Exposure to household air pollution from biomass-burning cookstoves and HbA1c and diabetic status among Honduran women.

Household air pollution from biomass cookstoves is estimated to be responsible for more than two and a half million premature deaths annually, primarily in low and middle-income countries where cardiometabolic disorders, such as Type II Diabetes, are increasing. Growing evidence supports a link between ambient air pollution and diabetes, but evidence for household air pollution is limited. This cross-sectional study of 142 women (72 with traditional stoves and 70 with cleaner-burning Justa stoves) in rural Honduras evaluated the association of exposure to household air pollution (stove type, 24-hour average kitchen and personal fine particulate matter [PM2.5 ] mass and black carbon) with glycated hemoglobin (HbA1c) levels and diabetic status based on HbA1c levels. The prevalence ratio (PR) per interquartile range increase in pollution concentration indicated higher prevalence of prediabetes/diabetes (vs normal HbA1c) for all pollutant measures (eg, PR per 84 µg/m3 increase in personal PM2.5 , 1.49; 95% confidence interval [CI], 1.11-2.01). Results for HbA1c as a continuous variable were generally in the hypothesized direction. These results provide some evidence linking household air pollution with the prevalence of prediabetes/diabetes, and, if confirmed, suggest that the global public health impact of household air pollution may be broader than currently estimated.

Regioselective copper-catalyzed direct arylation of benzodithiophene-S,S-tetraoxide.

An efficient copper-catalyzed direct arylation reaction for the regioselective functionalization of benzodithiophene-S,S-tetraoxide has been developed. The method demonstrates a broad scope with isolated yields ranging from good to excellent. Furthermore, the reaction specificity for aryl iodides over the unreactive aryl bromides provide a opportunity to generate a new donor-acceptor-donor triad.

Cardiac health and fitness of Colorado male/female firefighters.

BACKGROUND: Cardiovascular disease (CVD) is documented as the leading cause of mortality in on-duty firefighters. AIMS: To examine the prevalence of metabolic syndrome (MetS) components, cardiorespiratory fitness levels and the association between them in firefighters in Colorado, USA. METHODS: This study included male and female Colorado firefighters. MetS was identified where three or more metabolic abnormalities were present, using Cholesterol Education Program/Adult Treatment Panel III guidelines. Cardiorespiratory fitness (indicated by VO2 max) was evaluated with the Bruce protocol. Poisson regression was conducted to examine the association between MetS components and VO2 max. RESULTS: Among the 947 male and 76 female study subjects, MetS was present in 9% of all firefighters, in 5% of females and 10% of males. The mean age was 37 ± 10 years. MetS prevalence increased with age (from 3% at age <30 to 17% at 50 and older, data not shown). In addition, 35% had one and 19% had two abnormal MetS components and 49% of participants did not meet the minimum recommended VO2 max of 42.0 ml/kg/min. VO2 max was negatively associated with abnormal MetS components (incident rate ratios = 0.95, 95% confidence interval 0.94-0.96, P < 0.001). CONCLUSIONS: About one in 10 of these Colorado firefighters had MetS and nearly half had insufficient cardiorespiratory fitness. Comprehensive CVD risk management and cardiorespiratory fitness improvement are essential for firefighter health and safety.

Lipoprotein-associated phospholipase A2 (Lp-PLA2) and future risk of type 2 diabetes: results from the Cardiovascular Health Study.

INTRODUCTION: Lipoprotein-associated phospholipase A2 (Lp-PLA(2)) has been consistently associated with cardiovascular disease (CVD) risk factors and predictive of CVD outcomes; furthermore, it is consistently higher among type 2 diabetics than nondiabetics. However, the relationships of circulating Lp-PLA(2) mass and activity with incident type 2 diabetes mellitus have not been examined. Therefore, the purpose of this study was to determine the association of Lp-PLA(2) mass and activity with type 2 diabetes among older adults. METHODS: We conducted analyses of Lp-PLA(2) and prevalent and incident diabetes among 5474 men and women from the Cardiovascular Health Study (1989-2007). Lp-PLA(2) mass and activity were measured in baseline plasma. Diabetes status was ascertained annually with medication inventories and repeated blood glucose measurements. Generalized linear and Cox proportional hazards models were used to adjust for confounding factors including body mass index and inflammation. RESULTS: At baseline, the top two quintiles of Lp-PLA(2) activity were significantly associated with prevalent type 2 diabetes with a multivariable relative risk = 1.35 [95% confidence interval (CI) = 1.11-1.63] for quintile 4, and relative risk = 1.33 (95% CI = 1.07-1.66) for quintile 5. Among participants free of diabetes at baseline, we found a significant positive association with both the homeostatic model assessment for insulin resistance and ß-cell function per SD increase in Lp-PLA(2) activity (P values for both <0.01). In prospective analyses, the risk of incident type 2 diabetes was significantly higher among those in the highest quintile of Lp-PLA(2) activity [multivariable hazard ratio = 1.45 (95% CI = 1.01-2.07)] compared with the lowest quintile. Lp-PLA(2) mass was not significantly associated with incident type 2 diabetes. DISCUSSION: Lp-PLA(2) activity is positively associated with insulin resistance and predicts incident type 2 diabetes among older adults independent of multiple factors associated with diabetes pathogenesis.

Effect of self-assembled monolayers on charge injection and transport in poly(3-hexylthiophene)-based field-effect transistors at different channel length scales.

Charge injection and transport in bottom-contact regioregular-poly(3-hexylthiophene) (rr-P3HT) based field-effect transistors (FETs), wherein the Au source and drain contacts are modified by self-assembled monolayers (SAMs), is reported at different channel length scales. Ultraviolet photoelectron spectroscopy is used to measure the change in metal work function upon treatment with four SAMs consisting of thiol-adsorbates of different chemical composition. Treatment of FETs with electron-poor (electron-rich) SAMs resulted in an increase (decrease) in contact metal work function because of the electron-withdrawing (-donating) tendency of the polar molecules. The change in metal work function affects charge injection and is reflected in the form of the modulation of the contact resistance, R(C). For example, R(C) decreased to 0.18 MΩ in the case of the (electron-poor) 3,5-bis-trifluoromethylbenzenethiol treated contacts from the value of 0.61 MΩ measured in the case of clean Au-contacts, whereas it increased to 0.97 MΩ in the case of the (electron-rich) 3-thiomethylthiophene treated contacts. Field-effect mobility values are observed to be affected in short-channel devices (<20 µm) but not in long-channel devices. This channel-length-dependent behavior of mobility is attributed to grain-boundary limited charge transport at longer channel lengths in these devices.

Omega-3 fatty acids and lipoprotein associated phospholipase A(2) in healthy older adult males and females.

PURPOSE: Lipoprotein associated phospholipase A(2) (Lp-PLA(2)) is a novel inflammatory factor that has been independently associated with stroke and cardiovascular disease (CVD). Omega-3 fats have been implicated in reducing inflammation associated with CVD. The aim of this study was to determine if an 8-week isocaloric diet supplemented with eicosapentaenoic acid (EPA) and docosahexaenoic (DHA) in the form of fish oil or α-linolenic acid (ALA) in the form of flaxseed oil would alter Lp-PLA(2) among healthy adults ages 50 years and older. METHODS: Fifty-nine healthy adults (~75% female, average age 61 years) were randomized to one of three groups with equal amounts of total fat intake. All capsules contained ~1 g of fat. The control group (n = 19) consumed olive oil capsules (~11 g/day); the ALA group (n = 20) consumed flaxseed oil capsules (~11 g/day) and the EPA/DHA group (n = 20) consumed fish oil capsules (~2 g/day + 9 g/day of olive oil). Fasting blood samples were obtained before and after the 8-week intervention for determination of Lp-PLA(2) mass and activity as well as lipid values. RESULTS: We did not find any significant changes in Lp-PLA(2) mass or activity after the intervention in any of the groups; however, change in oxidized LDL was associated with change in Lp-PLA(2) mass (r = 0.37, p < 0.01). CONCLUSION: Supplementing the diet with omega-3 fatty acids for 8-weeks did not influence Lp-PLA(2) activity or mass among older adults; altering oxidized LDL may be necessary to see changes in Lp-PLA(2) levels.

Lipoprotein-associated phospholipase A(2) and future risk of subclinical disease and cardiovascular events in individuals with type 2 diabetes: the Cardiovascular Health Study.

AIMS/HYPOTHESIS: Type 2 diabetes is an established risk factor for cardiovascular disease (CVD). This increased risk may be due in part to the increased levels of inflammatory factors associated with diabetes. Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is a risk marker for CVD and has pro-inflammatory effects in atherosclerotic plaques. We therefore sought to determine whether Lp-PLA(2) levels partially explain the greater prevalence of subclinical CVD and greater incidence of CVD outcomes associated with type 2 diabetes in the Cardiovascular Health Study. METHODS: We conducted a cross-sectional and prospective study of 4,062 men and women without previous CVD from the Cardiovascular Health Study (1989 to 2007). Lp-PLA(2) mass and activity were measured in baseline plasma. Subclinical disease was determined at baseline and incident CVD was ascertained annually. We used logistic regression for cross-sectional analyses and Cox proportional hazards models for incident analyses. RESULTS: At baseline, Lp-PLA(2) mass did not differ significantly by type 2 diabetes status; however, Lp-PLA(2) activity was significantly higher among type 2 diabetic individuals. Baseline subclinical disease was significantly associated with baseline diabetes and this association was similar in models unadjusted or adjusted for Lp-PLA(2) (OR 1.68 [95% CI 1.31-2.15] vs OR 1.67 [95% CI 1.30-2.13]). Baseline type 2 diabetes was also significantly associated with incident CVD events, including fatal CHD, fatal myocardial infarction (MI) and non-fatal MI in multivariable analyses. There were no differences in these estimates after further adjustment for Lp-PLA(2) activity. CONCLUSIONS/INTERPRETATION: In this older cohort, differences in Lp-PLA(2) activity did not explain any of the excess risk for subclinical disease or CVD outcomes related to diabetes.

Diet and metabolic syndrome.

Given the higher burden of risk factors for metabolic syndrome (MetS) on morbidity and mortality, it is critical to prevent the development of metabolic syndrome in the first place. While dietary habits have been favorably associated with some of the factors included in the definition of metabolic syndrome, limited and inconsistent data have been reported on the role of nutrition in the development of metabolic syndrome. Currently, there is no consensus as to which dietary patterns would confer the lowest risk of MetS. Identification of dietary patterns, food groups, or nutrients that may lower the incidence of metabolic syndrome could improve prevention strategies as well as prognosis among subjects with existing MetS. This manuscript reviews current evidence on dietary patterns, consumption of fat, whole grains, carbohydrate quality and quantity, and moderate alcohol consumption as they relate to metabolic syndrome.

The peroxisome proliferator-activated receptor gamma coactivator-1 alpha gene (PGC-1alpha) is not associated with type 2 diabetes mellitus or body mass index among Hispanic and non Hispanic Whites from Colorado.

The objective of the study was to test for an association between type 2 diabetes mellitus (T2DM) and body mass index (BMI) and three single nucleotide polymorphisms (SNP)s in the peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1alpha) gene. We were also interested in whether these associations differed by tertiles of diet, physical activity or presence of polymorphisms in the peroxisome proliferator-activated receptor gamma (PPAR-gamma) gene among Hispanics and Non-Hispanic Whites (NHW) from Colorado. We studied 216 Hispanic pedigrees (1850 nuclear families) and 236 NHW pedigrees (1240 families) from the San Luis Valley and Denver. We genotyped the Gly482Ser, Thr528Thr and Thr612Met polymorphisms in the PGC-1alpha gene and the Pro12Ala polymorphism of the PPAR-gamma gene. Historical physical activity (average METS/week) as well as average dietary intake over the past year was assessed by self-report. Data were analyzed using the Family Based Association Test (FBAT) as well as generalized estimating equations (GEE). We did not find any significant association between three SNPs in the PGC-1alpha gene and T2DM in Hispanics or NHW; however, using FBAT, we found the common Thr612Thr allele of the PGC-1alpha gene to be associated with T2DM among Hispanic subjects carrying the rare Pro12Ala allele of the PPAR-gamma gene (p=.003). We found similar associations when we considered a haplotype containing that allele (p=.002). However, the results of the GEE analysis did not confirm these findings: odds ratio (OR)=1.68, 95% CI (0.5, 5.2) suggesting these results may due to chance. BMI also did not show any consistent associations with the PGC-1alpha gene. In conclusion, we did not find an association between the PGC-1alpha gene and T2DM or BMI and there were no consistent interactions with diet, physical activity or the Pro12Ala polymorphism of the PPAR-gamma gene.

Genetic and environmental influences on body fat and blood pressure in African-American adult twins.

OBJECTIVE: African Americans have a particularly high prevalence of excessive body fat and high blood pressure. Genetic and environmental influences may be implicated for both of these risk factors. We investigated the potential for common genetic and environmental influences on body fat (waist circumference (WC), body mass index (BMI)) and blood pressure measures (systolic and diastolic pressure (SBP, DBP)) among African-American male and female subjects. RESEARCH METHODS AND PROCEDURES: Measurements were taken as part of the Carolina African-American Twin Study of Aging (CAATSA). The CAATSA sample contains 217 same-sex African-American male and female twins with average age of 47 years. This analysis included 39 monozygotic male pairs (MZ), 43 dizygotic male pairs (DZ); 63 MZ female pairs, and 72 DZ female pairs. Maximum likelihood quantitative genetic analyses were used. RESULTS: The total genetic variance for SBP was 22% in male subjects and 40.1% in female subjects. Of this total variance, 3.1% was in common with BMI in male subjects and 6% was in common with BMI in female subjects. After controlling for the effects of BMI, WC had less than 1% of its variance in common with SBP in male and female subjects. For DBP, the total genetic variance was 16.9% in male and 38.7% in female subjects. Of this total variance 6.1% was in common with BMI in male subjects and 3.7% was in common in female subjects. Again, WC had less than 1% of its genetic variance in common with DBP in both male and female subjects. The environmental variance common among these measures was also very small. The remaining variance was primarily accounted for by genetic and environmental effects unique to each measure as well as age. DISCUSSION: Based on the very small common genetic variance for BMI, SBP, and DBP as well as WC and the blood pressure measures, our results suggest that searching for common genes among these measures may be inconclusive.

Sports injuries in adolescents.

Musculoskeletal injuries are the most common injuries in youth sports. A number of growth-related factors unique to the adolescent age group play an important role in the epidemiology, types, and management of these injuries. These mainly relate to the physical and psychosocial growth and development during adolescence and are discussed in this article. Overuse injuries are more commonly seen in this age group in the primary care setting. Shoulder impingement, elbow and shoulder injuries related to throwing, stress injuries of the wrist, spondylolysis, and anterior knee pain are some of the overuse injuries reviewed in this article.

Genetic and environmental influences on body fat distribution, fasting insulin levels and CVD: are the influences shared?

Central body fat distribution has been shown to be related to hyperinsulinemia, insulin resistance, hypertriglyceridemia, and atherosclerosis to a greater degree than general obesity. There are known to be both genetic and environmental effects on all components of this clustering. Whether these genetic effects are due to one set of genes in common to the components or whether genetic influences on insulin resistance and/or general/abdominal fatness 'turn on' other genes that affect other components of the syndrome is not clear. We analyzed data from the Swedish Adoption/Twin Study of Aging (60% female; monozygotic = 116, dizygotic = 202; average age 65 years) to determine whether there were genetic and/or environmental factors shared among general body fat distribution, abdominal body fat distribution, fasting insulin levels and cardiovascular disease. We found additive genetic effects in males to be significantly different from those in females with genetic effects accounting for variance in waist-hip ratio (males = 28%; females = 49%), body mass index (males = 58%; females = 73%), fasting insulin levels (FI) (males = 27%; females = 49%), and cardiovascular disease (CVD) (males = 18%; females = 37%). There were also shared genetic and environmental effects among all the variables except CVD, but a majority of the genetic variance for these measures was trait specific.

Implications of body fat distribution in an older twin population.

BACKGROUND: As people age, fat becomes preferentially deposited in the abdominal region over the periphery, and such changes are thought to be associated with adverse metabolic outcomes. We were interested in whether body mass index (BMI) and waist-hip ratio (WHR) are differentially associated with fasting insulin levels, triglycerides, and blood pressure (systolic and diastolic) in an older population. We were also interested in whether these associations change after controlling for genetic influences. METHODS: Data were obtained as part of the Swedish Adoption/Twin Study of Aging. All blood samples and anthropometric measures were assessed from 1989-1991 except insulin, which was assessed from 1986-1988. The sample contains 263 twin pairs (97 monozygotic and 166 dizygotic), 56% women, average age 65 years. RESULTS: In men and women, WHR and BMI were significantly associated with all the metabolic variables except for diastolic blood pressure. When BMI's association with the metabolic variables was assessed independent of WHR, it remained significantly associated with all metabolic variables except diastolic blood pressure in men and triglycerides in women. When WHR's association with the metabolic variables was assessed independent of BMI, it did not remain significantly associated with any of the metabolic variables in men and remained significantly associated with insulin and diastolic pressure in women. After controlling for genetic effects, the relationship between WHR and the metabolic variables became nonsignificant. However, BMI remained significantly associated with systolic blood pressure and triglycerides in men, independent of WHR. CONCLUSION: The results suggest that overall body fat is important to consider in relation to these metabolic parameters in older individuals. The results also suggest that BMI may share associations with blood pressure and triglycerides beyond those that can be attributed to familial influences.

Genetic and environmental influences on waist-to-hip ratio and waist circumference in an older Swedish twin population.

OBJECTIVE: To investigate the genetic and environmental influences on waist-to-hip ratio (WHR) and waist circumference (WC) measurements in males and females. DESIGN: Measurements taken from 1989-1991 as part of The Swedish Adoption/Twin Study of Aging (SATSA) were used for analysis. The SATSA sample contains both twins reared together as well as twins reared apart. SUBJECTS: 322 pairs of twins (50 identical, 82 fraternal male pairs and 67 identical, 123 fraternal female pairs); age range: 45-85y (average age, 65y). MEASUREMENTS: Waist-to-hip ratio (WHR), waist circumference (WC) and body mass index (BMI). RESULTS: In males, additive genetic effects were found to account for 28% of the variance in WHR and 46% of the variance in WC. In females, additive genetic effects were found to account for 48% of the variance in WHR and 66% of the variance in WC. The remaining variance in males was attributed to unique environmental effects (WHR, 72%; WC, 54%) and in females the remaining variance was attributed to unique environmental effects (WHR, 46%; WC, 34%) and age (WHR, 6%). When BMI was added into these models it accounted for a portion of the genetic and environmental variance in WHR, and over half of the genetic and environmental variance in WC. CONCLUSION: There are both genetic and environmental influences on WHR and WC, independent of BMI in both males and females, and the differences between the sexes are significantly different.

Psychological and behavioral predictors of body fat distribution: age and gender effects.

OBJECTIVE: Abdominal fat has been shown to be associated with several adverse outcomes including diabetes, cardiovascular disease, and hypertension. Risk factors for abdominal fatness include genetic effects, age, and gender. Most recently, it has been hypothesized that psychological factors, as well as behavioral factors, may play a part in where fat is distributed. The purpose of this study was to assess the longitudinal predictive power of psychological variables (cynicism, anger, anxiety, and depression) measured in 1987 on waist-hip ratio (WHR) measured from 1992 to 1994 among different age and gender groups, as well as to test if alcohol consumption or smoking (measured in 1990) would mediate any of the relationships found. RESEARCH METHODS AND PROCEDURES: Data from the Swedish Adoption/Twin Study of Aging (n = 1392; average age: 58 years for middle-aged group and 74 years for older group; 58% female) were analyzed using a maximum-likelihood regression model where age, gender, and age by gender effects were assessed. RESULTS: Cynicism and anxiety predicted WHR in middle-aged subjects regardless of gender. Cynicism explained 2.5% of the variance in WHR and anxiety explained 1.7% of the variance in WHR. Anger predicted WHR in males regardless of age, explaining 4.0% of the variance; depression predicted WHR only in middle-aged females, explaining 2.0% of the variance. All analyses adjusted for body mass index, and neither alcohol consumption or smoking status mediated the relationships. DISCUSSION: These findings are suggestive with regard to the hypotheses that certain psychological states and behaviors may be associated with increased abdominal fatness.

A multivariate model for the analysis of sibship covariance structure using marker information and multiple quantitative traits.

A model was developed to detect effects of quantitative trait loci (QTLs) in sibships from simulated nuclear family data using the full covariance structure of the data and analyzing all five quantitative traits simultaneously in a multivariate model. Evidence of the presence of loci was detected on chromosomes 4, 8, 9, and 10. The method provided stable results and is worth further exploration for its performance and optimal sample size requirements under realistic conditions.

Stimulation of human osteoblast differentiation and function by ipriflavone and its metabolites.

Ipriflavone (IP), an isoflavone derivative, has been shown to interfere with bone remodeling by inhibiting bone resorption and perhaps stimulating bone formation. In this study, we have analyzed the effect of IP and its metabolites on the differentiation and function of human osteoblastic cells. Bone marrow stromal osteoprogenitor cells (BMC) and trabecular bone osteoblasts (HOB) were isolated from human donors. The former can be induced to differentiate by treatment with dexamethasone, whereas the latter represent a more differentiated osteoblast. Incubation of BMC with metabolite III (10(-5) M) for 1 week induced modest but significant changes of alkaline phosphatase activity. Though both IP and metabolite III stimulated the expression of bone sialoprotein mRNA, a protein involved in cell attachment to the matrix, only metabolite III increased the steady-state level of decorin mRNA, a collagen fibrillogenesis-regulating proteoglycan. Metabolites III and V, but not the other isoflavones, increased the expression of type I collagen mRNA in HOB, whereas no detectable changes were observed in BMC cells with any of the experimental compounds. In HOB, an increased abundance of osteopontin and bone sialoprotein mRNA were also obtained after 1-week treatment with IP or metabolite V. No appreciable effects of IP or its metabolites were seen on osteocalcin expression and synthesis by either cell type. Finally, IP consistently increased the amount of 45Ca incorporated into the cell layer by BMC, and stimulated mineralization of both BMC and HOB, assessed by von Kossa staining. Thus, IP and its metabolites regulate the differentiation and biosynthetic properties of human bone-forming cells by enhancing the expression of some important matrix proteins and facilitating the mineralization process.

Acute intramuscular injection of oils or the oleic acid component protects mice against paraquat lethality.

Although selenium or vitamin E deficiencies or changing from cereal-based to purified diets augments paraquat toxicity, the action of other dietary components in normal animals fed nutritionally adequate diets is not clear. Upon injection of mice with antiinflammatory agents, a protective action of the corn oil vehicle against paraquat lethalities was noted. This preventive action of a large parenteral administration of unknown components in oils served as the basis for this study. Intramuscular injection of various vegetable oils protected similarly, indicating that in mixtures, the degree of lipid saturation did not seem to be an important factor. Injection of the monounsaturated fatty acid oleic acid decreased oral paraquat lethalities in mice, but linoleic, gamma-linoleic or linolenic acids were not protective in either male or female mice. Measurement of paraquat concentrations in various tissues at various times after administration indicated no effect of corn oil on paraquat distribution. Although the exact mechanism of the complex nature of oil protection against paraquat toxicity in mice is still unknown, this study provides evidence for in vivo oxidant protection by a monounsaturated fatty acid.

Ulnar nerve entrapment due to heterotopic bone formation after a severe burn.

Heterotopic bone formation occurs in approximately 2% of severe burns. It occurs most frequently about the elbow and is not related to the location of the burn. Although bony encasement of the ulnar nerve is frequently found, signs and symptoms of ulnar nerve compression due to heterotopic bone have not been previously reported. Early anterior transposition of the nerve is recommended to prevent progressive neurologic loss if compressive symptoms are found in the face of developing heterotopic bone.

Cisto dermóide de inclusäo da fontanela anterior: relato de um caso / Inclusion dermoid cyst of the anterior fontanelle: report of a case

Relato de caso de cisto dermóide de inclusäo da fontanela anterior em menino de 6 meses de idade, branco. Este é o terceiro caso relatado na literatura brasileira. Os achados radiográficos, cirúrgicos e histopatológicos säo descritos. Ampla revisäo da literatura sobre o assunto é apresentada