High-sensitivity versus conventional troponin in the emergency department for the diagnosis of acute myocardial infarction

Introduction  

Recently, newer assays for cardiac troponin (cTn) have been developed which are able to detect changes in concentration of the biomarker at or below the 99th percentile for a normal population. The objective of this study was to compare the diagnostic performance of a new high-sensitivity troponin T (HsTnT) assay to that of conventional cTnI for the diagnosis of acute myocardial infarction (AMI) according to pretest probability (PTP).     

Dynamic Relations Between Sedentary Behavior, Physical Activity, and Body Composition After Bariatric Surgery

Background

Physical activity has been shown to increase following obesity surgery; however, changes in sedentary behavior in this setting are not known. Our aim was to describe changes in both physical activity and sedentary behavior of obese patients after gastric bypass (GBP) and their relationships with changes in body composition.

Methods

Physical activity, time spent watching TV as typical sedentary behavior (self-report), and body composition (DXA) were assessed before and 6 and 12?months after GBP in 86 obese patients (67 women, 24?C66?years old, BMI 41.3?C53.5?kg/m²).

Results

One year after GBP (mean loss of weight ?37.1?kg, fat mass ?25.7?kg, lean body mass ?9.4?kg), leisure-time physical activity (LTPA) significantly increased from 2.0 (SD 3.7) to 3.8 (5.4) h/week and from 7.2 (12.5) to 14.1 (20.1) MET-h/week (MET: metabolic equivalent task), the number of LTPA performed increased from 1.3 (1.3) to 1.8 (1.4), and TV time decreased from 3.0 (1.6) to 2.4 (1.4) h/day (all p?Conclusions Together with increased LTPA, this study shows a decrease in sedentary behavior after GBP, which appears related to favorable changes in body composition. These observations are important to design future intervention studies, including physical activity and sedentary occupations aiming to optimize the care of patients after bariatric surgery.     

Stigma in HIV-Positive Women

PURPOSE: To present a metasynthesis of qualitative findings on stigma in HIV-positive women. METHOD: Metasummary and metasynthesis techniques were used to integrate findings on stigma in 93 reports of qualitative studies conducted between 1991 and 2002 with a total of 1,780 women, mostly from minority groups. FINDINGS: Both perceived and enacted stigma were pervasive in the lives of HIV-positive women. HIV-related stigma was intensified in women because they were women. Stigma management largely involved efforts to control information in the service of preserving social relations and maintaining moral identity. DISCUSSION: This metasynthesis reprises and clarifies the connections between recurring themes in primary quantitative studies and metastudies of HIV-positive people and of stigmatizing diseases and conditions. This work also shows how affected people's location on key axes of difference can both facilitate and complicate efforts to manage stigma. CONCLUSIONS: HIV-positive women experience stigmatization in relationships with others. HIV-related stigma is as much a reflection of these others as it is central to the experience of HIV-positive people themselves. Even those not infected with HIV are still affected by it and are thus appropriate targets for interventions to reduce its negative effects.