Impact of a physical activity program on cerebral vasoreactivity in sedentary elderly people

AIM

The aim of the present study was to determine the effect of a physical activity program on the hemodynamic response of the brain (vasoreactivity) in elderly people.

METHODS

Eighteen men and 25 women (aged 62-67 years) were randomly assigned to an experimental (EXP, N.=22, 12 women) and a control (CON, N.=21, 13 women) group. Subjects in EXP group were required to complete a 7-month program based on aerobic training (3-4 sessions/weekd, 50 min/session, 3-4 sessions/week, at 70% maximum heart rate). Transcranial Doppler ultrasound was used to examine the cerebral blood flow response to hypercapnic and hypocapnic stimuli. We also determined blood pressure, total serum cholesterol, HDL and LDL cholesterol, and triglycerides, and conducted an aerobic capacity test (the 2.4-Km walking test). RESULTS.Brain vasomotor reactivity improved in the EXP group, reflected by a higher blood flow velocity in the middle cerebral artery (MCA) in both cerebral hemispheres in response to hypercapnia (induced by breath holding) (P<0.05). Subjects in EXP group also improved the cardiovascular profile aerobic physical condition (P<0.001) in terms of reduced arterial pressure, total cholesterol and triglyceride levels.

CONCLUSION

Our findings indicate that cerebral vasoreactivity in elderly may be improved by undertaking an aerobic exercise program.

[ALPHA-fitness test battery: health-related field-based fitness tests assessment in children and adolescents]

Hereby we summarize the work developed by the ALPHA (Assessing Levels of Physical Activity) Study and describe the tests included in the ALPHA health-related fitness test battery for children and adolescents. The evidence-based ALPHA-Fitness test battery include the following tests: 1) the 20 m shuttle run test to assess cardiorespiratory fitness; 2) the handgrip strength and 3) standing broad jump to assess musculoskeletal fitness, and 4) body mass index, 5) waist circumference; and 6) skinfold thickness (triceps and subscapular) to assess body composition. Furthermore, we include two versions: 1) the high priority ALPHA health-related fitness test battery, which comprises all the evidence-based fitness tests except the measurement of the skinfold thickness; and 2) the extended ALPHA health-related fitness tests battery for children and adolescents, which includes all the evidence-based fitness tests plus the 4 x 10 m shuttle run test to assess motor fitness.

[Genetic characterization of the virus causing H1N1 influenza pandemic in Chile: analysis of the first detected cases]

BACKGROUND

Following the announcement of the Influenza A(H1N1) pandemic by the World Health Organization in April 2009, a surveillance program was carried out in Chile to detect the introduction of the virus in the country and to monitor its propagation and impact.

AIM

To describe the onset of the outbreak and the genetic characterization of the pandemic H1N1 influenza virus in the first detected cases in Chile.

MATERIAL AND METHODS

Analysis of18 clinical samples coming from suspicious patients, received in a National Reference Laboratory. RNA reverse transcription and real time influenza gene DNA amplification was carried out in a 7500 Fast and Step One Real Time PCR Systems of Applied Biosystems and MxPro-Mx3000P thermocycler from Stratagene. Super Script III Platinum One-Step Quantitative RT-PCR was used.

RESULTS

The virus was first detected in three persons returning from the Dominican Republic via Panamá and a child from the east zone of Santiago. Genetic characterization of the virus showed that the child was infected by a different variant of the pandemic virus than the three persons returning from the Caribbean.

CONCLUSIONS

The onset of the Influenza outbreak in Chile apparently carne from two different epidemiological groups. The spread of the virus detected in the voyagers was limited immediately However the virus of the fourth case was found in different regions of Chile.

Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa

Please cite this paper as: Van Kerkhove et al. (2011) Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa. Influenza and Other Respiratory Viruses 5(6), e487–e498.

Introduction and Setting  Our analysis compares the most comprehensive epidemiologic and virologic surveillance data compiled to date for laboratory‐confirmed H1N1pdm patients between 1 April 2009 ‐ 31 January 2010 from five temperate countries in the Southern Hemisphere–Argentina, Australia, Chile, New Zealand, and South Africa.

Objective  We evaluate transmission dynamics, indicators of severity, and describe the co‐circulation of H1N1pdm with seasonal influenza viruses.

Results  In the five countries, H1N1pdm became the predominant influenza strain within weeks of initial detection. South Africa was unique, first experiencing a seasonal H3N2 wave, followed by a distinct H1N1pdm wave. Compared with the 2007 and 2008 influenza seasons, the peak of influenza‐like illness (ILI) activity in four of the five countries was 3‐6 times higher with peak ILI consultation rates ranging from 35/1,000 consultations/week in Australia to 275/100,000 population/week in New Zealand. Transmission was similar in all countries with the reproductive rate ranging from 1.2–1.6. The median age of patients in all countries increased with increasing severity of disease, 4–14% of all hospitalized cases required critical care, and 26–68% of fatal patients were reported to have ≥1 chronic medical condition. Compared with seasonal influenza, there was a notable downward shift in age among severe cases with the highest population‐based hospitalization rates among children <5 years old. National population‐based mortality rates ranged from 0.8–1.5/100,000.

Conclusions  The difficulty experienced in tracking the progress of the pandemic globally, estimating its severity early on, and comparing information across countries argues for improved routine surveillance and standardization of investigative approaches and data reporting methods.

Substance abuse and health self-perception in Spanish children and adolescents

OBJECTIVE

The aim of this study was to analyze substance abuse and health self-perception in children and adolescents from the province of Cádiz (Spain).

METHODOLOGY

Participants were 738 students, 50.9 boys and 49.1% girls, from elementary school to high school (1st to 12th grade, mean age 12.2. years), who responded a Spanish adaptation of the Health Behavior in School-aged Children Inventory.

RESULTS

No difference was observed in percentage of boys and girls reporting to smoke or drink alcohol. Smoking and drinking habits increased with age, being higher in 11th and 12th grade students. Significant differences were observed among the percentage of smokers and non smokers recognizing to have parents, older brothers or friends who smoke. Rates of drug abuse were generally low, being cannabis the most frequently consumed illicit drug. Most respondents had a perception of excellent or good health, with no significant gender differences. About half of subjects considered that health exclusively depends on self behavior, but an important percentage also gave a relevant role to luck. Stomach-ache was the most frequent physical complaint, followed by headache. Psychological complaints mainly corresponded to nervousness and bad temper. Only a small percentage of subjects declared the use of medicines or tablets without prescription. No significant difference in the percentage of respondent who perceived an excellent or good health was observed among substance users and non users.

CONCLUSIONS

Substance abuse and health self-perception in children and adolescents are the result of the interaction of a complex series of individual and social factors. Activities aimed to improve health focusing on partial aspects of adolescents' lifestyle most probably will have limited results, and global programs are required.

Preliminary study of the inflammatory response to subcutaneous implantation of three root canal sealers

AIM

To evaluate the kinetics of the inflammatory tissue response to three root canal sealers using a physicochemical method for quantification of the enhanced vascular permeability and histopathological analysis.

METHODOLOGY

Twenty-eight male Wistar rats randomly assigned to four groups according to the evaluation periods (1, 3, 7 and 14 days) were used to assess the vascular permeability and histopathological reaction to RoekoSeal, AH Plus and Sealapex (new formulation) sealers, using saline and Chloropercha as negative and positive controls, respectively. Seven rats were sacrificed per period. The biocompatibility of the sealers was evaluated spectrophotometrically and histopathologically.

RESULTS

At day 14, Sealapex produced significantly more inflammatory exudate than AH Plus and RoekoSeal (P < 0.05); however, there was no significant difference between AH Plus and RoekoSeal (P > 0.05). Sealapex (new formulation) was the most irritating sealer, producing severe inflammation with the presence of multinucleated giant cells. RoekoSeal was the most biocompatible sealer, producing the least amount of inflammatory exudate.

CONCLUSIONS

RoekoSeal root canal sealer was biocompatible when implanted in connective tissue.

[Positive sentinel node risk in relation to oestrogen receptors in breast cancer in premenopausal and postmenopausal women]

OBJECTIVE

The influence of the relationship between pre- and post-menopausal stage of patients with breast cancer (BC) and the risk of sentinel lymph node (SLN) metastasis as well as the influence of oestrogen receptor (ER) status within each one of these groups were analyzed.

METHODS

A BC database with 1,388 patients was analysed. Three age groups were studied: A, elderly postmenopausal, 200 patients, ≥ 70 years old; B, younger postmenopausal, 89 patients, 55-69 years old; C, premenopausal, 85 patients, <55 years old. In each group 2 subgroups were analyzed: positive ER and negative ER tumours. Data analysed: SLN-positive patients, non-sentinel node (NSN)-positive patients, non-surgical detections (NSD) and non disease-free (NDF) patients after a follow-up of 52 months.

STATISTICAL ANALYSIS

chi-squared test, significance: P ≤ 0.05.

RESULTS

SLN metastasis was significantly (P<0.025) more common in premenopausal than in postmenopausal patients, and within those, mainly in negative ER tumours. Positive-NSN increases slightly in premenopausal patients (exclusively in negative ER tumours). NDF patients are similar in the 3 groups and in all of them it is much more frequent in negative ER tumours.

CONCLUSION

SLN metastasis varies significantly according to hormonal state and not according to age, being more frequent in premenopausal patients and mainly in ER negative tumours.

Pandemic (H1N1) 2009 in breeding turkeys, Valparaiso, Chile

Pandemic (H1N1) 2009 virus was detected in breeding turkeys on 2 farms in Valparaiso, Chile. Infection was associated with measurable declines in egg production and shell quality. Although the source of infection is not yet known, the outbreak was controlled, and the virus was eliminated from the birds.

[Health behaviour of school children at the province of Cádiz]

OBJECTIVE

The aim of this study was to analyze some characteristics of health-related behaviour in school children at the province of Cadiz, centering on engagement in sports and physical activity, and on dietary habits.

METHODOLOGY

Participants were 738 students, mean age 12.2 years, from primary school o high school. 50.9% were boys and 49.1% girls, who responded a Spanish adaptation of the Health Behavior in Schoolchildren Inventory.

RESULTS

Sex differences were observed in the percentage of subjects not engaged in sports, which was higher in girls. Boys practiced sports and physical activity at a higher intensity and more time than girls. A large number of subjects considered good or normal their physical fitness, with only and small percentage describing it as regular. More than half of participants felt a support by parents, and to a smaller extent by brothers and friends. An important part of the subjects did not have breakfast every day, and some even never. A high percentage of the sample ate candies 1 to 3 days per week, being also high the intake of chips, nuts, hamburgers and sausages. Near a quarter of subjects reported not to consume vegetables.

CONCLUSIONS

Results obtained confirm the necessity of an adequate lifestyle habits education and the development of intervention programs in children and youth, counseling on diet and physical activity and targeting on girls, who are less physically active and on risk of serious disorders.

Circulating chromogranin A as a marker for poor-prognosis hormone refractory prostate cancer without neuroendocrine features: Prospective analyses of a cohort of patients

e16130

Background: Some patients may develop hormone refractory prostate (HRPC) cancer with neuroendocrine features, although they were not recognizable in the initial biopsy. Serum chromogranin is a marker for tumors with neuroendrocrine differentiation. Purpose: To analyze if serum levels of chromogranin A may identify poor prognosis HRPC patients in patients without neuroendocrine features in the initial biopsy. Methods: Circulating chromogranin A was prospectively analyzed in 34 patients when they were diagnosed under the standard criteria of HRPC. A patient was considered to have higher than normal levels of serum chromogranin if levels were above 100 ug/L. Patients were also assessed for serum PSA, enolase, serum alkaline phosphatase, albumin, and hemoglobin. Results were correlated with clinical prognostic factors as ECOG, PSA double time and Gleason score. We analyzed the time to hormone-refractory disease since diagnosis, and overall survival, as well as pattern of relapse (visceral vs. nonvisceral disease). Results: Median age was 63 (49–85). Median PSA was 33 (0.04–1455). At baseline, 16 patients were chromogranin-negative (46%), and 18 patients were chromogranin-positive (54). Chromogranin A did not correlate with either enolase or PSA. Patients with positive (>100 ug/L) had stadistically significant lower levels of hemoglobine (13.8 vs 12.3), and a trend to have more visceral disease vs locoregional diasease or bone metastases, a lower albumine level (39.85 vs 45.05), higher alkaline phosphatase (221 vs 111), and LDH (1,914.5 vs 415). In this group of patients, we did not find differences in PSA double time, time to hormone-refractory disease or Gleason score. Conclusions: The analysis of this cohort of patients suggests that serum chromogranine A correlates with other known adverse prognosis factors of survival in prostate cancer patients.

No significant financial relationships to disclose.

Treatment of childhood glial tumors with cisplatin and irinotecan

10062

Background: Childhood glial tumors are heterogeneous neoplasias for which non-surgical management is controversial. After a pilot study suggesting that irinotecan/cisplatin (I/C) may be effective in children (Mora et al, Neuro Oncol 2007), we initiated a phase II prospective trial with the aim of avoiding radiation therapy for low grade's (LG) and improve outcome for high grade's (HG). Methods: The indication for adjuvant therapy was based upon histology, the extent of surgical resection, and the presence of clinical or neuroradiological signs of progression. Weekly Irinotecan (50 mg/m2 and 65 mg/m2 the last 2 cycles) and Cisplatin (30 mg/m2) for four consecutive weeks (1 cycle), and a total of 4 cycles was used. Results: From January 2004 to December 2007, 30 children aged 6 months to 17 years were treated, 21 at diagnosis, 7 at progression and 2 at relapse. Fourteen tumors were WHO grades I-II gliomas (LGG), 10 grade III (6 gliomas, 2 anaplastic ependymomas and 2 AT/RT), and 6 had no biopsy (3 brainstem (BST) and 3 optic-pathway tumors (OPT)). Two patients had type-1 neurofibromatosis and OPT. Primary sites included: 4 supratentorial, 8 BST, 9 OPT, 2 cerebellar, and 7 spinal. Prior to the I/C regimen, gross total resection was performed in 7 and biopsy in 14 tumors; 9 patients received chemotherapy and 5 radiotherapy. All but 6 patients, 2 because of C allergy and 4 BST because of progression, completed the protocol, with no grade 3–4 side effects. Vomiting was the main side effect. Twenty (90%) of 22 patients with evaluable clinical symptoms had a complete and rapid response, with objective functional recovery. With a median follow-up of 25 months, 14 (47%) patients had a complete/partial response (7 out of 10 HG), 10 (40%) had stable disease (8 out of 14 LG), and 6 (20%) progressed (all BST). Five patients died of disease, all BST. Twenty-five (83%) patients remain progression-free, median 27 months from protocol entry. Conclusions: Seventy percent objective response rate for HG and avoidance of radiotherapy for 93% of LG was obtained using the I/C regimen. Remarkable fast clinical responses and functional recoveries occurred.

No significant financial relationships to disclose.

Treatment of relapsed/refractory pediatric sarcomas with gemcitabine and docetaxel

10059

Background: Cure rates for children andadolescent's cancer have improved steadily for most tumor types. However, recurrent disease or progressive-refractory sarcomas remain incurable and most of these patients die within 1 to 2 years after diagnosis. In this report we describe experience with gemcitabine-docetaxel (G+D) in pediatric patients with relapsed or refractory sarcomas. Methods: Ten relapsed/refractory pediatric sarcoma patients including 6 Ewing sarcoma, 2 synovial sarcoma, 1 osteosarcoma, and 1 undifferentiated sarcoma were treated in an outpatient setting with gemcitabine 1000 mg/m2 over 90 minutes on day 1 and 8, and docetaxel 100 mg/m2 ver 3 to 4 hours on day 8 of a 21-day cycle, as an investigational rescue therapy. Results: A median of 7 cycles were given per patient (range, 4 to 10), and a total of 70 cycles were administered. To date, 2 patients continue on treatment. All symptomatic patients responded clinically to this regimen. No grade 3–4 toxicities were encountered. Five patients (50%) had a CR/functional CR, 4 patients (40%) had a PR/SD, and 2 patients (20%) had PD, which provides an overall response rate (CR+PR/SD) of 90%. Prolonged disease stabilization was achieved even for multiple relapsed patients with the G + D regimen, median duration of responses 11 months. Five out of the 10 patients (50%) are alive, median follow-up 48 months from diagnosis. Conclusions: The G + D regimen seems to be active against advanced pediatric sarcomas. It does not exacerbate pre-existing toxicities and allows good quality of life. Evaluation in a large, formal phase II trial for ES patients is ongoing.

No significant financial relationships to disclose.