Effect of diet composition on energy expenditure during weight loss: the POUNDS LOST Study

BACKGROUND

Weight loss reduces energy expenditure, but the contribution of different macronutrients to this change is unclear.

HYPOTHESIS

We tested the hypothesis that macronutrient composition of the diet might affect the partitioning of energy expenditure during weight loss.

DESIGN

A substudy of 99 participants from the Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST) trial had total energy expenditure (TEE) measured by doubly labeled water, and resting energy expenditure (REE) measured by indirect calorimetry at baseline and repeated at 6 months in 89 participants. Participants were randomly assigned to one of four diets with either 15 or 25% protein and 20 or 40% fat.

RESULTS

TEE and REE were positively correlated with each other and with fat-free mass and body fat, at baseline and 6 months. The average weight loss of 8.1 ± 0.65 kg (least-square mean ± s.e.) reduced TEE by 120 ± 56  kcal per day and REE by 136 ± 18 kcal per day. A greater weight loss at 6 months was associated with a greater decrease in TEE and REE. Participants eating the high-fat diet (HF) lost significantly more fat-free mass (1.52 ± 0.55 kg) than the low-fat (LF) diet group (P<0.05). Participants eating the LF diet had significantly higher measures of physical activity than the HF group.

CONCLUSION

A greater weight loss was associated with a larger decrease in both TEE and REE. The LF diet was associated with significant changes in fat-free body mass and energy expenditure from physical activity compared with the HF diet.

Depletion of RUNX1/ETO in t(8;21) AML cells leads to genome-wide changes in chromatin structure and transcription factor binding

The t(8;21) translocation fuses the DNA-binding domain of the hematopoietic master regulator RUNX1 to the ETO protein. The resultant RUNX1/ETO fusion protein is a leukemia-initiating transcription factor that interferes with RUNX1 function. The result of this interference is a block in differentiation and, finally, the development of acute myeloid leukemia (AML). To obtain insights into RUNX1/ETO-dependant alterations of the epigenetic landscape, we measured genome-wide RUNX1- and RUNX1/ETO-bound regions in t(8;21) cells and assessed to what extent the effects of RUNX1/ETO on the epigenome depend on its continued expression in established leukemic cells. To this end, we determined dynamic alterations of histone acetylation, RNA Polymerase II binding and RUNX1 occupancy in the presence or absence of RUNX1/ETO using a knockdown approach. Combined global assessments of chromatin accessibility and kinetic gene expression data show that RUNX1/ETO controls the expression of important regulators of hematopoietic differentiation and self-renewal. We show that selective removal of RUNX1/ETO leads to a widespread reversal of epigenetic reprogramming and a genome-wide redistribution of RUNX1 binding, resulting in the inhibition of leukemic proliferation and self-renewal, and the induction of differentiation. This demonstrates that RUNX1/ETO represents a pivotal therapeutic target in AML.

Hemoglobin A2Fitzroy δ 142 ALA → ASP: A New Delta-Chain Variant

HbA2 Fitzroy is a new delta-chain variant with the amino acid substitution delta 142 (H2O) Ala----Asp. This variant was detected solely due to its abnormal electrophoretic mobility.

Local control with conventional and hypofractionated adjuvant radiotherapy for ductal carcinoma in-situ: is there a difference in outcome?

Abstract #1162

Purpose&#x2028; Trials of adjuvant whole breast radiotherapy (WBRT) following breast-conserving surgery for invasive breast cancer indicate equivalent efficacy and morbidity for conventional and hypofractionated treatment. WBRT for ductal carcinoma in-situ (DCIS) improves local control, however an optimal dose fractionation remains undefined. Our group policy allowed for the use of both schedules, therefore we compared local control in women with DCIS following breast-conserving surgery.&#x2028; Methods&#x2028; Two hundred and sixty six patients treated between January 1999 and December 2004 with conventional (50 Gy/25 fractions) or hypofractionated (42.4 Gy/16 daily fractions or 40 Gy/16 fractions + 12.5 Gy/5 fraction boost) radiotherapy schedules to the whole breast after breast-conserving surgery for DCIS were identified and retrospectively reviewed. Treatment schedules were evaluated for outcomes in terms of ipsilateral breast recurrence.&#x2028; Results&#x2028; The median age at diagnosis 56.7 years (range 32.2-83.8 years), and 82% (218 patients) presented with mammographic abnormality. Median tumour size was 1.5 cm (range 0.4-10 cm), grade 3 tumours were present in 105 women (39%), and comedonecrosis in 145 (55%). Fifty-one patients (19%) had multifocal disease. Median follow-up was 45.1 months (range 0.7-106.8 months). Prognostic features were well matched in both groups.&#x2028; One-hundred and four patients (39%) were treated with conventional and 162 (61%) with hypofractionated WBRT. There were a total of 14 confirmed local recurrences in the previously radiated breast. Six recurrences occurred in the 104 (5.8%) patients treated with a conventional schedule and 8 of 162 (4.9%) patients treated with a hypofractionated schedule. Actuarial risk of recurrence at 4 years was 7% with hypofractionated WBRT and 5% with a standard schedule (p=0.85).&#x2028; &#x2028; Eight patients recurred with DCIS and 6 with invasive carcinomas, all 14 were treated surgically with adjuvant treatment as indicated clinically, 1 patient with clinical recurrent disease refused biopsy and further conventional treatment. Univariate analysis showed a trend to increased risk of recurrence with grade 3 tumours (10% at 4 years vs. 3% for grade1/2, p=0.053) and presence of comedonecrosis (8% vs. 2%, p=0.096), but not multi-focal disease (7% vs. 5%, p=0.78).&#x2028; Conclusions&#x2028; Hypofractionated adjuvant WBRT schedules following breast-conserving surgery for DCIS have comparable local control rates to a conventional radiation schedule. Hypofractionated WBRT is more convenient for patients, has equivalent morbidity and should be considered in this patient group.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1162.

Identifying barriers to prehospital thrombolysis in the treatment of acute myocardial infarction

BACKGROUND AND OBJECTIVES

After an acute myocardial infarction (AMI) prehospital thrombolysis (PHT) reduces mortality compared with inhospital thrombolysis. In practice, a relatively small proportion of the total population with AMI receives PHT. This study was designed to identify the current barriers to PHT.

METHODS

A retrospective practice review of 57 consecutive patients treated in or before arrival at a district general hospital emergency department. All patients received thrombolysis for an AMI.

RESULTS

The main barriers to delivery of PHT appear to be the inclusion and exclusion criteria laid out in the ambulance service central guidelines. Despite recent widening of the inclusion criteria, 54% of patients eligible for immediate treatment on arrival in hospital either received or were eligible for PHT.

CONCLUSION

To increase the number of patients who are eligible for PHT these guidelines need to be revised further in line with inhospital criteria for thrombolysis.

When is a door not a door? The difference between documented and actual arrival times in the emergency department

OBJECTIVES

An observational study to determine the difference between documented ambulance arrival times and the actual arrival times of patients from the ambulance into the emergency department.

METHODS

In a busy, purpose built, modern emergency department with easy access, we recorded the time that ambulance borne patients were wheeled over the threshold of the clinical area and compared this to the times recorded by the ambulance trusts as the official ambulance arrival times.

RESULTS

352 ambulance arrivals were observed. Data were incomplete in 34 instances (9.5%) and were not included in the analysis. For the remaining 318 arrivals, the median time difference was 2 min 1 s (range 5 s to 21 min 45 s). In a subgroup of chest pain patients (45 patients), the median time difference was 2 min 11 s (range 23 s to 5 min 38 s). The difference between the chest pain group and the remaining patients was not significant (p = 0.528).

CONCLUSIONS

There is inevitably some delay between the arrival of an ambulance and the arrival of the patient into a clinical area. This study quantifies that difference. In an era of stringent time related standards, this paper highlights the need for accurate recording of times to enable us to carry out valid audit of these standards. This study supports the redefining of an arrival time as the time when the patient arrives in the clinical area.

Percent body fat measured by BIA and DEXA in obese, African-American adolescent girls

OBJECTIVE

To compare the estimation of body fat between bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DEXA) in overweight, African-American female adolescents.

SUBJECTS

In total, 54 African-American adolescent female subjects were recruited for Study 1. Each adolescent's body mass index was greater than the 85th percentile and their average body fat was 45% according to DEXA. A total of 26 African-American adolescent female subjects were available for Study 2, and had an average body fat of 26% according to DEXA.

MEASUREMENTS

Percent body fat was measured by DEXA and BIA. Seven different BIA equations were tested. Both sets of data were analyzed using Bland-Altman regression analyses, utilizing percent body fat measured by DEXA as the criterion.

RESULTS

The Kushner equation provided estimates that were unaffected by body fat in both studies. Estimates were unbiased when applied to the exclusively overweight sample and biased when utilized with the separate sample of normal weight and obese girls. The remaining equations were biased, provided inconsistent estimates across body weight, or were biased and provided inconsistent estimates. Ethnicity-specific and ethnicity-combined equations performed similarly in the obese sample, but became more disparate when applied to a sample encompassing a wider body weight range. The limits of agreement between all BIA equations and the DEXA estimates ranged from 6 to 9%.

CONCLUSION

The study suggests that the Kushner BIA equation is appropriate for use with African-American female adolescents across the weight spectrum, while the majority of BIA equations underestimated percent body fat as body fat increased.

Assessment of the environmental impact of artificial effluent lagoon in Jiayuguan City of China

An artificial effluent lagoon for storing wastewater were excavated in Jiayuguan City since 1994. As a part of a demonstration project of Sino-Australia cooperation, an assessment of the environmental impact of the lagoon was carried out. The assessment was based on field and laboratory tests and predictive model. The main impacts from the lagoon site are likely to be on the groundwater system, and, to a lesser extent, on ambient air quality in the vicinity. Currently it is expected that groundwater is being polluted with effluent from the effluent lagoon. Air pollution (odor nuisance) is mainly caused by untreated effluent in the irrigation channel. The impact of high total dissolved salt (TDS) on groundwater is likely to be significant in the long run if the lagoon is continuously used. There is, consequently, no likelihood of contamination of surface water system, particularly of the city water supply system, from infiltration of effluent at the lagoon.

Mitogen-activated protein kinase (MAPK) pathway activation: effects of age and acute exercise on human skeletal muscle

The purpose of this investigation was to examine the activation (phosphorylation) and total protein content of MAPK signalling cascade proteins (ERK 1/2, p90RSK, Mnk 1, eIF4E, p38 MAPK, JNK/SAPK, MKP 1) at rest and following exercise, in sedentary young and old men. Eight young (22 +/- 1 years; YM) and eight old (79 +/- 3 years; OM) men underwent a resting muscle biopsy of the vastus lateralis; they then performed a knee extensor resistance exercise session (29 contractions at approximately 70 % of max), followed by a post-exercise biopsy. Western immunoblot analysis demonstrated that the OM had higher resting phosphorylation of ERK 1/2, p90RSK, Mnk 1, p38 MAPK and JNK/SAPK proteins versus YM (P < 0.05). The resistance exercise bout caused an increase in phosphorylation of the ERK 1/2, p90RSK and Mnk 1 proteins (P < 0.05) in the YM. Conversely, the OM had a decrease in ERK 1/2, p90RSK, Mnk 1, p38 MAPK and JNK/SAPK phosphorylation (P < 0.05) after the exercise bout. Neither group showed a change in eIF4E phosphorylation. The total amount of protein expression of the MAPK signalling proteins was not different between the YM and OM, except that there was a higher (P < 0.05) MKP 1 protein content in the OM. This investigation is the first to provide evidence that MAPK proteins are differentially activated at rest and in response to a bout of resistance exercise in skeletal muscle of young and old men. These findings may have implications for other processes (e.g. transcription and translation) involved in skeletal muscle type and growth, when examining the changes occurring with ageing muscle before and after resistance exercise/training.

Mood change through physical exercise in nine- to ten-year-old children

The present study assessed the effect of two types of physical exercise on the self reported mood of 64 9 and 10-yr.-old children who responded to a self-report mood meassure after two different types of aerobic exercise of 15 min., and after a 15-min. video. Significant increases in positive mood and significant decreases in negative mood were found after each exercise treatment; however, positive mood decreased and negative mood increased following the video treatment. Interestingly, no significant difference in mean mood scores was found between the two exercise treatments. These data suggest that short bouts of physical exercise have psychological benefits for children.

Comparative expressed sequence hybridization to chromosomes for tumor classification and identification of genomic regions of differential gene expression

Altered expression of genes can have phenotypic consequences in cancer development and treatment, developmental abnormalities, and differentiation processes. Here we describe a rapid approach, termed comparative expressed sequence hybridization (CESH), which gives a genome-wide view of relative expression patterns within tissues according to chromosomal location. No prior knowledge of genes or cloning is required, and minimal amounts of tissue can be used. Expression profiles are achieved in a manner similar to the identification of chromosomal imbalances by comparative genomic hybridization analysis. The approach is demonstrated to indicate a chromosomal region that harbors overexpressed genes that may be associated with a drug-resistant phenotype. In addition, known and new regions of differential gene expression in both normal tissues and tumor samples from the soft tissue sarcoma group of rhabdomyosarcoma (RMS) are indicated. These regions included 2p24; overexpression of MYCN at 2p24 was confirmed by quantitative reverse transcription-PCR for all of the alveolar RMS cases and did not necessarily correspond to genomic amplification. Evidence including region specific microarray analysis indicated that overexpression of several genes from a region may be required for detection by CESH. This evidence is consistent with clusters of functionally related genes and mechanisms that affect the expression of a number of genes at a particular genomic location. The distinctive CESH profiles demonstrated in different subtypes of RMS show potential for tumor classification.

Calcified cutaneous nodules on the heels of children: a complication of heel sticks as a neonate

We report the presence of calcified nodules on the heels secondary to heel sticks in healthy monozygotic twins in childhood. The subjects were born preterm at 34 weeks. The heels were normal at birth. While in the hospital, they underwent multiple heel sticks as a means of venesection. The wounds failed to heal normally and warty lesions developed. Calcified cutaneous nodules secondary to heel sticks have been reported primarily in high-risk, preterm infants. There have also been two reports of their development in normal healthy infants. To date, all reported lesions have been asymptomatic, with spontaneous resolution by 18-30 months. These cases indicate that such lesions can in fact be chronic, extending into childhood, when they may become symptomatic. Dermatologists should therefore consider this diagnosis as a cause of warty, calcified nodules on the heel in childhood as well as in infants and in neonates.

The effect of hair loss on quality of life

BACKGROUND

The aim of this study was to quantify the effect of hair loss on quality of life. Patients were recruited from an alopecia support group, and were assessed using the Dermatology Life Quality Index (DLQI) and an adapted version of the DLQI. Financial utility questions, an abbreviated version of the Center for Epidemiologic Studies Depression Scale and open-ended questions were also used.

OBSERVATIONS

Seventy (90% response rate) questionnaires were returned. DLQI scores in responders with hair loss (mean score = 8.3, SD = 5.6, range 0-23, n = 70) were similar to those recorded in severe psoriasis. The hair loss continued to have a significant impact on life quality well after the initial event (median duration of hair loss = 138 months +/- 114; range 7-588, n = 70). Forty per cent of patients also felt dissatisfied with the way in which their doctor dealt with them.

CONCLUSIONS

This study specifically identifies the feelings of loss of self-confidence, low self-esteem and heightened self-consciousness in people affected by hair loss.