Seasonal Changes in Midlife Women'S Percentage Body Fat: A 1-Year Cohort Study.

Objective: The purpose of this longitudinal, observational study was to examine whether age and seasonal changes in sedentary activity (sedAct), moderate-to-vigorous physical activity (MVPA), and energy intake (EI) predict changes in body composition among midlife women. We hypothesized that reductions in MVPA and increases in sedAct and EI in winter, along with greater baseline age would predict increases in percentage body fat (%BF) across seasons. Design: This study used a longitudinal, within-subjects design. Setting: This study took place in Grand Forks, North Dakota. Participants: Participants included 52 midlife women (aged 40-60 years) who were observed over the course of one year. Measurements: Percentage body fat measures were obtained via whole body Dual Energy X-ray absorptiometry. Participants were scanned once per season. We measured EI using the ASA24®. We used a GTX3 accelerometer to measure physical activity. Each season, participants wore the monitors for 7 days, 12 hours per day. All measures began in summer. Results: Results of hierarchical multiple regression (MR) analyses showed that age increases (ß = 0.310, p = 0.021) and summer-to-fall increases in EI (ß = 0.427, p = 0.002) predicted seasonal increases in %BF (R2 = .36, F(5, 42)= 4.66, p = 0.02). Changes in MVPA and sedAct were not significant predictors. Repeated measures ANCOVA revealed that summer (M = 37.7263, 95% CI [35.8377, 39.6149]) to winter (M = 38.1463, 95% CI [36.1983, 40.0942]) increases in %BF are not reversed by spring (M = 37.8761, 95% CI [35.9365, 39.8157]). Conclusions: To minimize increases in %BF and maintain health, midlife women, particularly older women, should be encouraged to pay extra attention to their diet in the fall months.

Theileria orientalis Ikeda genotype infection associated with anaemia, abortion and death in beef cattle in Western Australia.

BACKGROUND: Theileria orientalis infection causes a clinical syndrome in cattle characterised by weakness, reluctance to walk, anaemia, jaundice and death in peri-parturient cows and young calves, referred to as bovine anaemia caused by Theileria orientalis group (BATOG). Abortions in pregnant cows are also reported. Pallor, pyrexia and elevated heart and respiratory rates are typical findings on physical examination. CASE REPORT: A syndrome of abortions, lethargy, inappetence, jaundice and deaths in beef cattle on two separate properties and a separate cluster of three properties within 15 km west of the town of Denmark in Western Australia was associated with the presence of severe regenerative anaemia and the presence of Theileria orientalis Ikeda genotype in blood samples taken from affected cattle and their cohorts. A diagnosis of bovine anaemia caused by the T. orientalis group was based on consistent clinical, haematological, biochemical and PCR findings. Conventional PCR testing detected only the T. orientalis Ikeda type. On the two properties where it was investigated, quantitative PCR testing for parasite load was suggestive of recent infections. Sequencing of T. orientalis major piroplasm surface protein gene PCR products demonstrated that they were identical to those from similar bovine cases in New South Wales. CONCLUSION: The clinical history of affected cattle and the biochemical, haematological and PCR findings were consistent with bovine anaemia caused by the T. orientalis Ikeda genotype. This clinical syndrome had not been recognised in Western Australia before this series of cases.

In vitro isolation and characterisation of the first canine Neospora caninum isolate in Australia.

Neospora caninum was isolated and established in vitro from the skin lesion of a naturally infected dog. The identity of the parasite was evaluated by immunofluorescent antibody test (IFAT), microscopy, Western blotting and polymerase chain reaction (PCR). N. caninum DNA was detected in the whole blood, serum, skin lesion, rectal scrapings and faeces of the infected dog utilising a nested PCR targeting the Nc-5 gene of N. caninum. Antigenic and genetic characterisation of the isolate, designated WA-K9, at a number of loci including the Nc-5 gene, heat shock protein 70 (HSP-70) gene, alpha-tubulin and beta-tubulin genes revealed no variation between this isolate and two N. caninum isolates from different geographic areas. Clinical aspects of this case, which included cutaneous and neurological disease, are also discussed.

The response of human peripheral blood mononuclear phagocytes to rheumatoid arthritis.

The maturity of peripheral blood mononuclear phagocytes (B-MPs) from patients with rheumatoid arthritis (RA), osteoarthritis (OA), and reference ("normal") subjects was compared. Mononuclear cell isolates from peripheral blood were separated on discontinuous gradients of Percoll into low density (more mature) and high density (less mature) subpopulations. Contrary to expectations, the proportion of immature B-MPs in RA patients was found to be significantly lower than that in reference subjects. In RA patients with synovial effusions the proportion of immature B-MPs approached but did not exceed those found in reference subjects, despite the fact that 31% of these patients displayed a peripheral blood monocytosis. It was concluded that the bone marrow precursor population had adapted to the long-term demand for B-MPs in the course of this chronic inflammatory disease.

Development of an enzyme immunoassay for the quantitation of cellular antigen expression.

An enzyme immunoassay is described which can be used to quantitate the cellular expression of antigens recognised by mouse monoclonal antibodies (mAb). To provide the sensitivity required, complexes of alkaline phosphatase and mouse monoclonal anti-alkaline phosphatase (APAAP) have been used. The speed and reproducibility of the assay was improved with the aid of immunofiltration methodology. Quantitative measurement of HLA-DR antigen expression by ELISA did not correlate directly with the number of mononuclear cells scored positive following immunohistochemical staining of cytocentrifuged preparations. In patients with rheumatoid arthritis, more HLA-DR was expressed on synovial fluid mononuclear cells than on the corresponding cells obtained from peripheral blood.

Bovine glycogenosis type II: the molecular defect in Shorthorn cattle.

The molecular defect in Shorthorn cattle affected with glycogenosis type II was studied. Polyclonal and monoclonal antibodies specific for bovine skeletal muscle acid alpha-glucosidase were raised and used to study the molecular and biochemical defect in seven affected animals. Cultured normal bovine fibroblasts pulsed and chased with [3H] leucine produced a 130 kDa precursor form of acid alpha-glucosidase which was processed via several 100 kDa intermediate forms to the 65 kDa mature form within 26 h. Fibroblasts from affected animals were labelled in vitro and were shown to produce a cross-reactive protein which was identified as the precursor form of the enzyme. The mature form of the enzyme was not found. The precursor form of the enzyme was demonstrated in Western blots of muscle tissue extracts from affected animals. Glycogenosis type II in Shorthorn and Brahman cattle must be caused by a different, independent maturation, since Brahman cattle lack the cross-reactive protein for acid alpha-glucosidase.

Natural bone marrow transplantation in cattle with Pompe's disease.

Adding acid alpha-glucosidase to cultures of Pompe's disease muscle has resulted in enzyme uptake and reduction in concentration of glycogen. However, bone marrow transplantation has been unsuccessful as a treatment. Immune rejection may have contributed to this failure. Twin calves share a placenta and carry lymphoreticular cells of each other's type, they become lymphoreticular chimeras in utero and immune rejection does not occur. One natural and three sets of twins produced by embryo transfer were studied in Pompe's disease cattle. Chimerism persisted throughout life and the situation was analogous to a transplant of histocompatible bone marrow stem cells. The activity of acid alpha-glucosidase in leucocytes and in biopsies of the semitendinosus muscle and the mean activity in diaphragm, spleen and lymph node obtained after death from affected twins were significantly higher than in single affected calves. Glycogen concentration was lowered in liver, spleen and lymph node but not in muscles. The affected twins showed clinical signs and changes in muscle similar to those seen in affected single calves. It is concluded that bone marrow transplantation is unlikely to be a successful treatment for Pompe's disease.

Lectin staining of trichostrongylid nematode eggs of sheep: rapid identification of Haemonchus contortus eggs with peanut agglutinin.

The binding of 10 different lectins to the surface of trichostrongylid nematode eggs of sheep were investigated. Osage orange seed agglutinin bound to eggs from Haemonchus contortus, Ostertagia circumcincta and Trichostrongylus colubriformis, jack bean agglutinin to H. contortus and O. circumcincta eggs and peanut agglutinin to H. contortus eggs only. Staining of egg mixtures with fluorescein-labelled peanut agglutinin showed that the lectin correctly identified the percentage of H. contortus eggs present. Identification of eggs by lectin staining correlated well with results from larval differentiation. The findings suggest that peanut agglutinin can be used in routine diagnostic parasitology for the rapid identification of H. contortus eggs.

Development of the gout tophus. An hypothesis.

Sequential stages have been demonstrated in the development of individual focal deposits of crystalline urate and associated cell infiltrates within subcutaneous gout tophi. The findings suggest that acini of macrophages are formed and that active cellular transport of urate from the interstitial fluid into the central zones of these structures accounts for the focal nature of crystallization within the tophus. This process seems to account for the formation of focal urate deposits up to some 1.5-2 mm in diameter. The corona then commonly disappears and adjacent deposits may fuse. These events may lessen the consequences of hyperuricemia.

Fenbufen compared with indomethacin in osteoarthrosis.

A double-blind, crossover clinical trial was carried out with a new propionic acid derivative, fenbufen, versus indomethacin and placebo in 20 patients with osteoarthrosis. Active drug dosages of 75 mg indomethacin daily and 600 mg fenbufen daily were used. Fenbufen scored significantly better than placebo with respect to two and indomethacin better than placebo with respect to five of the assessment indices used. Indomethacin was significantly better than fenbufen with respect to two indices and, overall, appeared more effective in the dosages tested. Biochemical abnormalities of liver function (serum alkaline phosphatase and/or SGOT) were noted in 5 patients after fenbufen therapy (in 3 patients after 4-weeks' treatment and in 2 after 6 weeks) but in none after indomethacin therapy. The significance of these findings is discussed. It is concluded that fenbufen should be withdrawn from further clinical use until the true incidence and significance of hepatotoxicity has been evaluated.

Clinical evaluation of two daily doses of naproxen and indomethacin: result of a double-blind crossover trail.

A double-blind crossover clinical trial is reported on the effects of naproxen in two doses, 500 mg. and 750 mg. daily, and 100 mg. indomethacin daily in 23 patients with classical rheumatoid arthritis, each drug being given for 1 week. The results show that there was little to choose between the drugs and that there was clinical equivalence between the two doses of naproxen. Radioactive pertechnetate (99mTc) joint uptakes were depressed by both naproxen and indomethacin, indicating anti-inflammatory effect.

Oxaprozin and sulindac in rheumatoid arthritis: a double-blind comparative trial.

Oxaprozin, an anti-inflammatory agent with a half-life of 50 hours, was compared in regard to efficacy and tolerance with sulindac in a 12-week double-blind parallel treatment trial of rheumatoid arthritis. Oxaprozin was given as a single morning daily dose of 1200 mg, sulindac was given as 200 mg twice daily. Analysis of the results from the 20 patients (10 in each group) who completed the trial indicated that both drugs produced statistically significant improvement in morning stiffness, walking speed and the Ritchie index, but only sulindac produced significant improvement in hand function. Neither drug was associated with significant side-effects.

A single-blind crossover trial of the anti-inflammatory drug sodium meclofenamate and placebo, including an evaluation of hand grip and of lymphocyte responsiveness.

A single-blind crossover trial was carried out in 21 patients with active rheumatoid arthritis to assess the effectiveness and tolerance of sodium meclofenamate (300 mg per day) compared with placebo. After a 1-week washout period patients had two periods of active medication, each of 2 weeks, separated by 1 week on placebo. Morning stiffness, walking speed, pain score, patient impression of response, joint tenderness and power, work and maximum grip strength achieved by hand grip were all improved by sodium meclofenamate and an anti-inflammatory effect of the drug was demonstrated, with some reduction in the swelling of PIP joints. There was no advantage in assessing pain on full movement of the small joints of the hands in addition to direct tenderness. Power, work and rate of grip release achieved during hand grip provided more information about hand function than maximum grip strength alone. Lymphocyte transformation to non-specific mitogens was enhanced by the drug. Twelve patients had some form of gastro intestinal complaint during the study and it is suggested that diarrhoea is likely to prove to be the major limiting factor of acceptance by some patients.

Differential relationships between stress and disease activity for immunologically distinct subgroups of people with rheumatoid arthritis.

Immunologically distinct subgroups of patients with rheumatoid arthritis (RA)--those with the autoantibody rheumatoid factor (seropositive RA) and those without (seronegative RA)--were compared on a variety of clinical and self-report measures in a consecutive series of women with disease of 7 years' or less duration. The groups were comparable on clinical, pain, functional, and psychosocial variables. However, the seronegative RA group reported elevated levels of preonset negative life event stress. Postonset life event stress and disease activity were significantly correlated for the seronegative RA group, but not for the seropositive RA group. Results suggest that stress factors may be more important in the etiology and maintenance of seronegative RA and that the seronegative RA group may possibly derive particular benefit from psychological techniques to enhance stress management skills.

Non-steroidal anti-inflammatory drugs in combination. Experimental observations.

Diflunisal in combinations with oxaprozin, indomethacin and sodium meclofenamate produced significant synergistic suppression of carrageenan-induced oedema of the rat foot-pad. Oxaprozin, benoxaprofen, indomethacin, diflunisal, sodium meclofenamate and auranofin in some paired combinations but not in others were associated with a greater effect than the component drugs used alone. Antagonism was demonstrated with other combinations of these drugs.

Protection by sucralfate against indomethacin induced gastric ulceration in the guinea pig.

In the management of rheumatic diseases, peptic ulceration associated with anti-inflammatory drug therapy is a major problem and seriously limits the usefulness of these agents. In acute experiments with a guinea pig total gastric pouch preparation, gastric damage induced by the prostaglandin synthetase inhibitor indomethacin was shown to be enhanced by preliminary mucosal exposure to bile salts. In the present study, using the same preparation, we report that sucralfate, a basic aluminium salt of sucrose octasulphate, completely prevents the gastric damage observed in pouches exposed to sodium taurocholate and indomethacin. Prevention is shown not to relate solely to bile salt binding or to the weak antacid property of sucralfate.

Lymphocytes, polymorphonuclear leukocytes, macrophages and platelets in synovium involved by rheumatoid arthritis. A study with monoclonal antibodies.

The inflammatory cell infiltrate involving synovial tissues from joints affected by rheumatoid arthritis (RA)++ has been contrasted with that present in synovium removed from joints involved by previous trauma (T) or osteoarthritis (OA). Cell deployment has been mapped by immunohistochemistry using monoclonal antibodies which recognise epitopes characterising T and B cells, polymorphonuclear leukocytes, mononuclear phagocytes and platelets. Mononuclear phagocytes were the most consistent feature of the rheumatoid inflammatory cell exudate and were present, particularly in the synovial layer, in all OA/T samples. The synovial cells lacked the C3b complement receptor, CR1, but expressed CR3, the receptor for C3bi. In rheumatoid synovium, interdigitating cells were difficult to identify but cells of dendritic morphology bore at least one macrophage epitope. T cells far out-numbered B cells and generally lacked the IL-2 receptor which is an indicator of T cell activation. Care is required in the estimation of the T helper/inducer (TH) T suppressor/cytotoxic (Ts) ratio. Polymorphonuclear leukocytes were demonstrated around vessels and near the synovial intimal cell layer suggesting rapid tissue transit. Extravascular platelets were sparse. Follicular dendritic cells were defined by their central location in lymphoid follicles and strong expression of CR1 receptors. HLA-DR expression was widespread except on endothelial cells.

Immunohistochemical analysis of synovial membranes from inflammatory and non-inflammatory arthritides: scarcity of CD5 positive B cells and IL2 receptor bearing T cells.

Rheumatoid Arthritis (RA) synovial membranes were examined by single and dual immunohistological techniques with a number of monoclonal antibodies against lymphocyte and macrophage related antigens. CD4 positive T lymphocytes frequently expressed MHC Class II antigens and were found in sublining collections in close association with activated macrophages as well as B lymphocytes. CD8 positive T cells surrounded these collections as well as being scattered throughout the membrane and also frequently expressed MHC Class II antigens. IL2 receptor (IL2r) expression on T cells and CD5 expression on B cells were rarely seen in these synovial membranes. Similar immunohistological architecture was found in synovial membranes from patients with psoriatic arthritis (PA) and Reiter's Syndrome (RS). Normal synovium contained few T cells, with few cells expressing MHC Class II antigens. Synovium from osteoarthritis (OA) patients also demonstrated similar immunohistological changes to those found in inflammatory arthritides, suggesting that there are only quantitative rather than qualitative differences between the synovial membrane immunohistological architecture from patients with inflammatory and noninflammatory arthritides.

Measurement of an eosinophil differentiation factor in sheep before and after infection with Trichostrongylus colubriformis.

A bioassay for the measurement of an ovine eosinophil differentiation factor (EDF) was developed. Recombinant murine interleukin-5 (rmIL-5) and supernatant from concanavalin A stimulated lymphocytes induced eosinophil differentiation and proliferation in ovine bone marrow cell culture, which was determined by an eosinophil peroxidase assay (EPO). The assay was used to measure the production of an ovine eosinophil differentiation factor by lymphocytes following experimental infection of sheep with Trichostrongylus colubriformis. Sixteen sheep were immunised and challenged with T. colubriformis and grouped into responders (n = 10) and non-responders (n = 6) based on the lower 99% confidence limit of the worm burden of the unimmunised control group (n = 10). Total worm burdens of all animals were established 10 days after initial challenge. Peripheral blood lymphocytes at Day 0 (pre-challenge values) and Day 9 (post-challenge values) from all sheep and lymphocytes of mesenteric lymph nodes from eight sheep were stimulated with third stage larval antigen of T. colubriformis. The resulting lymphocyte conditioned medium (LyCM) was tested for EDF by its ability to induce growth and differentiation of eosinophils in liquid bone marrow cell cultures. No significant difference was found between the animal groups. No correlation was found between EDF activity and total worm numbers.

Lateral subluxation of the atlas in rheumatoid arthritis.

Two patients with lateral subluxation of the atlas resulting from rheumatoid disease involving the upper cervical spine have been described. The deformity can be suspected on clinical grounds and in one of our two patients spinal cord damage was a sequel. Erosion of the opposing surfaces of the odontoid and lateral masses of the atlas with detachment of the transverse ligament and deeper fibres of the posterior longitudinal ligament appear to underlie this deformity. Radiological confirmation may require AP views with the head tilted to one or other side.