Serum adiponectin and renal dysfunction in men with type 2 diabetes

OBJECTIVE: Inflammation is associated with both chronic kidney dysfunction and type 2 diabetes. Adiponectin, a novel circulating anti-inflammatory protein made by adipocytes, has been reported to be lower in diabetic than nondiabetic subjects. In contrast, serum levels of adiponectin are elevated in end-stage renal disease. We sought to investigate the relation between adiponectin and mild to moderate renal dysfunction in men with type 2 diabetes. RESEARCH DESIGN AND METHODS: Multivariate logistic regression was used to evaluate the relation between serum adiponectin concentrations and the presence of renal dysfunction (estimated glomerular filtration rate [eGFR] <60 ml/min per 1.73 m(2) by the four-variable Modification of Diet in Renal Disease equation) in participants with type 2 diabetes in the Health Professionals' Follow-Up Study. A total of 733 men were included in this cross-sectional analysis. RESULTS: Adiponectin was positively correlated with age (Spearman coefficient, r = 0.19, P < 0.001) and negatively correlated with weight (Spearman coefficient, r = -0.18, P < 0.001). Those with adiponectin in the second quartile or higher (>10 microg/ml) compared with those in the first quartile had a reduced odds for renal dysfunction (multivariate odds ratio 0.48 [95% CI 0.28-0.81]). These results were unchanged when serum lipids were included in the multivariate model. CONCLUSIONS: We conclude that a higher serum adiponectin concentration is associated with reduced odds of moderate renal dysfunction in men with type 2 diabetes.     

Fatty acid intake and the risk of community-acquired pneumonia in U.S. women

OBJECTIVE: Despite substantial progress in the treatment of community-acquired pneumonia, there are limited data on dietary risk factors. Fatty acid intake may influence community-acquired pneumonia risk by modulating the immune system. Our study prospectively examined the association between fatty acid intake and community-acquired pneumonia risk. METHODS: The study population included 83165 women from the Nurses' Health Study II cohort who were 27 to 44 y old in 1991. The women reported lifestyle habits on biennial questionnaires and dietary intake every 4 y by validated semiquantitative food frequency questionnaires. There were 925 pneumonia cases over 10 y of follow-up. We examined independent associations for six fatty acids using Cox's proportional hazards regression. RESULTS: Women in the highest quintile of palmitic acid intake had a 54% greater risk of pneumonia compared with those in the lowest quintile (multivariate relative risk 1.54, 95% confidence interval 1.12-2.12, P for trend = 0.002). Oleic acid intake was inversely associated with pneumonia risk (highest quintile multivariate relative risk 0.75, 95% confidence interval 0.55-1.04, P for trend = 0.02). Women in the highest quintile of docosahexanoic acid and eicosapentaenoic acid intake had a 24% greater risk of community-acquired pneumonia than did those in the lowest quintile (multivariate relative risk 1.24, 95% confidence interval 1.00-1.55, P for trend = 0.08). No significant associations were found for linoleic acid, alpha-linolenic acid, or docosahexanoic acid alone. CONCLUSION: Fatty acid intake may affect the risk of community-acquired pneumonia in young and middle-aged women. Higher dietary intake of palmitic acid and possibly docosahexanoic and eicosapentaenoic acids may increase the risk of community-acquired pneumonia in women, whereas higher oleic acid intake may decrease the risk.     

血管内皮生长因子与基质金属蛋白酶2在血管瘤不同生长过程中的表达特征

目的:观察血管内皮生长因子与基质金属蛋白酶2在血管瘤不同分期中的表达。方法:取自承德医学院附属医院1998-01/2005-12期间血管瘤手术切除的标本共60例及正常带血管皮肤手术切除标本10例,患者家属知情同意。①实验分组:根据Mulliken标准进行病理诊断并分类,所有标本共分4组。增生组22例;退化组20例;退化完成组18例。另取10例正常带血管皮肤组织作为对照组。②采用免疫组织化学S-P法对各组标本的血管内皮生长因子、基质金属蛋白酶2进行染色。③实验评估:以正常血管上皮细胞或肿瘤细胞胞浆出现棕黄色颗粒为阳性,检测各组血管内皮生长因子与基质金属蛋白酶2的表达。结果:①随着血管瘤病理时期的变化,血管内皮生长因子与基质金属蛋白酶2出现明显不同的表达。②增生组血管内皮生长因子与基质金属蛋白酶2的阳性表达率明显高于其他各组,且随着血管瘤的退化,两者的阳性表达率逐渐下降,至退化完成期时与对照组几乎无差别。③血管内皮生长因子与基质金属蛋白酶2的表达呈正相关。结论:血管内皮生长因子与基质金属蛋白酶2在血管瘤的不同分期中起重要作用,其表达水平与血管瘤的病理分期有密切关系。     

A Prospective Study of Caffeine Intake and Risk of Incident Tinnitus

Background

Caffeine is a commonly consumed substance that has been thought to play a role in the development of tinnitus, but prospective data are lacking. We prospectively evaluated the association between caffeine intake and self-reported tinnitus in a female cohort.

Methods

Participants were 65,085 women in the Nurses' Health Study II, aged 30 to 44 years and without tinnitus at baseline in 1991, who completed questionnaires about lifestyle and medical history every 2 years and food frequency questionnaires every 4 years. Information on self-reported tinnitus and date of onset was obtained from the 2009 questionnaire, with cases defined as those reporting experiencing symptoms “a few days/week” or “daily.” Multivariable adjusted hazard ratios were calculated using Cox proportional hazards regression models.

Results

At baseline, the mean age of the cohort was 36.3 years and the mean caffeine intake was 242.3 mg/d. After 18 years of follow-up, 5289 incident cases of tinnitus were reported. There was a significant inverse association between caffeine intake and the incidence of tinnitus. Compared with women with caffeine intake less than 150 mg/d (150 mg corresponds to ∼ one 8-ounce cup of coffee), the multivariable adjusted hazard ratios were 0.85 (95% confidence interval, 0.76-0.95) for those who consumed 450 to 599 mg/d and 0.79 (0.68-0.91) for those who consumed 600 mg/d or more.

Conclusions

In this prospective study, higher caffeine intake was associated with a lower risk of incident tinnitus in women.     

Effect of interval training programme on pulse pressure in the management of hypertension: a randomized controlled trial

Background

Pulse pressure (PP), might be a stronger determinants of cardiovascular risk.

Objective

To investigate the effect of interval training program on PP in subjects with hypertension.

Methods

Two hundred and forty five male patients with mild to moderate (Systolic Blood Pressure [SBP] between 140–179 & Diastolic Blood Pressure [DBP] between 90–109 mmHg) essential hypertension were age-matched and grouped into exercise and control groups. The exercise (work: rest ratio of 1:1) groups involved in an 8-weeks interval training programs of between 45–60 minutes, at intensities of 60–79% of HR max (maximum heart rate), while the control group remained sedentary during this period. SBP, DBP, VO₂max and PP were assessed.

Results

Findings of the study revealed significant correlation between PP and blood pressure; correlation of PP with SBP was much stronger (95% variance). Also, there was significant effect of the exercise training program on SBP, DBP and PP. Changes in VO₂max also negatively correlated with changes in PP (r= −.285) at p<0.05.

Conclusion

Moderate intensity interval training programs is effective in the non-pharmacological management of hypertension and may prevent cardiovascular event through the down regulation of PP in hypertension.     

Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement

BACKGROUND: It is well known that serum creatinine may be used as a marker of renal function only if taking into account factors that influence creatinine production, such as age, gender, and weight. Serum cystatin C has been proposed as a potentially superior marker than serum creatinine, because serum cystatin C level is believed to be produced at a constant rate and not to be affected by such factors. However, there are limited data on factors that may influence serum cystatin C levels, and there are limited data comparing cystatin C-based estimates of renal function with creatinine-based estimates that adjust for such factors, especially in individuals with normal, or mildly reduced, renal function. METHODS: This was a cross-sectional study of 8058 inhabitants of the city of Groningen, The Netherlands, 28 to 75 years of age. Serum cystatin C and serum creatinine levels were measured, and creatinine clearance was determined from the average of two separate 24-hour urine collections. We performed multivariate analyses to identify factors independently associated with serum cystatin C levels after adjusting for creatinine clearance. Then, partial Spearman correlations were obtained after adjusting for factors that may influence serum cystatin C and creatinine levels. We also compared the goodness-of-fit (R(2)) of different multivariate linear regression models including serum cystatin C level and serum creatinine level for the outcome of creatinine clearance. RESULTS: Older age, male gender, greater weight, greater height, current cigarette smoking, and higher serum C-reactive protein (CRP) levels were independently associated with higher serum cystatin C levels after adjusting for creatinine clearance. After adjusting for age, weight, and gender, the partial Spearman correlations between creatinine and, respectively, serum cystatin C level and serum creatinine level were -0.29 (P < 0.001) and -0.42 (P < 0.001), respectively. The R(2) values for serum cystatin C level and serum creatinine level adjusted for age, weight, and gender were 0.38 and 0.42, respectively. The addition of cigarette smoking and serum CRP levels did not improve the R(2) value for the multivariate serum cystatin C-based model. CONCLUSION: Serum cystatin C appears to be influenced by factors other than renal function alone. In addition, we found no evidence that multivariate serum cystatin C-based estimates of renal function are superior to multivariate serum creatinine-based estimates.     

Addressing the mental health nurse shortage: Undergraduate nursing students working as assistants in nursing in inpatient mental health settings

The population of mental health nurses is ageing and in the next few years we can expect many to retire. This paper makes an argument for the employment of undergraduate nursing students as Assistants in Nursing (AINs) in mental health settings as a strategy to encourage them to consider a career in mental health nursing. Skill mix in nursing has been debated since at least the 1980s. It appears that the use of AINs in general nursing is established and will continue. The research suggests that with the right skill mix, nursing outcomes and safety are not compromised. It seems inevitable that assistants in nursing will increasingly be part of the mental health nursing workforce; it is timely for mental health nurses to lead these changes so nursing care and the future mental health nursing workforce stay in control of nursing.