Low trehalase activity is associated with abdominal symptoms caused by edible mushrooms.

BACKGROUND: The purpose of the study was to evaluate whether maldigestion of trehalose causes abdominal symptoms and which available diagnostic method best distinguishes intolerant from tolerant subjects. METHODS: A 25-g oral trehalose load test was performed in 64 subjects. The 19 experiencing clear symptoms constituted the trehalose-intolerant subjects. Changes from base-line levels of blood glucose, breath hydrogen, and methane and symptoms were recorded after the test. Trehalase activity was determined in serum and on a duodenal biopsy specimen obtained by endoscopy. RESULTS: Intolerant subjects were best differentiated from tolerant subjects by changes in breath gases (hydrogen and methane) and duodenal trehalase to sucrase ratio. The change in breath gases correlated inversely with duodenal trehalase activity, duodenal trehalase to sucrase ratio, and plasma trehalase activity. The correlation between serum and duodenal trehalase activities was on the order of 0.6. Two subjects were found to have trehalase deficiency. CONCLUSIONS: It is obvious that trehalose maldigestion can cause symptoms similar to those of lactose maldigestion and intolerance. Three factors control the genesis of symptoms: 1) the activity of small-bowel trehalase: if it is low, trehalose is maldigested and more trehalose is passed into the colon; 2) the maldigested trehalose, which causes osmotic water flow into the colon, resulting in loose stools and diarrhea; and 3) most importantly, the microflora of the colon, from which symptoms will arise if there are bacteria capable of producing gases from maldigested trehalose. If colonic bacteria cannot produce gases, then distention of the abdomen and intestinal gas expulsion as eructations and flatus will not occur.     

Recessive PYROXD1 mutations cause adult-onset limb-girdle-type muscular dystrophy

Journal of Neurology - To describe adult-onset limb-girdle-type muscular dystrophy caused by biallelic variants in the PYROXD1 gene, which has been recently linked to early-onset congenital...     

Detection of human metapneumovirus and respiratory syncytial virus by duplex real-time RT-PCR assay in comparison with direct fluorescent assay

Human respiratory syncytial virus (hRSV) and human metapneumovirus (hMPV) are important respiratory pathogens of small children and adults. The present study aimed to design a sensitive real-time RT-PCR assay for the detection of hRSV and hMPV in comparison with direct fluorescent assay (DFA) and to determine the incidence of hMPV and hRSV as causative agents of respiratory infections in a Finnish population. For DFA detection of hMPV antigen, four commercial antibodies were evaluated. The duplex real-time RT-PCR assay achieved a sensitivity of 10³ copies/mL of specimen for hRSV and hMPV type A viruses and 10⁴ copies/mL for type B hMPV. The detection rate of the RT-PCR assay was compared with those for DFA detection of hMPV and hRSV in analyses of 350 nasopharyngeal aspirates sent to HUSLAB, Helsinki University Hospital, for routine virus diagnostics during November 2007 to June 2008. Of the samples analyzed, 43 (12.3%) were positive for hRSV by DFA and an additional 13 specimens (3.7%) were positive for hRSV by RT-PCR. Only four samples (1.1 %) were found to be positive for hMPV RNA by RT-PCR, with two of them also positive by DFA. The duplex real-time RT-PCR assay described in the present study can therefore be applied for efficient identification of hMPV and hRSV in clinical specimens and collection of information on the epidemiology and clinical outcome of these viruses.     

Magnetic particle imaging: Introduction to imaging and hardware realization

Magnetic Particle Imaging (MPI) is a recently invented tomographic imaging method that quantitatively measures the spatial distribution of a tracer based on magnetic nanoparticles. The new modality promises a high sensitivity and high spatial as well as temporal resolution. There is a high potential of MPI to improve interventional and image-guided surgical procedures because, today, established medical imaging modalities typically excel in only one or two of these important imaging properties. MPI makes use of the non-linear magnetization characteristics of the magnetic nanoparticles. For this purpose, two magnetic fields are created and superimposed, a static selection field and an oscillatory drive field. If superparamagnetic iron-oxide nanoparticles (SPIOs) are subjected to the oscillatory magnetic field, the particles will react with a non-linear magnetization response, which can be measured with an appropriate pick-up coil arrangement. Due to the non-linearity of the particle magnetization, the received signal consists of the fundamental excitation frequency as well as of harmonics. After separation of the fundamental signal, the nanoparticle concentration can be reconstructed quantitatively based on the harmonics. The spatial coding is realized with the static selection field that produces a field-free point, which is moved through the field of view by the drive fields.This article focuses on the frequency-based image reconstruction approach and the corresponding imaging devices while alternative concepts like x-space MPI and field-free line imaging are described as well. The status quo in hardware realization is summarized in an overview of MPI scanners.     

Association of age at menarche with cardiovascular risk factors, vascular structure, and function in adulthood: the Cardiovascular Risk in Young Finns study

BACKGROUND: It is unclear whether age at menarche is an independent determinant of future cardiovascular risk. OBJECTIVE: We aimed to determine whether menarcheal age is an independent predictor of body mass index (BMI) and a wide range of cardiovascular risk factors in adolescence and adulthood. DESIGN: We examined the associations of menarcheal age with BMI (in kg/m(2)) and other cardiovascular risk factors in adolescence and adulthood in a population-based sample of 794 female adolescents aged 9-18 y at baseline. Their age at first menstruation was requested at baseline and again 3 and 6 y later. Cardiovascular risk factors were assessed at baseline and at age 30-39 y. RESULTS: A 1-y decrease in menarcheal age was associated with 0.81 (95% CI: 0.53, 1.08) higher adult BMI as well as greater waist circumference and waist-to-hip ratio, elevated systolic blood pressure, higher insulin resistance, and greater risk of metabolic syndrome (P < 0.05 for all). In multivariable analysis in which these adult risk factors were mutually adjusted for, only the inverse association between age at menarche and adult BMI remained. However, this inverse association was lost after adjustment for premenarcheal BMI (beta: -0.16; 95% CI -0.55, 0.23; P = 0.42). Higher premenarcheal BMI predicted earlier menarche, and the strong association between premenarcheal BMI and adult BMI was robust to adjustment for age at menarche. CONCLUSIONS: These findings suggest that early menarche is only a risk marker. Greater childhood BMI seems to contribute to earlier age at menarche and, because of tracking, greater adult BMI and associated cardiovascular risk. An independent effect of early menarche on adult adiposity cannot be excluded, but it is likely to be small at best.     

Lower fertility associated with obesity and underweight: the US National Longitudinal Survey of Youth

BACKGROUND: It has been hypothesized that body weight predicts the number of children that a person will have: obese and underweight persons are hypothesized to have fewer children than do their normal-weight counterparts. OBJECTIVE: We aimed to prospectively examine the association between body weight in young adulthood and achieved fertility in later life. DESIGN: A representative national sample of 12 073 American young adults (aged 17-24 y in 1981) were followed through 2004 (19 survey waves of the National Longitudinal Survey of Youth). RESULTS: Obese young women and men were less likely to have their first child by the age of 47 y than were their normal-weight counterparts [relative risk (RR) = 0.69; 95% CI: 0.61, 0.78 in women; RR = 0.75; 95% CI: 0.66, 0.84 in men). Obesity also predicted a lower probability of having more than one child, particularly for women. These associations were partly explained by a lower probability that obese participants will marry. Underweight men were less likely to have the first, second, third, and fourth child than were normal-weight men (RRs = 0.75-0.88; 95% CIs: 0.61, 0.95). These associations were largely explained by the lower marriage probability of underweight men. Obese women and men and underweight men were less likely to have as many children in adulthood as they had desired as young adults. CONCLUSIONS: Obesity may be an important risk factor for lower fertility because of its social and possibly biological effect on reproductive behavior. Further data are needed to assess whether this association holds in more recent cohorts.     

Overall Diet History and Reversibility of the Metabolic Syndrome Over 5 Years: The Whitehall II prospective cohort study

OBJECTIVE

We examined the impact of adherence to the Alternative Healthy Eating Index (AHEI), a set of dietary guidelines targeting major chronic diseases, on metabolic syndrome (MetS) reversion in a middle-aged population.

RESEARCH DESIGN AND METHODS

Analyses were carried out on the 339 participants (28% women, mean age 56.4 years) from the Whitehall II study with MetS as defined by the National Cholesterol Education Program Adult Treatment Panel III criteria. Reversion was defined as not having MetS after 5 years of follow-up (158 case subjects).

RESULTS

After controlling for potential confounders, adherence to AHEI was associated with MetS reversion (odds ratio 1.88 [95% CI 1.04–3.41]), predominantly in participants with central obesity and in those with high triglyceride.

CONCLUSIONS

Our findings support the benefit of adherence to AHEI dietary guidelines for individuals with MetS, especially those with central obesity or high triglyceride levels.The metabolic syndrome (MetS), prevalence estimated at between 10 and 25% in adult populations worldwide (1), is associated with an increased risk of type 2 diabetes and cardiovascular diseases (CVDs). Lifestyle modification, such as increased physical exercise (2) and diet therapies (3,4), may have a beneficial impact on MetS. We examined a set of dietary guidelines targeting major chronic diseases known as the Alternative Healthy Eating Index (AHEI) (5). Our goal was to examine whether adherence to AHEI was associated with reversion of the MetS over a 5-year period in a middle-aged population.     

Results of metal-on-metal hip resurfacing in patients 40 years old and younger

The prevalence of total hip arthroplasty in young patients is small but increasing. We analyzed the results of metal-on-metal hip resurfacing (MMHR) in patients aged 40 years or less. In total 74 operations were performed on 64 patients. Mean age at operation was 33.2 years. HHS averaged 92.3 points at latest follow-up, mean UCLA activity was 8.2. Patients with comorbidity evinced lower scores in HHS, in UCLA activity and in quality of life than patients without comorbidities. Eight revisions (10.8 %) were performed, of which seven due to adverse reaction to metal debris. Seven-year survival was 90.5 %. The functional outcome of hip resurfacing in this cohort was excellent, but overall survival was unsatisfactory. Further analysis is required to verify the role of hip resurfacing among young and active patients.