Altered cortical bone strength and lean mass in young women with long-duration (19 years) type 1 diabetes.

To investigate bone health and body composition in young women with long-duration type 1 diabetes (T1D) in relation to matched controls. Twenty-three Swedish women, age 19.2-27.9 years, with a T1D duration of 10 years or more were recruited from the Swedish National Diabetes Registry (NDR). An age-, gender- and geography-matched control group was recruited. Bone mass and body composition were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography. Data was retrieved from the NDR and SWEDIABKIDS registries. T1D individuals had a mean diabetes duration of 19 years. T1D individuals had reduced lean mass (40.0 ± 6.1 kg vs. 43.9 ± 4.9 kg) and were shorter (1.66 ± 0.06 m vs. 1.71 ± 0.06 m) although comparable BMI. Subjects with T1D had lower muscle area (P = 0.0045). No differences were observed for fractures; physical activity; total, lumbar spine or femur areal bone mineral density. The cortical bone strength strain index was lower for TD1 patients (1875 ± 399 mm3 vs. 2277 ± 332 mm3). In conclusion, young women with long-term diabetes duration showed reduced cortical bone strength, decreased periosteal circumference, endosteal circumference and altered body composition. These factors contribute to the health burden of TD1, which warrants further attention for advancing bone health in women with T1D.

Assessing heart rate variability in type 1 diabetes mellitus-Psychosocial stress a possible confounder.

BACKGROUND: Autonomic neuropathy (AN) commonly arises as a long-term complication in diabetes mellitus and can be diagnosed from heart rate variability (HRV), calculated from electrocardiogram recordings. Psychosocial stress also affects HRV and could be one of several confounders for cardiac AN. The present work investigated the impact of psychosocial stress on HRV in individuals with type 1 diabetes mellitus (T1DM) and assessed the use of salivary cortisol as a biomarker for psychosocial stress in this context. METHODS: A total of 167 individuals 6-60 years old (113 with T1DM and 54 healthy controls) underwent 24-hr ECG recordings with HRV analysis. Salivary cortisol was sampled thrice during the registration day. Perceived psychosocial stress along with other factors of possible importance for the interpretation of HRV was documented in a diary. RESULTS: Heart rate variability (high-frequency power during sleep) was reduced (p < .05) with older age, longer diabetes duration, higher mean glucose levels, physical inactivity, and perceived psychosocial stress. Salivary cortisol levels in the evening were increased (p < .05) in women in ovulation phase, in individuals with preceding hypoglycemia or with hyperglycemia. The amplitude of salivary cortisol was reduced (p < .05) with the presence of perceived psychosocial stress, but only in adult healthy controls, not in individuals with diabetes. CONCLUSION: Psychosocial stress might be a confounder for reduced HRV when diagnosing cardiac AN in T1DM. Salivary cortisol is, however, not a useful biomarker for psychosocial stress in diabetes since the physiological stress of both hypoglycemia and hyperglycemia seems to overrule the effect of psychosocial stress on cortisol.

Acute Ischemic Stroke in Late Pregnancy Treated with Intravenous Thrombolysis and Endovascular Therapy.

Pregnancy has usually been an exclusion criterion in clinical trials with thrombolysis and endovascular therapy in acute ischemic stroke. For that reason, these therapies are not recommended causing lack of evidence and vice versa. In this case report, we describe a pregnant woman in week 33 + 3 presenting with acute ischemic stroke, which was successfully treated with systemic thrombolysis and endovascular therapy, resulting in a good clinical outcome for both mother and child. The altered fibrinolytic system and the risk factors related to pregnancy constitute a challenge for clinicians when choosing the most suitable treatment modality for treating acute ischemic stroke in pregnancy. It is still uncertain whether thrombolysis in combination with endovascular therapy or endovascular therapy alone is the most appropriate treatment option. However, there is slowly growing evidence that thrombolysis and thrombectomy in pregnancy are feasible and safe with a good clinical outcome for both the mother and the child.

Secondary traumatic stress in Norwegian SUD-therapists: Symptoms and related factors.

This study examined the prevalence of secondary traumatic stress (STS) among substance-abuse therapists in relation to burnout, work-related stressors, as well as peer and leader support. METHODS: A quantitative cross-sectional design examining 383 Norwegian substance-abuse therapists. Electronic surveys were distributed to practitioners in Norway via email and social media. RESULTS: A total 22% of the respondents reported experience of secondary trauma, with the most frequently reported symptoms being flashbacks (13%) and intrusive thoughts (13%). More than 72% of therapists had also been exposed to patient direct threats. Female therapists estimated the level of trauma among their patients as higher than did male therapists. Male therapists (32%) were more likely to report secondary trauma than females (19%). CONCLUSIONS: The findings indicate a high prevalence of trauma symptoms in substance-abuse therapists, and suggest increased focus on the role of patient direct threats when treating patients with substance-abuse disorder. The study also highlights the need for research that examines variables that interact with gender in predicting STS in therapists treating substance abuse, as well as trauma.

Sleep deprivation sensitizes human craniofacial muscles.

It is unknown whether and how sleep deprivation influences craniofacial muscle sensitivity in healthy humans. We investigated whether total sleep deprivation (TSD) and one night of recovery sleep (RS) can alter mechanical pain sensitivity in temporal and masseter muscles. Fifteen healthy volunteers participated in three consecutive sessions. Pressure pain thresholds were measured on the temporal and masseter muscles. Both temporal and masseter muscles became sensitized after 24 h of TSD. RS reversed the muscle sensitization.

The association between fluoride in drinking water and dental caries in Danish children. Linking data from health registers, environmental registers and administrative registers.

OBJECTIVES: To study the association between fluoride concentration in drinking water and dental caries in Danish children. METHODS: The study linked registry data on fluoride concentration in drinking water over a 10-year period with data on dental caries from the Danish National Board of Health database on child dental health for 5-year-old children born in 1989 and 1999, and for 15-year-old children born in 1979 and 1989. The number of children included in the cohorts varied between 41.000 and 48.000. Logistic regression was used to assess the correlations, adjusting for gender and taxable family income as a proxy variable for socioeconomic status. RESULTS: Fluoride concentration in drinking water varied considerably within the country from very low (<0.10 mg/l) to more than 1.5 mg/l. Only little variation was found over the 10-year study period. Dental caries in both 5-year-olds and 15-year-olds decreased over the study period. An inverse relation between the risk of dental caries and fluoride concentration in drinking water was found in both primary and permanent teeth. The risk was reduced by approximately 20% already at the lowest level of fluoride exposure (0.125-0.25mg/l). At the highest level of fluoride exposure (>1 mg/l), a reduction of approximately 50% was found. Similar findings were found if analysis was limited to children residing in the same place during the entire study period. CONCLUSIONS: The study confirmed previous findings of an inverse relation between fluoride concentration in the drinking water and dental caries in children. This correlation was found in spite of the extensive use of fluoridated toothpaste and caries-preventive programs implemented by the municipal dental services in Denmark. Linking Danish health registers with environmental and administrative registers offers an opportunity for obtaining sample sizes large enough to identify health effect, which otherwise could not be identified.

Morphology of the large intestine of the pig: haustra versus taenia.

The aim of the present study was to compare the morphological characteristics of the taenia and haustra of the large intestine in pigs. Ten pigs were fed a barley/wheat-based diet for a period of five weeks. Tissue samples were taken from the cecum and the proximal part of the colon at slaughter and processed histologically for determination of crypt volume, depth and density of the crypts, thickness of muscularis externa, and carbohydrate histochemistry. In all parameters examined regional differences in mucosal architecture of the cecum and proximal colon were demonstrated. Apparently, the regional differences in mucosal architecture between taenia and haustra were more pronounced in the cecum than in the proximal colon. The regional variation in mucin characteristics and in crypt parameters could be explained by differences in functional status and/or in the local environment. As all the parameters investigated in this study are not only dependent on sampling site, but also, e.g., on type of diet and its physical form, great care must be taken to obtain tissue from comparable sites in all animals in experimental studies to avoid incorrect conclusions.