Does Patient Weight, Age, or Gender Correlate With the Ability to Visualize the Distal Aorta on Bedside Aortic Ultrasounds in the Emergency Department?

INTRODUCTION: Abdominal aortic aneurysms (AAA) have a varied presentation, which often makes the diagnosis difficult. The most common location for an AAA is in the infra-renal or distal aorta, which can be difficult to visualize using bedside ultrasound.  Objective: This study was designed to identify if a patient's weight, gender, or age influenced our ability to visualize the distal aorta on bedside abdominal aortic ultrasound scans.  Methods: All aortic scans completed in the Emergency Department (ED) from September 2010 to September 2013 were retrospectively evaluated. Patients 21 years and older were included. Scans missing age, gender, or self-reported weight were excluded.  Results: 500 aortic scans were included. The distal aorta was visualized in 393 scans (78.6%). The mid aorta was visualized in 417 scans (83.4%). The proximal aorta was visualized in 454 scans (90.8%). For the distal aorta, the average weight for visualized versus not visualized was 75.7 kg versus 79.7 kg. For the proximal aorta, the average weight for visualized versus not visualized was 75.8 kg versus 84.0 kg. Weight significantly predicted the ability to visualize the proximal aorta (unadjusted p=0.0098, adjusted p=0.0095) and marginally predicted the ability to visualize the distal aorta (unadjusted p=0.071, adjusted p=0.019). Neither age (unadjusted p=0.13, adjusted p=0.052) nor gender (unadjusted p=0.74, adjusted p=0.40) was significantly associated with visualization. CONCLUSION: There is no clinically significant difference in the ability to visualize a patient's distal aorta with bedside ultrasound based on a patient's body weight, gender, or age.

Acute effects of Surya Namaskar on the cardiovascular & metabolic system.

UNLABELLED: With the recent rise in obesity awareness and the increased understanding of the importance of physical activity in promoting overall health, greater emphasis has been placed on improving physical fitness to enhance quality of life. Surya Namaskar, a component of Hatha Yoga, has been practiced by Asian Indians for hundreds of years and is often used in place of a typical fitness program. It consists of a series of postures (asanas) that are repeated 12 times per round. Only one published study has looked specifically at Surya Namaskar, measuring the energy cost of individual asanas (Sinha et al., 2004). However, practitioners typically perform several rounds of the asanas during a session. PURPOSE: To assess the cardiorespiratory and metabolic responses of four rounds of Surya Namaskar, a typical amount performed by practitioners, to determine its potential as a training and weight loss tool. METHODS: Six healthy Asian Indian men and women (18-22 years) who had trained in Surya Namaskar for over two years participated in the study. Testing was completed in a single session lasting about 30 min. To measure heart rate and oxygen consumption while performing the four rounds, participants were connected to a heart rate monitor and the Oxycon Mobile Metabolic System. RESULTS: Participants exercised at 80% of age-predicted maximal heart rate (HRmax) during Round 2, 84% during Round 3, and 90% during Round 4. Average intensity during the four rounds was 80% HRmax, sufficient to elicit a cardiorespiratory training effect. Oxygen consumption averaged 26 ml/kg/min during each round, resulting in an energy expenditure of 230 kcals during a 30 min session for a 60 kg individual. CONCLUSION: Regular practice of Surya Namaskar may maintain or improve cardiorespiratory fitness, as well as promote weight management.

Potential selective advantage mechanism for polymorphic genetics in celiac disease.

Celiac Disease is a common cause of morbidity in the developed world but its etiology is still unknown. Considering that Celiac Disease was first documented in Scandinavian Europe, a population exposed to a high fat diet, perhaps the polymorphic genetics of the disease provides balanced polymorphism against this environmental stimulus. Celiac Disease has been associated with higher levels of the T cell receptor (TCR)γδ, receptors that have played a greater role in recognizing microbial lipids. Furthermore, obesity has been associated with lower levels of CD-3 expression while Celiac Disease has been associated with an up regulation of this molecule. These finding might help to describe a balance polymorphism that exists in Celiac Disease as well as an etiological factor that lead to the development of the disease.