Frequency of the CHEK2 1100delC mutation among women with breast cancer: an international study

A founder allele in the CHEK2 gene (1100delC) has been associated with an elevated risk of breast cancer. This allele is responsible for the majority of CHEK2-associated breast cancers in women from northern European countries; however, within Europe, it seems to be rare in countries that are close to the Mediterranean. The frequency of the 1100delC allele has not been measured in non-White populations. We measured the frequency of the CHEK2 founder allele in 3,882 breast cancer patients and 8,609 controls from various countries. The allele was not seen among Asian patients (from Pakistan or the Philippines) and was present in 1 of 155 cases from Brazil. Among White women, the allele was present in 1.5% of 825 familial cases of breast cancer and in 0.7% of 1,106 patients with nonfamilial breast cancer. The allele was equally frequent in Jewish and non-Jewish patients. We estimate that the CHEK2 1100delC allele is associated with an odds ratio of 2.6 for breast cancer, which corresponds to a lifetime risk of approximately 24% in Ontario.     

Effectiveness and Acceptability of a Mobile Phone Text Messaging Intervention to Improve Blood Pressure Control (TEXT4BP) among Patients with Hypertension in Nepal: A Feasibility Randomised Controlled Trial

Background:Uncontrolled blood pressure (BP) is the leading cause of preventable deaths in low- and middle-income countries. mHealth interventions, such as mobile phone text messaging, are a promising tool to improve BP control, but research on feasibility and effectiveness in resource-limited settings remains limited.Objective:This feasibility study assessed the effectiveness and acceptability of a mobile phone text messaging intervention (TEXT4BP) to improve BP control and treatment adherence among patients with hypertension in Nepal.Methods:The TEXT4BP study was a two-arm, parallel-group, unblinded, randomised controlled pilot trial that included 200 participants (1:1) (mean age: 50.5 years, 44.5% women) with hypertension at a tertiary referral hospital in Kathmandu, Nepal. Patients in the intervention arm (n = 100) received text messages three times per week for three months. The control arm (n = 100) received standard care. The COM-B model informed contextual co-designed text messages. Primary outcomes were change in BP and medication adherence at three months. Secondary outcomes included BP control, medication adherence self-efficacy and knowledge of hypertension. A nested qualitative study assessed the acceptability of the intervention.Results:At three months, the intervention group had greater reductions in systolic and diastolic BP vs usual care [–7.09/–5.86 (p ≤ 0.003) vs –0.77/–1.35 (p ≥ 0.28) mmHg] [adjusted difference: systolic β = –6.50 (95% CI, –12.6; –0.33) and diastolic BP β = –4.60 (95% CI, –8.16; –1.04)], coupled with a greater proportion achieving target BP (70% vs 48%, p = 0.006). The intervention arm showed an improvement in compliance to antihypertensive therapy (p < 0.001), medication adherence (p < 0.001), medication adherence self-efficacy (p = 0.023) and knowledge on hypertension and its treatment (p = 0.013). Participants expressed a high rate of acceptability and desire to continue the TEXT4BP intervention.Conclusion:The TEXT4BP study provides promising evidence that text messaging intervention is feasible, acceptable, and effective to improve BP control in low-resource settings.Trial registration:anzctr.org.au Identifier ACTRN12619001213134.     

Erfolgreiche Monotherapie der hypereosinophilen Dermatitis mit PUVA-BadPhotochemotherapie

Zusammenfassung Eine 70j?hrige Patientin mit einer seit über 2 Jahren bestehenden hypereosinophilen Dermatitis wurde mit einer PUVA-Badphotochemotherapie über insgesamt 1 Jahr behandelt. Die 8-Methoxypsoralenkonzentration im Badewasser betrug 0,5 mg/l, unmittelbar im Anschlu? an das Psoralenvollbad erfolgte die Bestrahlung mit UVA. Die kumulative UVA-Dosis der gesamten Behandlung betrug 245 J/cm². Bereits nach 19 Behandlungen kam es zu einer deutlichen Besserung des Juckreizes und nach 32 Behandlungen zu einem vollst?ndigen Rückgang der erythematischen Maculae. W?hrend der Erhaltungstherapiephase über weitere 44 Wochen sowie im Verlauf der bislang 5monatigen Nachbeobachtungszeit kam es zu keinem Rezidiv. Aufgrund der fehlenden systemischen Nebenwirkungen und der guten therapeutischen Wirksamkeit stellt die PUVA-Bad-Photochemoterapie eine neue therapeutische Alternative in der Behandlung der hypereosinophilen Dermatitis dar. Eingegangen am 20. August 1996 Angenommen am 22. Januar 1997     

Abstracts from the 5th International Scientific Conference on Exercise and Quality of Life

Power output and force development during exercise are thought to be important indices of performance in elite athletes. The aim of this preliminary study was to determine the forces applied at the footrest during ergometric kayaking in individual kayakers at different competitive levels. Three elite female kayakers participated voluntarily in the study. Oxygen consumption (VO2) and mean power were measured during paddling at three different work levels (15 W below onset of blood lactate accumulation (OBLA), at OBLA, 15 W above OBLA and all-out paddling) on a modified kayak ergometer. External force sensors were attached to the wires on right and left side connecting the paddle to the flywheel of the kayak ergometer. Individual footrests were built to enable measurements of pushing and pulling forces and to distinguish between the left and right foot. The relative differences between the three athletes were similar for power, VO2peak and forces at the paddle. There were, however, differences in the forces applied at the footrest, where the most accomplished paddler generated forces 3 to 26 times as high as the least accomplished paddler. The relative differences between the three athletes were similar for power, VO2 and forces at the paddle. There were, however, dramatic differences in the forces applied at the footrest.     

N-acetylated Proline-Glycine-Proline induced G-protein dependent chemotaxis of neutrophils is independent of CXCL8 release

Chronic inflammation in lung diseases contributes to lung tissue destruction leading to the formation of chemotactic collagen fragments such as N-acetylated Proline–Glycine–Proline (N-ac-PGP). In this study, we investigated in more detail the mechanism of action of N-ac-PGP in neutrophilic inflammation. N-ac-PGP was chemotactic for human neutrophils via pertussis toxin sensitive G protein-coupled receptors in vitro and directly activated this cell type, which led to cytosolic calcium mobilization and release of CXCL8. Furthermore, using a selective CXCR2 antagonist confirmed that N-ac-PGP-induced neutrophil chemotaxis is mediated through CXCR2 activation. To determine whether N-ac-PGP was solely responsible for the migration and activation of human neutrophils in vitro and not the released CXCL8 upon stimulation with N-ac-PGP, an antibody directed against CXCL8 was used. Performing chemotaxis and calcium influx assays in the presence of this antibody did not alter the effects of N-ac-PGP whereas effects of CXCL8 were attenuated. These experiments indicate that N-ac-PGP, in addition to the direct induction of chemotaxis, also directly activates neutrophils to release CXCL8. In vivo, this may lead in the long term to a self-maintaining situation enhanced by both N-ac-PGP and CXCL8, leading to a further increase in neutrophil infiltration and chronic inflammation.     

Blood glucose and nocturnal blood pressure in African and Caucasian men: The SABPA study

Aim

To investigate the relationship between nocturnal blood pressure and chronically elevated blood glucose to determine if these elevated blood glucose concentrations contribute to a non-dipping blood pressure, especially in high-risk groups such as Africans.

Methods

Nocturnal blood pressures and blood glucose levels of 41 non-dipping African and 28 non-dipping Caucasian men were investigated. Ambulatory systolic (SBP) and diastolic blood pressure (DBP) were measured and blood collected in sodium fluoride tubes from the antebrachial vein to determine serum glucose and glycosylated hemoglobin A1c (HbA1c) percentage. The estimated average glucose (eAG) was determined from HbA1c percentage with a regression formula.

Results

The African non-dippers had higher blood pressures (p < 0.001) and elevated HbA1c (p = 0.037) and eAG (p = 0.041) levels compared to the Caucasians. In single, partial and multiple regression analyses nighttime (00:00-04:00) SBP correlated positively with HbA1c (p = 0.069) and eAG (p < 0.001) in the African men. No correlations were found in the Caucasian men. Sensitivity analysis confirmed that the association between nighttime SBP (00:00-04:00) and eAG was independent of carotid intima-media thickness in the African men (R² = 0.617; β = 0.438; p = 0.008).

Conclusion

The blunted nocturnal decline in SBP during the early morning hours is associated with chronically elevated blood glucose in non-dipper African men.