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- [The effectiveness of the treatment program "Enjoy eating" on health and mood in obese women]. [English Abstract, Journal Article, Randomized Controlled Trial]
- Laeknabladid 2014 Jan; 100(1):27-33.
Obesity is one of the greatest public health challenges world wide and its prevalence has increased during the past 20-30 years. Obesity is related to physical and mental health and increased mortality. There are few evidence-based treatment options for the obese available in Iceland.The purpose of this pilot study was to develop a 15 week group program based on Cognitive Behavior Therapy and Appetite Awareness Training for young obese women. The participants were randomly allocated to two groups, A and B, in a convenience sample of 20 women, aged 19-44 with a BMI 30-39.9 kg/m². Group A attended the program while group B served as a control in a crossover design where group B subsequently participated in the program. The effectiveness of the program was evaluated before, during and at the end of the program and at six and twelve month follow-up. Information was collected on body weight, BMI, body fat and body fat mass, blood pressure, cholesterol, triglyceride, high density lipoprotein and 25(OH)D, quality of life (SF-36 and OP scale), symptoms of depression (BDI-II) and anxiety (BAI). Additionally participants completed a questionnaire on demographics and their view on participating in the program was assessed.Participants reduced their weight (P=0.001), BMI (P=0.001), body fat (P=0.010), body fat mass (P=0.002), diastolic blood pressure (P=0.005) and vitamin D status improved (P=0.008). Symptoms of depression and anxiety decreased (P<0.001 and P<0.004). Quality of life measured with OP scale improved (P=0.006) and the mental component summary (MCS) (P=0.012) of the SF-36 scale. The mean weight loss was 3.7 kg following intervention which was maintained at follow up."The enjoy eating" program is a promising health promotion approach in the health care sector for obese women to improve mental health, quality of life and loose weight.
- Electroacupuncture improves cardiac function and remodeling by inhibition of sympathoexcitation in chronic heart failure rats. [JOURNAL ARTICLE]
- Am J Physiol Heart Circ Physiol 2014 Feb 28.
Chronic heart failure (CHF) is responsible for significant morbidity and mortality worldwide, mainly as a result of neurohumoral activation. Acupuncture has been used to treat a wide range of diseases and conditions. In this study, we investigated the effects of electroacupuncture (EA) on the sympathetic nerve activity, heart function and remodeling in CHF rats after ligation of the left anterior descending coronary artery. CHF rats were randomly selected to EA and control groups for acute and chronic experiments. In the acute experiment, both the renal sympathetic nerve activity (RSNA) and cardiac sympathetic afferent reflex (CSAR) elicited by epicardial application of capsaicin were recorded. In the chronic experiment, we performed EA for 30 minutes once a day for 1 week to test the long-term EA effects on heart function , remodeling as well as infarct size in CHF rats. The results show EA significantly decreased the RSNA effectively, inhibited CSAR and lowered the blood pressure of CHF rats. Treating CHF rats with EA for 1 week dramatically increased left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS); and reversed the enlargement of left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic dimension (LVEDD); and shrunk the infarct size. In this experiment, we demonstrated EA attenuates sympathetic overactivity. Additionally, long-term EA improves cardiac function and remodeling and reduces infarct size in CHF rats. EA is a novel and potentially useful therapy for treating CHF. Key words: heart failure, electroacupunture, renal sympathetic nerve activity, cardiac sympathetic afferent reflex.
- From pericytes to perivascular tumours: correlation between pathology, stem cell biology, and tissue engineering. [JOURNAL ARTICLE]
- Int Orthop 2014 Feb 25.
Pericytes were once thought only to aid in angiogenesis and blood pressure control. Gradually, the known functions of pericytes and other perivascular stem cells (PSC) have broadly increased. The following review article will summarize the known functions and importance of pericytes across disciplines of pathology, stem cell biology, and tissue engineering.A literature review was performed for studies examining the importance of pericytes in pathology, stem cell biology, and tissue engineering.The importance of pericytes most prominently includes the identification of the perivascular identity of mesenchymal stem cells (or MSC). Now, pericytes and other PSC are known to display surface markers and multilineage differentiation potential of MSC. Accordingly, interest in the purification and use of PSC for mesenchymal tissue formation and regeneration has increased. Significant demonstration of in vivo efficacy in bone and muscle regeneration has been made in laboratory animals. Contemporaneously with the uncovering of an MSC identity for pericytes, investigators in tumour biology have found biologically relevant roles for pericytes in tumor formation, lymphovascular invasion, and perivascular tumor spread. As well, the contribution of pericytes to perivascular tumors has been examined (and debated), including glomus tumour, myopericytoma and solitary fibrous tumour/hemangiopericytoma. In addition, an expanding recognition of pericyte mimicry and perivascular tumour invasion has occurred, encompassing common malignancies of the brain and skin.In summary, pericytes have a wide range of roles in health and disease. Pericytes are being increasingly studied for their role in tumour formation, growth and invasion. Likewise, the application of pericytes/PSC for mesenchymal tissue engineering is an expanding field of interest.
- Multivariate generalized multifactor dimensionality reduction to detect gene-gene interactions. [Journal Article]
- BMC Syst Biol 2013.:S15.
Recently, one of the greatest challenges in genome-wide association studies is to detect gene-gene and/or gene-environment interactions for common complex human diseases. Ritchie et al. (2001) proposed multifactor dimensionality reduction (MDR) method for interaction analysis. MDR is a combinatorial approach to reduce multi-locus genotypes into high-risk and low-risk groups. Although MDR has been widely used for case-control studies with binary phenotypes, several extensions have been proposed. One of these methods, a generalized MDR (GMDR) proposed by Lou et al. (2007), allows adjusting for covariates and applying to both dichotomous and continuous phenotypes. GMDR uses the residual score of a generalized linear model of phenotypes to assign either high-risk or low-risk group, while MDR uses the ratio of cases to controls.In this study, we propose multivariate GMDR, an extension of GMDR for multivariate phenotypes. Jointly analysing correlated multivariate phenotypes may have more power to detect susceptible genes and gene-gene interactions. We construct generalized estimating equations (GEE) with multivariate phenotypes to extend generalized linear models. Using the score vectors from GEE we discriminate high-risk from low-risk groups. We applied the multivariate GMDR method to the blood pressure data of the 7,546 subjects from the Korean Association Resource study: systolic blood pressure (SBP) and diastolic blood pressure (DBP). We compare the results of multivariate GMDR for SBP and DBP to the results from separate univariate GMDR for SBP and DBP, respectively. We also applied the multivariate GMDR method to the repeatedly measured hypertension status from 5,466 subjects and compared its result with those of univariate GMDR at each time point.Results from the univariate GMDR and multivariate GMDR in two-locus model with both blood pressures and hypertension phenotypes indicate best combinations of SNPs whose interaction has significant association with risk for high blood pressures or hypertension. Although the test balanced accuracy (BA) of multivariate analysis was not always greater than that of univariate analysis, the multivariate BAs were more stable with smaller standard deviations.In this study, we have developed multivariate GMDR method using GEE approach. It is useful to use multivariate GMDR with correlated multiple phenotypes of interests.
- Gene-centric Meta-analysis in 87,736 Individuals of European Ancestry Identifies Multiple Blood-Pressure-Related Loci. [JOURNAL ARTICLE]
- Am J Hum Genet 2014 Mar 6; 94(3):349-360.
Blood pressure (BP) is a heritable risk factor for cardiovascular disease. To investigate genetic associations with systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP), we genotyped ∼50,000 SNPs in up to 87,736 individuals of European ancestry and combined these in a meta-analysis. We replicated findings in an independent set of 68,368 individuals of European ancestry. Our analyses identified 11 previously undescribed associations in independent loci containing 31 genes including PDE1A, HLA-DQB1, CDK6, PRKAG2, VCL, H19, NUCB2, RELA, HOXC@ complex, FBN1, and NFAT5 at the Bonferroni-corrected array-wide significance threshold (p < 6 × 10(-7)) and confirmed 27 previously reported associations. Bioinformatic analysis of the 11 loci provided support for a putative role in hypertension of several genes, such as CDK6 and NUCB2. Analysis of potential pharmacological targets in databases of small molecules showed that ten of the genes are predicted to be a target for small molecules. In summary, we identified previously unknown loci associated with BP. Our findings extend our understanding of genes involved in BP regulation, which may provide new targets for therapeutic intervention or drug response stratification.
- Determinants of health-related quality of life among community dwelling elderly. [Journal Article]
- Ann Acad Med Singapore 2014 Jan; 43(1):3-10.
Introduction: This study determines the associations between self-reported chronic conditions, limitations in activities of daily living and health-related quality of life (HRQoL) among community dwelling elderly in Singapore. Materials and
Methods:A populationbased cross-sectional survey was conducted among a random sample of 4200 residents from 58 blocks of dwellings in Marine Parade housing estate between April and May 2011. A structured questionnaire was used to collect data on demographic characteristics; chronic disease profile, health screenings, healthcare utilisation, physical activity, activities of daily living (ADL) and functional ability and health related quality of life. Quality of life was assessed using European Quality of life 5 Domain (EQ-5D). Ordinary least squares (OLS) regression was used to identify independent predictors of health related quality of life.
Results:A total of 2454 respondents for included for analysis. Most of the respondents were females (57.2%) and aged between 65 and 74 years (48.5%). Among them, 79.1% of the respondents were Chinese. Approximately three-fourth (77.5%) of the survey respondents reported having at least one of the 13 chronic medical conditions; high blood pressure (57.7%), high blood cholesterol (51.6%), diabetes (22.9%) were the most commonly reported conditions. Independent predictors of HRQoL with greatest decrements in EQ-5D index and visual analog scores (VAS) were unemployment, selfreported depression, arthritis and osteoporosis and ADL limitations for activities such as "unable to shower", "unable to do housework" and elderly with depressive symptoms (GDS score ≥ 5).
Conclusion:The study had identified predictors of HRQoL in elderly Singapore residents and also provides community-based EQ-5D index and VAS scores associated with a wide variety of chronic conditions and ADL limitations.
- Thermodilution-Derived Coronary Blood Flow Pattern Immediately After Coronary Intervention as a Predictor of Microcirculatory Damage and Midterm Clinical Outcomes in Patients With ST-Segment-Elevation Myocardial Infarction. [JOURNAL ARTICLE]
- Circ Cardiovasc Interv 2014 Feb 18.
Despite a sufficient coronary blood flow after primary percutaneous coronary intervention for patients with ST-segment-elevation myocardial infarction; some patients have a poor outcome because of microcirculatory damage. This study evaluates whether the thermodilution-derived coronary blood flow parameters immediately after primary percutaneous coronary intervention predict early microvascular damage and midterm outcomes in patients with ST-segment-elevation myocardial infarction.Using a pressure sensor/thermistor-tipped guidewire, we measured the index of microcirculatory resistance at maximum hyperemia, and coronary blood flow pattern was assessed from the thermodilution curves after successful primary percutaneous coronary intervention in 88 patients with ST-segment-elevation myocardial infarction. Coronary blood flow pattern was classified into 3 groups according to the shape of thermodilution curve: a narrow unimodal (n=41), a wide unimodal (n=32), or bimodal (n=15). All patients had contrast-enhanced cardiac magnetic resonance scans within 2 weeks. The index of microcirculatory resistance values were significantly higher both in a wide unimodal and in a bimodal groups than in a narrow unimodal group (65±41 and 76±38 versus 20±9U; P<0.001). Bimodal group had higher prevalence of microvascular obstruction on contrast-enhanced cardiac magnetic resonance when compared with the other groups (100%, 78%, and 30%; P<0.001). Patients in bimodal group had a higher risk of death and heart failure rehospitalization at 6 months (73%, 6.3%, 7.3%; P<0.001). Multivariate analysis revealed that bimodal shape of the thermodilution curve was the only independent predictor of cardiac death at 6 months after ST-segment-elevation myocardial infarction (P<0.01).A bimodal shape of the thermodilution curve, which may indicate myocardial edema and consequent extrinsic compression of the capillary network, is associated with microcirculatory damage and poor midterm clinical outcomes rather than index of microcirculatory resistance value itself.
- Cohort Profile: The Social Inequality in Cancer (SIC) cohort study. [JOURNAL ARTICLE]
- Int J Epidemiol 2014 Feb 17.
The Social Inequality in Cancer (SIC) cohort study was established to determine pathways through which socioeconomic position affects morbidity and mortality, in particular common subtypes of cancer. Data from seven well-established cohort studies from Denmark were pooled. Combining these cohorts provided a unique opportunity to generate a large study population with long follow-up and sufficient statistical power to develop and apply new methods for quantification of the two basic mechanisms underlying social inequalities in cancer-mediation and interaction. The SIC cohort included 83 006 participants aged 20-98 years at baseline. A wide range of behavioural and biological risk factors such as smoking, physical inactivity, alcohol intake, hormone replacement therapy, body mass index, blood pressure and serum cholesterol were assessed by self-administered questionnaires, physical examinations and blood samples. All participants were followed up in nationwide demographic and healthcare registries. For those interested in collaboration, further details can be obtained by contacting the Steering Committee at the Department of Public Health, University of Copenhagen, at email@example.com.
- Reproducibility of diabetes quality of care indicators as reported by patients and physicians. [JOURNAL ARTICLE]
- Eur J Public Health 2014 Feb 17.
Introduction: Self-report of diabetes care has moderate validity and is prone to under- and over-reporting. We assessed reproducibility of a range of processes and outcomes of diabetes care as reported by patients and physicians.In a Swiss community-based survey, patients with diabetes and physicians independently reported past 12 months processes of care (HbA1c, lipids, microalbuminuria, blood pressure, weight, foot and eye examinations) and last measured values of HbA1c, height, weight and blood pressure. For dichotomous variables, we assessed reliability by Cohen's kappa and agreement by uniform kappa. For continuous measures, we used Lin's concordance correlation coefficient and limits of agreement, respectively.Mean age of the 210 patients was 65 years; 40% were women, and 51% had diabetes for >10 years. Agreement was good for recommended processes of care such as blood pressure (uniform kappa = 0.94), HbA1c (0.93), weight (0.88) and lipid (0.78), but lower for microalbuminuria, foot and eye examinations (all <0.50). Cohen's kappa values were all low (<0.25). Comparisons of reported continuous variables showed large limits of agreement for height (±6 cm) and weight (8-10 kg) despite high concordance correlation coefficients (0.93 and 0.97). Concordance correlation coefficients were smaller for HbA1c (0.72) and blood pressure (0.5-0.6), with large limits of agreement (±2% and ±25 mmHg).While agreement of routine processes of care was good, agreement was less satisfactory for microalbuminuria, foot and eye examinations. Reports of continuous outcomes yielded good reliability but too wide limits of agreement. Quality of care evaluation relying on self-report only should be made cautiously.
- A comparative analysis of leukocyte and leukocyte subtype counts among isolated systolic hypertensive, systo-diastolic hypertensive and nonhypertensive patients. [JOURNAL ARTICLE]
- Kardiol Pol 2014 Feb 14.
Isolated systolic hypertension (ISHT) is a subtype of hypertension (HT) that often exhibits wide pulse pressure, and pulse pressure has a strong predictive value for future adverse cardiovascular events. Previous studies have shown the effects of : leukocyte count on prognosis of ischemic heart disease and HT.Thus, in this cross-sectional study, we analyzed the relationship between leukocyte counts and subtypes in HT and non-HT groups. The study population consisted of 960 consecutive patients who were admitted to the outpatient clinic of our hospital. After ambulatory blood pressure (ABP) values were assessed, the participants were divided into three groups: isolated systolic hypertensives (98), systo-diastolic hypertensives (405), and nonhypertensives (457).The subjects in the ISHT group were older than those in the systo-diastolic HT and non-HT groups (64±10, 53±12, and 52±13, respectively; p<0.001). The leukocyte and neutrophil counts and neutrophil/lymphocyte (NL) ratios were significantly different in all groups. In subgroup analysis, the leukocyte count, neutrophil count, and N/L ratio were higher in the ISHT and systo-diastolic HT groups than in the non-HT group (p<0.001 for all). The leukocyte count, neutrophil count, and N/L ratio were significantly higher in the ISHT group than in the systo-diastolic HT group (p=0.023, p=0.007, p=0.010, respectively). Neutrophil count (p=0.012; OR=1.229, 95% Cl 1.046-1.444) was independent risk factors for ISHT in multivariate logistic regression analysis.The leukocyte and neutrophil counts and N/L ratios were higher in the ISHT group than in the systo-diastolic HT and non-HT groups. High neutrophil count was an independent predictor of ISHT.