Design of the sex hormones and physical exercise (SHAPE) study

Background  

Physical activity has been associated with a decreased risk for breast cancer. The biological mechanismn(s) underlying the association between physical activity and breast cancer is not clear. Most prominent hypothesis is that physical activity may protect against breast cancer through reduced lifetime exposure to endogenous hormones either direct, or indirect by preventing overweight and abdominal adiposity. In order to get more insight in the causal pathway between physical activity and breast cancer risk, we designed the Sex Hormones and Physical Exercise (SHAPE) study. Purpose of SHAPE study is to examine the effects of a 1-year moderate-to-vigorous intensity exercise programme on endogenous hormone levels associated with breast cancer among sedentary postmenopausal women and whether the amount of total body fat or abdominal fat mediates the effects.     

Comorbidity,limitations in activities and pain in patients with osteoarthritis of the hip or knee

Background  

This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study were (i) to describe the prevalence of comorbidity and (ii) to describe the relationship between comorbidity (morbidity count, severity and the presence of specific diseases) and limitations in activities and pain in elderly patients with knee or hip OA using a comprehensive inventory of comorbidity.     

Cholinergic but not GABAergic neuronal markers are decreased in primary neuronal cultures treated with choline mustard

Nitrogen mustard analogues of choline are potent irreversible inhibitors of high-affinity choline transport at the cholinergic presynaptic nerve terminal in vitro. Ethylcholine mustard aziridinium ion, and to a lesser extent choline mustard aziridinium ion, have been used as tools to chemically lesion cholinergic neurons in the central nervous system. The selectivity of these compounds as neurotoxins for cholinergic neurons in vivo has been questioned and the mechanism by which they mediate neuronal death has not been elucidated. The objective of the present study was to investigate the selectivity of choline mustard aziridinium ion on embryonic rat brain neurons maintained in primary culture. The effect of choline mustard aziridinium ion on levels of cholinergic neuronal markers was compared with markers for GABAergic neurons as a measure of neuronal specificity. Choline mustard aziridinium ion at 10 and 30 microM irreversibly inhibited hemicholinium-sensitive, high-affinity choline transport into the cultured neurons without altering sodium-dependent, high-affinity GABA transport. Similarly, incubation of the neurons for 30 min in the presence of 10 microM choline mustard aziridinium ion led to a decrease in choline acetyltransferase activity of the cultures which was maintained for 72 h; glutamic acid decarboxylase activity was not altered under the same experimental conditions. Protein and DNA content and DNA-to-protein ratios of the choline mustard aziridinium ion-treated cultures were monitored as indicators of generalized cellular damage.(ABSTRACT TRUNCATED AT 250 WORDS)     

Megaprepuce associated with vesicoureteric reflux.

OBJECTIVE: To describe 4 patients in whom megaprepuce was associated with vesicoureteric reflux (VUR). PATIENTS AND METHODS: Four boys aged 6, 4, 5 and 7 months, respectively, presented with dribbling of urine, gross penile swelling and inability to void spontaneously. The first 3 patients had a history of documented urinary tract infection. Micturating cystourethrogram (MCUG) revealed grade III VUR on the right in the first patient, grade V on the left in the second patient, grade III on the right and grade IV in both moieties of left duplex system in the third patient and bilateral grade III in the fourth patient. All patients underwent circumcision. RESULTS: Follow-up MCUG demonstrated complete resolution of VUR in 2 patients after circumcision. One patient with bilateral VUR showed resolution of VUR on right side but persistence of VUR into the lower moiety of left duplex system after circumcision. Vesicoureteric reflux was downgraded from grade 5 to grade 3 after circumcision in one patient. CONCLUSION: These cases demonstrate for the first time the association of megaprepuce with VUR. VUR associated with megaprepuce is usually resolved after circumcision.     

The Treatment of Septicemia in Pacemaker Patients

The authors analyzed the data of seven patients who had undergone open heart surgery because of pacemaker endocarditis in the past 4 years. Repeated surgical interventions on the pacemaker system were found to be the most common predisposing factors. Staphylococcus aureus and Staphylococcus epidermidis were the most common causative organisms. Two-dimensional echocardiography was important in the diagnosis of cases with atypical clinical picture and negative blood cultures. We concluded that: (1) any pacemaker patient with fever should be considered to have a pacemaker endocarditis; (2) all of these patients should be examined by two-dimenensional echocardiography; and (3) the total removal of the infected hardware seems to be the only way to achieve complete recovery.     

Cerebral Embolism Due to a Retained Pacemaker Lead: A Case Report

There are only a few reported cases of a pacemaker lead migrating inadvertently into the left atrium or ventricle. An unusual complication of unremoved, unwanted pacemaker lead is presented. The free tip of the lead caused cerebral embolism after perforating the interatrial septum.     

Recent trends in breast cancer incidence in US white women by county-level urban/rural and poverty status

Background  

Unprecedented declines in invasive breast cancer rates occurred in the United States between 2001 and 2004, particularly for estrogen receptor-positive tumors among non-Hispanic white women over 50 years. To understand the broader public health import of these reductions among previously unstudied populations, we utilized the largest available US cancer registry resource to describe age-adjusted invasive and in situ breast cancer incidence trends for non-Hispanic white women aged 50 to 74 years overall and by county-level rural/urban and poverty status.     

Recipient bed perfusion as a predictor for postoperative complications in irradiated patients with microvascular free tissue transfer of the head and neck area: a clinical analysis of 191 microvascular free flaps

Purpose

Despite microvascular free tissue transfer being the mainstay of care in the reconstruction of larger maxillofacial defects, a significant number of patients experience postoperative complications due to impaired blood supply of the flap. In this context, the early influence of recipient bed perfusion remains unclear, but there is evidence that it is associated with free flap viability immediately after surgery.

Methods

We analyzed flap and recipient bed perfusion within the first 2 weeks after surgery by using the oxygen-to-see device. One hundred ninety-one patients who underwent free flap surgery in our department were included.

Results

Flow parameters were higher and postoperative complications were less frequent in radial forearm free flaps compared to any other type of flap. Flow parameters of the recipient bed were higher than transferred tissue at all times, implicating flap autonomization is not completed within 2 weeks. Previous radiotherapy significantly decreased flow parameters of the recipient bed but not of the flaps. Furthermore, irradiated patients with postoperative complications were found to have reduced flow parameters of their recipient bed compared to non-irradiated patients with postoperative complications.

Conclusion

We conclude that monitoring of recipient bed perfusion is useful for detecting flap compromise of irradiated patients in the early postoperative period.