Utility of the hypertriglyceridemic waist phenotype in the cardiometabolic risk assessment of youth stratified by body mass index.

BACKGROUND: It is unclear whether the hypertriglyceridemic waist phenotype (HTWP) can be used to identify those at most risk of cardiometabolic disorders. OBJECTIVES: The utility of the HTWP as a useful predictor of cardiometabolic risk in youth stratified by body mass index was assessed. METHODS: Three hundred and eighty-seven children (12-17.5 years) were used within this cross-sectional study. Participants were classified as normal weight or overweight/obese according to the International Obesity Task Force criteria. The HTWP phenotype was defined as having a waist circumference ≥90th percentile for age and gender with concomitant triglyceride concentrations ≥1.24 mmol L(-1) . Cardiometabolic risk profiles were compared using MANCOVA. RESULTS: Normal weight participants with the HTWP had significantly higher levels of C-reactive protein 2.6 ± 0.4 vs. 1.6 ± 0.3 mg L(-1) (P < 0.05) and cardiometabolic risk scores (1.3 ± 0.3 vs. -0.7 ± 0.2 and 2.1 ± 0.4 vs. -0.5 ± 0.2; both P < 0.05) compared with those of a normal weight without the HTWP. Overweight/obese participants with the HTWP had significantly higher C-reactive protein levels (3.5 ± 0.6 vs. 2.6 ± 0.5; P < 0.05) as well as both cardiometabolic risk scores (1.6 ± 0.6 vs. 0.9 ± 0.2 and 2.2 ± 0.6 vs. 0.8 ± 0.2; both P < 0.001) when compared with overweight/obese participants without the HTWP. CONCLUSIONS: The HTWP may serve as a simple and clinically useful approach to identify youth at increased cardiometabolic risk.

Sprint interval training (SIT) is an effective method to maintain cardiorespiratory fitness (CRF) and glucose homeostasis in Scottish adolescents.

The present study examined the physiological impact of a school based sprint interval training (SIT) intervention in replacement of standard physical education (SPE) class on cardio-respiratory fitness (CRF) and glucose homeostasis during the semester following summer vacation. Participants (n=49) were randomly allocated to either intervention (SIT; n=26, aged 16.9 ± 0.3 yrs) or control group who underwent standard physical education (SPE; n=23, aged 16.8 ± 0.6 yrs). CRF (VO2max) and glucose homeostasis were obtained prior-to and following 7 weeks of SIT exercise. Significant group x time interaction was observed for CRF (P < 0.01) with non-significant trends for fasting insulin (P= 0.08), and HOMA-IR (P=0.06). CRF decreased (P < 0.01) in SPE such that POST intervention CRF was significantly lower (P< 0.05) in SPE. Fasting plasma glucose (P < 0.01), insulin (P< 0.01) and HOMA-IR (P< 0.01) increased significantly amongst SPE. The main finding of the present study is that 7-weeks of SIT exercise is an effective method of maintaining (but not improving) CRF and fasting insulin homeostasis amongst school-going adolescents. SIT exercise demonstrates potential as a time efficient physiological adjunct to standard PE class in order to maintain CRF during the school term.

Strength and body composition changes in recreationally strength-trained individuals: comparison of one versus three sets resistance-training programmes.

PURPOSE: The purpose of this study was to determine the effects of increasing the volume of weight-training from one to three sets upon body composition and muscular strength. METHODS: Sixteen male weight-trainers volunteered to act as subjects and were randomly assigned to one of two training groups. Supervised weight-training targeting the upper body was conducted three times per week for eight weeks using one set (n = 8) or three sets (n = 8) of six repetitions to fatigue. Subjects were measured before and after the training intervention for (1) strength performance (N and kg) and (2) adiposity (sum of seven skinfold thicknesses in mm). RESULTS: Both training groups improved significantly (20.7%) in terms of muscular strength (P < 0.05) with no differences being observed between the one set (21.98% increase) and three set group (20.71% increase) after the training interventions (P > 0.05). Significant decreases were also observed for skinfold measures in the one set group (P < 0.05). CONCLUSIONS: One set of high intensity resistance training was as effective as three sets for increasing the strength of muscle groups in the upper body. The one set protocol also produced significantly greater decreases in adiposity.

Physical activity interventions: effects of duration and intensity.

The purpose of this study was to examine the effects of exercising at different intensities over 7 weeks on components of physical fitness and CVD risk factors. Forty-seven boys and 10 girls, (16.4±0.7 years of age) were divided into a moderate, high intensity, or a control group. All participants had indices of obesity and blood pressure recorded in addition to four physical performance measures pre- and post-intervention. In addition, the intervention groups repeated the physical performance measures at the 4th week phase of the intervention. Following the intervention, significant improvements (P<0.05) in the high-intensity group were found in the 20 MSFT, agility, CMJ and 10 m sprint post-intervention. Participants in the moderate intensity group displayed significant improvements (P<0.05) in both the CMJ and 20 MSFT post-intervention. Body fat % significantly improved (P<0.01) in the moderate group only post-intervention. Interestingly, Systolic blood pressure significantly improved post-intervention (112±10 vs 106±11 mmHg) (P=0.017) in the high intensity group. In conclusion, high-intensity exercise over 7 weeks is a very time efficient means of improving important components of physical fitness in adolescents.

Protein annotation and modelling servers at University College London.

The UCL Bioinformatics Group web portal offers several high quality protein structure prediction and function annotation algorithms including PSIPRED, pGenTHREADER, pDomTHREADER, MEMSAT, MetSite, DISOPRED2, DomPred and FFPred for the prediction of secondary structure, protein fold, protein structural domain, transmembrane helix topology, metal binding sites, regions of protein disorder, protein domain boundaries and protein function, respectively. We also now offer a fully automated 3D modelling pipeline: BioSerf, which performed well in CASP8 and uses a fragment-assembly approach which placed it in the top five servers in the de novo modelling category. The servers are available via the group web site at http://bioinf.cs.ucl.ac.uk/.

Home monitoring service improves mean arterial pressure in patients with essential hypertension. A randomized, controlled trial.

BACKGROUND: Technological advances in the distribution of information have opened new avenues for patient care. Few trials, however, have used telemedicine to improve blood pressure in patients with essential hypertension. OBJECTIVE: To determine the efficacy of a telecommunication service in reducing blood pressure. DESIGN: Randomized, controlled trial. SETTING: University-affiliated primary care outpatient clinics. PATIENTS: 121 adults with essential hypertension who were under evaluation for a change in antihypertensive therapy. INTERVENTION: A home service consisting of automatic transmission of blood pressure data over telephone lines, computerized conversion of the information into report forms, and weekly electronic transmission of the report forms to physicians and patients. MEASUREMENTS: 24-hour ambulatory blood pressure monitoring at baseline and exit. The primary end point was change in mean arterial pressure from baseline to exit. RESULTS: Mean arterial pressure decreased by 2.8 mm Hg in patients receiving the home service and increased by 1.3 mm Hg in patients receiving usual care (P = 0.013 for the difference). Mean diastolic blood pressure decreased by 2.0 mm Hg for home service but increased by 2.1 mm Hg for usual care (P = 0.012 for the difference). Mean systolic blood pressure decreased by 4.9 mm Hg for home service and 0.1 mm Hg for patients receiving usual care (P = 0.047 for the difference). Among African-American patients, mean arterial pressure decreased by 9.6 mm Hg in those receiving home service and increased by 5.25 mm Hg in those receiving usual care (P = 0.047). Part of the decrease in blood pressure for home service was due to more frequent changes in the type or dose of antihypertensive medications. CONCLUSION: This telecommunication service was efficacious in reducing the mean arterial pressure of patients with established essential hypertension.

A rapid classification protocol for the CATH Domain Database to support structural genomics.

In order to support the structural genomic initiatives, both by rapidly classifying newly determined structures and by suggesting suitable targets for structure determination, we have recently developed several new protocols for classifying structures in the CATH domain database (http://www.biochem.ucl.ac.uk/bsm/cath). These aim to increase the speed of classification of new structures using fast algorithms for structure comparison (GRATH) and to improve the sensitivity in recognising distant structural relatives by incorporating sequence information from relatives in the genomes (DomainFinder). In order to ensure the integrity of the database given the expected increase in data, the CATH Protein Family Database (CATH-PFDB), which currently includes 25,320 structural domains and a further 160,000 sequence relatives has now been installed in a relational ORACLE database. This was essential for developing more rigorous validation procedures and for allowing efficient querying of the database, particularly for genome analysis. The associated Dictionary of Homologous Superfamilies [Bray,J.E., Todd,A.E., Pearl,F.M.G., Thornton,J.M. and Orengo,C.A. (2000) Protein Eng., 13, 153-165], which provides multiple structural alignments and functional information to assist in assigning new relatives, has also been expanded recently and now includes information for 903 homologous superfamilies. In order to improve coverage of known structures, preliminary classification levels are now provided for new structures at interim stages in the classification protocol. Since a large proportion of new structures can be rapidly classified using profile-based sequence analysis [e.g. PSI-BLAST: Altschul,S.F., Madden,T.L., Schaffer,A.A., Zhang,J., Zhang,Z., Miller,W. and Lipman,D.J. (1997) Nucleic Acids Res., 25, 3389-3402], this provides preliminary classification for easily recognisable homologues, which in the latest release of CATH (version 1.7) represented nearly three-quarters of the non-identical structures.

Alcohol versus natural drying for newborn cord care.

OBJECTIVE: To compare alcohol cleaning and natural drying of newborn umbilical cords. DESIGN: Prospective, randomized controlled trial. SETTING: Tertiary-level university teaching hospital and level II community hospital. PARTICIPANTS: Of 1,876 singleton full-term newborns enrolled, 1,811 completed the study. INTERVENTIONS: Newborns, from birth until separation of the cord, were randomized to either (a) umbilical cleansing with 70% isopropyl alcohol at each diaper change or (b) natural drying of the umbilical site without special treatment. MAIN OUTCOME MEASURES: Umbilical infection, cord separation time, maternal comfort, and cost. RESULTS: No newborn in either group developed a cord infection. Primary care providers obtained cultures for cord concerns in 32 newborns (1.8%), with colonization for normal flora, Staphylococcus aureus, and Group B streptococcus proportionately equal in alcohol and air dry groups. Cord separation time was statistically significantly different (alcohol group, 9.8 days; natural drying group, 8.16 days; t = 8.9, p = < .001). Mothers described similar comfort with cord care and relief with cord separation. Costs of alcohol drying while in the hospital were greater than those of natural drying. CONCLUSIONS: (a) Evidence does not support continued use of alcohol for newborn cord care; (b) health care providers should explain the normal process of cord separation, including appearance and possible odor; and (c) health care providers should continue to develop evidence to support or eliminate historic practices.

Forecasting the demand for maternity services.

Faced with demands on maternity services exceeding design capacity, one British Columbia hospital commissioned forecasting studies to determine trends in demand and if accurate forecasts could be obtained. In addition to describing the forecasting method employed, the data used and the results, the authors look at what literature is available on obstetrics forecasting.

Diagnosis and management of inflammatory bowel disease.

The onset of ulcerative colitis is characterized by diarrhea and bleeding, while granulomatous ileocolitis may be similar or more obscure with abdominal pain, bowel obstruction, loss of weight, iritis, arthritis or hypoalbuminemia. The diagnosis in ulcerative colitis is made by sigmoidoscopy and barium enema, while small bowel follow through is necessary in ileocolitis. Ulcerative colitis is treated by adrenocorticosteroids as retention enemas when limited to the left colon, intravenous ACTH or steroids in severe pancolitis and oral steroids in others. Sulphasalazine is used in addition to steroids in acute cases and as maintenance to prevent exacerbations. Proctocolectomy is indicated in those with severe disease with complications not responding to steroids. The treatment of Crohn's disease is similar but complicated by small bowel involvement and recurrence after surgery.

Arteriovenous malformation of the stomach.

A patient with chronic anemia is presented who radiologically showed prominent rugae of the stomach. Angiography demonstrated an arteriovenous malformation with a large feeding artery and prominent draining veins.