Dietary Protein Intake and Overall Diet Quality are Associated with Handgrip Strength in African American and White Adults

Objective

To determine the association of handgrip strength (HS) with protein intake, diet quality, and nutritional and cardiovascular biomarkers in African American and White adults.

Design

Cross-sectional wave 3 (2009–2013) of the cohort Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study.

Participants

Socioeconomically diverse urban population of 2,468 persons aged 33 to 71 years.

Measurements

Socio-demographic correlates, dietary intakes and biomarkers, HS, physical performance measures were collected. HS was measured using a dynamometer with the dominant hand. Functional measures included chair, tandem, and single leg stands. Two 24-hour recalls were collected using the US Department of Agriculture Automated Multiple Pass Method. The total protein intake and diet quality, evaluated by adherence to the DASH eating plan and Healthy Eating Index-2010, were calculated. Biomarkers included nutritional anemia, and serum levels of albumin, cholesterol, magnesium, and glucose.

Results

The mean ±SE age of the sample was 52.3±0.2 years. Approximately 61% were African American and 57% were women. The mean ±SE HS of women was 29.1±0.2kg and for men was 45.9±0.4 kg. Protein, gm, per kg body weight for the women was 0.94±0.02 compared to 1.16 ±0.02 for men. After adjusting for socio-demographic factors, hypertension, and diabetes, HS/BMI ratio was significantly associated with protein intake per kg body weight (p<0.001) and diet quality, assessed by either the DASH adherence (p=0.009) or Health Eating Index-2010 (p=0.031) scores. For both men and women, participants in the upper tertile of HS maintained a single leg and tandem stances longer and completed 5 and 10 chair stands in shorter time compared to individuals in the lower HS tertile. Of the nutritional status indicators, the percent of men in the upper HS tertile with low serum magnesium and albumin, was significantly lower than those in the lower HS tertile [magnesium,7.4% vs 16.1%; albumin, 0.4% vs 4.5%]. The only difference observed for women was a lower percent of diabetes (14.4% for the upper HS tertile compared to 20.5% for the lower HS tertile.

Conclusions

The findings confirm the role of protein and a healthful diet in the maintenance of muscle strength. In this community sample, HS was significantly associated with other physical performance measures but did not appear to be strongly associated with indicators of nutritional risk. These findings support the use of HS as a proxy for functional status and indicate the need for research to explore its role as a predictor of nutritional risk.

     

Anomalous origin of the right coronary artery mimicking aortic dissection at transesophageal echocardiography

Transesophageal echocardiography (TEE) is the most common imaging modality for the detection of acute aortic syndromes. However anomalous anatomic structures may be occasionally misunderstood as pathologic due of lack of familiarity with anatomical variations; false-positive diagnosis can result, potentially leading to unnecessary surgical intervention. It is crucial for echocardiographers to be aware of possible pitfalls which may create false positive findings, since the complementary use of other imaging modalities, such as multislice spiral computed tomography (MSCT), could improve the diagnostic accuracy of TEE. We report a case in which an image resembling an acute aortic dissection (AAD) on transthoracic (TTE) and transesophageal echocardiography was found in a patient with acute chest pain; MSCT detected an anomalous origin of the right coronary artery as cause of false aortic dissection image at echocardiography.     

Amine oxidases and monooxygenases in the in vivo metabolism of xenobiotic amines in humans: has the involvement of amine oxidases been neglected?

In this review, the major enzyme systems involved in vivo in the oxidative metabolism of xenobiotic amines in humans are discussed, i.e. the monooxygenases [cytochrome P450 system (CYPs) and flavin-containing monooxygenases (FMOs)] and the amine oxidases (AOs). Concerning the metabolism of xenobiotic amines (drugs in particular) by monoamine oxidases (MAOs), this aspect has been largely neglected in the past. An exception is the extensive investigation carried out on the inhibition of the metabolism of tyramine, when tyramine-containing food is ingested by subjects taking inhibitors of MAO A or of both MAO A and B. Moreover, investigations in humans on the metabolism of drug amines on the market by AOs, such as semicarbazide-sensitive amine oxidases (SSAOs) and polyamine oxidases (PAOs), are practically nonexistent, with the exception of amlodipine. In contrast to MAOs, monooxygenases (CYP isoenzymes more than FMOs) have been extensively investigated concerning their involvement in the metabolism of xenobiotics. It is possible that the contribution of AOs to the overall metabolism of xenobiotic amines in humans is underestimated or erroneously estimated, as most investigations of drug metabolism are performed using in vitro test systems optimized for CYP activity, such as liver microsomes, and most investigations of drug metabolism in vivo in humans carry out only the identification of the final, stable metabolites. However, for some drugs on the market, the involvement of MAOs in their in vivo metabolism in humans has been demonstrated recently, among these drugs citalopram, sertraline and the triptans are examples that can be mentioned.     

In Vitro and In Vivo Human Herpesvirus 8 Infection of Placenta

Herpesvirus infection of placenta may be harmful in pregnancy leading to disorders in fetal growth, premature delivery, miscarriage, or major congenital abnormalities. Although a correlation between human herpesvirus 8 (HHV-8) infection and abortion or low birth weight in children has been suggested, and rare cases of in utero or perinatal HHV-8 transmission have been documented, no direct evidence of HHV-8 infection of placenta has yet been reported. The aim of this study was to evaluate the in vitro and in vivo susceptibility of placental cells to HHV-8 infection. Short-term infection assays were performed on placental chorionic villi isolated from term placentae. Qualitative and quantitative HHV-8 detection were performed by PCR and real-time PCR, and HHV-8 proteins were analyzed by immunohistochemistry. Term placenta samples from HHV-8-seropositive women were analyzed for the presence of HHV-8 DNA and antigens. In vitro infected histocultures showed increasing amounts of HHV-8 DNA in tissues and supernatants; cyto- and syncitiotrophoblasts, as well as endothelial cells, expressed latent and lytic viral antigens. Increased apoptotic phenomena were visualized by the terminal deoxynucleotidyl transferase-mediated deoxyuridine nick end-labeling method in infected histocultures. Ex vivo, HHV-8 DNA and a latent viral antigen were detected in placenta samples from HHV-8-seropositive women. These findings demonstrate that HHV-8, like other human herpesviruses, may infect placental cells in vitro and in vivo, thus providing evidence that this phenomenon might influence vertical transmission and pregnancy outcome in HHV-8-infected women.     

Botulinum toxin type A in the healing of chronic lesion following bilateral spasticity of gluteus muscle

Use of botulinum toxin is expanding as the clinical studies demonstrate new potential therapeutic applications. In rehabilitation, botulinum toxin is above all used as adjunct therapy for the treatment of spasticity, but it may prove useful for other atypical clinical situations. A 17‐year‐old man had a sub‐arachnoid haemorrhage following the rupture of cerebral aneurism. The patient presented gluteus maximus and medius bilaterally spasticity that produced a chronic lesion in the intergluteal cleft, a flexed wrist and a flexed elbow. As treatment for this spasticity, a total of 100 U botulinum toxin type A were injected into the glutei muscles. This treatment allowed for application of topical medication and subsequently, chronic lesion healing. Botulinum toxin A may be an important therapeutic aid for clinicians faced with treating persistent pathological conditions caused by spasticity.     

The Effect of Floods on Sediment Contamination in a Microtidal Coastal Lagoon: The Lagoon of Lesina,Italy

The effects on the microtidal lagoon of Lesina of runoff and the discharge of water and material from agricultural activities were investigated combining chemical analyses of pollutants [11 metals and 16 priority polycyclic aromatic compounds (PAHs)], determination of organic matter and grain size, and performance of innovative ecotoxicological tests. For metals, enrichment factors >3 for arsenic, nickel, and copper (Cu) were observed in the eastern zone of the lagoon, which is affected by nearby urban activities with discharge of water and domestic waste and by agricultural input with waters rich in fertilizers. Cu was correlated with no other metal, and its high concentrations (≤77 µg g^?1) may result from the use of Cu-based fungicides in vineyards. Total PAHs (2,230 ± 3,150 ng g^?1) displayed a wide range of concentrations with hot spots near freshwater inputs from the part of the catchment area exploited for wheat crops. Pyrolitic contamination also emerged, with higher-mass PAH congeners, such as asphalt, bitumen or coal, usually present in higher fractions as the dominant components. Ecotoxicological evaluations recorded moderate to high toxicity levels; the innovative MOT test bioassay showed good discriminatory ability because it identified a lagoon area whose inputs mainly depend on agricultural activities and which is impacted by metals rather than PAHs. Floods during periods of heavy rain and the discharge of water and material from agricultural activities may impact vulnerable systems, such as the lagoon of Lesina, where the presence of hot spots with remarkably high pollution values was observed.     

Dissecting histone deacetylase role in pulmonary arterial smooth muscle cell proliferation and migration

Pulmonary Arterial Hypertension (PAH) is a rare and devasting condition characterized by elevated pulmonary vascular resistance and pulmonary artery pressure leading to right-heart failure and premature death.     

Is the detection rate of 18F-choline PET/CT influenced by androgen-deprivation therapy?

Purpose

To evaluate if the detection rate (DR) of ¹⁸F-choline (18F-CH) PET/CT is influenced by androgen-deprivation therapy (ADT) in patients with prostate cancer (PC) already treated with radical intent and presenting biochemical relapse.

Materials and methods

We have retrospectively evaluated ¹⁸F-CH PET/CT scans of 325 consecutive PC patients enrolled in the period November 2009 to December 2012 previously treated with radical intent and referred to our centre to perform ¹⁸F-CH PET/CT for biochemical relapse. Two different groups of patients were evaluated. group A included the whole sample of 325 patients (mean age 70 years, range: 49–86) who presented trigger PSA between 0.1 and 80 ng/ml (mean 5.5 ng/ml), and group B included 187 patients (mean age 70 years, range 49–86) with medium-low levels of trigger PSA ranging between 0.5 and 5 ng/ml (mean PSA 2.1 ng/ml); group B was chosen in order to obtain a more homogeneous group of patients in terms of PSA values also excluding both very low and very high PSA levels avoiding the “a priori” higher probability of negative or positive PET scan, respectively. At the time of examination, 139 patients from group A and 72 patients from group B were under ADT: these patients were considered to be hormone-resistant PC patients because from their oncologic history (>18 months) an increase of PSA levels emerged despite the ongoing ADT. The relationship between ¹⁸F-CH PET/CT findings and possible clinical predictors was investigated using both univariate and multivariate binary logistic regression analyses, including trigger PSA and ADT.

Results

Considering the whole population, overall DR of ¹⁸F-CH PET was 58.2 % (189/325 patients). In the whole sample of patients (group A), both at the univariate and multivariate logistic regression analysis, trigger PSA and ADT were significantly correlated with the DR of ¹⁸F-CH PET (p?<?0.05). Moreover, the DR in patients under ADT (mean PSA 7.8 ng/ml) was higher than in patients not under ADT (mean PSA 3.9 ng/ml), (DR was 70.5 % and 48.9 %, respectively; p?<?0.001), therefore, demonstrating the existence of a significant correlation between the DR of ¹⁸F-CH PET and ADT. In group B patients only trigger PSA resulted a reliable predictor of the ¹⁸F-CH positivity, since ADT was not correlated to the DR of ¹⁸F-CH PET (p?=?0.061). Also in group B the DR of ¹⁸F-CH PET in patients under ADT was higher than in patients not under ADT (65.3 % and 51.3 %, respectively) but the difference was not significant without a statistically significant correlation in the Mann Whitney test (p?=?0.456) therefore, suggesting the lack of correlation between DR ¹⁸F-CH PET/CT and ADT.

Conclusion

Similarly to previous published studies, in our series the overall DR of ¹⁸F-CH PET/CT was 58 % and was significantly correlated to trigger PSA. The most important finding of the present study is that ADT does not negatively influence DR of ¹⁸F-CH PET/CT in PC patients with biochemical relapse; therefore, it can be suggested that it is not necessary to withdraw ADT before performing ¹⁸F-CH PET/CT.     

Calcium Burden Assessment and Impact on Drug-Eluting Balloons in Peripheral Arterial Disease

Purpose

This study was designed to assess the effect of calcium on the efficacy of DEB during revascularization of steno-obstructive SFA lesions.

Methods

Sixty patients with de novo lesions of the superficial femoral artery underwent endovascular treatment with drug eluting balloons (DEB). DEB was selected according to vessel reference diameter (1:1). In case of residual stenosis > 50 % or flow-limiting dissection, postdilatation with conventional balloon or provisional stenting was done. Patients were classified into eight groups according to circumferential distribution of calcium on CT-angiography axial images (from 0° to 360°) and to its length (length < or > 3 cm) evaluated with digital-subtraction-angiography. Ankle-brachial index (ABI), late lumen loss (LLL), target lesion revascularization (TLR), primary (PP) and secondary (SP) patency, major adverse events (MAE), and Rutherford shift were evaluated at 1-year follow-up and correlated with the amount of calcium.

Results

Revascularization was successful in all cases. Flow-limiting dissection occurred in five cases (8.3 %) with a higher circumferential degree of calcium and solved in three cases with postdilatation and in the other two with provisional stenting. DEB effect was lower in patients with higher degree of calcium (>270° vs. <90°): ABI 0.71 ± 0.07 versus 0.92 ± 0.07; LLL 0.75 ± 0.21 versus 0.45 ± 0.1; PP 50 versus 100 %; SP 50 versus 100 %; TLR 25 versus 0 %; MAE 25 versus 0 %.

Conclusions

Calcium represents a barrier to optimal drug absorption. Circumferential distribution seems to be the most influencing factor with the worst effect noticed in 360° calcium presence.