Early experience with medial femoral tension band plating in idiopathic genu valgum

Purpose  

For correction of angular deformity, tension band plating has been proposed as a safe and minimally invasive technique. The purpose of this study was to assess the experiences and report the rate of correction obtained with this procedure in patients with idiopathic genu valgum.     

Cognitive impairment predicts fatal incident stroke: findings from a national sample of older adults

OBJECTIVES: To investigate the effect of cognitive impairment on fatal and nonfatal incident stroke in older adults. DESIGN: A large, national, prospective, population‐based study of a representative cohort of older Canadians followed over a 10‐year period. SETTING: Secondary analyses were conducted using data from the Canadian Study of Health and Aging, a population‐based study of older adults followed prospectively from 1991 to 2001. PARTICIPANTS: Nine thousand four hundred fifty‐one adults aged 65 and older who had not previously been diagnosed with stroke at baseline (in 1991). MEASUREMENTS: In addition to known risk factors, the independent contribution of cognitive function (diagnosed in a clinical examination) was examined as a risk for stroke in older adults. RESULTS: Multinomial logistic regression analyses showed that cognitive impairment was associated with twice the odds of fatal incident stroke, controlling for well‐established risk factors. CONCLUSION: This study provides further evidence for the need to consider cognitive function in relation to stroke risk in older populations.     

Effect of exercise training on plasma levels and functional properties of high-density lipoprotein cholesterol in the metabolic syndrome

Intense lifestyle modifications can change the high-density lipoprotein (HDL) cholesterol concentration. The aim of the present study was to analyze the early effects of short-term exercise training, without any specific diet, on the HDL cholesterol plasma levels and HDL functional characteristics in patients with the metabolic syndrome (MS). We studied 30 sedentary subjects, 20 with and 10 without the MS. The patients with the MS underwent moderate intensity exercise training for 3 months on bicycle ergometers. Blood was sampled before and after training for biochemical analysis, paraoxonase-1 activity, and HDL subfraction composition and antioxidative capacity. Lipid transfer to HDL was assayed in vitro using a labeled nanoemulsion as the lipid donor. At baseline, the MS group had greater triglyceride levels and a lower HDL cholesterol concentration and lower paraoxonase-1 activity than did the controls. Training decreased the plasma triglycerides but did not change the low-density lipoprotein or HDL cholesterol levels. Nonetheless, exercise training increased the HDL subfractions' antioxidative capacity and paraoxonase-1 activity. After training, the MS group had compositional changes in the smallest HDL subfractions associated with increased free cholesterol and cholesterol ester transfers to HDL, reaching normal values. In conclusion, the present investigation has added relevant information about the dissociation between the quantitative and qualitative aspects of HDL after short-term exercise training without any specific diet in those with the MS, highlighting the importance of evaluating the functional aspects of the lipoproteins, in addition to their plasma levels.     

Novel mutation in MCT8 gene in a Brazilian boy with thyroid hormone resistance and severe neurologic abnormalities

MCT8 is a cellular transporter of thyroid hormones important in their action and metabolization. We report a male patient with the novel inactivating mutation 630insG in the coding region in exon 1 of MCT8. He was characterized clinically by severe neurologic impairment (initially with global hypotonia, later evolving with generalized hypertonia), normal growth during infancy, reduced weight gain, and absence of typical signs and symptoms of hypothyroidism, while the laboratory evaluation disclosed elevated T3, low total and free T4, and mildly elevated TSH serum levels. Treatment with levothyroxine improved thyroid hormone profile but was not able to alter the clinical picture of the patient. These data reinforce the concept that the role of MCT8 is tissue-dependent: while neurons are highly dependent on MCT8, bone tissue, adipose tissue, muscle, and liver are less dependent on MCT8 and, therefore, may suffer the consequences of the exposition to high serum T3 levels.     

Attachment dimensions and group climate growth in a sample of women seeking treatment for eating disorders

Adult attachment and group process research are emerging areas of research for treating eating disorders. In this study, we examined several aspects of group processes: the weekly growth of group therapy climate, the relationship between group climate growth and outcomes, and the impact of the group on individual experiences of group climate. Further, we assessed the relationship between adult attachment dimensions and these group processes. Women (n = 264) diagnosed with an eating disorder completed attachment scales pre-treatment, eating disorder symptom scales pre- and post-treatment, and group climate scales weekly during treatment. Treatment consisted of a specialized eating disorders group-based day hospital program with rolling admissions. Engaged group climate increased and Avoidance group climate decreased across weeks of treatment. Engaged group climate growth was associated with improved eating disorder symptoms post-treatment. Higher attachment avoidance at pre-treatment was related to lower Engaged group climate at week 1, and was related to a greater impact of the group on the individual's experience of group engagement. Clinicians might improve group processes and outcomes by tailoring interventions to individuals' attachment avoidance when treating women for eating disorders.     

Effects of low-level laser therapy on expression of TNF-α and TGF-β in skeletal muscle during the repair process

The aim of the present study was to determine the effect of low-level laser therapy (LLLT) on the expression of TNF-α and TGF-β in the tibialis anterior muscle of rats following cryoinjury. Muscle regeneration involves cell proliferation, migration and differentiation and is regulated by growth factors and cytokines. A growing body of evidence suggests that LLLT promotes skeletal muscle regeneration by reducing the duration of acute inflammation and accelerating tissue repair. Adult male Wistar rats (n = 35) were randomly divided into three groups: control group (no lesion, untreated, n = 5), cryoinjury without LLLT group (n = 15), and cryoinjury with LLLT group (n = 15). The injured region was irradiated three times a week using an AlGaInP laser (660 nm; beam spot 0.04 cm², output power 20 mW, power density 500 mW/cm², energy density 5 J/cm², exposure time 10 s). Muscle remodeling was evaluated at 1, 7 and 14 days (long-term) following injury. The muscles were removed and total RNA was isolated using TRIzol reagent and cDNA synthesis. Real-time polymerase chain reactions were performed using TNF-α and TGF-β primers; GAPDH was used to normalize the data. LLLT caused a decrease in TNF-α mRNA expression at 1 and 7 days following injury and in TGF-β mRNA expression at 7 days following cryoinjury in comparison to the control group. LLLT modulated cytokine expression during short-term muscle remodeling, inducing a decrease in TNF-α and TGF-β.