Physical Activity Is Associated with Slower Cognitive Decline in Older Adults with Type 2 Diabetes.

BACKGROUND: Physical activity is associated with slower cognitive decline in old age. Type 2 diabetes (T2d) is a risk factor for dementia and cognitive decline. Physical activity protects against several T2d complications. Yet, little is known about the contribution of physical activity to cognitive health among the elderly with T2d. OBJECTIVES: To examine the association between physical activity and cognitive decline in older adults with T2d. DESIGN: This is a prospective longitudinal study using data from the Israel Diabetes and Cognitive Decline (IDCD) study. SETTING: ICDC study (N=1,213), is a population-based cohort of adults over the age of 65, diagnosed with type 2 diabetes, who were cognitively normal at baseline and followed up every 18 months. PARTICIPANTS: Participants with at least one follow-up assessment who were in the same physical activity group consistently and had complete demographic data. MEASUREMENTS: Physical activity was measured using Minnesota Leisure Time Activity Questionnaire, cognitive functioning was measured using a broad neuropsychological assessment measuring Executive Functioning, Attention/Working Memory, Semantic Categorization and Episodic Memory. RESULTS: Participants were classified into physical activity groups based on self-reported physical activity at baseline and all follow ups: "active" - participation in recreational physical activity (n=286); "non-active"- the only physical activity was walking from place to place (n=93) and "sedentary" (n=19). Linear mixed effects models were applied to adjust for key demographic and cardiovascular risk factors. Participants were 72.4 (SD 4.6) years old, had 13.3 (SD 3.6) years of education, and 163 (41%) were female. In the fully adjusted model, compared to the non-active group the active group had significantly slower rate of decline in Global Cognition (p=0.005), Executive Functioning (p=.014), and Attention/Working Memory (p=.01). There were no significant group differences for Semantic Categorization (p=.17) and Episodic Memory (p=.88). CONCLUSIONS: Among initially cognitively normal and independent older adults with T2d, a physically active lifestyle was associated with a slower rate of cognitive decline. Future research should examine whether promoting physical activity may prevent or delay onset of dementia in this high-risk population.

ECM-transmitted shear stress induces apoptotic cell extrusion in early breast gland development.

Epithelial cells of human breast glands are exposed to various mechanical ECM stresses that regulate tissue development and homeostasis. Mechanoadaptation of breast gland tissue to ECM-transmitted shear stress remained poorly investigated due to the lack of valid experimental approaches. Therefore, we created a magnetic shear strain device that enabled, for the first time, to analyze the instant shear strain response of human breast gland cells. MCF10A-derived breast acini with basement membranes (BM) of defined maturation state and basoapical polarization were used to resemble breast gland morphogenesis in vitro. The novel biophysical tool was used to apply cyclic shear strain with defined amplitudes (≤15%, 0.2 Hz) over 22 h on living spheroids embedded in an ultrasoft matrix (<60 Pa). We demonstrated that breast spheroids gain resistance to shear strain, which increased with BM maturation and basoapical polarization. Most intriguingly, poorly developed spheroids were prone to cyclic strain-induced extrusion of apoptotic cells from the spheroid body. In contrast, matured spheroids were insensitive to this mechanoresponse-indicating changing mechanosensing or mechanotransduction mechanisms during breast tissue morphogenesis. Together, we introduced a versatile tool to study cyclic shear stress responses of 3D cell culture models. It can be used to strain, in principle, all kinds of cell clusters, even those that grow only in ultrasoft hydrogels. We believe that this approach opens new doors to gain new insights into dynamic shear strain-induced mechanobiological regulation circuits between cells and their ECM.

Diabetes mellitus in midlife and the risk of dementia three decades later.

OBJECTIVE: To examine the association between diabetes in midlife (1963-1968) and dementia more than three decades later (1999-2001). METHODS: The authors characterized dementia using standard methods for 1,892 participants among 2,606 survivors of 10,059 participants in the Israeli Ischemic Heart Disease study, a longitudinal investigation of the incidence of and risk factors for cardiovascular disease among Jewish male civil servants in Israel. Face to face interviews were conducted with the 652 subjects identified as possibly demented by the Modified Telephone Interview for Cognitive Status. Logistic regression analysis was performed to assess the association of diabetes with dementia controlling for sociodemographic and cardiovascular variables compared to those with no cognitive impairment. RESULTS: Of 1,892 assessed subjects (mean age 82 at assessment), 309 (16.3%) had dementia. Diabetic subjects had significantly more dementia than non-diabetic subjects (chi2 = 7.54, df = 1, p = 0.006, OR 2.83 [95% CI = 1.40 to 5.71]). Those who survived to the time of this study were younger and healthier than those who died. CONCLUSIONS: Evidence for diabetes as a risk factor for dementia was found, similar to other epidemiologic studies. In contrast to the earlier studies, however, the authors linked diabetes in midlife to dementia more than three decades later in the very old survivors of a large male cohort.

Saline augmentation mammaplasty: nursing implications.

Saline augmentation mammaplasty has dramatically increased in popularity over the past 5 years. Maximizing immediate and long-term results requires skilled perioperative nursing intervention.

The adjustable saline augmentation mammaplasty.

The use of an expander/implant for augmentation mammaplasty allows for increased patient satisfaction in the postoperative period. Surgical time may be shortened as final volume determination is not an intraoperative concern, and secondary surgery for certain complications such as asymmetry, wrinkling, and capsular contracture can often be avoided.

Elevated serum Chlamydia trachomatis IgG antibodies. What do they mean for IVF pregnancy rates and loss?

OBJECTIVE: To evaluate the impact of elevated serum Chlamydia IgG antibodies (Ab) on in vitro fertilization (IVF) outcome in a large infertility population. STUDY DESIGN: One hundred ninety-four women under 40 years of age undergoing a total of 316 IVF cycles were evaluated. All couples with positive serum Chlamydia IgG Ab were pretreated with doxycycline, 100 mg twice daily, for 10 days prior to the first IVF cycle. RESULTS: One hundred seven women (55.2%) had elevated serum Chlamydia IgG Ab. One hundred seventy-two IVF cycles (54.4%) were in patients with elevated Ab as compared to 144 cycles (45.6%) in controls with negative Ab. There were no significant differences in mean age, number of mature oocytes obtained or number of embryos transferred between the two groups. Patients with elevated IgG Ab had on ongoing pregnancy rate of 30.2% (52/172) and implantation rate of 13.5% (101/746) as compared to 34.7% (50/144) and 13.6% (88/649) in the negative Ab group, respectively (P = NS for both). Two ectopic pregnancies occurred in the elevated Ab group (1.2%, 2/172) vs. none in the negative Ab group. The incidence of early pregnancy loss was 8.7% (15/172) and 9.7% (14/144) in the positive and negative Ab groups, respectively (P = NS). CONCLUSION: The prevalence of elevated serum Chlamydia IgG Ab in patients presenting for IVF was higher than in the general population. In the absence of an active genital tract infection, the presence of elevated serum Chlamydia IgG Ab was not associated with a poor IVF outcome when couples were treated with antibiotics prior to stimulation. In addition, there was no correlation between IVF outcome and quantitative IgG Ab titers in women with elevated serum Chlamydia Ab. We recommend that all couples with elevated titers be treated with doxycycline prior to the first IVF attempt to optimize pregnancy rates and minimize infectious complications.

Rhytidectomy: from consultation to recovery.

Rhytidectomy, a popular cosmetic surgical procedure, requires a collaborative effort between the surgeon, nurse, and patient for a successful outcome. The prevention of complications is an ongoing process that begins with patient selection and continues through recovery.

Liposuction: an overview.

Liposuction, the most popular cosmetic surgical procedure today, can offer a substantial benefit to the realistic, well-motivated patient. Continual perioperative assessment and early intervention serve to maximize recovery and minimize complications.

Infrared observations of the neptunian system.

The infrared interferometer spectrometer on Voyager 2 obtained thermal emission spectra of Neptune with a spectral resolution of 4.3 cm(-1). Measurements of reflected solar radiation were also obtained with a broadband radiometer sensitive in the visible and near infrared. Analysis of the strong C(2)H(2) emission feature at 729 cm(-1) suggests an acetylene mole fraction in the range between 9 x 10(-8) and 9 x 10(-7). Vertical temperature profiles were derived between 30 and 1000 millibars at 70 degrees and 42 degrees S and 30 degrees N. Temperature maps of the planet between 80 degrees S and 30 degrees N were obtained for two atmospheric layers, one in the lower stratosphere between 30 and 120 millibars and the other in the troposphere between 300 and 1000 millibars. Zonal mean temperatures obtained from these maps and from latitude scans indicate a relatively warm pole and equator with cooler mid-latitudes. This is qualitatively similar to the behavior found on Uranus even though the obliquities and internal heat fluxes of the two planets are markedly different. Comparison of winds derived from images with the vertical wind shear calculated from the temperature field indicates a general decay of wind speed with height, a phenomenon also observed on the other three giant planets. Strong, wavelike longitudinal thermal structure is found, some of which appears to be associated with the Great Dark Spot. An intense, localizd cold region is seen in the lower stratosphere, which does not appear to be correlated with any visible feature. A preliminary estimate of the effective temperature of the planet yields a value of 59.3 +/- 1.0 kelvins. Measurements of Triton provide an estimate of the daytime surface temperature of 38(+3)(-4) kelvins.

Extracorporeal shock wave lithotripsy: interventional radiologic solutions to associated problems.

Among 1,500 patients treated with extracorporeal shock wave lithotripsy, 1,300 had calculi less than 2.5 cm in diameter and 200 had calculi of 2.5 cm or larger. Although most patients did well and required no further radiologic intervention, 178 interventional radiologic procedures were performed. Urinary tract obstruction often developed in patients with large stones when the collecting system filled with stone fragments (steinstrasse). Nephrostomy was performed in 5.3% of the total patient population and in 29% of the patients with stones measuring 2.5 cm or more. Only 1.8% of the patients with calculi smaller than 2.5 cm required radiologic intervention. When the obstructed collecting system could not be crossed with conventional angiographic techniques, the stone fragments were removed through a percutaneous nephrostomy tract either by flushing or by suctioning with a pulsating water jet.

Ultraviolet spectrometer observations of uranus.

Data from solar and stellar occultations of Uranus indicate a temperature of about 750 kelvins in the upper levels of the atmosphere (composed mostly of atomic and molecular hydrogen) and define the distributions of methane and acetylene in the lower levels. The ultraviolet spectrum of the sunlit hemisphere is dominated by emissions from atomic and molecular hydrogen, which are kmown as electroglow emissions. The energy source for these emissions is unknown, but the spectrum implies excitation by low-energy electrons (modeled with a 3-electron-volt Maxwellian energy distribution). The major energy sink for the electrons is dissociation of molecular hydrogen, producing hydrogen atoms at a rate of 10(29) per second. Approximately half the atoms have energies higher than the escape energy. The high temperature of the atmosphere, the small size of Uranus, and the number density of hydrogen atoms in the thermosphere imply an extensive thermal hydrogen corona that reduces the orbital lifetime of ring particles and biases the size distribution toward larger particles. This corona is augmented by the nonthermal hydrogen atoms associated with the electroglow. An aurora near the magnetic pole in the dark hemisphere arises from excitation of molecular hydrogen at the level where its vertical column abundance is about 10(20) per square centimeter with input power comparable to that of the sunlit electroglow (approximately 2x10(11) watts). An initial estimate of the acetylene volume mixing ratio, as judged from measurements of the far ultraviolet albedo, is about 2 x 10(-7) at a vertical column abundance of molecular hydrogen of 10(23) per square centimeter (pressure, approximately 0.3 millibar). Carbon emissions from the Uranian atmosphere were also detected.

Abdominal abscess drainage under radiologic guidance: causes of failure.

The results of percutaneous drainage of abdominal abscesses in 136 patients are analyzed, revealing a failure rate of 23% (31 patients). The mortality rate was 1.4% (two patients); the rate of serious complications was 5% (seven patients). Failure rate was lowest in critically ill patients having palliative drainage only (12%), emphasizing the importance of immediate drainage to stabilize such patients. The low mortality rate is also attributed to prompt palliative drainage. Technical errors were most commonly responsible for failure of procedures (14%), especially failure to recognize and respond to loculation or subseptation, premature withdrawal of drains (12 patients), and inappropriate approach to the abscess (nine patients). Assignment of patients to a clinical interventional radiology service for the duration of this treatment may greatly facilitate management.

An epizootiological study of acute death syndrome and leg weakness in broiler chickens in western Canada.

In a survey of 51 broiler chicken flocks, the incidence of chickens dying from acute death syndrome and of those with skeletal deformities varied from 0.71 to 4.07% and from 0.46 to 4.08% among the flocks, respectively. The average incidence of those with skeletal deformities was 1.72%; 1.10% were culled in the field, and 0.62% were condemned or downgraded as carcasses. The major types of skeletal deformities were valgus deformation of the intertarsal joint (70%), varus deformation of the intertarsal joint (9%), tibial rotation (7%), and spondylolisthesis (14%). The strain and source of chickens and the management and nutritional practices were recorded for each flock. Statistical analyses were conducted in an attempt to identify factors that might correlate with the incidence of either chickens dying from acute death syndrome or those with skeletal deformities. Results of these analyses are discussed.

Morphological and molecular characterization of several actinophages isolated from soil which lyse Streptomyces cattleya or S. venezuelae.

Several lytic and lysogenic actinophages were isolated from soil samples infected with Streptomyces cattleya and S. venezuelae. The morphologies and some biological properties of the phages, and the physico-chemical characteristics of their DNAs, were compared. Electron micrographs indicated that all the phage heads were of an icosahedral form, but head size and length of the tail varied. Two of the phages had a broad host range; the other isolates could lyse only a limited number of species. The molecular sizes of the phage DNAs were between 32.2 and 98.5 kb as estimated by electron microscopy and restriction enzyme analysis. The same study also indicated that one of the DNA species contained cohesive ends. The G + C content of the DNAs ranged between 45.1 and 74.2 mol % as estimated from melting studies. Sedimentation velocity experiments implied that several of the phage DNAs were probably heavily glycosylated or methylated. These modifications might explain the partial or slow digestion of some of the DNAs by several of the 23 restriction enzymes tested. Protoplasts of the appropriate Streptomyces strains could be efficiently transfected with phage DNA in the presence of 25% (w/v) polyethylene glycol (mol. wt 6000).