Change in levels of physical activity after diagnosis of type 2 diabetes: an observational analysis from the NAVIGATOR study.

Increased physical activity is known to be beneficial in people with type 2 diabetes mellitus (T2DM), but it is not known whether individuals change their activity levels after T2DM diagnosis. The present Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial, conducted in participants with impaired glucose tolerance at high cardiovascular risk, assessed ambulatory activity annually using research-grade pedometers. Oral glucose tolerance tests were performed annually and repeated to confirm T2DM diagnosis. This observational analysis used general linear models to compare step counts before and after T2DM diagnosis in the 2816 participants with the requisite data. Participants were relatively inactive at baseline, taking a median (interquartile range) of 5488 (3258-8361) steps/day, which decreased after T2DM diagnosis by a mean (s.e.) of 258 (64) steps/day (p < 0.0001); however, after adjusting for background trend for activity, step count after T2DM diagnosis was unchanged [mean (s.e.) of 103 (87) fewer steps/day; p = 0.23]. Awareness of T2DM diagnosis had no impact on the trajectory of activity established before the diagnosis.

Role of TNF in sickness behavior and allodynia during the acute phase of Chagas' disease.

Chagas disease, caused by the intracellular protozoan Trypanosoma cruzi, is associated with inflammation, discomfort and pain during the acute phase. The influence of TNF-α (tumor necrosis factor) in this disease outcome is controversial. In this way, the aim of this work was to determine the role of the TNF-α blocker etanercept in the pain, discomfort, and survival during the Chagas' acute phase of mice experimentally infected with a wild virulent strain of T. cruzi. The infection with this wild strain was responsible for a severe visceral inflammation and said parasite showed a tropism in peritoneal fluid cells. Etanercept was able to restore spontaneous vertical and horizontal activities during the second week after infection and to abolish mechanical allodynia during the first week after infection. Finally, etanercept delayed the mortality without any effect on the parasitemia rates. This is the first report that correlates sickness behavior and allodynia with TNF-α and suggests that this cytokine may play an important role in the physiopathology of the acute phase.

Automated analysis of cellular change in histological sections.

An image analysis computer has been used to count and measure goblet cells in the epithelium of the bronchiolar tree of rats exposed to sulfur dioxide vapor. A technique was developed which enabled a bioassay of the irritant effects of the gas.

The toxicity of dimethyl sulphoxide (DMSO) for the dog, pig, rat and rabbit.

Dimethyl sulphoxide (DMSO) was tested for oral toxicity in rats and dogs, and dermal toxicity in rabbits and pigs. Oral administration was by gastric intubation as a 50% equeous solution, 5 days/week at levels equivalent to 9.0, 3.0 or 1.0 ml undiluted DMSO/hg/day. For dermal application 50% and 90% equeous solutions were used to give levels equivalent to 8.1, 4.5, 2.7 or 1.5 ml DMSO/hg/day, as one daily application for rabbits, and divided into two applications/day for pigs. Dogs were dosed for approximately 2 years and pigs for 1 year, although half the animals of both species were dosed for only 18 weeks. Rats were dosed for 18 months, but some were used for interim sacrifice after a year. Rabbits received applications to normal and abraded skin for 6 months. Minor changes in bodyweight and haematological values were observed, together with a physiological diuretic response to DMSO, but the target organ was the eye, principally the lenticular nucleus. Ocular effects in dogs started after 5-10 weeks dosing at 9 ml/kg and consisted of central (nuclear) lens changes with alteration of the refractive index (myopia); transitory equatorial opacities during the 5th month; central (nuclear) opalescence; and changes in the vitreous humour. Similar changes occurred more slowly at 3 ml/kg, the alterations to the vitreous being first observed after 9-10 months at this level. Progressive nuclear refractive changes occurred after dosing for considerably longer than 6 months at 1ml/kg, but none of the animals in this group manifested the opalescence. Biochemical investigation of the lenses revealed reduction of soluble protein (mainly alpha-crystallin), glutathione and water levels, and an increase of insoluble protein. Evidence of recovery was limited mainly to a reduction in the number of dioptres needed to correct nuclear refractive change. Cessation of dosing led to regression of refractive nuclear changes but did not prevent the appearance of opalescence at 3 ml/kg and above. Dogs were the most severely affected of the 4 species, with nuclear effects at 1ml/kg, extensive changes in the lens, and involvement of the vitreous. Pigs and rabbits were affected by dose levels of 2.7 ml/kg and 1.5 ml/kg respectively. Rats occasionally showed minimal changes at 9 ml/kg. The importance of the findings in dogs is discussed in relation to general toxicological protocols. It is emphasised that reversibility of signs, and adequate duration of administration, must both be considered when ascertaining whether changes occur at levels approximating to those of human intake.

Identity, ideology and medicine: health attitudes and behavior among Hindu religious renunciates.

In-depth interviews and participant observation was conducted with 14 Hindu religious renunciates, 70 years or older. Despite having taken vows renouncing concern for physical pain or comfort, respondents differed markedly in their attitudes toward pain and their rationale for utilizing medical treatment. They differed still further in their use of Ayurvedic and allopathic medicine, with the most culturally conservative accepting only Ayurvedic medicine. Rejection of allopathic medicine tended to be associated with a highly systematized religious world-view. The results are discussed in terms of both the ideological conflict between religious world-view and medical usage, and the need for sophisticated distinction of religious world-view if research on the religious factor of health care utilization is to prove fruitful.

Phenomenology of life satisfaction among elderly men: quantitative and qualitative views.

Standardized measures of subjective well-being were compared with qualitative analysis of life satisfaction from 100 elderly men (70 years and older) from New Delhi, India, and London, England. 3 structured measures were used, Life Satisfaction Index (A), Cantril Self-Anchoring Ladder, and a one-item happiness question. Qualitative data were obtained from semistructured interviews covering past and present experiences. Meaning units were extracted from interview protocols, emerging themes were identified for each respondent, and overall summaries were written for English and Indian samples. Groups did not differ significantly on any of the structured measures, but showed marked differences in the qualitative analysis. Limitations of structured measures of subjective well-being are discussed in terms of "context-stripping," both in data collection and data analysis.

Head and neck manifestations of gastroesophageal reflux.

Gastroesophageal reflux (GER) is a common condition with many manifestations which are of interest to the otolaryngologist. Factors predisposing to GER include anatomic abnormalities of the esophagus and pharynx, neurogenic disease and diet induced decreased lower esophageal sphincter pressure. Three interesting cases are reported, including subglottic stenosis which has not previously been thought to be a complication of GER. A literature review of otolaryngologic symptoms, the problems of diagnosis, and a suggested treatment plan are presented.

Survival of herpes simplex virus and other selected microorganisms on patient charts: potential source of infection.

This study indicated that when inoculated onto dental charts, both viruses and bacteria were capable of survival allowing the potential for transmission of infection within the dental office. The conscientious dental practitioner can take steps to reduce this possible mode of infection by removing contaminated surgical gloves or washing hands before handling the chart. An additional method of reducing this potential would be to wipe the chart with an antiseptic solution. Although this study has shown that there is a potential for the spread of infection with the organisms tested, the actual extent of dental chart contamination and resultant illnesses contracted are the basis for further study. Additional studies are needed to follow the pattern of chart distribution from person to person within the dental office, determine the types and quantities of pathogens present in the mouth that would contaminate the charts, and sample the charts under actual clinical conditions to determine the types and viability of the organisms present.

lsokinetic Torque Levels for Adult Females: Effects of Age and Body Size.

The effects of age and body size on isokinetic torque levels for adult females were statistically analyzed. Results indicate that age and to a lesser extent weight and height can account for torque differences in adult women. Additionally, this relationship exists regardless of speed of movement (i. e., 60 degrees /sec and 240 degrees /sec).J Orthop Sports Phys Ther 1984;6(1):21-24.

Correlates of sexual interest among elderly men.

Interview data were collected from 46 English elderly men (age 70 to 94 years) relating to attitudes, psychological traits, and life satisfaction. Sexual interest was not related to life satisfaction or marital status but was significantly correlated with measures of emotional expressivity, personal identity, as well as regrets about the past. Findings are discussed in terms of Erikson's later stages of ego development.

Is the second sodium pump electrogenic?

Transepithelial sodium transport is a process that involves active Na(+) transport at the basolateral membrane of the epithelial cell. This process is mediated by the Na(+)/K(+) pump, which exchanges 3 internal Na(+) by 2 external K(+) inducing a net charge movement and the second Na(+) pump, which transports Na(+) accompanied by Cl(-) and water. It has been suggested that this pump could also be electrogenic. Herein, we evaluated, in MDCK cells, the short-circuit current (Isc) generated by these Na(+) pumps at the basolateral membrane of the epithelial cells, using amphotericin B as an apical permeabilizing agent. In Cl(-)-containing media, Isc induced by amphotericin B is totally inhibited by ouabain, indicating that only the electrogenic Na(+)/K(+) pump is detectable in the presence of Cl(-). Electrogenicity of the second Na(+) pump can be demonstrated in Cl(-)-free media. The existence of a furosemide-sensitive component of Isc, in addition to an ouabain-sensitive one, was identified in absence of chloride. Passive Cl(-) movement associated with the function of the second Na(+) pump seems to be regulated by the pump itself. These results demonstrate that the second Na(+) pump is an electroneutral mechanism result from the stoichiometric movement of Na(+) and Cl(-) across the basolateral plasma membrane of the epithelial cell.