Unique relationships between facets of mindfulness and eating pathology among female smokers

Female smokers often have higher levels of eating disorder symptoms than non-smokers, and concerns about eating and weight might interfere with smoking cessation. Thus, it is critical to identify factors to promote healthier eating and body image in this population. Initial research suggests that specific aspects of trait mindfulness predict lower body dissatisfaction and eating disorder symptoms among non-smokers. However, these relationships are unknown among smokers. The current study examined associations between facets of trait mindfulness and eating disorder symptoms in 112 college female smokers (83% Caucasian; mean age 20 years, SD = 1.69). After controlling for relevant sociodemographic variables, Describing and Nonjudging facets of mindfulness predicted lower bulimic symptoms and body dissatisfaction (ps < .05), while Acting with Awareness predicted lower bulimic and anorexic symptoms, ps < .05. Observing predicted higher anorexic symptoms, p < .05. These results suggest that specific mindfulness facets are related to lower eating disorder symptoms among smokers, whereas other facets are not associated or have a positive relationship with these symptoms. Mindfulness-based interventions focusing on Describing, Nonjudging, and Acting with Awareness may help to reduce eating pathology among female smokers, which could potentially improve smoking cessation rates in this population.     

Colpodella spp.-like parasite infection in woman, China

The phylum Apicomplexa comprises intracellular protozoa that include many human pathogens. Their nearest relatives are chromerids and colpodellids. We report a case of a Babesia spp.-like relapsing infection caused by a newly described microorganism related to the Apicomplexa. This case is highly suggestive of a previously undescribed type of colpodellid that infects vertebrates.     

Can Prenatal Care Impact Future Well-Child Visits? The Experience of a Low Income Population in New York State Medicaid Managed Care

To examine the association between maternal characteristics and care patterns and the subsequent utilization of well–child visits in a low income population in New York State (NYS). We analyzed Medicaid managed care birth data from 2004 to 2005 linked to an administrative database to obtain information on preventive well-care visits for the child. The outcome variable was whether the child had five or more well-child visits (WCVs) in their first 15 months of life. Of the 101,461 children in this study 67% had received five or more well-child visits by 15 months of age. This varied by region with a lesser proportion of children receiving well-child visits in New York City (NYC) and a higher proportion in the rest-of-state. Children born to mothers with intensive and adequate prenatal care were significantly more likely to have the necessary well-child visits. Foreign born women were more likely than US born women to bring their children in for well-child visits across all racial and ethnic groups. This study indicated that women who received adequate prenatal care were more likely to bring their children to well-child visits even after adjusting for maternal and infant characteristics. Maternal birthplace modified the association between race and well-child visits. The black-white disparity typically seen in WCVs in the United States was not found in NYC among children of US born women in Medicaid managed care.     

Managing Hypertension in the Elderly: A Common Chronic Disease with Increasing Age

Background

Hypertension increases with age, affecting approximately 66% of the elderly population (aged ≥65 years). By the year 2030, 1 of 5 Americans will be aged ≥65 years. A number of placebo-controlled clinical trials have demonstrated that blood pressure (BP) control reduces cardiovascular events in elderly patients, even in those aged >80 years. Despite advances in medical care, hypertension control rates remain low, especially in the elderly population.

Objective

The goal of this article is to review the information that addresses hypertension in the elderly and current strategies that can facilitate improvement in the management of this common, chronic, and life-threatening condition, which is often undertreated or inappropriately managed.

Discussion

The goals and strategies of treating hypertension in the elderly population are different from, and more challenging than, those in younger patients. Lifestyle modification is effective in this population, but it is difficult to maintain. Many antihypertensive medications are available, with thiazide diuretics being the preferred first-line treatment. Beta-blockers and alpha-blockers are generally not recommended in this population. A majority of older patients will require 2 or 3 antihypertensive medications to reach BP goal. This article reviews current data on hypertensive treatment in the elderly and summarizes the strategies and challenges healthcare providers face when dealing with this population.

Conclusion

Understanding the strategies and challenges that apply to the management of hypertension in the US elderly population can help providers and payers better address the growing need for improving the management of this condition in the elderly, because their numbers are expected to increase dramatically in the coming decades.Hypertension, defined as systolic blood pressure (BP) ≥140 mm Hg, diastolic BP ≥90 mm Hg, increases with age, affecting more than 50% of patients aged ≥60 years, and approximately 66% of those aged ≥65 years.1–3 It is well known that by 2030, 1 of 5 Americans is expected to be 65 years or older. Hypertension is the number one diagnosis in the ambulatory setting, and is one of the top diagnoses in the nursing home.4 Data from the Framingham Heart Study suggest that patients who are normotensive at age 55 years have a 90% lifetime risk of developing hypertension.5Between 1988–1994 and 2005–2008, the prevalence of hypertension increased among patients aged ≥65 years.6 The use of antihypertensive medications also increased during that period.6 As life expectancy continues to rise, approaching 75 years for men and 80 years for women, the use of antihypertensive medications in the elderly will intensify.6 Approximately 10% of the current US total annual drug expenditure is spent on antihypertensive medications.7 In 2009, the total direct and indirect costs attributable to hypertension in the United States were estimated to be $73.4 billion.8     

Tocotrienols Reverse Cardiovascular,Metabolic and Liver Changes in High Carbohydrate,High Fat Diet-Fed Rats

Tocotrienols have been reported to improve lipid profiles, reduce atherosclerotic lesions, decrease blood glucose and glycated haemoglobin concentrations, normalise blood pressure in vivo and inhibit adipogenesis in vitro, yet their role in the metabolic syndrome has not been investigated. In this study, we investigated the effects of palm tocotrienol-rich fraction (TRF) on high carbohydrate, high fat diet-induced metabolic, cardiovascular and liver dysfunction in rats. Rats fed a high carbohydrate, high fat diet for 16 weeks developed abdominal obesity, hypertension, impaired glucose and insulin tolerance with increased ventricular stiffness, lower systolic function and reduced liver function. TRF treatment improved ventricular function, attenuated cardiac stiffness and hypertension, and improved glucose and insulin tolerance, with reduced left ventricular collagen deposition and inflammatory cell infiltration. TRF improved liver structure and function with reduced plasma liver enzymes, inflammatory cell infiltration, fat vacuoles and balloon hepatocytes. TRF reduced plasma free fatty acid and triglyceride concentrations but only omental fat deposition was decreased in the abdomen. These results suggest that tocotrienols protect the heart and liver, and improve plasma glucose and lipid profiles with minimal changes in abdominal obesity in this model of human metabolic syndrome.     

Evidence of associations between feto-maternal vitamin D status, cord parathyroid hormone and bone-specific alkaline phosphatase, and newborn whole body bone mineral content

In spite of a high prevalence of vitamin D inadequacy in pregnant women and neonates, relationships among vitamin D status (25(OH)D), parathyroid hormone (PTH), bone specific alkaline phosphatase (BALP), and whole body bone mineral content (WBBMC) in the newborn are poorly characterized. The purpose of the present study was to investigate the relationships between maternal and cord 25(OH)D, PTH, BALP, and WBBMC in newborns in a multiethnic population in Oakland, California and to evaluate the predictive value of the biochemical indices as indicators of WBBMC. Maternal and cord blood were collected from 80 mother-infant pairs and infant WBBMC was measured by dual energy X-ray absorptiometry 8-21 days post-birth. Cord PTH and BALP were each inversely correlated with infant WBBMC (r = -0.28, p = 0.01 and r = -0.26, p = 0.02) and with cord 25(OH)D (r = -0.24, p = 0.03 and r = -0.34, p = 0.002), while cord 25(OH)D and unadjusted or weight-adjusted WBBMC were not significantly correlated with one other. In multivariate regression modeling, infant WBBMC was most strongly predicted by infant weight (p < 0.0001), while either PTH or BALP contributed modestly but significantly to the model (p = 0.006 and p = 0.03 respectively). Cord 25(OH)D was not a significant predictor of infant WBBMC. This study provides evidence of associations between feto-maternal 25(OH)D, cord PTH and BALP, and early infant WBBMC, though neither feto-maternal 25(OH)D nor the measured biochemical indices were suitable indicators of WBBMC.     

CONSERVATIVE MANAGEMENT OF SPORTS HERNIA IN A PROFESSIONAL GOLFER: A CASE REPORT

Study Design:

Case Report

Background

Activity‐limiting groin pain is relatively common in athletes who participate in sports which involve rapid or repetitive twisting, cutting, and/or kicking. Despite the reported prevalence of this condition in athletes, there is still much controversy as to the anatomical structures involved and most effective treatment approach. There is limited evidence favoring conservative management of sports hernia as opposed to surgical intervention in professional athletes, and there are no reports of sports hernia management in the professional golf population. The purpose of this case report is to describe the conservative management and decision making used with a professional golfer with symptoms consistent with a sports hernia which allowed for successful return to prior level of sport participation.

Case Presentation

The subject of this case report is a professional golfer who developed lower abdominal and groin pain after changes in conditioning routine. Clinical presentation was consistent with a diagnosis of sports hernia. Rehabilitation of this athlete included a structured core muscle retraining program which utilized a step wise progression through the neurodevelopmental sequence in order to allow for development of neuromuscular control and stability required for return to golf.

Outcome

This athlete was able to return to full golf participation after 13 physical therapy visits over 4 weeks.

Discussion

The available evidence supports surgical intervention over conservative management in the treatment of sports hernia in the athletic population. A structured and comprehensive rehabilitation program addressing core muscle weakness and contributing impairments adjacent to injury may be a beneficial treatment option prior to surgical repair potentially allowing return to sport in some athletes.

Levels of Evidence:

4