Just how special are the physical activity cognitions in diseased populations? Preliminary evidence for integrated content in chronic disease prevention and rehabilitation

Background: The extant literature is building on subdividing physical activity (PA) correlates and interventions by health condition (e.g., diabetes, cancer, etc.).Purpose: The purpose of this study was to compare the mean values and correlations of a population sample divided by mutually exclusive health condition status (“nondiseased,” cardiovascular disease and risk factors, cancer, diabetes, and arthritis) on theory of planned behavior beliefs and physical activity after adjusting for sociodemographic factors. The relationship between compounding health conditions/comorbidities and these beliefs with PA was also evaluated.Methods: Participants were a U.S. sample of 6,739 adults (M age=49.65, SD=16.04) who completed relevant social and medical demographics, measures of behavioral, normative, and control beliefs, and self-reported PA.Results: Mean analyses identified greater health barriers to PA for the arthritis population compared to the other groups (η²>.025), whereas physician norms and health barriers were higher for compounding health condition populations compared to the nondiseased group (η²>.025). Belief-behavior correlations, however, were not different across health conditions (q<.19), and nondiseased and single disease populations had larger control belief-behavior correlations than those populations with compounding health conditions (q>.19).Conclusions: These data generally provide preliminary evidence for an integrated approach to PA promotion content in primary prevention and health rehabilitation with some possible tailoring in the areas of health barriers. This area of research will benefit from future studies that build off of these results. Ryan E. Rhodes is supported by a scholar award from the Michael Smith Foundation for Health Research, a new investigator award from the Canadian Institutes of Health Research, and with funds from the Social Sciences and Humanities Research Council of Canada. Chris M. Blanchard is supported by a Canada Research Chair in the Faculty of Medicine, Dalhousie University.     

K-ras mutations, rectal crypt cells proliferation, and meat consumption in patients with left-sided colorectal carcinoma.

It has been suggested that N-nitroso compounds derived from meat may increase the risk of K-ras mutations in the human colon. We sought evidence of associations between red meat consumption, frequency and type of K-ras mutations in resected tumours, and the rate of crypt cell proliferation (CCP) in the normal mucosa of patients with left-sided colorectal carcinoma. Meat consumption was assessed by food frequency questionnaire, and CCP was determined in rectal biopsies obtained prior to surgery. K-ras mutations in the resected tumours were determined using a PCR-based oligonucleotide hybridization assay. Fifteen K-ras mutations were detected in tumours from 43 patients; 13/15 in codon 12, 3/15 in codon 13, and 1/15 in both codons 12 and 13. All mutations were G-->A or G-->T transitions. There was no statistically significant difference between intakes of red meat in patients with a K-ras mutation (92.4 +/- 9.7 g/day) and those without (82.3 +/- 7.7 g/day). Rectal CCP was significantly higher in patients than in healthy controls, but there was no correlation with meat consumption or K-ras mutation. These data do not support the hypothesis that meat consumption is a risk factor for acquisition of K-ras mutations during colorectal carcinogenesis.     

Regional variation and differential response to therapy for knee synovitis adjacent to the cartilage–pannus junction and suprapatellar pouch in inflammatory arthritis: Implications for pathogenesis and treatment

Objective

To use magnetic resonance imaging (MRI) to investigate the importance of knee joint synovitis at the cartilage–pannus junction (CPJ) in rheumatoid arthritis (RA) as compared with synovitis at a distant site in the suprapatellar pouch (SPP) and as compared with CPJ synovitis in the spondylarthropathies (SpA), and to assess the relative response of knee joint synovitis to therapy at the CPJ and SPP sites.

Methods

Dynamic contrast‐enhanced MRI (DEMRI) of actively involved knee joints in 24 patients (13 with RA and 11 with SpA) was undertaken. The area of synovitis was calculated at the CPJ and SPP regions of interest in patients with RA and in patients with SpA. Differences in CPJ and SPP synovitis were determined using calculated DEMRI parameters which included the initial rate of contrast enhancement (IRE) and the maximal enhancement (ME). Changes in the synovial area at the CPJ and SPP were also measured in 10 patients with early RA, following treatment with disease‐modifying antirheumatic drugs (DMARDs) (either methotrexate or leflunomide).

Results

In patients with RA or SpA, the area of synovitis was significantly larger immediately adjacent to the CPJ compared with a distant site at the SPP (in RA, mean synovitis area 162 mm² at the CPJ versus 114 mm² at the SPP [P = 0.010]; in SpA, mean synovitis area 214 mm² at the CPJ versus 143 mm² at the SPP [P = 0.002]), but the differences in the areas of synovitis at these sites were not significant between the RA and SpA patients. The IRE and ME values were also higher at the CPJ compared with the SPP, both in the RA patients (IRE P = 0.054, ME P = 0.018) and in the SpA patients (IRE P = 0.002, ME P = 0.001). A larger reduction in the area of synovitis was seen at the SPP compared with the CPJ following DMARD therapy in the RA patients (mean reduction 35% at the SPP [P = 0.023] and 12% at the CPJ [P not significant]).

Conclusion

The non–disease‐specific variations in synovitis and the differential responses to therapy in RA patients have implications for improving our understanding of CPJ synovitis. The results suggest that the pathophysiologic events at the CPJ reflect common anatomic, immune system, or biomechanical factors that play a role in modulating the severity of arthritis, and these events are not specific to RA since the same process was observed in other arthritides.

     

Common polymorphisms of protein tyrosine phosphate non-receptor type 2 gene are not associated with risk of Crohn’s disease in Indian

BACKGROUNDMultiple genetic risk factors for Crohn’s disease (CD) have been identified. However, these observations are not consistent across different populations. The protein tyrosine phosphate non-receptor type 2 (PTPN2) gene plays a role in various aspects of host defense including epithelial barrier function, autophagy, and innate and adaptive immune response. Two common polymorphisms in the PTPN2 gene (rs2542151 and rs7234029) have been associated with risk of CD in Western countries. AIMTo evaluate the association of PTPN2 gene polymorphisms with risk of CD in Indian population.METHODSWe conducted a prospective case-control study. Patients with CD were recruited, and their clinical and investigation details were noted. Controls were patients without organic gastrointestinal disease or other comorbid illnesses. Two common polymorphisms in the PTPN2 gene (rs2542151 and rs7234029) were assessed. DNA was extracted from peripheral blood samples of cases and controls and target DNA was amplified using specific sets of primers. The amplified fragments were digested with restriction enzymes and the presence of polymorphism was detected by restriction fragment length polymorphism. The frequency of alleles was determined. The frequencies of genotypes and alleles were compared between cases and controls to look for significant differences.RESULTSA total of 108 patients with CD (mean age 37.5 ± 12.7 years, females 42.6%) and 100 controls (mean age 39.9 ± 13.5 years, females 37%) were recruited. For the single nucleotide polymorphism (SNP) rs7234029, the overall frequency of G variant genotype (AG or GG) was noted to be significantly lower in the cases compared to controls (35.2% vs 50%, P = 0.05). For the SNP rs2542151, the overall frequency of G variant genotype (GT or GG) was noted to be similar in cases compared to controls (43.6% vs 47%, P = 0.73). There were no significant differences in minor allele (G) frequency for both polymorphisms between the cases and controls. Both the SNPs had no significant association with age of onset of illness, gender, disease location, disease behaviour, perianal disease, or extraintestinal manifestations of CD.CONCLUSIONUnlike observation form the West, polymorphisms in the PTPN2 gene (rs7234029 and rs2542151) are not associated with an increased risk of developing CD in Indian patients.     

A further look at the institutionalized chronic alcoholic scale

Investigated a newly developed MMPI scale – the Institutionalized Chronic Alcohol Scale (ICAS) – designed to separate alcoholics from neurotics. With a sample of 75 alcoholic and 50 neurotic male Veterans Administration Hospital inpatients, the ICAS was found to separate the two groups, correctly identifying 78%, but was slightly less effective than two other previously used alcoholism scales by MacAndrew (Amac) and Holmes (Am). Data from 30 male Veterans Administration Hospital heroin addicts lend some support to the statement, which appears in the original article, that the ICAS should not be used to distinguish between alcoholics and people other than neurotics.     

Evidence-making controversies: the case of hepatitis C treatment and the promise of viral elimination

Contested science presents a problem for ‘evidence-based’ public health intervention. Taking a perspective that treats evidence as constituted through the practices which make it, we treat controversies in public health science as events of ‘evidence-making’ intervention. We look back on a recent controversy in evidence-making regarding the curative potential of new treatments for hepatitis C. The controversy concerned the publication of a systematic review conducted by the Cochrane Collaboration. We explore how published responses critical of the review enact their evidence-making. We do this to illuminate how moments of controversy offer useful sites of evidencing-making investigation for public health research. We identify four intersecting objects of evidence-making in the published responses: cure; expertise; hope; and morality. We reflect on how different experts perform evidence differently, how these evidence performances are in friction yet incorporate one another, and how such evidence-making practice fuses together different knowledge forms within and beyond science. Controversy makes visible the multiplicity and fluidity of evidence objects which might otherwise be constituted as singular and robust. A prime matter of concern in this exemplar is ‘cure’ and the protection of curative potential linked to new treatments in the presence of evidence uncertainty. We use our case study to argue for the benefits of an ‘evidence-making intervention’ approach to the study and use of evidence in critical public health research.