Trends in aerobic fitness among Canadians, 1981 to 2007-2009

Public health surveillance systems often monitor physical activity trends, but fitness assessment is relatively rare. This study investigated secular changes in aerobic fitness among Canadian adults and children. Participants aged 8-69 years were from 2 nationally representative surveys, conducted in-home in 1981 and in mobile examination centers in 2007-2009. In both surveys, submaximal step tests using progressive age- and sex-specific exercise stages were completed after initial screening (Physical Activity Readiness Questionnaire, heart rate, blood pressure). Between surveys, the step-test protocol had been modified to reduce underestimation of fitness among fitter and older individuals. Maximal oxygen uptake was estimated for adults using validated historical and updated prediction equations, adjusted to reflect protocol differences. Because these equations are not validated for young people, maximal aerobic power was predicted at a heart rate of 200 beats·min(-1) by regressing observed heart rates on the oxygen costs of stepping for children and youth who completed at least 2 exercise stages. Overall, despite protocol differences, we found that the aerobic fitness levels of Canadians were lower in 2007-2009 than in 1981, with declines apparent in all age and both sex groups, thereby increasing the number of those at risk of adverse health outcomes. Future work is required to validate prediction equations of aerobic fitness for young people to make it possible to compare fitness levels over the lifespan and across time.     

Benefits of belly dance on quality of life,fatigue, and depressive symptoms in women with breast cancer – A pilot study of a non-randomised clinical trial

Objective

To analyse the influence of belly dance on the quality of life, fatigue, and depressive symptoms in women with breast cancer.

Brain abscess in children

Objectives: Brain abscess is a serious life-threatening complication of several diseases. The objective of this study was to look at the clinical profile of patients, predisposing conditions, microbiology and outcome of children suffering from brain abscess.Methods: Thirty children aged less than 15 years were reviewed. There were 15 males and 15 females. The mean age of presentation was 5.6±4.4 years.Results: The duration of illness at the time of admission was 17.6±24.6 days. Typically patients presented with fever, vomiting, headache and seizures. The predisposing conditions found were cyanotic congenital heart disease in 11 (37%) of children, meningitis in 6 (20%), septicemia in 7 (23%), and no underlying cause was found in 5 (17%) children. The most common microbe in children with cyanotic congenital heart disease was of theStreptococcus milleri group (52%). Computerized tomography confirmed the diagnosis and the most common location of the abscess was the parietal lobe of the cerebral hemisphere. All abscesses were large, more than 2 cm in diameter and were aspirated surgically. Excision was performed in 6 children. Five children expired, one due to a intracranial bleeding and the others due to severe cerebral edema and tentorial herniation. Complications were seen in 20 children and 16 had sequelae, hemiparesis in 11 and seizure disorder in 5.Conclusion: Brain abscess is a serious infection with poor outcome if diagnosed late. Delayed surgical drainage has high morbidity and mortality. The threshold for diagnosis should be low, particularly in children with a predisposing condition like cyanotic congenital heart disease.     

Postmortem Diagnosis of Dengue as an Epidemiological Surveillance Tool

Dengue remains a problem in Brazil, and a substantial number of cases that progress to death are not diagnosed by health services. We evaluated the impact of a protocol adopted by the Coroner''s Office Rocha Furtado (CO-RF) for the detection of unreported deaths from dengue in Brazil. We evaluated prospectively cases of deaths referred to the CO-RF with suspicion of dengue and those referred with other diagnosis in which the pathologists suspected dengue as the cause of death. Biological material was collected from all bodies autopsied, for which the suspected cause of death was dengue, between January 2011 and December 2012. Of the 214 bodies autopsied, 134 (62.6%) tested positive for dengue; of these cases, 121 were classified as dengue according to the World Health Organization''s case definition (1997 or 2009, as appropriate). Thus, CO-RF detected 90 deaths from dengue, which were not suspected during disease progression. This CO-RF protocol, through a combined effort of the surveillance and laboratory teams, increased the detection of fatal dengue cases by 5-fold. This is the largest series of autopsies performed in cases of death related to dengue in the world to date.     

Relative distribution of Ca2+ channels at the crayfish inhibitory neuromuscular junction

We investigated the Ca(2+) channel-synaptic vesicle topography at the inhibitor of the crayfish (Procambarus Clarkii) neuromuscular junction (NMJ) by analyzing the effect of different modes of Ca(2+) channel block on transmitter release. Initial identification of Ca(2+) channels revealed the presence of two classes, P and non-P-type with P-type channels governing approximately 70% of the total Ca(2+) influx. The remaining Ca(2+) influx was completely blocked by Cd(2+) but not by saturating concentrations of omega-conotoxins MVIIC and GVIA, or nifedipine and SNX-482. To examine the relative spatial distribution of Ca(2+) channels with respect to synaptic vesicles, we compared changes in inhibitory postsynaptic current amplitude and synaptic delay resulting from different spatial profiles of [Ca(2+)](i) around release sites. Specifically, addition of either [Mg(2+)](o), which decreases single-channel current, or omega-Aga IVA, which completely blocks P-type channels, prolonged synaptic delay by a similar amount when Ca(2+) influx block was <40%. Because non-P-type channels are able to compensate for blocked P-type channels, it suggests that these channels overlap considerably in their distribution. However, when Ca(2+) influx was blocked by approximately 50%, omega-Aga IVA increased delay significantly more than Mg(2+), suggesting that P-type channels are located closer than non-P-type channels to synaptic vesicles. This distribution of Ca(2+) channels was further supported by the observations that non-P-type channels are unable to trigger release in physiological saline and EGTA preferentially prolongs synaptic delay dominated by non-P-type channels when transmitter release is evoked with broad action potentials. We therefore conclude that although non-P-type channels do not directly trigger release under physiological conditions, their distribution partially overlaps with P-type channels.     

Effort thrombosis in a young triathlete: an unusual presentation of painless neck swelling secondary to right brachiocephalic vein thrombosis

Effort thrombosis of the upper extremity is secondary to thrombosis of the axillary and/or subclavian veins that develop from heavy arm exertion. This case illustrates venous thrombosis of the right brachiocephalic vein in a 32-year-old man who presented with a cyst-like swelling in the right neck with no associated pain or trauma. Our patient, a trained athlete, was preparing for a triathlon at the time of presentation. He was treated by first-line therapy of subcutaneous and oral anti-coagulation medication. In this study, we highlight the importance of early investigation and treatment of symptomatic athletes so that long-term disability can be prevented. This study also shows the timely use of computed tomography imaging, which can help to identify the syndrome in previously undiagnosed patients.     

Difference between self-reported and accelerometer measured moderate-to-vigorous physical activity in youth

We examined differences between objective (accelerometer) and subjective (selfreport) measures of moderate-to-vigorous physical activity (MVPA) in youth. Participants included 2761 youth aged 12-19 years. Within each sex and race group, objective and self-reported measures of MVPA were poorly correlated (R2 = .01-.10). Self-reported MVPA values were higher than objective values (median: 42.4 vs. 15.0 min/d). 65.4% of participants over-reported their MVPA by 35 min/d. The difference between self-reported and objective measures was not influenced by sex, age, or race. There was, however, a systematic difference such that inactive participants over-reported their MVPA to the greatest extent.