Cardiorespiratory fitness status and body mass index change over time: a 2-year longitudinal study in elementary school children

OBJECTIVE

This study aimed to examine the prospective relationship of baseline body mass index (BMI) and performance in a cardiorespiratory fitness (CRF) field test with a change in BMI (DeltaBMI) over a 2-year period in a sample of rural children from elementary school in Fundão, Portugal.

METHODS

Obesity status was obtained by the age- and sex-specific BMI cut-off points and CRF by a 9-minute run test.

RESULTS

BMI stratification at baseline showed that overweight/obese children were over 11 times (OR=11.31; p=0.007) more likely to be DeltaBMI gainers than their normal weight peers. Those who were classified as unfit were 3.9 times more likely to be DeltaBMI gainers than those classified as fit at baseline. Both BMI at time 1 and CRF change (DeltaCRF) were not significantly associated with DeltaBMI over time.

CONCLUSION

The findings of this study suggest that children who have higher BMI and lower CRF are likely to have greater BMI gain over time.

Allele-specific CDH1 downregulation and hereditary diffuse gastric cancer

Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant cancer susceptibility syndrome characterized by early-onset diffuse gastric cancer (DGC) and lobular breast cancer. E-cadherin (CDH1) heterozygous germline mutations and deletions are found in 40% of families. Independent of CDH1 alterations, most HDGC tumours display mislocalized or absent E-cadherin immunoexpression, therefore undetected defects at the CDH1 locus may still be involved. We aimed at determining whether CDH1 mutation-negative probands display germline CDH1 allele-specific expression (ASE) imbalance, using a single-nucleotide primer extension-based procedure and tried to uncover the underlying molecular defect. CDH1 ASE analysis was performed using three intragenic SNPs in RNA extracted from the blood of 21 cancer-free individuals and 22 HDGC probands (5 CDH1 mutation carriers and 17 CDH1 negative). Germline promoter methylation, deletions and haplotype-related susceptibility at the CDH1 locus were analysed. Both CDH1 alleles from cancer-free individuals displayed equivalent expression levels, whereas monoallelic CDH1 expression or high allelic expression imbalance (AI) was present in 80% of CDH1 mutant and 70.6% (n = 12) of CDH1-negative HDGC probands. Germline deletions and promoter hypermethylation were found in 25% of probands displaying high CDH1 AI. No particular haplotype was found to be associated with CDH1 high AI. Germline CDH1 AI is highly frequent among CDH1 mutation-negative probands but was not seen in cancer-free individuals. This implicates the CDH1 locus in the majority of mutation-negative HDGC families.

Predictors of women's sexual desire: the role of psychopathology, cognitive-emotional determinants, relationship dimensions, and medical factors

INTRODUCTION

Deficient sexual desire is a common sexual difficulty among women, often related to medical and psychiatric problems, lack of adjustment in a relationship, or age. However, the relative contribution of each one of these dimensions is not yet well establish.

AIM

The aim of this study was to evaluate the main predictive factors of female sexual desire.

METHODS

A total of 237 women from the general population answered to a set of questionnaires assessing psychopathology, cognitive-emotional factors, dyadic adjustment, presence of medical pathologies, and menopause.

MAIN OUTCOME MEASURES

Psychopathology measured by the Brief Symptom Inventory (BSI), dysfunctional sexual beliefs measured by the Sexual Dysfunctional Beliefs Questionnaire, thoughts and emotions in sexual context measured by the Sexual Modes Questionnaire, dyadic adjustment measured by the Dyadic Adjustment Scale, medical condition measured by the Medical History Formulation, and sexual desire measured by the Sexual Desire subscale of the Female Sexual Function Index.

RESULTS

Findings indicated that psychoticism was the only psychopathological dimension that significantly predicted sexual desire (beta = 0.37). Conservative beliefs (beta = -0.33) and age-related beliefs (beta = -0.25) were also significant predictors of desire. Additionally, lack of erotic thoughts (beta = -0.28), failure and disengagement sexual thoughts (beta = -0.64), and thoughts related to female passivity (beta = 0.31) during sexual activity were significant predictors of desire. Regarding relationship dimensions, dyadic cohesion (beta = 0.37), and dyadic affection (beta = 0.45) were the best predictors of sexual desire. Moreover, postmenopausal women and women with medical problems presented reduced sexual desire. A multiple regression analysis (enter method) including all these variables plus age, indicated that failure/disengagement thoughts during sexual activity was the only significant predictor of sexual desire in women (beta = -0.52).

CONCLUSIONS

Results support the role of cognitive dimensions in the maintenance of women's sexual interest, and suggest implications for assessment and treatment of sexual desire difficulties.

Multicomponent exercise program improves blood lipid profile and antioxidant capacity in older women

This study intended to determine the effect of multicomponent exercise on blood lipid profile and on antioxidant capacity in older women. Forty women aged 60-80 years participated in a supervised multicomponent exercise program. Plasma contents of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), apolipoprotein A-1 (Apo A-1) and apolipoprotein B (Apo B-100), total antioxidant status (TAS) and the enzymatic activities of glutathione reductase (GR) and glutathione peroxidase (GPx) were evaluated before and after 8-month training. The multicomponent exercise program induced a significant decrease in TG, TC/HDL-C and Apo B/Apo A-1 and a significant increase in HDL-C and Apo A-1 (p<0.05). There was a significant increase in plasma TAS as well as GR and GPx enzyme activities. The present data show that an 8-month supervised moderate-intensity multicomponent exercise program resulted in beneficial improvements of blood lipid profile that were accompanied by positive modulation of antioxidant capacity.

Quantification of epigenetic and genetic 2nd hits in CDH1 during hereditary diffuse gastric cancer syndrome progression

BACKGROUND & AIMS

Hereditary diffuse gastric cancer (HDGC) families carry CDH1 heterozygous germline mutations; their tumors acquire complete CDH1 inactivation through "2nd-hit" mechanisms. Most frequently, this occurs via promoter hypermethylation (epigenetic modification), and less frequently via CDH1 mutations and loss of heterozygosity (LOH). We quantified the different 2nd hits in CDH1 occurring in neoplastic lesions from HDGC patients.

METHODS

Samples were collected from 16 primary tumors and 12 metastases from 17 patients among 15 HDGC families; CDH1 mutations, LOH, and promoter hypermethylation were analyzed. E-cadherin protein expression and localization were determined by immunohistochemistry.

RESULTS

Somatic CDH1 epigenetic and genetic alterations were detected in lesions from 80% of HDGC families and in 75% of all lesions analyzed (21/28). Of the 28 neoplastic lesions analyzed, promoter hypermethylation was found in 32.1%, LOH in 25%, both alterations in 17.9%, and no alterations in 25%. Half of the CDH1 2nd hits in primary tumors were epigenetic modifications, whereas a significantly greater percentage of 2nd hits in metastases were LOH (58.3%; P = .0274). Different neoplastic lesions from the same patient frequently displayed distinct 2nd-hit mechanisms. Different 2nd-hit mechanisms were also detected in the same tumor sample.

CONCLUSION

The 2nd hit in CDH1 frequently occurs via epigenetic changes in HDGC primary tumors and LOH in metastases. Because of the concomitance and heterogeneity of these alterations in neoplastic lesions and the plasticity of hypermethylated promoters during tumor initiation and progression, drugs targeting only epigenetic alterations might not be effective, particularly in patients with metastatic HDGC.

Relationship between intensity of physical activity and health-related quality of life in Portuguese institutionalized elderly

AIMS

Health-related quality of life (HRQOL) is considered to be the key goal for health promotion in older people. This study explores the relationship between HRQOL and objectively measured intensity of physical activity (PA) in institutionalized older adults. The analysis of the PA patterns of the subjects in relation to recommended levels of PA was also performed.

METHODS

One hundred and eighty-five residents of long-term care homes aged 65 years or more, volunteered for this study. The Medical Outcome Study Short Form 36-Item health survey (MOS SF-36) questionnaires and the uni-axial MTI Actigraph were used to assess HRQOL and PA, respectively. Participants were classified as less active, reasonably active and more active by tertile of moderated physical activity (MPA).

RESULTS

(i) The men represented a greater number of counts/h and min of MPA in all the tertile groups; (ii) men from the less active group had a significantly higher body mass index; (iii) women came third and exhibited less total activity even though they used this time in more intense activities; (iv) there was a higher significant correlation between MPA, physical function and negative association with body pain in relation to the time of institutionalization in both sexes but was more strongly visible in men; and (v) only men presented a significant positive association with physical health, mental health and vitality.

CONCLUSION

Any intensity of PA seems to be better than no activity for HRQOL, but MPA confers greater benefits for the perception of physical function and body pain in the case of institutionalized elderly persons.

Effects of resistance and multicomponent exercise on lipid profiles of older women

OBJECTIVE

The purpose of this study was to compare the effects of two exercise programs of 8 months duration on lipid profiles in older women.

METHODS

In 2006, 77 women from Porto, Portugal, aged 60-79 years were randomly assigned into a multicomponent exercise (ME) program or resistance exercise (RE) program. Before- and after-training, body composition, daily physical activity (DPA), aerobic endurance, plasma concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were assessed. Training was performed twice weekly. The protocol for the ME included aerobic exercise, muscular endurance exercises and activities targeted to improve balance and flexibility. The RE protocol included leg press, leg extensions and curls, double chest raises, lateral raises, overhead press and abdominal exercises.

RESULTS

Significant decreases in TG (-5.1%, p=0.006), and significant increases in HDL-C (9.3%, p<0.001) were observed in the ME group. Following 8 months no significant changes were observed on lipid profile in RE group, although lipid- and lipoprotein-related variables tended to alter favorably. Both regimens resulted in significant improvements on 6-min walk test (6.4%, p=0.001 for ME; and 6.0%, p=0.044 for RE). No significant changes were observed in total DPA and body fat in either group after exercise interventions. No significant correlations were found between body composition, physical activity, aerobic endurance, and lipid profile.

CONCLUSIONS

The data suggested that 8 months of ME may be more effective than RE for inducing favorable changes in plasma lipoprotein and lipid profiles.

Analysis of discordance between the tuberculin skin test and the interferon-gamma release assay

OBJECTIVE

To analyze factors associated with discordance between tuberculin skin test (TST) and interferon-gamma release assay (IGRA) results among household contacts of pulmonary tuberculosis (PTB) patients.

DESIGN

TST (purified protein derivative) and IGRA (QuantiFERON-TB Gold) were performed on household contacts of PTB patients diagnosed between 2006 and 2007 in Salvador, Brazil. Discordant test groups were compared with the TST-/IGRA- group.

RESULTS

Of 261 household contacts satisfactorily tested by TST, 145 (55.6%) had positive TST results; of 298 satisfactorily tested by IGRA, 127 (43.1%) had positive results. The test agreement was 0.76 (kappa = 0.53, 95%CI 0.43-0.63). Sixty-one (24%) were discordant: 44 (72%) with TST+/IGRA- and 17 (28%) with TST-/IGRA+ results. Compared to the TST-/IGRA- group, the TST+/IGRA- and TST+/IGRA+ groups were significantly more likely to have a chest X-ray showing old lung scars (OR = 6.8, 95%CI 1.3-35.0; OR = 7.4, 95%CI 2.2-24.4, respectively). The TST-/IGRA+ group was exposed to their index cases for significantly longer than the TST-/IGRA- group (OR = 7.2, 95%CI 1.7-29.3).

CONCLUSION

The TST+/IGRA- and TST+/IGRA+ groups shared more similar characteristics with each other than with the TST-/IGRA- group. In a setting endemic for TB, TST results appear to be more suitable in the decision to treat latent TB infection.

[Femoro-distal revascularization surgery: 5-years retrospective analysis of results]

PURPOSE

We describe the outcomes of femoro-distal bypass procedures used to treat peripheral arterial occlusive disease (PAOD). The aim of this retrospective analysis was to evaluate primary patency and limb salvage at 5 years.

METHODS AND PATIENTS

We retrospectively studied 122 consecutive patients who underwent femoro-distal bypass surgery from 1999 to 2002. Information was collected from clinical charts at S. João Hospital, Porto, Portugal. Kaplan-Meier curves were used to calculate primary patency and limb salvage rates; groups were compared using Cox proportional hazards models.

RESULTS

Five-year cumulative primary patency was 67,1% and limb-salvage rate was 71,1%. Major amputation risk for diabetics was significantly higher - 49% - compared with 18% in non-diabetics patients (p=0,0001). There were trends associating major amputation with women and smokers; there were also trends associating hypertension and in situ saphenous vein bypass with lower risk of major amputation .

CONCLUSION

Our preliminary results support the view that infrainguinal revascularization can be safely performed, with acceptable five-year cumulative primary patency and major amputation rates. The risk of major amputation, however, is significantly increased in diabetic patients.

Continuous CSF drainage in AD: results of a double-blind, randomized, placebo-controlled study

BACKGROUND

Alzheimer disease (AD) has been associated with abnormal cerebral clearance of macromolecules, such as amyloid and microtubule-associated-protein tau (MAP-tau). We hypothesized that improving clearance of macromolecules from the CNS might slow the progression of dementia.

OBJECTIVE

This prospective, randomized, double-blinded, placebo-controlled trial evaluated the safety and effectiveness of a surgically implanted shunt in subjects with probable AD.

METHODS

A total of 215 subjects with probable AD by National Institute of Neurological Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria received either a low-flow ventriculoperitoneal shunt or a sham (occluded) shunt for 9 months. Longitudinal CSF sampling was performed in both active and control subjects. Primary outcome measures were the Mattis Dementia Rating Scale and the Global Deterioration Scale. CSF Abeta((1-42)) and MAP-tau also were assayed.

RESULTS

After a planned interim analysis, the study was halted for futility. Using the intent-to-treat population, no between-group differences were observed in the primary outcome measures. The surgical procedure and device were associated with 12 CNS infections, some temporally associated with CSF sampling. All were treated successfully.

CONCLUSIONS

We found no benefit to low-flow CSF shunting in subjects with mild to severe Alzheimer disease. CSF infections, while treatable, occurred more frequently than expected, in some cases likely related to CSF sampling.

Relationships between physical activity, obesity and meal frequency in adolescents

OBJECTIVE

The purpose of this study was to assess the associations and impact of increased meal frequency, physical activity and 'skipping' breakfast on obesity levels in a sample of urban adolescents, aged 13-17 years old, from Porto, Portugal.

METHODS

Overweight and obesity were defined according to age- and sex-specific BMI cut-points. Daily meal frequency was assessed by questionnaire. Self-reported physical activity was recalled.

RESULTS

The proportion of overweight/obese girls (p < or = 0.05) and boys (p < or = 0.001) that consumed fewer than three meals was significantly higher than those reported from normal-weight counterparts. While no statistically significant differences were reported in girls, obese boys skipped breakfast significantly more (13% vs 5.6%; p < or = 0.05) than normal-weight counterparts did. Normal-weight boys but not girls were significantly more active (p < or = 0.01) than obese peers. An additional meal in boys (OR: 2.75; p < or = 0.05) and girls (OR: 1.97; p < or = 0.05) reduced the risk of being overweight/obese. Regardless of gender, breakfast skipping is not seen as a predictor of being overweight/obese. However, boys (OR: 2.10; p < 0.003), but not girls, who were moderately active were more likely to be of normal weight.

CONCLUSION

The data indicate that increased meal frequency may have a beneficial effect on a reduced BMI. Physical activity and breakfast skipping may be candidate targets for prevention programmes aimed at reducing overweight/obesity among adolescents.

The NMD mRNA surveillance pathway downregulates aberrant E-cadherin transcripts in gastric cancer cells and in CDH1 mutation carriers

Germline mutations in the gene encoding the tumour suppressor E-cadherin (CDH1) are the underlying genetic defect responsible for hereditary diffuse gastric cancer (HDGC). A remarkably high percentage ( approximately 80%) of CDH1 mutations in HDGC patients and carriers generate premature termination codons (PTCs). Here, we examined whether CDH1 transcripts harbouring PTCs are downregulated by nonsense-mediated decay (NMD), an RNA surveillance pathway that degrades PTC-bearing transcripts. Using an allele-specific expression (ASE) assay to differentiate between mutated and wild-type CDH1 alleles, we found that PTC-bearing CDH1 mRNAs are strongly downregulated in normal gastric tissue from several CDH1 mutation carriers. We show that NMD is responsible for this robust downregulation, as CDH1 transcripts harbouring PTCs in the KATO-III gastric tumour cell line were upregulated in response to protein synthesis inhibitors or depletion of the NMD factors UPF1 and eIF4AIII. Analysis of HDGC patients harbouring CDH1 alleles with PTCs at a wide variety of different positions indicates an association of their predicted ability to induce NMD and an earlier age of onset of gastric cancer. This suggests that NMD may be detrimental for HDGC patients and therefore NMD is a potentially useful therapeutic target for CDH1 mutation carriers.

["Physical fitness of institutionalized elderly: comparative analysis with reference values"]

In many elders the causes of dependency and institutionalization appear to be simply a progressive loss of functional capacity to undertake the instrumental daily living activities (personal toilet, dressing, etc.). Various professionals thus show considerable interest in the potential to prevent and reverse functional limitations, disability, and dependency by an appropriate regimen of regular PA. The purpose of this study was to characterize the levels of physical performance of 185 institutionalized elders by gender and age, and compare our results with normative standards to determine their functional status. This study reports: (i) men present better physical fitness; (ii) elders present better scores to the standard in the strength and in the aerobic resistance and (iii) worse scores in the flexibility and agility.

Development of a method using image analysis for the measurement of cellulose-binding domains adsorbed onto cellulose fibers

The surface concentration of CBD-FITC conjugates, adsorbed on cellulose fibers, was determined by image analysis. The program consists of two scripts, the first dedicated to the elaboration of the calibration curve. The emission of fluorescent light, detected by image analysis, is correlated with the concentration of CBD solutions. This calibration is then used (second script) to determine the concentration of CBDs adsorbed on cellulosic fibers. This method allows the direct estimation of the surface concentration of adsorbed CBDs, which usually is not accurately calculated from depletion studies, since the surface area is hardly known. By observing different spots in the surface of the fibers, site-specific information is obtained. It was verified that the physically heterogeneous fibers exhibit different amounts of adsorbed CBDs.

Active versus passive transportation to school-differences in screen time, socio-economic position and perceived environmental characteristics in adolescent girls

OBJECTIVE

The aims of this study were (1) to assess the relationships between transport to and from school (active vs. passive), sedentary behaviours, measures of socio-economic position and perceived environmental variables, and (2) to determine which, if any, variables were predictors of active transportation.

METHODS

The sample comprised 705 girls with mean age of 14.7 (SD = 1.6) years old. Questionnaires were used to describe travel mode to school and to estimate weekly television and computer use (screen time). Girls were assigned to active transportation (AT) or passive transportation (PT) groups depending on whether they walked or bicycled (AT) to and from school or travelled by car or bus (PT). Screen time was determined by the number of hours they reported watching television and using computers in the week preceding the examination, including weekends. Socio-economic position was established by parental occupation and educational level. A questionnaire assessed Perceived Neighbourhood Environments.

RESULTS

No statistically significant differences were seen for screen time between travel groups. Occupational status of both mother (r = -0.17) and father (r = -0.15) and father's educational level (r = -0.10) were significantly and negatively associated with AT, while street connectivity (r = 0.10) was positively and significantly associated with AT. Logistic regression analysis showed that the likelihood of active commuting decreased by around 50% with increasing father's occupation (odds ratio (OR) = 0.51; p </= 0.05) and father's education (OR = 0.52; p </= 0.05) from low to middle socio-economic position groups. Further, the data showed that girls who agreed that 'there are many four-way intersections in my neighbourhood' were more likely to be active (OR = 1.63; p </= 0.05).

CONCLUSION

The data of this study showed that lower socio-economic position is associated with active commuting to school and that street connectivity is a predictor of active transportation in adolescent girls.

Perceived neighborhood environments and physical activity in an elderly sample

Increasing evidence indicates the importance of environmental variables in explaining physical activity. This study evaluated sex differences in perception of home and neighborhood environmental support and assessed which neighborhood environmental variables were associated with reported physical activity of elderly people. A sample of 126 women (M age = 79.1 +/- 6.6 yr.) and 55 men (M age = 76.6 +/- 7.7 yr.) were healthy, community-dwelling individuals. A questionnaire about environmental variables was administered. Physical activity was assessed on the Baecke Questionnaire. Logistic regression analysis showed that Neighborhood Safety was related to total physical activity, activity in leisure time, and sport activities. Men were also likely to be more active in leisure time than women. Neighborhood Personal Safety was associated with physical activity of these elderly people, showing a potential influence of the environmental domain in physical activity.