cross-sectional area and volume. The numerical data relating to the size of neural ossification centers of the atlas and axis derived from the CT and digital-image analysis are considered specific-age reference values of potential relevance in both the ultrasound monitoring and the early detection of spinal abnormalities relating to the neural processes of the first two cervical vertebrae in the fetus.

     

New anatomical data on the growing C4 vertebra and its three ossification centers in human fetuses

Purpose

Detailed knowledge on the normative growth of the spine is of great relevance in the prenatal diagnosis of its abnormalities. The present study was conducted to compile age-specific reference data for vertebra C4 and its three ossification centers in human fetuses.

Materials and methods

With the use of CT (Biograph mCT), digital image analysis (Osirix 3.9) and statistical analysis (Wilcoxon signed-rank test, Kolmogorov–Smirnov test, Levene’s test, Student’s t test, one-way ANOVA, post hoc RIR Tukey test, linear and nonlinear regression analysis), the normative growth of vertebra C4 and its three ossification centers in 55 spontaneously aborted human fetuses (27 males, 28 females) aged 17–30 weeks was examined.

Results

Significant differences in neither sex nor laterality were found. The height and transverse and sagittal diameters of the C4 vertebral body increased logarithmically as: y = ?3.866 + 2.225 × ln(Age) ± 0.238 (R ² = 0.69), y = ?7.077 + 3.547 × ln(Age) ± 0.356 (R ² = 0.72) and y = ?3.886 + 2.272 × ln(Age) ± 0.222 (R ² = 0.73), respectively. The C4 vertebral body grew linearly in cross-sectional area as y = ?7.205 + 0.812 × Age ± 1.668 (R ² = 0.76) and four-degree polynomially in volume as y = 14.108 + 0.00007 × Age⁴ ± 6.289 (R ² = 0.83). The transverse and sagittal diameters, cross-sectional area and volume of the ossification center of the C4 vertebral body generated the following functions: y = ?8.836 + 3.708 × ln(Age) ± 0.334 (R ² = 0.76), y = ?7.748 + 3.240 × ln(Age) ± 0.237 (R ² = 0.83), y = ?4.690 + 0.437 × Age ± 1.172 (R ² = 0.63) and y = ?5.917 + 0.582 × Age ± 1.157 (R ² = 0.77), respectively. The ossification center-to-vertebral body volume ratio gradually declined with age. On the right and left, the neural ossification centers showed the following growth: y = ?19.601 + 8.018 × ln(Age) ± 0.369 (R ² = 0.92) and y = ?15.804 + 6.912 × ln(Age) ± 0.471 (R ² = 0.85) for length, y = ?5.806 + 2.587 × ln(Age) ± 0.146 (R ² = 0.88) and y = ?5.621 + 2.519 × ln(Age) ± 0.146 (R ² = 0.88) for width, y = ?9.188 + 0.856 × Age ± 2.174 (R ² = 0.67) and y = ?7.570 + 0.768 × Age ± 2.200 (R ² = 0.60) for cross-sectional area, and y = ?13.802 + 1.222 × Age ± 1.872 (R ² = 0.84) and y = ?11.038 + 1.061 × Age ± 1.964 (R ² = 0.80) for volume, respectively.

Conclusions

The morphometric parameters of vertebra C4 and its three ossification centers show no sex differences. The C4 vertebral body increases logarithmically in height and both sagittal and transverse diameters, linearly in cross-sectional area, and four-degree polynomially in volume. The three ossification centers of vertebra C4 grow logarithmically in both transverse and sagittal diameters, and linearly in both cross-sectional area and volume. The age-specific reference intervals for evolving vertebra C4 may be useful in the prenatal diagnosis of congenital spinal defects.     

Morphometric study of the T6 vertebra and its three ossification centers in the human fetus

Purpose

Knowledge on the normative growth of the spine is critical in the prenatal detection of its abnormalities. We aimed to study the size of T6 vertebra in human fetuses with the crown-rump length of 115–265 mm.

Materials and methods

Using the methods of computed tomography (Biograph mCT), digital image analysis (Osirix 3.9) and statistics, the normative growth of the T6 vertebral body and the three ossification centers of T6 vertebra in 55 spontaneously aborted human fetuses (27 males, 28 females) aged 17–30 weeks were studied.

Results

Neither male–female nor right–left significant differences were found. The height, transverse, and sagittal diameters of the T6 vertebral body followed natural logarithmic functions as y = ?4.972 + 2.732 × ln(age) ± 0.253 (R ² = 0.72), y = ?14.862 + 6.426 × ln(age) ± 0.456 (R ² = 0.82), and y = ?10.990 + 4.982 × ln(age) ± 0.278 (R ² = 0.89), respectively. Its cross-sectional area (CSA) rose proportionately as y = ?19.909 + 1.664 × age ± 2.033 (R ² = 0.89), whereas its volumetric growth followed the four-degree polynomial function y = 19.158 + 0.0002 × age⁴ ± 7.942 (R ² = 0.93). The T6 body ossification center grew logarithmically in both transverse and sagittal diameters as y = ?14.784 + 6.115 × ln(age) ± 0.458 (R ² = 0.81) and y = ?12.065 + 5.019 × ln(age) ± 0.315 (R ² = 0.87), and proportionately in both CSA and volume like y = ?15.591 + 1.200 × age ± 1.470 (R ² = 0.90) and y = ?22.120 + 1.663 × age ± 1.869 (R ² = 0.91), respectively. The ossification center-to-vertebral body volume ratio was gradually decreasing with age. On the right and left, the neural ossification centers revealed the following models: y = ?15.188 + 6.332 × ln(age) ± 0.629 (R ² = 0.72) and y = ?15.991 + 6.600 × ln(age) ± 0.629 (R ² = 0.74) for length, y = ?6.716 + 2.814 × ln(age) ± 0.362 (R ² = 0.61) and y = ?7.058 + 2.976 × ln(age) ± 0.323 (R ² = 0.67) for width, y = ?5.665 + 0.591 × age ± 1.251 (R ² = 0.86) and y = ?11.281 + 0.853 × age ± 1.653 (R ² = 0.78) for CSA, and y = ?9.279 + 0.849 × age ± 2.302 (R ² = 0.65) and y = ?16.117 + 1.155 × age ± 1.832 (R ² = 0.84) for volume, respectively.

Conclusions

Neither sex nor laterality differences are found in the morphometric parameters of evolving T6 vertebra and its three ossification centers. The growth dynamics of the T6 vertebral body follow logarithmically for its height, and both sagittal and transverse diameters, linearly for its CSA, and four-degree polynomially for its volume. The three ossification centers of T6 vertebra increase logarithmically in both transverse and sagittal diameters, and linearly in both CSA and volume. The age-specific reference intervals for evolving T6 vertebra present the normative values of potential relevance in the diagnosis of congenital spinal defects.     

The suprascapular notch narrows with aging: a preliminary solution of the old conjecture based on a 3D-CT evaluation

Purpose

The purpose of this study was to describe the morphology of the suprascapular notch in terms of age distribution. We hypothesized that the notch narrows with aging.

Methods

Seven hundred and sixty consecutive patients (465 men and 295 women) scheduled for a shoulder surgery were retrospectively reviewed. A 3D-CT of the shoulder was taken to evaluate the shape of the notch according to the Rengachary classification. The six types of Rengachary classification were arranged into three major categories according to transverse scapular ligament ossification and notch size as follows: the wide notch (type 1 and type 2); the narrow notch (type 3 and type 4); and the ossified notch (type 5 and type 6). Comparisons between categories were done with a one-way analysis of variance.

Results

There was a statistically significant difference among the three categories (P < .01): the narrow notch group (n = 442, 63.4 ± 12.8 years) and the ossified notch group (n = 66, 65.9 ± 10.6 years) were significantly older than the wide notch group (n = 252, 57.5 ± 17.8 years), respectively. In patients with Rengachary type 5 shoulders, ossification was dominant on the medial side of the notch in 37 of 39 shoulders (92.3 %).

Conclusion

The current study showed that morphological changes of the scapular notch are related to aging. The narrow notch and the ossified notch are seemed to be developed from the wide notch in terms of the ossification starting from the medial side.

     

High-dose inhaled terbutaline increases muscle strength and enhances maximal sprint performance in trained men

Purpose

The purpose of the present study was to investigate the effect of high-dose inhaled terbutaline on muscle strength, maximal sprinting, and time-trial performance in trained men.

Methods

Nine non-asthmatic males with a \(\dot{V}O_{2max}\) of 58.9 ± 3.1 ml min^?1 kg^?1 (mean ± SEM) participated in a double-blinded randomized crossover study. After administration of inhaled terbutaline (30 × 0.5 mg) or placebo, subjects’ maximal voluntary isometric contraction (MVC) of m.quadriceps was measured. After MVC, subjects performed a 30-s Wingate test. Sixty minutes following the Wingate test, subjects exercised for 10 min at 80 % of \(\dot{V}O_{2max}\) and completed a 100-kcal time trial. Aerobic contribution was determined during the Wingate test by indirect calorimetry. Furthermore, plasma terbutaline, lactate, glucose, and K⁺ were measured.

Results

Inhalation of 15 mg terbutaline resulted in systemic concentrations of terbutaline of 23.6 ± 1.1 ng ml^?1 30 min after administration, and elevated plasma lactate (P = 0.001) and glucose (P = 0.007). MVC was higher for terbutaline than placebo (738 ± 64 vs. 681 ± 68 N) (P = 0.007). In addition, Wingate peak power and mean power were 2.2 ± 0.8 (P = 0.019) and 3.3 ± 1.0 % (P = 0.009) higher for terbutaline than placebo. Net accumulation of plasma lactate was higher (P = 0.003) for terbutaline than placebo during the Wingate test, whereas \(\dot{V}O_{2}\) above baseline was unchanged by terbutaline (P = 0.882). Time-trial performance was not different between treatments (P = 0.236).

Conclusion

High-dose inhaled terbutaline elicits a systemic response that enhances muscle strength and sprint performance. High-dose terbutaline should therefore continue to be restricted in competitive sport.

     

Exercise type and volume alter signaling pathways regulating skeletal muscle glucose uptake and protein synthesis

Purpose

The aim of this study was to compare activation of cellular signaling pathways regulating protein synthesis and glucose uptake in skeletal muscle between resistance and endurance exercise. Moreover, the effect of resistance exercise volume was examined.

Methods

Three groups of male volunteers (26 ± 3 years) were examined: 5 × 10 repetition maximum (RM) resistance exercise (RE) with leg press device (5 × 10 RE; n = 8), 10 × 10 RE (n = 11), and endurance exercise (strenuous 50-min walking with extra load on a treadmill; EE; n = 8). Muscle biopsies were obtained from m.vastus lateralis 30 min pre- and post-exercise.

Results

Downstream markers of mTORC1, p-p70S6K^{Thr421/Ser424} and p-rpS6^Ser240/244, increased more after 10 × 10 RE than after 5 × 10 RE (p < 0.05) and EE (p < 0.01–0.001). Exercise-induced changes in p-IRS-I^Ser636/639 that inhibit IRS-I signaling via negative feedback from hyperactivated mTORC1 signaling were greater (p < 0.05) after 10 × 10 RE compared with 5 × 10 RE and EE. The changes in energy sensor p-AMPKα^Thr172 were greater after 10 × 10 RE and EE (p < 0.05–0.01) than after 5 × 10 RE. A major regulator of glucose uptake in muscle, p-AS160^Thr642, increased more after 10 × 10 RE than after 5 × 10 RE (p < 0.01) and EE (p < 0.05).

Conclusion

10 × 10 RE induced greater activation of important signaling proteins regulating glucose uptake (p-AS160) and protein synthesis (p-p70S6K, p-rpS6) than 5 × 10 RE and EE. The present findings further suggest that, especially after 10 × 10 RE, IRS-I signaling is downregulated and that AS160 is activated through AMPK signaling pathway.

     

Effekte einer adaptiven Servoventilation auf Herzrhythmusstörungen bei Patienten mit chronischer Herzinsuffizienz und schlafbezogenen Atmungsstörungen

Background

In patients with chronic heart failure with reduced left ventricular ejection fraction (HFrEF) sleep-disordered breathing (SDB) is linked with an increased risk for nocturnal cardiac arrhythmias. SDB can be effectively treated with adaptive servo-ventilation (ASV). Therefore, we tested the hypothesis that ASV therapy reduces nocturnal arrhythmias and heart rate in patients with HFrEF and SDB.

Methods

In a non-prespecified subanalysis of a multicenter randomized-controlled trial (ISRCTN04353156) twenty consecutive patients with stable HFrEF (age 67 ± 9 y; left ventricular ejection fraction 32 ± 7?%) and SDB (apnea-hypopnea index, AHI 48 ± 20/h) were randomized to either ASV (n = 10; Philips Respironics, Murrysville, PA, USA) or optimal medical treatment alone (control, n = 10). Polysomnography (PSG) with centralized scoring and blinded analysis where obtained at baseline and 12 weeks. The electrocardiograms (ECG) of the PSGs were analyzed with 24 h-Holter electrocardiography software (Pulse Biomedical Inc., QRS-Card^TM Cardiology Suite, USA).

Results

There was a decrease in ventricular ectopic beats (VEBs) per hour recording time in the ASV-group compared to the control group (?8.1 ± 42.4 versus +9.8 ± 63.7/h, p = 0.356). ASV reduced the number of ventricular couplets as well as non-sustained ventricular tachycardias (nsVT) compared to the control-group (?2.3 ± 6.9 versus +2.1 ± 12.7/h, p = 0.272, and ?0.1 ± 0.5 versus +0.1 ± 1.1/h, p = 0.407, respectively). Mean nocturnal heart rate decreased in the ASV group compared to the control-group (?2.0 ± 2.7 versus +3.9 ± 11.5/minute, p = 0,169). Described changes were not significantly different between groups.

Conclusions

In HFrEF patients with SDB ASV treatment may reduce nocturnal ventricular ectopic beats, couplets, nsVT and mean nocturnal heart rate. Findings underscore the need for further analyses in larger studies.

     

Sources of Variability in Physical Activity Among Inactive People with Multiple Sclerosis

Purpose

Evidence supports that physical activity (PA) improves symptoms of multiple sclerosis (MS). Although application of principles from Social Cognitive Theory (SCT) may facilitate positive changes in PA behaviour among people with multiple sclerosis (pwMS), the constructs often explain limited variance in PA. This study investigated the extent to which MS symptoms, including fatigue, depression, and walking limitations combined with the SCT constructs, explained more variance in PA than SCT constructs alone among pwMS.

Method

Baseline data, including objectively assessed PA, exercise self-efficacy, goal setting, outcome expectations, 6-min walk test, fatigue and depression, from 65 participants of the Step It Up randomized controlled trial completed in Ireland (2016), were included. Multiple regression models quantified variance explained in PA and independent associations of (1) SCT constructs, (2) symptoms and (3) SCT constructs and symptoms.

Results

Model 1 included exercise self-efficacy, exercise goal setting and multidimensional outcomes expectations for exercise and explained ~14% of the variance in PA (R ²=0.144, p < 0.05). Model 2 included walking limitations, fatigue and depression and explained 20% of the variance in PA (R ²=0.196, p < 0.01). Model 3 combined models 1 and 2 and explained variance increased to ~29% (R ²=0.288; p<0.01). In Model 3, exercise self-efficacy (β=0.30, p < 0.05), walking limitations (β=0.32, p < 0.01), fatigue (β = ?0.41, p < 0.01) and depression (β = 0.34, p < 0.05) were significantly and independently associated with PA.

Conclusion

Findings suggest that relevant MS symptoms improved by PA, including fatigue, depression and walking limitations, and SCT constructs together explained more variance in PA than SCT constructs alone, providing support for targeting both SCT constructs and these symptoms in the multifactorial promotion of PA among pwMS.

     

Acute systemic insulin intolerance does not alter the response of the Akt/GSK-3 pathway to environmental hypoxia in human skeletal muscle

Purpose

To investigate how acute environmental hypoxia regulates blood glucose and downstream intramuscular insulin signaling after a meal in healthy humans.

Methods

Fifteen subjects were exposed for 4 h to normoxia (NOR) or to normobaric hypoxia (HYP, F_iO₂ = 0.11) in a randomized order 40 min after consumption of a high glycemic meal. A muscle biopsy from m. vastus lateralis and a blood sample were taken before (T0), after 1 h (T60) and 4 h (T240) in NOR or HYP and blood glucose levels were measured before exposure and every 30 min.

Results

In HYP, blood glucose was reduced 100 min (110.1 ± 5.4 in NOR vs 89.5 ± 4.7 mg dl^?1 in HYP) and 130 min (98.7 ± 3.8 in NOR vs 85.6 ± 4.9 mg dl^?1 in HYP) after completion of a meal, which resulted in an 83 % lower AUC in HYP compared to NOR (p = 0.006). This coincided with 40 % lower GLUT4 protein in the cytosolic fraction (p = 0.013) and a tendency to increase in the crude membrane fraction (p = 0.070) in HYP compared to NOR. At T240, blood glucose concentration was similar between HYP and NOR, whereas plasma insulin as well as phosphorylation of muscle Akt and GSK-3 was ~2-fold higher in HYP compared to NOR (p < 0.05). In contrast, Rac1 protein was less abundant in the membrane fraction in HYP compared to NOR (p = 0.003), reflecting lower activation.

Conclusion

Acute environmental hypoxia initially reduced blood glucose response to a meal, possibly via an increase in GLUT4 abundance at the sarcolemmal membrane. Later on, whole body insulin intolerance developed independently of defects in conventional insulin signaling in skeletal muscle.

     

Anthropometric approach to lumbar vertebral body volumes

Objective

To assess the relationship between the maximum volume of lumbar vertebral bodies and patient morphological features. Knowledge of the volume of the vertebral body is useful when performing vertebroplasty and kyphoplasty.

Methods

129 patients (18–85 years) were included consecutively over an 8-month period. All had been subject to abdominopelvic CT scans. The weight, height and body mass index (BMI) were known. The volume of each vertebral body was calculated using the formula V = π R ². H (V = volume, R = radius, H = height). A statistical analysis of the data divided into three groups, men/women, men only and women only, was conducted by calculating the Pearson correlation coefficient.

Results

The volume of the vertebral body increased from L1 to L4, but the volume of the L5 vertebral body was lower than that of L3 and L4 in all three groups. The volumes of the vertebral bodies were greater in men than in women. Calculating the correlation coefficient showed that the variable most correlated with volume was patient’s height in both the men/women and women-only groups, while the most correlated variable in the male-only group was weight. Vertebral height was the variable most correlated with overall height in all three groups.

Conclusion

There is a wide variability in the volume of lumbar vertebrae. The volume of the vertebral body appears to vary not only with a person’s height but also their weight. The vertebral body seems to expand with weight in men.

     

Biosimilars for the Treatment of Chronic Inflammatory Diseases: A Systematic Review of Published Evidence

Background

Clinicians are required to assimilate, critically evaluate, and extrapolate information to support appropriate use of biosimilars across indications.

Objectives

The objective of this study was to systematically collate all published data in order to assess the weight (quantity and quality) of available evidence for each molecule and inform and support healthcare decision-making in chronic inflammatory diseases.

Methods

MEDLINE^®, EMBASE^®, and ISI Web of Science^® were searched to September 2015. Selected conference proceedings were searched from 2012 to July 2015. Studies disclosing biosimilars with unique identifiers were categorized by originator, study type, and indication. Risk of bias assessments were performed. Intended copies were differentiated as commercially available agents without evidence of rigorous comparative biosimilarity evaluations.

Results

Proposed biosimilars for adalimumab, etanercept, infliximab, and rituximab are reported in the published literature. Across indications, approved biosimilars infliximab CT-P13, SB2, and etanercept SB4 have published studies involving the largest number of patients or healthy subjects (n = 1405, 743, and 734, respectively), mostly in rheumatoid arthritis. At data cut-off, only CT-P13 had published data in ankylosing spondylitis (n = 250; randomized control trial) and ulcerative colitis/Crohn’s disease (n = 336; observational studies). Published data were not available for ongoing studies in psoriasis patients. Four intended copies were identified in published studies (total: n = 1430; n = 1372 in observational studies). Thematic analysis of non-empirical publications showed that indication extrapolation remains an issue, particularly for gastroenterologists.

Conclusions

While most agents display a moderate to high degree of similarity to their originator in the published studies identified, large discrepancies persist in the overall amount and type of data available in the public domain. Significant gaps exist particularly for intended copies, reinforcing the need to maintain a clear differentiation between these molecules and true biosimilars.

     

Implanting straight into cochlea risks the facial nerve: a Cartesian coordinate study

Purpose

To describe the straight-into-cochlea line that affords the best access for an electrode array to enter via the round window, and how this line relates to the facial nerve, the incus, and mastoid size. The straight-into-cochlea line is important to minimize the cochlear trauma and maximize the likelihood of placement into the scala tympani.

Methods

High-resolution CT scans were obtained for ten craniums with the extremes of large (N = 5) and small (N = 5) mastoid pneumatization; the specimens were from a series of 41 ear normal craniums. Using FIJI, a publicly available software program, the straight-into-cochlea insertion line was determined by defining the x–y–z coordinates of the middle of the round window and a point 6.0 mm into the cochlea on its centrifugal wall. Then, from the extended straight-into-cochlea insertion line, we determined the shortest perpendicular distance to the middle of the fallopian canal, and from that “fallopian point” to the apex of the posterior process of the incus.

Results

We found good repeatability of measurements. We found the extended straight-into-cochlea insertion lines routinely close to or in the midst of the fallopian canal (50 % ≤ 1.0 mm). We found the lines 4.7–7.8 mm from the apex of the posterior process of the incus. Line positions relative to “fallopian point” and incus showed no relation to mastoid pneumatization. For the distance “fallopian point” to incus, bilateral symmetry was suggested.

Conclusions

Using landmarks registered in an x–y–z coordinate system, straight-into-cochlea insertion via the round window puts the facial nerve at risk.

     

Motivational and Volitional Correlates of Physical Activity in Participants Reporting No,Past, and Current Hypertension: Findings from a Cross-Sectional Observation Study

Purpose

The study investigated differences in motivational and volitional correlates of physical activity in persons who reported currently having hypertension, had hypertension in the past, or had no hypertension by using the health action process approach as a theoretical background.

Method

Self-reported data from 512 participants (71.9% women; M _age = 46.83 years; SD _age = 13.77; M _BMI = 24.89; SD _BMI = 4.71) were analyzed using multivariate analysis of variance (MANOVA), analysis of variance (ANOVA), and post hoc comparisons of groups to determine differences in motivational and volitional correlates for physical activity between groups followed by analysis of covariance (ANCOVA). Additionally, χ ² statistic was used to analyze differences in the distribution of behavioral stages between groups.

Results

Participants with hypertension reported a higher perceived vulnerability (d = 0.99) and lower action planning (d = 0.32) and self-efficacy (d = 0.30) compared to those who indicated no hypertension. Their perceived vulnerability was also higher compared to those who indicated past hypertension on the mean level (d = 0.60). Significant main effects for all independent variables were found when controlling for gender and HAPA stages with main effects for perceived vulnerability, action planning, and self-efficacy. Participants with current hypertension were more prominent in the intender stage, whereas participants with past hypertension were more likely to be in the actor stage. Participants with no hypertension at all were equally distributed across the intender and actor stages.

Conclusion

The study contributes to the understanding of differences in motivational and volitional correlates of physical activity in persons who reported different hypertension statuses.

     

Minocycline affects human neutrophil respiratory burst and transendothelial migration

Objective

This study aimed at investigating the in vitro activity of minocycline and doxycycline on human polymorphonuclear (h-PMN) cell function.

Methods

h-PMNs were isolated from whole venous blood of healthy subjects; PMN oxidative burst was measured by monitoring ROS-induced oxidation of luminol and transendothelial migration was studied by measuring PMN migration through a monolayer of human umbilical vein endothelial cells. Differences between multiple groups were determined by ANOVA followed by Tukey’s multiple comparison test; Student’s t test for unpaired data for two groups.

Results

Minocycline (1–300 µM) concentration dependently and significantly inhibited oxidative burst of h-PMNs stimulated with 100 nM fMLP. Ten micromolar concentrations, which are superimposable to C _max following a standard oral dose of minocycline, promoted a 29.8 ± 4 % inhibition of respiratory burst (P < 0.001; n = 6). Doxycycline inhibited ROS production with a lesser extent and at higher concentrations. 10–100 µM minocycline impaired PMN transendothelial migration, with maximal effect at 100 µM (42.5 ± 7 %, inhibition, n = 5, P < 0.001).

Conclusions

These results added new insight into anti-inflammatory effects of minocycline exerted on innate immune h-PMN cell function.

     

The Relation of Light-to-Moderate Alcohol Consumption to Glucose Metabolism and Insulin Resistance in Nondiabetic Adults: the Moderating Effects of Depressive Symptom Severity,Adiposity, and Sex

Purpose

We examined the relation of alcohol consumption to glucose metabolism and insulin resistance (IR) as a function of depressive symptoms, adiposity, and sex.

Method

Healthy adults (aged 18–65 years) provided fasting blood samples and information on lifestyle factors. Alcohol intake was categorized as never, infrequent (1–3 drinks/month), occasional (1–7 drinks/week), and regular (≥2 drinks/day) drinkers. The Beck Depression Inventory (BDI) was used to assess symptom severity. Primary outcomes were fasting insulin, glucose, and IR assessed by the homeostasis model assessment (HOMA).

Results

In univariate analysis, alcohol consumption was negatively associated with HOMA-IR (p = 0.03), insulin (p = 0.007), and body mass index (BMI) (p = 0.04), but not with glucose or BDI. Adjusting for potential confounders including BMI, alcohol consumption was associated with HOMA-IR (p = 0.01) and insulin (p = 0.009) as a function of BDI and sex. For women with minimal depressive symptoms, light-to-moderate alcohol consumption was associated with lower HOMA-IR and insulin. Alcohol consumption was not associated with metabolic markers in women with higher depressive symptoms and in men. In analysis using BMI as a continuous moderator, alcohol consumption was only associated with insulin (p = 0.004). Post-hoc comparisons between BMI groups (<25 vs ≥25 kg/m²⁾ revealed that light-to-moderate alcohol consumption was associated with lower insulin but only in subjects with BMI ≥ 25 kg/m².

Conclusions

The benefits of light-to-moderate alcohol consumption on fasting insulin and IR are sex dimorphic and appear to be independently moderated by adiposity and depressive symptom severity.

     

The interplay between arms-only propelling efficiency,power output and speed in master swimmers

Purpose

To explore the interplay between arms-only propelling efficiency (η _p), mechanical power output (\(\dot W_{\text{tot}}\)) and swimming speed (V); these three parameters are indeed related through the following equation V ³ = 1/kη _p \(\dot W_{\text{tot}}\) (where k is the speed-specific drag; k = F/V ²); thus, the larger are η _p and \(\dot W_{\text{tot}}\) the larger is V. We furthermore wanted to test the hypothesis that a multiple linear regression between \(\dot W_{\text{tot}}\), η _p and V would have a stronger correlation coefficient than a linear regression between \(\dot W_{\text{tot}}\) and V alone.

Methods

To this aim we recruited 29 master swimmers (21 M/8F) who were asked to perform (1) an incremental protocol at the arm-ergometer (dry-land test) to determine \(\dot W_{\text{tot}}\) at \(\dot V\)O_2max (e.g. \(\dot V\) _max); (2) a maximal 200 m swim trial (with a pull buoy: arms only) during which V and η _p were determined.

Results

No relationship was found between \(\dot W_{\text{max}}\) and η _p (not necessarily the swimmers with the largest \(\dot W_{\text{max}}\) are those with the largest η _p and vice versa) whereas significant correlations were found between \(\dot W_{\text{max}}\) and V (R = 0.419, P = 0.024) and η _p and V (R = 0.741, P = 0.001); a multiple linear regression indicates that about 75 % of the variability of V can be explained by the variability of \(\dot W_{\text{max}}\) and η _p (R = 0.865, P < 0.001).

Conclusions

These findings indicate that η _p should be taken into consideration when the relationship between \(\dot W_{\text{max}}\) and V is investigated and that this allows to better explain the inter-subject variability in performance (swimming speed).

     

Mental Distress Factors and Exercise Capacity in Patients with Coronary Artery Disease Attending Cardiac Rehabilitation Program

Purpose

There is still insufficient data on mental distress factors contributing to exercise capacity (EC) improvement before and after cardiac rehabilitation (CR) in patients with coronary artery disease (CAD). The aim of our study was to evaluate the associations between various mental distress factors and EC before and after exercise-based CR (EBCR).

Methods

Over 12 months, 223 CAD patients (70% men, mean age 58 ± 9 years) were evaluated for socio-demographic, clinical, and mental distress symptoms as measured by the Hospital Anxiety and Depression scale (HADS), Beck Depression Inventory-II (BDI-II), and Spielberger State-Trait Anxiety Inventory (STAI). Patients were tested for EC at baseline and after EBCR.

Results

In a multivariate linear regression model, EC before EBCR was associated with HADS anxiety subscale (β = ?.186, p = .002) and BDI-II somatic/affective subscale (β = ?.249, p < .001). EC after EBCR was associated with HADS anxiety and depression subscales (β = ?.198, p < .001; β = ?.170, p = .002, respectively) and BDI-II (β = ?.258, p < .001). The BDI-II somatic/affective subscale was the best predictor of reduced EC before and after EBCR.

Conclusions

Mental distress and somatic/affective symptoms of depression are strongly associated with EC both at the beginning and after EBCR. Analysis of possible mediating or moderating factors was beyond the scope of our study. Future studies should focus on comprehensive evaluation of EC risk factors including other mental distress characteristics, subjectively experienced fatigue, and post-operative CAD symptoms.

     

Morphometric variability of pyramidalis muscle and its clinical significance

Purpose

The goal of the study is to analyze the morphometric diversity of the pyramidalis muscle (PM) and to evaluate how it is affected by gender and side of occurrence.

Materials and methods

Ninety-six (50 male and 46 female) formalin-embalmed Greek cadavers were dissected.

Results

The PM was present in 93.8 %, usually bilaterally (79.2 %) than unilaterally (14.6 %) (p = 0.003) and more frequently in females (91.3 %) than in males (68 %) (p = 0.0001). Side symmetry was detected. The mean length of PM in males and females was 8.37 ± 2.80 and 6.18 ± 1.64 cm on the right and 7.50 ± 2.66 and 6.56 ± 1.68 cm on the left side. Male predominance existed on the right and left-sided PM lengths (p = 0.0001 and p = 0.054). The mean width of the right-sided PMs in males and females was 1.61 ± 0.55 and 1.50 ± 0.44 cm and the left-sided 1.56 ± 0.53 and 1.55 ± 0.38 cm without gender dimorphism. The positive correlation between the PM length and width indicates a symmetrical muscle augmentation on the two dimensions.

Conclusions

The study demonstrates that the PM is almost constant in Greeks. Among populations the muscle morphometric variability, its clinical significance and its variable uses will help surgeons when intervening in the lower abdominal wall.

     

Delta neutrophil index (DNI) as a novel diagnostic and prognostic marker of infection: a systematic review and meta-analysis

Objective

Delta neutrophil index (DNI) representing the number of immature granulocytes is an emerging marker used in diagnosis of infections and prediction of mortality in infected patients. The present study evaluated the diagnostic accuracy of DNI as a predictive and prognostic factor in infected patients.

Methods

We performed a PubMed search on January 1st, 2017 and identified studies that evaluated DNI as either a predictive or prognostic factor in infected patients. Studies with appropriate information to construct 2 × 2 contingency tables were extracted. We calculated pooled sensitivity and specificity. Meta-analysis of the multivariate logistic regression data set was performed to assess whether DNI functions as an independent factor.

Results

Overall, 12 articles fulfilled the inclusion criteria and a total of 499 cases and 9549 controls were examined. As a predictive factor of infection, DNI’s pooled sensitivity was 0.67 (95% CI 0.62–0.71, I ² = 86.0%) and pooled specificity was 0.94 (95% CI 0.94–0.95, I ² = 92.8%). Area under the receiver operating characteristics (ROC) curve was 0.89. As a prognostic factor for death in infected patients, DNI’s pooled sensitivity was 0.70 (95% CI 0.56–0.81, I ² = 0.0%) and pooled specificity was 0.78 (95% CI 0.73–0.83, I ² = 26.6%). Area under the ROC curve was 0.84. Meta-analysis of the multivariate logistic regression data set showed insignificant results.

Conclusions

DNI is a potentially useful diagnostic tool and predicts mortality among infected patients and should be more widely used in the clinical practice.