The relationship between anthropometry and body composition from computed tomography: The Mediators of Atherosclerosis in South Asians Living in America Study

Objective: Few studies examine the relationships between anthropometry and the body composition measures they approximate, or whether they differ by sex, and no studies have examined these relationships in South Asians living in the US.

Design: We conducted a cross-sectional study of 871 participants in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study who had BMI?2 and underwent abdominal CT scans for measurement of visceral and subcutaneous fat. Linear regression was used to model the associations between anthropometric measures and naturally log-transformed body composition measures.

Results: All measures of anthropometry, except height, were significantly associated with visceral fat and had a significant non-linear component (p?p?=?.007 for interaction) and waist-to-hip ratio (women 25.9, men 717.4, p?2): 10.3, 14.0; waist circumference (cm): 1.51, 3.36; hip circumference (cm): 2.53, 4.50) with p?Conclusions: In MASALA participants, the relationships of anthropometric measures with visceral and subcutaneous fat appear similar to other race/ethnic groups, but with weaker non-linearity and heterogeneity by sex. Given these results, researchers should consider separate models by sex for US South Asians when approximating subcutaneous fat or when using waist circumference to approximate visceral fat.     

Acculturation Strategies Among South Asian Immigrants: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study

In the past, epidemiologic research on acculturation and health has been criticized for its conceptual ambiguity and simplistic measurement approaches. This study applied a widely-used theoretical framework from cross-cultural psychology to identify acculturation strategies among South Asian immigrants in the US and to examine sociodemographic correlates of acculturation strategies. Data were from the Mediators of Atherosclerosis in South Asians Living in America study. We used latent class analysis to identify groups of individuals that were similar based on cultural attitudes and behaviors. We used latent class regression analysis to examine sociodemographic correlates of acculturation strategies. We found that South Asian immigrants employed three acculturation strategies, including separation (characterized by a relatively high degree of preference for South Asian culture over US culture), assimilation (characterized by a relatively high degree of preference for US culture over South Asian culture), and integration (characterized by a similar level of preference for South Asian and US cultures). Respondents with no religious affiliation, those with higher levels of income, those who lived a greater percentage of their lives in the US, and those who spoke English well or very well were less likely to use the separation strategy than the assimilation or integration strategies. Using epidemiologic cohort data, this study illustrated a conceptual and methodological approach that addresses limitations of previous research on acculturation and health. More work is needed to understand how the acculturation strategies identified in this study affect the health of South Asian immigrants in the US.     

Fetuin-A and incident diabetes mellitus in older persons

Joachim H. Ix, MD, MAS; Christina L. Wassel, MS; Alka M. Kanaya, MD; Eric Vittinghoff, PhD; Karen C. Johnson, MD, MPH; Annemarie Koster, PhD; Jane A. Cauley, DrPh; Tamara B. Harris, MD; Steven R. Cummings, MD; Michael G. Shlipak, MD, MPH; for the Health ABC Study

JAMA. 2008;300(2):182-188.

Context  Fetuin-A is a hepatic secretory protein that binds the insulin receptor and inhibits insulin action in vitro. In prior cross-sectional studies in humans, higher fetuin-A levels were associated with insulin resistance. However, the longitudinal association of fetuin-A with incident type 2 diabetes mellitus is unknown.

Objective  To determine whether fetuin-A levels are associated with incident diabetes in older persons.

Design, Setting, and Participants  Observational study among 3075 well-functioning persons aged 70 to 79 years. In this case-cohort study, we retrospectively measured fetuin-A levels in baseline serum among 406 randomly selected participants without prevalent diabetes, and all participants who developed incident diabetes mellitus during a 6-year follow-up (to August 31, 2005).

Main Outcome Measure  Incident diabetes mellitus.

Results  Incident diabetes developed in 135 participants (10.1 cases/1000 person-years). Participants with fetuin-A levels within the highest tertile (> 0.97 g/L) had an increased risk of incident diabetes (13.3 cases/1000 person-years) compared with participants in the lowest tertile ( 0.76 g/L) (6.5 cases/1000 person-years) in models adjusted for age, sex, race, waist circumference, body weight, physical activity, blood pressure level, fasting glucose level, high-density lipoprotein cholesterol concentration, triglyceride concentration, and C-reactive protein level (adjusted hazard ratio, 2.41; 95% confidence interval, 1.28-4.53; P = .007). The association was not affected by adipocytokine levels but was moderately attenuated by adjustment for visceral adiposity (adjusted hazard ratio of highest vs lowest tertile 1.72; 95% confidence interval, 0.98-3.05; P = .06).

Conclusion  Among well-functioning older persons, serum fetuin-A is associated with incident diabetes, independent of other markers of insulin resistance.

     

Clinical and mutation profile of multicentric osteolysis nodulosis and arthropathy

​Multicentric osteolysis nodulosis and arthropathy (MONA) is an infrequently described autosomal recessive skeletal dysplasia characterized by progressive osteolysis and arthropathy. Inactivating mutations in MMP2, encoding matrix metalloproteinase‐2, are known to cause this disorder. Fifteen families with mutations in MMP2 have been reported in literature. In this study we screened thirteen individuals from eleven families for MMP2 mutations and identified eight mutations (five novel and three known variants). We characterize the clinical, radiographic and molecular findings in all individuals with molecularly proven MONA from the present cohort and previous reports, and provide a comprehensive review of the MMP2 related disorders. © 2015 Wiley Periodicals, Inc.

     

Infusion Related Hypersensitivity Reactions with Bio-similar Anti CD-20 Monoclonal Antibody Rituximab in Indian Patients: A Retrospective Study

There is paucity of data on infusion related hypersensitivity reactions (IRHR) pattern of bio-similar rituximab in B-cell lymphoma patients. As bio-similar molecules are independently developed monoclonal antibodies, they are likely to differ in immunogenicity and therefore, the hypersensitivity data of the innovator rituximab may not be directly applicable to patients treated with the biosimilar rituximab molecule. We analysed our data of 256 patients of B cell lymphoid neoplasm who received bio-similar rituximab (Reditux) based chemo-immunotherapy for their treatment. Total 56/256 (21.8%) patients had ≥ grade II IRHR with first dose of rituximab. Grade II reactions were seen in 32/256 (12.5%) cases, grade III and grade IV reactions were seen in 21/256 (8.2%) and 3/256 (1.2%) cases, respectively. Rituximab was withdrawn from all further therapy in only 2 patients due to grade IV IRHR after attempting re-challenge of the drug under intensive monitoring. There was no difference in complete response rates in patients with or without IRHR during their first rituximab infusion. The IRHRs with bio-similar rituximab noted in our study were comparable with the previously published reactions associated with the original rituximab.     

Cosmeceutical potential of geranium and calendula essential oil: Determination of antioxidant activity and in vitro sun protection factor

The present investigation was aimed to find out the sun protection factor (SPF) and antioxidant potential of geranium essential oil (GEO) and calendula essential oil (CEO) because having a combination of these two properties moves up the oils as an active ingredient of various cosmeceutical formulations for their preventive and protective properties. Essential oils were obtained by hydrodistillation of Pelargonium graveolens leaves (GEO) and Calendula officinalis flowers (CEO). The composition and identification of chemical constituents of oils were determined by GCMS analysis. Free radical scavenging activity was measured by nitric oxide scavenging activity and 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH) radical scavenging activity. It was observed that both GEO and CEO have the potential to reduce or prevent oxidative stress and can be used in skin care regimen to slow down skin aging via its antioxidant properties. In vitro SPF was determined by a very simple and rapid spectroscopic method. SPF value of GEO and CEO was found to 6.45 and 8.36, respectively. The SPF of CEO was higher than GEO, and the results of SPF show that these essential oils can be employed in sunscreen formulations to protect the skin from sunburn. From the results, it can be concluded that the combined antioxidant and SPF property of GEO and CEO can provide synergistic photoprotective effect or lift up the additional value of the cosmeceutical formulation.     

Sequential testing with different tissue transglutaminase antibodies,a new approach for diagnosis of celiac disease

Background

The diagnosis of celiac disease (CeD) in clinical practice relies on serological testing for IgA antibodies to human tissue transglutaminase (anti-tTG) which diagnose CeD autoimmunity. We compared three kits for their performance in diagnosis of the disease and evaluated the point prevalence of CeD autoimmunity in a South Indian urban population.

Methods

In the first part of the study, sera from 90 patients with documented CeD and 92 healthy controls were tested for anti-tTG using three different kits. One thousand nine hundred and seventeen healthy adults residing in urban areas of Vellore and Kancheepuram districts were tested for CeD autoimmunity using a sequential two-test strategy.

Results

The sensitivity, specificity, false positivity, false negativity, positive predictive value, and negative predictive value for the three assays respectively were as follows: 95.5%, 82.6%, 17.3%, 4.4%, 84.3%, and 95% for the Aeskulisa New Generation Assay; 85.5%, 100%, 0%, 14.4%, 100%, and 87.6% for Quanta Lite; and 71.1%, 100%, 0%, 28.8%, 100%, and 71% for Celiac Microlisa. The ROC curves showed good discrimination for all three ELISAs with an AUC of 0.947, 0.950, and 0.886 for the Aeskulisa, Quanta Lite, and Celiac Microlisa, respectively. Of 1917 (males 908, females 1009) healthy adults, 113 (5.89%) were seropositive for IgA anti-htTG in the Aeskulisa test. Two of the latter tested positive in the Quanta Lite assay and/or the Celiac Microlisa assay. The CeD autoimmunity prevalence in this urban population was 1.0 per thousand (95% confidence interval 0.3 to 3.7 per thousand).

Conclusion

Sequential testing for anti-tTG using first a highly sensitive assay followed by a very specific assay is a new strategy for screening for CeD in clinical practice.

     

Skin Prick Test in Patients with Chronic Allergic Skin Disorders

Background:

Chronic allergic skin disorders are the inflammatory and proliferative conditions in which both genetic and environmental factors play important roles. Chronic idiopathic urticaria (CIU) and atopic dermatitis (AD) are among the most common chronic allergic skin disorders. These can be provoked by various food and aeroallergens. Skin prick tests (SPTs) represent the cheapest and most effective method to diagnose type I hypersensitivity. Positive skin tests with a history suggestive of clinical sensitivity strongly incriminate the allergen as a contributor to the disease process.

Aims and Objectives:

To determine the incidence of positive SPT in patients with chronic allergic skin disorders and to identify the various allergens implicated in positive SPT.

Methods:

Fifty patients of chronic allergic disorders were recruited in this study. They were evaluated by SPT with both food and aeroallergens.

Results:

In our study, SPT positivity in patients of CIU was 63.41% and in AD was 77.78%. Out of the 41 patients of CIU, the most common allergen groups showing SPT positivity were dust and pollen, each comprising 26.83% patients. SPT reaction was positive with food items (21.6%), insects (17.07%), fungus (12.20%), and Dermatophagoides farinae, that is, house dust mite (HDM) (7.32%). The allergen which showed maximum positivity was grain dust wheat (19.51%). Among nine patients of AD, maximum SPT positivity was seen with Dermatophagoides farinae, pollen Amaranthus spinosus, grain dust wheat, and cotton mill dust; each comprising 22.22% of patients.

Conclusion:

Our study showed that a significant number of patients of CIU and AD showed sensitivity to dust, pollen, insects, Dermatophagoides farinae, and fungi on SPT. Thus, it is an important tool in the diagnosis of CIU and AD.     

Peripheral osteoma of the maxilla: A rare case report

Osteoma is a benign osteogenic lesion with a very slow growth, characterized by proliferation of either cancellous or compact bone. Depending on its location, osteoma may be classified as central, peripheral or extraskeletal type. Although peripheral osteomas of the upper jaw are rare, diagnosticians can however encounter them in their clinical practice, which are probably misdiagnosed. These should be considered in the differential diagnosis of any slow-growing, non-tender, bony hard, non-compressible, non-fluctuant and non-pulsatile swelling present on the Oral and Maxillofacial region. We report a rare case of maxillary peripheral osteoma in a 50-year-old female patient. To best of our knowledge this is the eleventh case of maxillary osteoma reported in the English language literature.