Physical activity and type 2 diabetes. Recommandations of the SFD (Francophone Diabetes Society) diabetes and physical activity working group.

Although regular physical activity is an integral part of T2D management, few diabetic patients have a sufficient level of physical activity. However over the past decade or so, the beneficial effects of regular physical activity have been well demonstrated, both in T2D prevention (50% reduction in the incidence of T2D in subjects with high metabolic risk) as well as T2D management for the improvement of glycaemic control (mean 0.7% improvement of HbA1c) and the reduction of T2D-related comorbidities (improvement in blood pressure values and lipid profile, decrease in insulin resistance). Physical activity has both acute effects (effects of one exercise session) and more prolonged effects of exercise when it is repeated on a regular basis (training effect). In addition, the physical activity recommendations have been extended to a wide range of physical activities (by combining both endurance and muscle strengthening exercises), thus varying the physical activity practiced according to the patient's available time, practice sites, preferences and interests. Following a pathophysiology review, the effects of physical activity will be discussed and presented in terms of evidence-based medicine. The recommendations will be defined and practical prescribing information will be suggested, while taking into account that clinicians are concerned with answering questions regarding how, where and with whom: how can patients be motivated to practice a physical activity over the long-term? And how can qualified exercise trainers and appropriate practice settings be found?

Evaluation of xenobiotic impact on urban receiving waters by means of statistical methods.

Xenobiotics in urban receiving waters are an emerging problem. A sound knowledge of xenobiotic input, distribution and fate in the aquatic environment is a prerequisite for risk assessments. Methods to assess the impact of xenobiotics on urban receiving waters should address the diverse characteristics of the target compounds and the spatiotemporal variability of concentrations. Here, we present results from a one-year-monitoring program concerning concentrations of pharmaceuticals, additives from personal care products and industrial chemicals in an urban drainage catchment in untreated and treated wastewater, surface water and groundwater. Univariate and multivariate statistical methods were applied to characterize the xenobiotic concentrations. Correlation and principal component analysis revealed a pronounced pattern of xenobiotics in the surface water samples. The concentrations of several xenobiotics were characterized by a negative proportionality to the water temperature. Therefore, seasonal attenuation is assumed to be a major process influencing the measured concentrations. Moreover, dilution of xenobiotics the surface water was found to significantly influence the concentrations. These two processes control more the xenobiotic occurrence in the surface water than the less pronounced concentration pattern in the wastewater sources. For the groundwater samples, we assume that foremost attenuation processes lead to the found differentiation of xenobiotics.

Mass fluxes and spatial trends of xenobiotics in the waters of the city of Halle, Germany.

The behaviour and the effects of xenobiotics including pharmaceuticals and fragrances in the environment are widely unknown. In order to improve our knowledge, field investigations and modelling approaches for the entire area of the city of Halle/Saale, Germany, were performed. The distribution of the concentration values and mass fluxes are exemplified using indicators such as Bisphenol A, t-Nonylphenol, Carbamacepine, Galaxolide, Tonalide, Gadolinium and isotopes. Concentrations at a magnitude of ng/L to microg/L were found ubiquitously in the ground and surface waters. Using the concentration values, the impact of the city concerning the indicators was not always evident. Only the assessment of the mass fluxes shows significant urban impacts along the city passage. The calculation of the mass fluxes shows increasing values for all investigated xenobiotics during the city passage; only Bisphenol A stagnates. A balance model of water and indicator mass fluxes was built up for the entire city area.

Inflammatory activity in river-water samples.

Contamination of the urban aquatic environment with chemical and biological substances could have a long-term impact on human health because these substances threaten the integrity of the urban ecosystem and the availability of high-quality water for recreation and consumption. In light of this, the aim of the present study was to assess the potential immunological effects of water sampled at various sites along the River Saale near the city of Halle (in the state of Sachsen-Anhalt, Germany). For the control, Ficoll-separated peripheral blood mononuclear cells (PBMC) of healthy donors were cultured for 24 h in either filter-sterilized river water or drinking-water samples. Cell vitality was assessed using the MTT bioassay. Cytokines in culture supernatants were measured by ELISA. Endotoxin concentrations in the water samples were assessed by the limulus amoebocyte lysate (LAL) test. River water and drinking water showed comparably weak cytotoxic effects on PBMC. Drinking water did not exert any effect on cytokine secretion. In contrast, all river-water samples triggered secretion of proinflammatory cytokines, as shown for TNF-alpha, IL-1beta, and IL-6. Free endotoxin was detected in all river-water samples. However, the highest inflammatory activity regarding induction of all three cytokines, as well as the highest endotoxin content as determined by LAL, was found in a water sample taken immediately downstream of a wastewater treatment plant. Inhibition studies using the monoclonal anti-CD14 antibody biG14, which is known to suppress binding of lipopolysaccharide (LPS) to CD14 via binding CD14 itself, revealed that free endotoxin was indeed the major inducer of proinflammatory cytokines in the river-water samples. Taken together, the results suggest that the microorganism-derived endotoxin is a widely distributed contaminant in the urban aquatic environment that should be considered in routine monitoring and in assessing ecosystem and human health.

In-situ biodegradation of tetrachloroethene and trichloroethene in contaminated aquifers monitored by stable isotope fractionation.

Stable carbon isotope analysis of tetrachloroethene (PCE) and trichloroethene (TCE) was applied to evaluatenatural attenuation processes in the upper Quaternary and lower Tertiary aquifer in the area of a former dry-cleaning plant located in Leipzig, Germany. Groundwater samples were taken during one monitoring campaign in 2001. The 13C enrichment in contaminants along the water flow path suggested that both, PCE and TCE were degraded in the Quaternary aquifer. The enrichment of 13C in the residual PCE fraction and an isotope fractionation factor from laboratory experiments were used to calculate the extent of biodegradation in the Quatemary aquifer. These calculations indicated that a major portion of PCE was biodegraded in the course of the plume. In the Tertiary aquifer the carbon isotope ratios of PCE and TCE indicated that the decreasing concentrations of these contaminants were probably not caused by microbial processes.

Origin and distribution of sulphate in surface waters of the Mansfeld mining district (Central Germany)--a sulphur isotope study.

In the Mansfeld region (Central Germany) copper mining contributed to an enormous pollution of the environment. Metal- and sulphate-bearing sediments and leachates emerge from the former copper smelters and mining waste heaps, spread along local rivers and finally reach the Saale river. A sulphur isotope study on water and stream sediments was performed along the River "Böse Sieben" and from its tributaries to determine the different sulphur sources. Four major sulphur sources exist in the area: metal sulphide mineralisations (Kupferschiefer), met alliferous sulphidic flue dust, slag, and anhydrite and gypsum of Permian and Triassic age. We obtained delta34S(SO4)-values in water samples varying from +4 per thousand to -18 per thousand CDT, clearly reflecting the input of sulphate from different sources. Sulphate from the oxidation of sulphidic mining residues is restricted to the mining area and cannot be traced for more than 5 km downstream. The major source for sulphate is the dissolution of gypsum and anhydrite. The sulphur isotope composition in dissolved and sedimentary adsorbed sulphate differs only slightly from each other. Microbial dissimilatory sulphate reduction can not be excluded in the shallow sediment layers.

Clopidogrel bioavailability: absence of influence of food or antacids.

Two open, randomized, crossover bioavailability studies were carried out to assess the influence of concurrent antacid medication and food on the bioavailability of clopidogrel. A fed/fasting study was conducted in 12 elderly male subjects. Each subject took a single 75 mg dose of clopidogrel on two occasions-in the morning after an overnight fast, either during a standardized breakfast, or with breakfast delayed by 4 hours after dosing. A washout period of 7 days was observed between the two dosings. Twelve healthy male subjects participated in the antacid study. They fasted overnight and for 4 hours after dosing and took a single 75 mg dose of clopidogrel at 8:00 a.m. on two occasions separated by a washout period of 14 days. For one dose, Maalox 2 x 400 mg tablets were taken 1 hour before the clopidogrel dose. Pharmacokinetic parameters of SR26334, the main circulating metabolite of clopidogrel, were derived from plasma concentrations of the latter compound determined before and at regular intervals over 36 hours after dosing. For the fed/fasting study, mean Cmax values (+/-SD) were 2.7+/-0.62 mg/L and 2.1+/-0.96 mg/L for the fasting state and the fed state, respectively and the 90% CI of Cmax ratio was [0.57 - 0.97]. Mean AUC(0-obs) values (AUC to the last observed value) were 7.1+/-1.6 mg.h/L and 7.4+/-1.64 mg.h/L, respectively, and the 90% Cl of AUC ratios were [0.90 - 1.02] and [0.89 - 0.97], respectively. For the antacid study, mean Cmax values were 2.6+/-0.84 mg/L and 2.5+/-0.87 mg/L for the no-antacid regimen and the antacid regimen, respectively, and the 90% CI of Cmax ratio was [0.74 - 1.16]. Mean AUC(0-obs) values were 6.3+/-1.34 mg.h/L and 5.8+/-1.33 mg.h/L, respectively, and the 90% CI of AUC ratios was [0.89+/-0.97]. Thus, exposure to SR26334, and therefore net absorption of clopidogrel, was not significantly modified by food or by prior antacid ingestion.

Assessment of the Flow Dynamic of a Mining Lake by Stable Isotope Investigations.

For water samples from mining lake ML 111 of the Lusatian Lignite District and surrounding aquifers δ34S(SO4-b), δ15N(NH4+), δD, and δ18O (H2O) values have been determined to asess the flow dynamic of the in- and outflow scenario. The high mineralization and acidification (pH > 2.6) of the lake water results from an intensive interaction with the surrounding dump sites and the inflow of extremely sulfate rich dump water (up to 4,100mg/1 SO4-). δ34S values range from -7‰ to + 7°CDT in the inflow aquifers. The lake water is considered to be a mixture of different water bodies. The evaporation signature in the outflow aquifer suggests that the groundwater consists of 60% lake water. The nitrogen transfer is explained by 15N signature of ammonium. Sulfate reduction, perceptible in outflow and dump aquifer, cannot be proved within the mining lake by 34S and hydrochemistry.

Calorimetric validation of 13C bicarbonate and doubly labeled water method for determining the energy expenditure in goats.

The purpose of the present study was to validate the 13C bicarbonate method (13C-M) and the doubly labeled water method (DLWM) for the estimation of the CO2 production R(CO2) in goats as a ruminant model. Indirect calorimetry was chosen as the reference method. Studies were carried out in 2 male African dwarf goats at 3 different developing stages (age: 5, 10, and 14 months, body mass: 14.6, 20.3, and 21.7 kg). Animals were fed a balanced feed 14 days before and during the studies. The isotope tracers (4 mg/kg NaH13CO3, 120 mg/kg 2H2O, and 75 mg/kg H218O; 99 AT.-%) were simultaneously given as a single pulse injection into the jugular vein. Thereafter, the animals were kept for 8 days in two respiration chambers (volume of chamber: 2.85 m3, air flow rate: 25 1/min) for the estimation of CO2 production and O2 consumption. For the determination of R(CO2) using the 13C-M samples of exhaled breath were drawn from the respiration chambers. The 13C enrichment and CO2 concentration of breath samples were measured by means of an infrared isotope analyzer. In order to determine R(CO2) by means of the DLWM, blood serum was used. The 2H and 18O enrichments were measured by an isotope ratio mass spectrometer. Urine samples were collected over 24 h to quantify renal water losses. The R(CO2) was calculated by means of the 13C-M using the area under the 13C enrichment-time curve. The determination of R(CO2) by means of the DLWM was based on the slopes of the 2H and 18O disappearance curves and the body water pool obtained from the zero time intercept of the isotope curves. The values of R(CO2) resulting from the 13C-M were found to be comparable with those from the calorimetric measurement. Smaller (not statistically significant) values of R(CO2)--92% from 13C-M and 87% from DLWM--compared to the indirect calorimetry could indicate the incorporation of 13C and 2H into metabolites other than CO2 and H2O, respectively. The body water contents calculated from the zero time intercepts of the 2H and 18O disappearance curves amounted to 66% and 63%, respectively. The body water content was found to be not related to the age of animals. The renal water loss was calculated to be 35% of the total water loss (0.76 l/d.

The Asthma Impact Record (AIR) index: a rating scale to evaluate the quality of life of asthmatic patients in France.

Asthma is a chronic disease, which affects patients' daily lives. The goal of this study was the development of a disease-specific scale to evaluate quality of life in asthmatic patients in France: The Asthma Impact Record Index (AIR Index). The study was conducted with the participation of 486 asthmatic patients using the following steps: 1) selection of dichotomous items; 2) reduction of the number of items; 3) study of reproducibility of the questionnaire; 4) weighting of items; 5) study of the reliability and validity of the final version of the AIR Index. The final version of the AIR Index contains 63 unweighted items. The items were classified into subscales representing the main dimensions of quality of life: 1) physical, which was itself split into two subscales: a) physical activities; and b) symptoms; 2) psychological; and 3) social or relational. The internal consistency, measured by Cronbach's alpha coefficients, was found to be high, for the global scale and all subscales (range 0.79-0.94). The concurrent validity, evaluated by studying the relationship between the score values on the global scale and the subscales, and the parameters reflecting disease severity, was also high. We conclude that the AIR Index might represent a useful evaluative and discriminant instrument in studying quality of life in asthma in French populations.

Mineral- und heilwässer in sachsen - eine isotopenanalytische charakterisierung.

Abstract The groundwaters studied and labelled as mineral water were "natural mineral waters" for bottled waters and "natural curative waters" for heal therapeutical applications. They were characterized either by a specific mineralization or their suitability for balneology. To reveal the actual hydrological situation isotope investigations using (2)H, (18)O, (3)H, (12)C and (14)C (DIC) and (34)S (sulphate) were included in a study describing samples of 24 mineral water deposits in Saxonia. The water was classified into 4 hydrochemical types of genesis. Due to different hydrogeological and hydrochemical situations widely scattered isotope ratios were measured. Most of the investigated mineral waters are containing at least parts of younger waters (with residence times less than about 40 years). Correlations between chemical composition and the tritium content could be observed within different springs from the areas Bad Brambach, Bad Elster and Burkhardswalde. Strong variations in δ(34)S were found in samples with low sulphate content, showing different sulphur sources, as well as microbiological reactions. On the other hand mineral waters from Bad Brambach and Bad Elster show nearly the same δ(34)S value of about 6‰ CDT despite beeing of a different chemical type. The δ(13)C values between -22 and -2.2y PDB are related to different sources of CO(2).