Uncoupling of social zeitgebers and diurnal cortisol secretion in clinical depression

Daily activities (zeitgebers) such as waking, eating, and exercising, done alone or in the presence of others, may help to entrain biological rhythms. To examine whether the relationship between zeitgebers and biological rhythms is altered in depression, this study tracked daily activity and cortisol secretion in 50 depressed and 50 control participants using a daily diary methodology. The groups reported similar levels of regular daily activities. Among control participants, regular daily activities were associated with a normative decline in cortisol secretion. Among depressed participants, daily activities and cortisol secretion were unrelated, consistent with the hypothesis that these activities are less able to entrain diurnal rhythms. This lack of social entrainment may underlie some of the circadian disturbances in depression.     

Memantine enhances autonomy in moderate to severe Alzheimer's disease

BACKGROUND: Alzheimer's disease (AD) is the leading cause of dementia and its course renders patients functionally disabled. Memantine is the first drug to demonstrate a clinical benefit in the treatment of patients with moderately-severe to severe AD. OBJECTIVES: Our objective was to illustrate the benefits of memantine on functional disability. METHODS: We classified 252 patients from a randomised 28-week clinical trial of memantine vs placebo according to their Activities of Daily Living capabilities measured by the ADCS-ADLsev scale. The scale was divided into two sub-scores: basic and instrumental. The relevance of this classification was validated by comparing clinical and socio-demographic parameters between the different autonomy classes (autonomous and dependent). The effect of memantine was estimated by using a logistic regression model on the autonomy status of patients at week 28, controlling for confounding factors (Observed Cases analysis). RESULTS: Our results showed that dependent patients (n = 106) had significantly longer disease duration, poorer cognition, greater severity, more behavioural alterations and higher total societal costs compared with autonomous patients (n = 146). When controlling for autonomy and severity at baseline, memantine-treated patients were three times more likely [Odds Ratio (OR) = 3.03; 95% Confidence Intervals (CI) = (1.38, 6.66)] to remain autonomous after 28 weeks. Analysis of the Treated Per Protocol set and the use of Last Observation Carried Forward analyses confirmed this finding. CONCLUSIONS: Memantine enhances autonomy in patients with moderately-severe to severe AD by increasing the probability of their remaining autonomous, therefore delaying transition to the dependent stage.     

Trapezius muscle activity, neck and shoulder pain, and subjective experiences during monotonous work in women

The electromyographic (EMG) activity patterns of 18 female supermarket employees reporting neck and shoulder pain were compared with those of 6 of their female colleagues reporting no pain when doing cash-register work. It was found that the EMG activity of the trapezius muscle tended to show a lack of low and high levels among pain subjects, and that the time the trapezius muscle was at rest was longer in the group reporting no pain. In the non-dominant side, the muscle rest time was significantly longer (P < 0.05) in the group reporting no pain, and this group also showed a larger EMG activity difference between the dominant and non-dominant sides, indicating a less static bilateral muscle activation. Self-reports of negative experiences (stressed, exhausted and tense) were somewhat higher in the group reporting pain, while positive experiences during work (concentrated, stimulated and happy) appeared to be similar in the two groups of supermarket employees. Accepted: 8 June 2000     

Determination of Se content of 78 sesame accessions with different geographical origin

Selenium (Se) is an essential trace element for human health and plays an important role in fundamental physiological functions. Se accumulates in sesame seeds and this situation may differ between genotypes. Determination of Se content in food is very important because there is a narrow margin of safety between an adequate amount and overconsumption. The purpose of this study was to evaluate the variability in Se content among different sesame accessions from Turkey (12 sesame accessions) and 22 other countries from four continents (Asia, Africa, Europe and America). The determination of total Se in seed was performed with an atomic absorption spectrometer. The Se content of sesame seeds samples exhibited a wide range i.e. 0–9.32 mg kg⁻¹, with an average value of about 2.29 mg kg⁻¹. The accession India 1 had the highest Se concentration. The mean Se contents of sesame from 23 countries varied between 0.24–8.31 mg kg⁻¹ and with an average value of about 2.29 mg kg⁻¹. Sesame breeders can use the results of the present study to further the breeding programs for the development of new biofortified varieties.     

强化躯干核心肌群对脑卒中患者躯干控制平衡步行及日常生活能力的康复效果

目的 探讨躯干核心肌群训练的强度对脑卒中患者躯干控制、平衡步行及日常生活能力的康复效果。方法 选择2017年4月至2018年3月在华中科技大学同济医学院附属协和医院康复医学科住院治疗的90例脑卒中偏瘫患者为研究对象,按照随机数字表法将患者分为A、B、C组,每组各30例,3组患者均在常规治疗基础上联合不同强度的躯干核心肌群训练,其中A组每天训练1次,B组每天训练2次,C组每天训练3次,每次训练30 min,每周5天,共训练3个月。3组患者治疗1个月、2个月和3个月时采用躯干控制能力测试（TCT）、Berg平衡量表（BBS）评价躯干控制能力,采用步行功能评级（FAC）评定平衡步行功能、采用日常生活能力（MBI）评定日常生活能力。比较3组患者上述评分差异。结果 治疗前3组患者躯干控制能力、平衡步行功能和生活能力评分比较差异无统计学意义（P>0.05）,3组患者治疗1个月、2个月、3个月后躯干控制、平衡步行和日常生活能力评分均逐渐提高,差异均有统计学意义（P均<0.05）;且在1~3个月期间躯干控制和平衡能力评分C组高于B组,B组高于A组,差异均有统计学意义（P均<0.05）,但3个月时差异无统计学意义（P>0.05）。3组患者步行和日常生活能力在1个月期间组间差异无统计学意义（P>0.05）,但1个月后C组较B组,B组较A组均有统计学意义（P均<0.05）。结论 强化躯干核心肌力量可以显著提高患者躯干控制、平衡步行和日常生活能力,缩短康复时间。     

魏子孝教授辨治糖尿病性视网膜病变经验

糖尿病性视网膜病变是糖尿病常见的微血管并发症之一,目前现代医学治疗以控制血糖、血压、血脂、改善微循环等基础治疗方法为主,严重者采取激光光凝、手术或局部糖皮质激素治疗.中医药辅助治疗在减少潜在致盲并发症的发生率,延缓病情进展等方面具有独特的疗效.魏子孝教授参考眼底检查抓住患者"主证",运用中医药理论辨治糖尿病性视网膜病变...     

可吸入大气颗粒物污染与居民每日死亡关系的Meta分析

目的综合分析国内外可吸入大气颗粒物（PM10）短期暴露与人群死亡关系的流行病学资料,以获取大气PM10污染与居民死亡的暴露-反应关系。方法在计算机联机检索文献和手工检索的基础上,对近十年来发表的相关研究文献采用meta分析的方法进行综合评价,并检验、校正可能存在的发表偏倚,从而准确、定量地确定PM10污染与居民死亡的暴露-反应关系。结果建立了居民短期接触大气PM10污染的暴露一反应关系,即在未考虑发表偏倚的情况下,大气中PM10每增加1130μg／m3,居民死亡的相对危险度增加3．87％（95％CI：2．84％～5．02％）,在校正了发表偏倚后大气中PM10每增加100μg／m3,死亡的相对危险度增加下降为1．41％（95％CI：0．30％-2．43％）,与考虑偏倚前相比下降了63．6％。结论本研究建立的暴露-反应关系较早注意到发表偏倚的影响,具有一定的代表性与科学性,可用于大气颗粒物暴露健康危险度评价工作参考,为制定相关环境决策提供科学依据。     

Nutrition en hémodialyse quotidienne

Malnutrition is a frequent complication of chronic kidney disease. It results in many factors, such as uremia-linked anorexia, chronic inflammation, metabolic acidosis, lack of physical activity, endocrine disorders, and cardiac troubles. Dialysis in itself contributes to this phenomenon, by the induction of a catabolic metabolism when blood meets the dialysis membrane, and by the loss of amino-acid and glucide towards the dialysate. Malnutrition is a severe complication of chronic kidney disease, increasing the infections, the risk of fall, cardiac failure, and global mortality. Many studies have shown evidences that daily hemodialysis had beneficial effects on nutritional parameters. We can point out a significant raise in serum albumin concentration, an increase of the biceps circumference, and an increase of the dry weight compared to tri-weekly hemodialysis. Metabolic acidosis seems to be better controlled, and the needs of synthetic erythropoietin are diminished. These results coincide with the proved linear association between nutritional parameters and the dialysis clearance, estimated by the Kt/V. Daily dialysis provides actually in fine a weekly Kt/V almost equivalent to the double of the one obtained in tri-weekly hemodialysis. Finally, the quality of life of the patients in daily hemodialysis seems to be significantly improved. This renal replacement therapy seems therefore to be a promising approach.     

Exposure assessment of phthalate esters in Japanese pregnant women by using urinary metabolite analysis

Objectives  Our objectives were (1) to evaluate whether single spot urine is suitable media for longer-term phthalate esters exposure assessment, and (2) to estimate intake level of phthalate esters of Japanese pregnant women using urinary metabolites as an indicator of prenatal exposure level in their offspring. Methods  We analyzed nine metabolites (MMP, MEP, MnBP, MBzP, MEHP, MEOHP, MEHHP, MINP, MnOP) of seven phthalate esters in spot urine samples from 50 pregnant women by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Using four urine samples collected from each of 12 subjects from 50 pregnant women within 5–12 weeks, we compared intra- and interindividual variation in urinary metabolites by calculation of intraclass correlation coefficient (ICC). We estimated daily intakes of 50 pregnant women from their urinary metabolite concentrations. Results  ICCs for seven phthalate metabolite concentrations in single spot urine samples were: MMP (0.57), MEP (0.47), MnBP (0.69), MBzP (0.28), MEHP (0.51), MEHHP (0.43), and MEOHP (0.41) in 12 pregnant women. Phthalate ester metabolites had high detection rates in 50 subjects. The mean daily intake ranged from 0.01 to 2 μg/kg per day. The daily intake levels in all subjects were lower than corresponding tolerable daily intake (TDI) set by the European Food Safety Authority (EFSA), though maximum value for DnBP of 6.91 μg/kg per day accounted for 70% of TDI value. Conclusions  Higher ICCs indicated that phthalate metabolite levels in single spot urine could reflect longer-term exposure to the corresponding diesters of subjects. Although the current exposure level was less than TDIs, further studies and exposure monitoring are needed to reveal the toxicity of phthalate esters to sensitive subpopulation.     

Estimating the daily intake of essential and nonessential elements from lamb m. longissimus thoracis et lumborum consumed by the population in Missouri (United States)

This paper estimated the daily intake of essential and nonessential elements from lamb muscle longissimus thoracis et lumborum (m. LTL) available to the population in Missouri. Missouri grain-finished (n = 36), Missouri grass-finished (n = 40) and imported New Zealand grass-finished (n = 40) lamb m. LTL were purchased and assayed for their element composition. Total mercury in samples was quantified by atomic absorption spectrometry and other elements were analyzed by inductively coupled plasma-optical emission spectrometry. Analysis of certified reference materials (DORM-2 and TORT-2) gave recovery rates ranging from 86 to 108% and 85 to 104%, respectively. The abundance of essential elements in Missouri grain-finished and Missouri grass-finished lamb m. LTL followed the order: Potassium > phosphorus > sodium > magnesium > calcium > zinc > iron. The order in the imported New Zealand grass-finished group was: Potassium > phosphorus > sodium > calcium > magnesium > zinc > iron. Since many variables lacked normality, non-parametric (Kruskal–Wallis) comparison test was performed and the results suggested no significant difference (P > 0.05) in element composition among the lamb m. LTL groups. The estimated daily intake of 14 elements from consumption of 100 g lamb m. LTL posed no hazard to consumers.