Longitudinal Physical Activity Changes in Older Men in the Osteoporotic Fractures in Men Study

OBJECTIVES: To describe the change in physical activity (total, leisure, household, occupational) in men over a mean 5‐year follow‐up period and to identify sociodemographic and health factors associated with change in physical activity. DESIGN: Prospective cohort study; Osteoporotic Fractures in Men Study; data collected March 2000 through May 2006. SETTING: Six U.S. clinical centers. PARTICIPANTS: Volunteer sample of ambulatory community‐dwelling men aged 65 and older (N=5,161). MEASUREMENTS: Self‐reported physical activity assessed at baseline and Visit 2 (V2) (5 years apart) according to the Physical Activity Scale for the Elderly (PASE) (unitless, relative measure of physical activity). RESULTS: At baseline, PASE scores averaged 16.8±35.5 for occupational, 37.0±34.0 for leisure, 95.9±43.2 for household, and 149.7±67.6 for total physical activity. Occupational (?6.2±33.9), leisure (?3.2±37.3), household (?9.9±44.3), and total (?19.3±67.7) physical activity change scores declined, on average, from baseline to V2. On average, change in total PASE scores declined more with age: ?15.6±71.6 for men younger than 70, ?16.4±67.0 for men aged 70 to 74, ?21.4±66.9 for men aged 75 to 79, and ?29.5±60.7 for men aged 80 and older. Living alone, smoking cigarettes, poor health, and higher blood pressure were associated with greater declines in physical activity over time. Although average scores declined, some older men (1,335, 26%) reported increasing physical activity levels. Better physical and mental health, living with others, and being younger were associated with the probability of increasing physical activity over time. CONCLUSION: Over the 5‐year period, the majority of men reported declines in total physical activity. Older men in poor health who live alone have a high risk of physical activity declines and may be an important group to target for exercise interventions.     

Four-year experience with tacrolimus once-daily prolonged release in patients from phase II conversion and de novo kidney, liver, and heart studies

van Hooff JP, Alloway RR, Trune?ka P, Mourad M. Four‐year experience with tacrolimus once‐daily prolonged release in patients from phase II conversion and de novo kidney, liver, and heart studies.
Clin Transplant 2011: 25: E1–E12. © 2010 John Wiley & Sons A/S. Abstract: Introduction: This study assessed the long‐term effects of prolonged‐release tacrolimus (Advagraf^® [Tacrolimus QD]), which has been developed to provide similar efficacy and safety to twice‐daily tacrolimus (Prograf^® [Tacrolimus BID]) with the added benefit of once‐daily dosing. Methods: Adult participants from four phase II de novo (kidney, liver) or Tacrolimus BID to QD conversion (kidney, heart) studies were enrolled into the follow‐up study. Patients remained on the immunosuppressive regimen they were receiving on entry, unless medical needs required otherwise. The primary endpoint was patient and graft survival, and secondary endpoints were biopsy‐confirmed acute rejection (BPAR) and safety. Results: The full analysis set comprised 240 patients. Tacrolimus mean total daily dose and whole‐blood trough levels decreased over time, particularly in de novo patients. At four yr, Kaplan–Meier estimates of patient and graft survival were over 90%. Freedom from BPAR was 90.9/92.6% and 100/87.0% in the de novo kidney/liver and conversion kidney/heart patients, respectively. There were 13 deaths, and 20% patients withdrew from the study, mainly because of adverse events. Conclusions: The efficacy and safety of Tacrolimus QD was maintained for four yr in kidney, liver, and heart transplant recipients. Therefore, this formulation offers a convenient alternative to Tacrolimus BID.     

Electro-encephalogram disturbances in different sleep-wake states following exposure to high environmental heat

In this study, cerebral electrical activity or electro-encephalogram (EEG) was studied following exposure to high environmental heat, in three different age groups of freely moving rats. Each age group was subdivided into three groups: the acute heat stress group, subjected to a single exposure of 4h at 38°C in the biological oxygen demand incubator; the chronic heat stress group, exposed for 21 days, for 1 h each day, at 38°C in the incubator; and the handling control group. The polygraphic sleep-wake recordings involved simultaneous recordings of cortical EEG, electrooculogram (EOG), and electromyogram (EMG), on paper and in digital form on computer hard disk, just after the heat exposure for the acute stressed rats and on the 22nd day for the chronic stressed rats. The power spectrum was calculated for 2s epochs of the EEG signals. Quantitative analyses of EEG (qEEG) showed that, in all three age groups, changes in higher-frequency components (β₂) were significant in all sleep-wake states following both acute and chronic heat stress conditions. The power of β₂ activity in all three age groups after acute heat exposure was significantly decreased during slow wave sleep (SWS) (p<0.05) and rapid eye movement sleep (p<0.05), whereas the reverse was observed in the awake state (p<0.05). Following chronic heat exposure, β₂ activity was found to increase in all three sleep-wake stages in all groups of rats (p<0.01 for SWS in the weaning group and p<0.05 for other data). Thus the study demonstrated that the cortical EEG is sensitive to environmental heat, and alterations in EEG frequencies in different states of mental consciousness due to high heat can be differentiated efficiently by EEG power spectrum analysis.