Total Sitting Time and Sitting Pattern in Postmenopausal Women Differ by Hispanic Ethnicity and are Associated With Cardiometabolic Risk Biomarkers.

Background Sedentary behavior is pervasive, especially in older adults, and is associated with cardiometabolic disease and mortality. Relationships between cardiometabolic biomarkers and sitting time are unexplored in older women, as are possible ethnic differences. Methods and Results Ethnic differences in sitting behavior and associations with cardiometabolic risk were explored in overweight/obese postmenopausal women (n=518; mean±SD age 63±6 years; mean body mass index 31.4±4.8 kg/m2). Accelerometer data were processed using validated machine-learned algorithms to measure total daily sitting time and mean sitting bout duration (an indicator of sitting behavior pattern). Multivariable linear regression was used to compare sitting among Hispanic women (n=102) and non-Hispanic women (n=416) and tested associations with cardiometabolic risk biomarkers. Hispanic women sat, on average, 50.3 minutes less/day than non-Hispanic women (P<0.001) and had shorter (3.6 minutes less, P=0.02) mean sitting bout duration. Among all women, longer total sitting time was deleteriously associated with fasting insulin and triglyceride concentrations, insulin resistance, body mass index and waist circumference; longer mean sitting bout duration was deleteriously associated with fasting glucose and insulin concentrations, insulin resistance, body mass index and waist circumference. Exploratory interaction analysis showed that the association between mean sitting bout duration and fasting glucose concentration was significantly stronger among Hispanic women than non-Hispanic women (P-interaction=0.03). Conclusions Ethnic differences in 2 objectively measured parameters of sitting behavior, as well as detrimental associations between parameters and cardiometabolic biomarkers were observed in overweight/obese older women. The detrimental association between mean sitting bout duration and fasting glucose may be greater in Hispanic women than in non-Hispanic women. Corroboration in larger studies is warranted.

Experience with the use of apligraf to heal complicated surgical and nonsurgical wounds in a private practice setting.

Apligraf is supplied as a ready-to-use living fibroblast and keratinocyte bilayer in culture. This therapy has been shown to facilitate healing of venous ulcers and diabetic foot ulcers. Several case reports suggest that Apligraf may also be effective in healing acute excisional wounds and complicated surgical defects. Apligraf can, in appropriate settings, be used as an alternative to autografts, avoiding the morbidity of donor site wounds. The present case review summarizes outcomes in 16 patients with 18 complicated surgical and nonsurgical wounds treated with Apligraf, which was meshed or fenestrated as needed to obtain better wound coverage and to allow drainage. Of 16 patients, 15 (94%) experienced complete healing (16 of 18 wounds; 89%). Both surgical and nonsurgical wounds responded well, with healing times ranging from 21 to 550 days. Patients generally stated that they were satisfied with their degree of healing and with the opportunity to avoid the surgical procedures associated with autograft donor sites.