Physical activity and the risk of gestational diabetes mellitus: a systematic review and dose–response meta-analysis of epidemiological studies

Physical activity has been inconsistently associated with risk of gestational diabetes mellitus in epidemiological studies, and questions remain about the strength and shape of the dose–response relationship between the two. We therefore conducted a systematic review and meta-analysis of cohort studies and randomized trials on physical activity and gestational diabetes mellitus. PubMed, Embase and Ovid databases were searched for cohort studies, and randomized controlled trials of physical activity and risk of gestational diabetes mellitus, up to August 5th 2015. Summary relative risks (RRs) were estimated using a random effects model. Twenty-five studies (26 publications) were included. For total physical activity the summary RR for high versus low activity was 0.62 (95 % CI 0.41–0.94, I² = 0 %, n = 4) before pregnancy, and 0.66 (95 % CI 0.36–1.21, I² = 0 %, n = 3) during pregnancy. For leisure-time physical activity the respective summary RRs for high versus low activity was 0.78 (95 % CI 0.61–1.00, I² = 47 %, n = 8) before pregnancy, and it was 0.80 (95 % CI 0.64–1.00, I² = 17 %, n = 17) during pregnancy. The summary RR for pre-pregnancy activity was 0.70 (95 % CI 0.49–1.01, I² = 72.6 %, n = 3) per increment of 5 h/week and for activity during pregnancy was 0.98 (95 % CI 0.87–1.09, I² = 0 %, n = 3) per 5 h/week. There was evidence of a nonlinear association between physical activity before pregnancy and the risk of gestational diabetes mellitus, p_nonlinearity = 0.005, with a slightly steeper association at lower levels of activity although further reductions in risk were observed up to 10 h/week. There was also evidence of nonlinearity for physical activity in early pregnancy, p_nonlinearity = 0.008, with no further reduction in risk above 8 h/week. There was some indication of inverse associations between walking (before and during pregnancy) and vigorous activity (before pregnancy) and the risk of gestational diabetes mellitus. This meta-analysis suggests that there is a significant inverse association between physical activity before pregnancy and in early pregnancy and the risk of gestational diabetes mellitus. Further studies are needed to clarify the association between specific types and intensities of activity and gestational diabetes mellitus.     

Low molecular weight heparin: a practical approach in deep venous thrombosis in palliative care

Introduction:

Deep vein thrombosis (DVT) is one of the many cause of pain in advance cases of carcinoma cervix. The most widely used agent for combating DVT is unfractionated heparin.

Aims:

Aims of this study is to see the efficacy of the use of low molecular weight (LMW) haparin and its practical utility in palliative care settings.

Materials and Methods:

Twelve cases of established DVT received enoxaparin at 40 mg/m with warfarin.

Results:

There was 70% resolution of limb swelling in seven cases. Out of remaining four cases took two months to resolve and one case did not resolve completely.

Conclusions:

LMV heparin is effective in palliative care setting and also has added advantage of subcutaneous route of administration.     

Elevated levels of redox regulators, membrane-bound globin chains, and cytoskeletal protein fragments in hereditary spherocytosis erythrocyte proteome

Objective: Hereditary spherocytosis (HS), a common inherited hemolytic anemia characterized by decreased deformability, reduced surface to volume ratio, and increased osmotic fragility of the spheroidal erythrocytes, is associated with several mutations of α‐ and β‐spectrin, ankyrin, band 3, band 4.2. HS manifests itself with high degrees of clinical heterogeneity and the molecular events leading to premature hemolysis of the spherocytes are unclear. We have employed proteomic techniques to identify differentially regulated proteins in the membrane and hemoglobin‐depleted cytosol of HS erythrocytes. Methods: We have employed 2‐D gel electrophoresis and tandem matrix assisted laser desorption ionization‐time of flight/time of flight mass spectrometry to investigate the differential proteome profiling of membrane and hemoglobin‐depleted cytosol of erythrocytes isolated from the peripheral blood samples of HS patients and normal volunteers. Results: Our study showed that redox regulators are up‐regulated; while a co‐chaperone and a nucleotide kinase are down‐regulated in HS erythrocyte cytosol. We observed elevated levels of membrane‐associated globin chains and low‐molecular weight fragments of several major cytoskeletal proteins. Conclusion: The observed changes in the erythrocyte proteomes indicate altered redox regulation, nucleotide metabolism, protein aggregation and/or degradation, cytoskeletal disorganization, and severe oxidative stress in HS. Taken together, this study could enlighten upon disease progression and pathophysiology of HS.     

Being surveyed can change later behavior and related parameter estimates

Does completing a household survey change the later behavior of those surveyed? In three field studies of health and two of microlending, we randomly assigned subjects to be surveyed about health and/or household finances and then measured subsequent use of a related product with data that does not rely on subjects'' self-reports. In the three health experiments, we find that being surveyed increases use of water treatment products and take-up of medical insurance. Frequent surveys on reported diarrhea also led to biased estimates of the impact of improved source water quality. In two microlending studies, we do not find an effect of being surveyed on borrowing behavior. The results suggest that limited attention could play an important but context-dependent role in consumer choice, with the implication that researchers should reconsider whether, how, and how much to survey their subjects.     

F-cell levels are altered with erythrocyte density in sickle cell disease

Lighter cells from density fractionated erythrocytes of sickle cell disease (SCD) patients carry higher amount of externalized phosphatidylserine (PS) and cell surface glycophorins compared to the denser counterparts. Further analysis also revealed that the denser cells contained higher levels of fetal hemoglobin (HbF) compared to the lighter cells, supported by the presence of larger number of F-cells in these populations. In this report, we have found direct evidence on the higher survival of the HbF rich erythrocytes in SCD.