Smoking and operative treatment of rotator cuff tear

This registry study was set up to evaluate the effect of smoking on the pre‐operative status, intraoperative findings, and post‐operative status after rotator cuff reconstruction. Five hundred seventy‐six consecutive shoulders with primarily arthroscopically repaired penetrating rotator cuff tear were followed up. Tobacco consumption was recorded as pack‐years. Age‐adjusted Constant score was used as an outcome measure. Five hundred sixty‐four patients were available for 1‐year follow‐up (dropout rate 2%). One hundred fourteen (20%) and 450 (80%) patients were pre‐operatively recorded to be smokers and non‐smokers, respectively. The gender distribution did not differ between the groups (P = 0.286). The mean age of all patients was 55 years in smokers (SD 9.1) and 61 years in non‐smokers (SD 9.4) (P < 0.001). There was no statistically significant difference in pre‐operative Constant score (P = 0.075) or mean size of intraoperatively measured tendon tear (P = 0.290) between the groups. At final follow‐up, there was a statistically significant difference in Constant scores between smokers [71 (SE 1.4)] and non‐smokers [75 (SE 0.7)] (P = 0.017). The pack‐years of smoking correlated with neither the Constant score (P = 0.815) nor the size of the tear (P = 0.786). We conclude that operatively treated rotator cuff tear patients who smoked were significantly younger than non‐smokers, and that smoking was associated with lower post‐operative Constant score.     

Risk factors for developing tuberculosis in remand prisons in St. Petersburg,Russia — a case-control study

Background Detainees have a substantial risk to develop tuberculosis (TB) due to a higher incidence of TB in remand prison compared to the civil community. They develop TB during incarceration not only due to poor living conditions in remand prison, but also due to some factors affecting their life before imprisonment. Prevention measures against TB spread from penitentiary institutions to society include study of factors, which contribute to TB development. Current study aims at identification of important risk factors of TB development in remand prison in St. Petersburg, Russia. Methods A retrospective matched case–control study was performed from May 2002 to May 2003 in two remand prisons in St. Petersburg. One hundred and fourteen prisoners (57 cases, 57 controls) were interviewed by using standardised questionnaire. Logistic regression analysis was performed to identify risk factors. Results Six factors were significantly linked to the risk of developing TB: narcotic drug use (odds ratio (OR): 2.6, 95% confidence interval (CI): 1.0–6.9), low income (OR: 3.2, CI: 1.2–8.6), high ratio of prisoners per available bed (OR: 4.0, CI: 1.1–15.0), not having own bed clothes (OR: 13.0, CI: 2.7–61.6), and little time outdoors (OR: 3.3, CI: 1.3–8.5). However, good housing before imprisonment (OR: 4.2, CI: 1.1–15.7) was a separate risk factor for TB. Conclusions Three of the risk factors (high number of prisoners per bed, not having own bed clothes, and little time outdoors) are certainly possible to approach by improvement of conditions in remand prisons. The remaining three factors (narcotic drug use, good housing before imprisonment, and low income) provide knowledge about study population, but cannot be intervened by prison’s medical staff.     

Obesity and education: recent trends and disparities among 65- to 84-year-old men and women in Finland

OBJECTIVES: The purpose of this study was to analyze trends and disparities in obesity by education among Finnish men and women aged 65-84 years from 1993 to 2003. METHOD.: Data were derived from nationally representative monitoring surveys conducted biennially from 1993 to 2003 by the National Public Health Institute (KTL). In total, 5740 men and 5746 women were included in the study (response rate 80%). Obesity was set as body mass index (BMI) >or=30, based on self-reported measurements. Age adjusted trends were examined by education and gender. A logistic regression model was used to study educational disparities in obesity. RESULTS: Obesity trends were similar among men and women. The prevalence of obesity increased in both educational groups over the ten-year period. Throughout the period, those with lower education had higher risk of obesity, and educational disparities persisted at about the same level. CONCLUSIONS: Obesity is increasing among older people. Information on continuing socioeconomic disparities in obesity is important for those targeting health promotion activities.     

Ethanol inhibits alpha-amino-3-hydyroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor function in central nervous system neurons by stabilizing desensitization

Ethanol actions on alpha-amino-3-hydyroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-type glutamate receptors were studied using voltage-clamp recordings from mouse cortical and hippocampal neurons. During whole-cell recordings ethanol (EtOH) inhibited AMPA receptor-mediated currents in a dose-dependent manner at concentrations from 10 to 500 mM. The steady-state component of AMPA-activated current was more sensitive to EtOH than the peak component. To examine the effect of EtOH on a well resolved peak current component, patches were excised from cultured cortical neurons, to which AMPA and EtOH were applied using a piezoelectric solution application system. Under this condition, the peak current was not inhibited significantly by EtOH. To further study possible mechanisms of EtOH inhibition, kainate and AMPA were used to evoke currents in the absence and presence of cyclothiazide. Ethanol inhibition was stronger when receptors were activated by low than high kainate concentrations. Cyclothiazide reduced inhibition by EtOH regardless of the agonist used to activate the receptor. Finally, EtOH inhibition was reduced in a point mutated (L497Y) GluRAi receptor that lacks desensitization. These findings suggest that EtOH inhibits AMPA receptors by stabilizing the desensitized state. Our results can explain some of the variation observed in EtOH inhibition in previous studies, and support the idea that physiologically relevant concentrations of EtOH can have a strong effect on AMPA receptor function.     

Prevalence of sleep apnea syndrome in lone atrial fibrillation: a case-control study

BACKGROUND: According to several studies, obstructive sleep apnea predisposes to cardiac arrhythmias, but the prevalence of sleep apnea in specific arrhythmias has not been determined. Our case-control study assesses prevalence of sleep apnea syndrome (SAS) in lone atrial fibrillation (AF). METHODS: Patients with AF (n = 59; 48 men and 11 women; mean age, 59 years; age range, 25 to 84 years) without evident cardiovascular diseases, and their 56 gender-matched, age-matched, and cardiovascular morbidity-matched community control subjects underwent an overnight sleep study. RESULTS: Prevalence of SAS in the AF group was 32%, which did not differ from that in control subjects (29%, p = 0.67). In men, mean neck circumference was higher in the AF group (40.9 cm vs 39.5 cm, p = 0.01) than in control subjects. In men, after adjusting for body mass index and waist circumference, neck circumference was independently related to AF, with an odds ratio (OR) of 1.8 (95% confidence interval, 1.3 to 2.5) per 1-cm increase, and an OR of 5.2 (95% confidence interval, 1.6 to 17.0) for values > 40 cm. Compared to control subjects, the AF group reported more daily/almost-daily tiredness (29% vs 4%, p < 0.001), daily/almost-daily sleepiness (27% vs 7%, p = 0.005), and nightly/almost-nightly breathing pauses during sleep (12% vs 2%, p = 0.03). CONCLUSIONS: SAS seems to be common in lone AF. Nevertheless, we could not show SAS to be more common in patients with AF than in gender-matched, age-matched, and cardiovascular morbidity-matched community control subjects. Compared to control subjects, men with AF seem to have thicker necks, and patients with lone AF report more daytime tiredness, daytime sleepiness, and breathing pauses during sleep.     

Extracellular superoxide dismutase accelerates endothelial recovery and inhibits in-stent restenosis in stented atherosclerotic Watanabe heritable hyperlipidemic rabbit aorta.

OBJECTIVES: This study examined whether local gene therapy with extracellular superoxide dismutase (EC-SOD) could inhibit in-stent restenosis in atherosclerotic Watanabe heritable hyperlipidemic rabbits. BACKGROUND: Stenting causes an acute increase in superoxide anion production and oxidative stress; EC-SOD is a major component of antioxidative defense in blood vessels and has powerful cardioprotective effects in ischemic myocardium. METHODS: Endothelial denudation and stenting were done in 36 adult (15 to 18 months old) rabbits. Catheter-mediated intramural delivery of clinical good manufacturing practice-grade adenoviruses encoding rabbit EC-SOD were done simultaneously with stenting. Control animals received adenovirus-encoding nuclear-targeted beta-galactosidase (AdLacZ). Circulating markers for oxidative stress (nonesterified 8-iso-prostaglandin F2 alpha) were measured. Analysis of 6-day, 28-day, and 90-day vessel histology, radical production, oxidation-specific epitopes, and expression studies were performed. RESULTS: The EC-SOD treatment reduced oxidant production in stented vessels compared with control vessels. Early systemic recovery of total SOD activity was observed in the treated rabbits. The EC-SOD significantly accelerated endothelial recovery (67.4% +/- 10.8% vs. 24.2.1% +/- 4.6% at 6 days, p < 0.05; 89.3% +/- 3.7% vs. 45.1% +/- 9.6% at 28 days, p < 0.05), and the beneficial effect involved increased proliferation of regenerating endothelium. The EC-SOD group showed a 61.3% lower (p < 0.05) neointimal formation at 28 days, with a similar, albeit nonsignificant trend at 90 days (1.20 +/- 0.32 mm2 vs. 1.88 +/- 0.24 mm2, p = 0.06). CONCLUSIONS: The results suggest a central pathogenetic role of oxidation sensitive signaling processes in endothelial recovery and developing in-stent restenosis in atherosclerotic vessels. Local therapy against oxidative stress represents a promising therapeutic strategy in stent-induced vascular injury.     

Increase of HLA haplotype A9-Bw16 in familial insulin-dependent diabetes mellitus in Northern Finland

Summary Twenty-one families, each with two diabetic children, from North Finland were HLA typed. The grade of HLA identity between diabetic siblings was evaluated, and frequencies of various HLA antigens in familial cases were compared to those of non-familial cases from the same area. Ten pairs of diabetic children were HLA-identical and eleven haploidentical; two of the latter were identical for the HLA-D locus. These figures emphasize the significance of HLA-region associated genetic factors in the susceptibility to the disease, but do not support a simple dominant/recessive gene theory. There was a significant difference between familial and non-familial IDDM cases in the frequencies of B15, Bw16, B40 and Cw3 antigens. Bw16 was greatly increased and B15, B40 and Cw3 decreased among familial cases. The haplotype A9, Bw16 was common in familial cases, but, compared to healthy controls, the frequencies of the two antigens were also slightly increased among non-familial cases. Neither Dw3 nor Dw4 was associated with Bw16 antigen. The differences between familial and non-familial IDDM cases and the significance of the A9, Bw16 combination in the patients emphasize the heterogeneity of IDDM.