A two-step intervention of increase mammography among women aged 65 and older.

OBJECTIVES: This study evaluated a two-step intervention for mammography screening among older women. METHODS: Four hundred and sixty women, identified from physician practices, were randomized to a control or a two-step intervention (physician letter and peer counseling call) group. Women in the intervention group who obtained a mammogram received a grocery coupon. RESULTS: Over the 12 months of the study, more women in the intervention group than in the control group obtained mammograms (38% vs 16%). The most dramatic difference was in the higher odds that women in the intervention group would obtain a mammogram within 2 months (odds ratio = 10.5). CONCLUSIONS: The intervention significantly increased screening mammography. Future efforts must be multifaceted and incorporate the unique concerns of older women.     

Die diagnostische Verwertbarkeit einiger Methoden zur Provokation epileptischer Anfälle

Ohne Zusammenfassung     

In a model of immunoglobulin heavy-chain (IGH)/MYC translocation, the Igh 3' regulatory region induces MYC expression at the immature stage of B cell development

Reciprocal translocations involving the immunoglobulin loci and the cellular oncogene MYC are hallmark mutations of the human postgerminal center B cell neoplasm, Burkitt's lymphoma. They are occasionally found in other B cell lymphomas, as well. Translocations involving the heavy chain locus (IGH) place the MYC gene either in cis with both the intronic enhancer Emu and the IGH 3' regulatory region (3'RR) or in cis with only the 3'RR. The result is deregulated MYC expression. Recent studies have led to some controversy as to when, during B lymphocyte development, IGH/MYC chromosome translocations take place. A related issue, relevant not only to lymphoma development but also to normal controls on IGH gene expression, is the stage, during B lymphocyte development, at which the 3'RR is capable of activating MYC expression. We have developed mice transgenic for a human MYC (hMYC) gene under control of the four core enhancers from the mouse Igh 3'RR. Unlike other transgenic mouse models where premature and inappropriate MYC expression disrupts normal B cell development, the hMYC transgene in these studies carries a mutation that prohibits MYC protein synthesis. As a result, hMYC expression can be analyzed in all of the normal B cell compartments. Our data show that hMYC is expressed almost exclusively in B-lineage cells and is induced to high levels as soon as bone marrow cells reach the immature B cell stage.     

Evaluation of antihyperglycemic activity of methanolic Tecomaria capensis Thunb. (Bignoniaceae) leaves extract in alloxan induced hyperglycemic rats

ObjectiveTo evaluate the antihyperglycemic activity of Tecomaria capensis (T. capensis) Thunb. (Bignoniaceae) methanolic leaves extract (TCLE) using blood glucose level in normal fasted rats, glucose tolerance test and alloxan induced hyperglycemia models.MethodsTCLE (100, 300, 1 000 and 2 000 mg/kg body wt.) was given to rats orally to observe acute toxicity, and observed for 14 d. TCLE 200 and 400 mg/kg, and glibenclamide 0.6 mg/kg were given orally in all models.ResultsResults demonstrated that the no mortality was reported even after 14 d. This indicates that the methanol extract is safe up to a single dose of 2 000 mg/kg body weight. TCLE (200 and 400 mg/kg p.o.) exhibited remarkable blood glucose lowering effect in blood glucose level in normal fasted rats, glucose tolerance and alloxan induced hyperglycemia model. Cholesterol and triglyceride also decreased in alloxan induced hyperglycemia model.ConclusionsThe results of this study exhibites that methanol extract of T. capensis possesses antihypergycemic activity and it may prove to be effective for the treatment of hyperglycemia.     

Standardized AP radiographs do not provide reliable diagnostic measures for the assessment of acetabular retroversion

Diagnosis of acetabular retroversion is essential in femoroacetabular impingement (FAI), but its assessment from radiographs is complicated by pelvic tilt and the two‐dimensional nature of plain films. We performed a study to validate the diagnostic accuracy of the cross‐over sign (COS) and the posterior wall sign (PWS) in identifying acetabular retroversion. COS and PWS were evaluated from radiographs and computed tomography (CT) scans as the standard of reference in 50 hips of subjects with symptoms of FAI. A CT‐based method using three‐dimensional (3D) models was developed to measure the COS, PWS, true acetabular version, and pelvic tilt relative to the anterior pelvic plane. The new CT‐based method aimed to eliminate errors resulting from variations in the position and orientation of the pelvis during imaging. A low level of agreement for COS and PWS was found between radiographs and CT scans. A positive COS strongly correlated with pelvic tilt. These results suggest that COS and PWS determined from anteroposterior radiographs are considerably limited by pelvic tilt and inherent limitations of radiographs. Their use as the sole basis for deciding whether or not surgical intervention is indicated seems questionable. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:1369–1376, 2012     

Effects of Moderate-to-Vigorous Intensity Physical Activity on Overnight and Next-Day Hypoglycemia in Active Adolescents With Type 1 Diabetes

OBJECTIVE

Physical activity (PA) provides many benefits to adolescents with type 1 diabetes; however, these individuals tend to have lower fitness and PA levels than their disease-free counterparts. The purpose of this study was to examine the acute temporal associations between moderate-to-vigorous intensity PA (MVPA) and hypoglycemia (continuous glucose monitor [CGM] reading ≤70 mg/dL).

RESEARCH DESIGN AND METHODS

Nineteen participants (53% females) 14–20 years old with type 1 diabetes were recruited. Participant fitness was evaluated via indirect calorimetry using a maximal exercise test; body composition was measured using air displacement plethysmography. An accelerometer was worn continuously (3–5 days) and acceleration data used to estimate MVPA (minutes per day). Blood glucose values were simultaneously tracked using CGM. Controlling for sex, percent body fat (%BF), fitness, and concurrent MVPA, the likelihood of nighttime and next-day hypoglycemia due to MVPA was examined using logistic regression.

RESULTS

Participants were of average fitness (females: 43.9 mL/kg/min; males: 49.8 mL/kg/min) and adiposity (females: 26.2%; males: 19.2%); 63.2% met the U.S. federal guideline of accumulating 60 min/day of MVPA. Hypoglycemia was 31% more likely in those who accumulated 30 min/day more MVPA in the previous afternoon than those with less (95% CI 1.05–1.63; P = 0.017).

CONCLUSIONS

The results suggest that participating in afternoon MVPA increases the risk of overnight and next-day hypoglycemia, independent of sex, %BF, fitness, and concurrent MVPA. While promoting PA as a healthy behavior, it is important to educate adolescents with type 1 diabetes on prevention of hypoglycemia following PA.There are many benefits of physical activity (PA) in adolescents, including improved blood lipid profiles, cardiovascular fitness, bone health, and psychological well-being. PA is also inversely associated with levels of adiposity and stress (1). Not only are these health outcomes immediately beneficial, but also health outcomes and physically active behavior track into adulthood, further increasing the importance of regular PA (1). The U.S. Department of Health and Human Services'' 2008 Physical Activity Guidelines for Americans recommends a minimum of 60 min of moderate-to-vigorous intensity PA (MVPA) daily for children and adolescents (2). Despite the benefits of PA, the latest data from the 2011 Centers for Disease Control and Prevention Youth Risk Behavior Surveillance System indicate that only 28.7% of high school students are meeting the federal guideline of accumulating 60 min of MVPA daily (3). Research shows that these proportions are even lower for individuals with chronic diseases, including type 1 diabetes (4,5). Specifically, adolescents with type 1 diabetes spend 17 fewer min in MVPA per day than healthy adolescents and have 3–10 mL/kg/min lower VO₂max values (5,6).While regular PA is an important aspect of disease management for adolescents with type 1 diabetes, fear of hypoglycemia may lead to low levels of PA (7,8). This fear is valid because of the counterregulatory systems that control insulin levels not functioning properly, increasing the risk of exercise-induced hypoglycemia. Episodes of hypoglycemia have been associated in children and adolescents participating in prolonged moderate PA >60 min (9). Other factors that affect the glycemic response to exercise of an individual with type 1 diabetes include exercise duration, intensity, familiarity with type of activity, metabolic control, blood glucose levels, type and timing of insulin injections and food intake, insulin absorption, muscle mass required for activity, conditioning, degree of stress, and timing of activity (10). Robertson et al. (10) note that given consistent timing of exercise, amount of insulin, and pre-exercise meal, the response to 60 min of PA can be reproducible, indicating that it is safe for adolescents with type 1 diabetes to be physically active.The relationship between PA and glycemic control is complex. Some studies have shown no benefit of PA on glycemic control, as measured by HbA_1c (11)_. Others have shown that PA can reduce insulin requirements by 6–15% (11). This relationship, however, may be moderated by certain factors. Lukács et al. (5) have shown fitness to be inversely associated with HbA_1c, while other studies have failed to show an association (12,13). Research on the relationship between adiposity and HbA_1c has shown mixed results. In one study, BMI and adiposity were positively associated with HbA_1c (14); however, other studies have failed to show a significant association (5,9). Sex may or may not be an important modifier in the relationship between PA and glycemic control. Some research shows a lack of association between sex and HbA_1c (9), while others cite males as having more favorable HbA_1c values, independent of PA, than females (14).Studies have looked at the complex relationship between PA and glycemic control in young patients with type 1 diabetes, but most have used self-report methods, such as questionnaires, to assess daily PA participation (9,14–16). While questionnaires are a cost- and time-effective tool for assessing habitual PA, accelerometers are a more accurate measure of acute PA, as well as total PA level and energy expenditure. Additionally, accelerometers allow viewing of daily activity patterns (17).The aim of this study was to analyze the relationship between MVPA and hypoglycemia through the assessment of their acute, temporal associations. We asked: 1) what are the acute, temporal associations between MVPA and hypoglycemia in adolescents with type 1 diabetes and 2) are these associations moderated by sex, fitness, or adiposity?