Total Activity Score Research Articles

Physical activity level and association with behavioral factors in knee osteoarthritis.

The effects of physical activity (PA) in disease prevention and therapy have well-known effects on lower-limb osteoarthritis (OA), decreasing pain and improving function. We aimed to describe the level and factors affecting PA practices of people with knee OA. Prospective epidemiological study. In all, 548 people with knee OA were interviewed by use of self-administered anonymous questionnaires. The main outcome was physical activity level evaluated by the International physical activity questionnaire (IPAQ) (short version). Secondary outcomes included sociodemographic and clinical data, comorbidities, and barriers to and facilitators of practicing regular PA evaluated by 24 specific elements. The mean (SD) age of the study population was 67.6 (7.9) years; 73.9% were women and 30.9% had obesity (mean [SD] body mass index [BMI] 28.2 [5.7] kg/m2). Multi-joint OA affected 92% of the population, and 71.6% had comorbidities. The mean (SD) visual analog scale score for pain intensity was 4.5/10 (2.5), which was 51.4% better than the patient acceptable symptom state (PASS). The mean (SD) Western Ontario and McMaster Universities Osteoarthritis Index function score was 36.6/100 (20.7), which was 57.5% better than the PASS. In total, 67% of patients used analgesics, half of them at least once a week. According to the IPAQ, 42.6% of patients reported high, 38.6% moderate, and 18.8% low PA level; the median IPAQ total activity score was 2628 metabolic equivalent of task (MET)-min/week and time spent sitting was 257.1min/day. Only one third of participants received non-pharmacological treatment corresponding to the latest recommendations. Variables significantly related to inactive or minimally active PA levels were BMI (P=0.0294), sex (P=0.0008), and biomedical barriers, related to self-efficacy (P=0.0118). The OA study population was less active, more sedentary, and had more comorbidities and more barriers to PA practice than the overall population.

Increased risk of severe course of pemphigus in patients with pemphigus-associated alopecia: a prospective observational study.

Pemphigus-associated alopecia is considered rare, and has not been studied in detail. To evaluate the clinical and immunological characteristics of patients with pemphigus-associated alopecia. This prospective observational study included 80 consecutive patients with histopathologically and immunopathologically confirmed pemphigus, of whom 11 (13.8%) were found to have pemphigus-associated alopecia. Alopecia was observed in 11/52 patients with pemphigus and scalp involvement: [0/28 (35.7%) with pemphigus vulgaris and 1/24 (4.2%) with pemphigus foliaceus. The clinical and immunological characteristics of these patients were analysed. Patients with pemphigus-associated alopecia had a significantly higher Pemphigus Disease Area Index total activity score compared with patients who had no pemphigus-associated alopecia (21.8 ± 18.6 and 11.0 ± 20.5, respectively; P = 0.02). Mean serum anti-desmoglein (Dsg)1 antibody concentration was 141.8 ± 66.9 U/mL and 60.0 ± 52.6 U/mL, respectively (P = 0.03), and mean serum anti-Dsg3 concentration was 126.6 ± 36.7 U/mL and 67.4 ± 52.5 U/mL, respectively (P = 0.03). The values for achieving serological remission were 10% and 70%, respectively (P = 0.02). Pemphigus-associated alopecia is a marker of severe disease and a treatment-resistant disease course.

Porphyromonas gingivalis in the tongue biofilm is associated with clinical outcome in rheumatoid arthritis patients.

Several studies have suggested a link between human microbiome and rheumatoid arthritis (RA) development. Porphyromonas gingivalis seems involved in RA initiation and progression, as supported by the high occurrence of periodontitis. In this case-control study, we analysed tongue P. gingivalis presence and quantification in a large healthy and RA cohort. We enrolled 143 RA patients [male/female (M/F) 32/111, mean ± standard deviation (s.d.), age 57·5 ± 19·8 years, mean ± s.d. disease duration 155·9 ± 114·7 months); 36 periodontitis patients (M/F 11/25, mean ± s.d., age 56 ± 9·9 years, mean ± s.d. disease duration 25·5 ± 20·9 months); and 57 patients (M/F 12/45, mean ± s.d., age 61·4 ± 10·9 years, mean ± s.d. disease duration 62·3 ± 66·9 months) with knee osteoarthritis or fibromyalgia. All subjects underwent a standard cytological swab to identify the rate of P. gingivalis/total bacteria by using quantitative real-time polymerase chain reaction. The prevalence of P. gingivalis resulted similarly in RA and periodontitis patients (48·9 versus 52·7%, P = not significant). Moreover, the prevalence of this pathogen was significantly higher in RA and periodontitis patients in comparison with control subjects (P = 0·01 and P = 0·003, respectively). We found a significant correlation between P. gingivalis rate in total bacteria genomes and disease activity score in 28 joints (DAS28) (erythrocyte sedimentation rate) (r = 0·4, P = 0·01). RA patients in remission showed a significantly lower prevalence of P. gingivalis in comparison with non-remission (P = 0·02). We demonstrated a significant association between the percentage of P. gingivalis on the total tongue biofilm and RA disease activity (DAS28), suggesting that the oral cavity microbiological status could play a role in the pathogenic mechanisms of inflammation, leading to more active disease.

Inflammation on spinal magnetic resonance imaging is associated with poor bone quality in patients with ankylosing spondylitis

Objective: To determine the association between inflammatory lesions on spinal magnetic resonance imaging (MRI) and trabecular bone score (TBS) in patients with ankylosing spondylitis (AS).Methods: Ninety-seven patients with AS underwent spine MRI and dual energy X-ray absorptiometry of the lumbar spine to measure TBS and bone mineral density (BMD). Bone marrow edema (BME) on MRI was considered an inflammatory lesion. The presence, depth (>1 cm), and intensity of BME on MRI were scored for the 1st–4th lumbar spine segments. Inflammatory markers and spinal structural damage scores at the time of MRI examination were recorded. The association between inflammatory activity score on MRI and TBS was evaluated.Results: Among the 97 patients, 52 had BME on spinal MRI (L1–L4). The mean TBS values were 1.38 ± 0.11 and 1.43 ± 0.11 for patients with and without BME, respectively (p = .022). Total inflammatory activity scores on spinal MRI correlated negatively with TBS, but not with BMD. Patients with a TBS value representing a high fracture risk had more deep BME (>1 cm) (p = .048) on MRI. After adjustment for age, symptom duration, and lumbar spinal structural damage, the TBS decreased as inflammation severity on MRI increased (p = .026).Discussion: In AS patients, inflammation on spinal MRI was negatively correlated with TBS. The severity of local bone inflammation in the spine was associated with poor bone quality. These findings suggest that the control of active bone inflammation may be effective for preventing osteoporosis in AS patients.

Reversed Hand Movement during Sleep in Patients with Obstructive Sleep Apnea.

ObjectivePrevious findings suggest that hand movement laterality is reversed during sleep. The present study aimed to verify this phenomenon and evaluate whether the extent of reversal is correlated with the severity of sleep apnea.MethodsA total of 184 participants (mean age: 44.5±13.0 years; 81.5% males) wore actigraphs on both hands during sleep, and nocturnal polysomnography was simultaneously performed. ResultsActigraphic indices of hand movement were significantly higher for the left hand than those for the right hand (p<0.001), including total activity score, mean activity score, mean score in active periods and fragmentation index. Additionally, calculated differences between the fragmentation index for the left versus right hands were significantly correlated with the apnea-hypopnea index (AHI, r=0.149, p=0.032). The AHI was not significantly correlated with differences in hand movement between both hands movement assessed by total activity score (r=0.004, p=0.957), mean activity score (r=0.011, p=0.876), mean score in active periods (r=-0.080, p=0.255). ConclusionMore severe symptoms of obstructive sleep apnea was associated with larger degree of hand movement reversal at night. This result support the theory that homeostatic deactivation occurs in the dominant hemisphere during sleep.

Effects of long-term home-based Liuzijue exercise combined with clinical guidance in elderly patients with chronic obstructive pulmonary disease

PurposeThis study was designed to investigate the effects of long-term home-based Liuzijue exercise combined with clinical guidance in elderly patients with chronic obstructive pulmonary disease (COPD).MethodsForty patients with COPD at stages II–III of the Global Initiative for Chronic Obstructive Lung Disease were enrolled. The subjects were randomly allocated to the Liuzijue exercise group (LG) or control group (CG) in a 1:1 ratio. Participants in the LG performed six Liuzijue training sessions, including 4 days at home and 2 days in the hospital with clinical guidance for 60 minutes/day for 6 months. Participants in the CG conducted no exercise intervention. In addition, lung function test, 6-minute walking test (6MWT), 30-second sit-to-stand test (30 s SST), and the St George’s Respiratory Questionnaire (SGRQ) were conducted at the baseline and at the end of the intervention.ResultsThirty-six patients completed the study. The patients’ lung function improved significantly (p < 0.05) in the LG as well as the 6MWT, 30 s SST, and SGRQ score (p < 0.01). While the SGRQ total score, activity, and impact scores increased significantly (p < 0.05) in the CG. In addition, there were significant differences between the groups (p < 0.01) in regard to the values of forced expiratory volume in 1 second as a percentage of the predicted volume, 6MWT, 30 s SST, and SGRQ.ConclusionsLong-term home-based Liuzijue exercise combined with clinical guidance can effectively improve the pulmonary function, exercise capacity, and quality of life of elderly patients with moderate to severe COPD.

C3 glomerulonephritis and dense deposit disease share a similar disease course in a large United States cohort of patients with C3 glomerulopathy

C3 glomerulonephritis (C3GN) and dense deposit disease comprise the two classes of C3 glomerulopathy. Studies from Europe and Asia have aided our understanding of this recently defined disorder, but whether these data apply to a diverse United States patient population remains unclear. We, therefore, reviewed clinical and histopathological data, including generation of a C3 Glomerulopathy Histologic Index to score biopsy activity and chronicity, to determine predictors of progression to end-stage renal disease (ESRD) and advanced chronic kidney disease (CKD) in 111 patients (approximately 35% non-white) with C3 glomerulopathy: 87 with C3GN and 24 with dense deposit disease. Complement-associated gene variants and autoantibodies were detected in 24% and 35% of screened patients, respectively. Our C3 Glomerulopathy Histologic Index denoted higher activity in patients with C3GN and higher chronicity in patients with dense deposit disease. Over an average of 72 months of follow-up, remission occurred in 38% of patients with C3GN and 25% of patients with dense deposit disease. Progression to late-stage CKD and ESRD was common, with no differences between C3GN (39%) and dense deposit disease (42%). In multivariable models, the strongest predictors for progression were estimated glomerular filtration rate at diagnosis (clinical variables model) and tubular atrophy/interstitial fibrosis (histopathology variables model). Using our C3 Glomerulopathy Histologic Index, both total activity and total chronicity scores emerged as the strongest predictors of progression. Thus, in a large, diverse American cohort of patients with C3 glomerulopathy, there is a high rate of progression to CKD and ESRD with no differences between C3GN and dense deposit disease.

Hepatoprotection by probiotics in vivo: a systematic review and meta-analysis

Event Abstract Back to Event Hepatoprotection by probiotics in vivo: a systematic review and meta-analysis Faezah Sabirin1, 2, 3, Siong Meng Lim1, 2, Chin Fen Neoh1, 2 and Kalavathy Ramasamy1, 2* 1 Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Malaysia 2 Collaborative Drug Discovery Research (CDDR) Group, Universiti Teknologi MARA (UiTM), Pharmaceutical and Life Sciences Community of Research, Malaysia 3 Faculty of Dentistry, Universiti Teknologi MARA, Malaysia Background The severity of nonalcoholic fatty liver disease (NAFLD) has been found to be associated with gut dysbiosis. Probiotics, which are beneficial in maintaining a healthy gut, may be useful in delaying development of NAFLD. This study was undertaken to systematically review and analyse the impact of evidence pertaining to probiotic supplementation in NAFLD in vivo. Methods Literature search was conducted between October 2017 - May 2018 using Cochrane, PubMed/ MEDLINE, Embase, Springer and Web of Science. Article identification and data extraction were performed by four reviewers based on inclusion and exclusion criteria. Risk of bias was assessed using SYRCLE tool. Meta-analysis was performed using RevMan 5.3. The primary outcomes included severity of liver histopathology [i.e. total NAFLD activity score (NAS)] and serum alanine aminotransferase (ALT). The secondary outcomes included hepatic lipid and triglyceride, as well as serum triglyceride, HDL and LDL cholesterol. Mean differences (MD) or standard MD (SMD) between groups were analysed using Random-Effect Model. Statistical heterogeneity was assessed using I2 test. Results Twenty-eight studies were included in the systematic review whilst only 9 were selected for subsequent meta-analysis. The shortlisted literature was predominantly presented with low or unclear risk of bias. When compared to control, the total NAS was significantly lower in probiotic group (MD=-1.81; 95% CI=-2.37, -1.24, p<0.00001). The heterogeneity was moderate but insignificant (I2=55%, p=0.05). Significant reduction in ALT was noted in probiotic group (MD=-0.99; 95% CI=-1.55, -0.43, p=0.0005). The heterogeneity was, however, substantial (I2=70%, p<0.0001) when compared to control. The significant reduction in total NAS was accompanied by significantly lower hepatic lipid (p<0.00001) and triglyceride (p<0.0001). Nevertheless, no significant changes were noted in other serum parameters. Conclusion Probiotic supplementation was associated with significant reduction in total NAS and ALT. The present findings strongly implied the hepatoprotective potential of proboitics. Keywords: Dysbiosis, Hepatic lipid, ALT, NAFLD (non alcoholic fatty liver disease), Probiotics, total NAFLD activity score, hepatic triglyceride Conference: International Conference on Drug Discovery and Translational Medicine 2018 (ICDDTM '18) “Seizing Opportunities and Addressing Challenges of Precision Medicine”, Putrajaya, Malaysia, 3 Dec - 5 Feb, 2019. Presentation Type: Oral Presentation Topic: Metabolic diseases Citation: Sabirin F, Lim S, Neoh C and Ramasamy K (2019). Hepatoprotection by probiotics in vivo: a systematic review and meta-analysis. Front. Pharmacol. Conference Abstract: International Conference on Drug Discovery and Translational Medicine 2018 (ICDDTM '18) “Seizing Opportunities and Addressing Challenges of Precision Medicine”. doi: 10.3389/conf.fphar.2018.63.00140 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 22 Oct 2018; Published Online: 17 Jan 2019. * Correspondence: Dr. Kalavathy Ramasamy, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia, kalav922@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Faezah Sabirin Siong Meng Lim Chin Fen Neoh Kalavathy Ramasamy Google Faezah Sabirin Siong Meng Lim Chin Fen Neoh Kalavathy Ramasamy Google Scholar Faezah Sabirin Siong Meng Lim Chin Fen Neoh Kalavathy Ramasamy PubMed Faezah Sabirin Siong Meng Lim Chin Fen Neoh Kalavathy Ramasamy Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

S100A4 Gene is Crucial for Methionine-Choline-Deficient Diet-Induced Non-Alcoholic Fatty Liver Disease in Mice.

PurposeTo explore the influence of S100 calcium binding protein A4 (S100A4) knockout (KO) on methionine-choline-deficient (MCD) diet-induced non-alcoholic fatty liver disease (NAFLD) in mice.Materials and MethodsS100A4 KO mice (n=20) and their wild-type (WT) counterparts (n=20) were randomly divided into KO/MCD, Ko/methionine-choline-sufficient (MCS), WT/MCD, and WT/MCS groups. After 8 weeks of feeding, blood lipid and liver function-related indexes were measured. HE, Oil Red O, and Masson stainings were used to observe the changes of liver histopathology. Additionally, expressions of S100A4 and proinflammatory and profibrogenic cytokines were detected by qRT-PCR and Western blot, while hepatocyte apoptosis was revealed by TUNEL staining.ResultsSerum levels of aminotransferase, aspartate aminotransferase, triglyceride, and total cholesterol in mice were increased after 8-week MCD feeding, and hepatocytes performed varying balloon-like changes with increased inflammatory cell infiltration and collagen fibers; however, these effects were improved in mice of KO/MCD group. Meanwhile, total NAFLD activity scores and fibrosis were lower compared to WT+MCD group. Compared to WT/MCS group, S100A4 expression in liver tissue of WT/MCD group was enhanced. The expression of proinflammatory (TNF-α, IL-1β, IL-6) and profibrogenic cytokines (TGF-β1, COL1A1, α-SMA) in MCD-induced NAFLD mice were increased, as well as apoptotic index (AI). For MCD group, the expressions of proinflammatory and profibrogenic cytokines and AI in KO mice were lower than those of WT mice.ConclusionS100A4 was detected to be upregulated in NAFLD, while S100A4 KO alleviated liver fibrosis and inflammation, in addition to inhibiting hepatocyte apoptosis.

Diversity of activity participation determines bone mineral content in the lower limbs of pre-pubertal children with developmental coordination disorder.

Limited activity participation in children with developmental coordination disorder (DCD) may have a negative impact on bone mineral accrual. The objectives of this study were to compare bone mineralization and activity participation patterns of pre-pubertal children with DCD and those with typical development, and to determine the association between activity participation patterns and bone mineralization in children with DCD. Fifty-two children with DCD (mean age = 7.51years) and 61 children with typical development (mean age = 7.22years) participated in the study. Appendicular and total body (less head) bone mineral content (BMC) and bone mineral density (BMD) were evaluated by a whole-body dual-energy X-ray absorptiometry scan. Activity participation patterns were assessed using the Children's Assessment of Participation and Enjoyment (CAPE) questionnaire. Children with DCD had lower appendicular and total body BMCs and BMDs than children with typical development overall (p < 0.05). They also had lower CAPE total activity and physical activity diversity scores (p < 0.05). After accounting for the effects of age, sex, height, lean mass, and fat mass, the total activity diversity score remained independently associated with leg BMC in children with DCD, explaining 5.1% of the variance (p = 0.030). However, the physical activity diversity score was no longer associated with leg BMC (p = 0.090). Diversity of activity participation and bone mineralization were lower in pre-pubertal children with DCD. Decreased total activity participation diversity was a contributing factor to lower BMC in the legs of children with DCD.

MR brain volumetric measurements are predictive of neurobehavioral impairment in the HIV-1 transgenic rat.

IntroductionHIV infection is known to be associated with brain volume loss, even in optimally treated patients. In this study, we assessed whether dynamic brain volume changes over time are predictive of neurobehavorial performance in the HIV-1 transgenic (Tg) rat, a model of treated HIV-positive patients.Materials and methodsCross-sectional brain MRI imaging was first performed comparing Tg and wild type (WT) rats at 3 and 19 months of age. Longitudinal MRI and neurobehavioral testing of another group of Tg and WT rats was then performed from 5 to 23 weeks of age. Whole brain and subregional image segmentation was used to assess the rate of brain growth over time. We used repeated-measures mixed models to assess differences in brain volumes and to establish how predictive the volume differences are of specific neurobehavioral deficits.ResultsCross-sectional imaging showed smaller whole brain volumes in Tg compared to WT rats at 3 and at 19 months of age. Longitudinally, Tg brain volumes were smaller than age-matched WT rats at all time points, starting as early as 5 weeks of age. The Tg striatal growth rate delay between 5 and 9 weeks of age was greater than that of the whole brain. Striatal volume in combination with genotype was the most predictive of rota-rod scores and in combination with genotype and age was the most predictive of total exploratory activity scores in the Tg rats.ConclusionThe disproportionately delayed striatal growth compared to whole brain between 5 and 9 weeks of age and the role of striatal volume in predicting neurobehavioral deficits suggest an important role of the dopaminergic system in HIV associated neuropathology. This might explain problems with motor coordination and executive decisions in this animal model. Smaller brain and subregional volumes and neurobehavioral deficits were seen as early as 5 weeks of age, suggesting an early brain insult in the Tg rat. Neuroprotective therapy testing in this model should thus target this early stage of development, before brain damage becomes irreversible.

Service receipt of adults with rare genetic syndromes who engage in challenging behaviour

ABSTRACTBackground: There is limited research documenting the health and/or psychological services accessed by adults with rare genetic syndromes who engage in challenging behaviour. The study documented service receipt and associations with person characteristics.Method: Thirty-two parents of adults with rare genetic syndromes completed an adapted version of the Client Service Receipt Inventory. Access to services for general health and challenging behaviour in the last six months were documented. Person characteristics measured were: adaptive behaviour, autism spectrum disorder characteristics, impulsivity and overactivity.Results: Over half of adults who engaged in challenging behaviour did not receive professional input for behaviours. No association was found between the degree of challenging behaviour and service receipt for challenging behaviour. Total activity score (impulsivity and overactivity) was positively associated, and adaptive ability negatively associated, with accessing professionals.Conclusions: Service receipt is not appropriately linked to needs. Further research should examine factors that affect service access including individual characteristics and service experience.

Evaluation of a multi-year policy-focused intervention to increase physical activity and related behaviors in lower-resourced early care and education settings: Active Early 2.0.

Physical activity is a critical component of obesity prevention, but few interventions targeting early childhood have been described. The Active Early guide was designed to increase physical activity in early care and education (ECE) settings. The purpose of Active Early 2.0 was to evaluate the effectiveness of Active Early along with provider training, microgrant support, and technical assistance over 2 years (2012–2014) to increase physical activity and related behaviors (e.g., nutrition) in settings serving a high proportion of children from underserved groups in recognition of significant disparities in obesity and challenges meeting physical activity recommendations in low-resource settings. The physical activity and nutrition environment were assessed before and after the intervention in 15 ECE settings in Wisconsin using the Environment and Policy Observation Assessment tool, and interviews were conducted with providers and technical consultants. There was no significant change in Total Physical Activity Score or any EPAO subscale over the intervention period; however, significant improvements in the Total Nutrition Score and the several Nutrition subscales were observed. Additionally, the percentage of sites with written activity policies significantly increased. Overall minutes of teacher-led physical activity increased to 61.5 ± 29.0 min (p < 0.05). Interviews identified key benefits to children (i.e., more energy, better rest, improved behavior) and significant barriers, most notably care provider and child turnover and low parent engagement. Moderate policy and environmental improvements in physical activity and nutrition were achieved with this intervention, but more work is needed to understand and address barriers and to support sustained changes in lower-resource ECE settings.

How Should We Blend? The Impact of Blending Social Networks on High School Students’ Achievement and Social Networking Behaviors

This study examines the effect of blended learning environment, where social networks are utilized to supplement or enrich classroom environment, on the academic achievement and social network usage behaviors of high school students. The study was carried out with a total of 104 students in 10th grade of a state high school in Istanbul. It involved one control and two experimental groups. The students in the first experimental group were obliged to use social networking which aimed at complementing the class environment. The social networking environment was presented to the students in the second experimental group with the purpose of enriching the class environment. Yet, participation to this networking was voluntary. For the control group, all activities were held in face-to-face classroom setting. A 24-item test was developed to measure students’ academic achievement and administered as pre- and post-test. In addition, all activities of students on the social network were recorded to measure their social networking behaviors, and these records were used to calculate total activity scores, and course-related activity scores. Academic achievement test scores of both experimental groups were found to be significantly higher than those of the control group. Another finding of the study is that, in the social network, total course related activity scores did not significantly differ between experimental groups. Findings indicate that using social networks to supplement or enrich classroom setting increases student achievement. This increment is higher when the social network is used to supplement classroom setting instead of using social network as enriching medium. Suggestions were also provided.

Targeted mass media interventions promoting healthy behaviours to reduce risk of non-communicable diseases in adult, ethnic minorities.

Targeted mass media interventions promoting healthy behaviours to reduce risk of non-communicable diseases in adult, ethnic minorities.

Feasibility study to evaluate compliance of physical activity over a long time period and its influence on the total activity score, glucose metabolism and physical and psychological parameters following breast cancer.

Despite recommendations that patients with breast cancer ought to undertake physical exercise, a majority of breast cancer patients fail to change their lifestyle and to increase their physical activity following diagnosis. In this clinical intervention feasibility study, compliance and sustainability of a walking training program over 24 weeks in patients with breast cancer following treatment were examined. The endpoints were retention rates after 12 and 24 weeks (6 months) and serum levels of glucose metabolism, the total activity score, endurance, a subjectively perceived exertion-during-endurance stress test, quality of life and fatigue. A supervised walking training session for 60-75 min twice-weekly over 6 months in 35 patients with breast cancer following treatment was examined. The study retention at 12 weeks was 27/35 (77%), and at 24 weeks 24/35 (69%). After 24 weeks, the glycated hemoglobin (HbA1c) score was significantly lowered following the intervention (P=0.001). Insulin and glucose levels remained unchanged. Significant improvements were measured in the patients' body mass index (P=0.001), endurance (P=0.013) and in psychological parameters such as fatigue (P=0.008) and the quality of life (P=0.007). Furthermore, the patients exhibited significant improvements in their subjectively perceived exertion during an endurance-stress test (P=0.079) and in their total activity score (P=0.931). The present study demonstrated an increase in total activity resulting from the supervised walking training program twice-weekly over 6 months. Significant changes in long-term parameters of glucose metabolism, such as in the HbA1c score, also occurred. Furthermore, significant improvements in physical and psychological parameters were observed.

Prevalence and characteristics of impulse control disorders in a group of medical students

Objective: To determine the prevalence of impulse control disorders (ICDs) among medical students and evaluate the related socio-demographic and clinical features. Methods: A total of 277 students in the fourth and fifth year of medical school were included in the study. The study was conducted between September 2011 and June 2012 in Cukurova University Medical School, Adana, Turkey. A demographic data form has been completed. The Structured Clinical Interview for DSM-IV (SCID-I) was used to determine axis I psychiatric disorders. The prevalence rates of ICDs were investigated by using the modified version of the Minnesota Impulse Disorders Interview. All patients completed Barratt Impulsiveness Scale Version 11 (BIS-11) and Symptom Check List-90. Results: The lifetime prevalence of at least one ICD in our sample was 11.2% (n=31). When the participants with the diagnosis of ICDs not otherwise specified were excluded the prevalence rate decreased to 7.9%. The most common ICD was intermittent explosive disorder (6.1%), followed by trichotillomania (2.5%). History of suicide attempts was significantly higher in the group with ICD. There was statistically significant difference between comorbidity of other Axis I psychiatric disorders and a significant difference was observed in terms of total impulsivity, non-planning activity, and motor impulsivity scores as determined by BIS-11 between groups with or without ICDs. Conclusion: ICDs might be underdiagnosed in young adult populations. ICDs affect the quality of life, the course and outcome of comorbid disorders so it is important to ask for these disorders in regular psychiatric interviews and treating them in an appropriate and specific way.

Assessment of synovitis in rheumatoid arthritis by enhanced magnetic resonance imaging (OMERACT RAMRIS score) and power Doppler ultrasound: a comparative study

Background and objectives Disease activity in rheumatoid arthritis (RA) joints is conventionally assessed clinically in combination with the measurement of levels of biochemical surrogate markers. Plain radiography shows only late signs of preceding disease activity. Newer imaging modalities such as contrast-enhanced MRI and power Doppler ultrasonography (PDUS) may offer improved monitoring. The aim of the study was to compare the role of PDUS with enhanced MRI in the assessment and scoring of synovitis of the wrist and hand joints in RA patients. Patients and methods Fifty patients (39 female patients and 11 male patients) with RA were subjected to a PDUS study and enhanced MRI examination of the clinically dominant wrist and hand joints. The mean age of the patients was 45.3 years and mean disease duration was 6.2 years. Power Doppler score of synovitis was correlated and compared with MRI OMERACT score. Results PDUS detected increased vascularity within 30 (60%) wrist joints denoting active synovitis and MRI detected synovial enhancement within 38 (76%) wrist joints denoting active synovitis; both scoring systems agreed in the assessment of synovitis degree in 20 wrist joints. PDUS missed detection of synovitis in nine joints detected by MRI, seven of them estimated by MRI to be of mild activity (grade 1). PDUS detected synovial activity (increased vascularity) in metacarpophalangeal (MCP) joints of 21 patients, whereas MRI detected synovial activity (synovial enhancement) in MCP joints of nine patients. Both modalities agreed in eight patients as regards the total synovial activity score. Statistical analysis of these results showed a statistically significant correlation (P Conclusion Our results showed that both modalities are comparable and closely related in the assessment of synovial inflammatory process of the hand and wrist joints in RA patients.

Physical activity and health-promoting lifestyle of first and second year medical students

Objective - The aim of the study was to examine the relationship between physical activity intensity levels and health-promoting lifestyle among Croatian first and second year medical students. Materials and methods - The cross sectional study was conducted on a sample of first and second year students (n=885). Data were collected by means of a self-administered anonymous questionnaire: The International Physical Activity Questionnaire (IPAQ - long form) and The Health-Promoting Lifestyle Profile [HPLP II] (Adult Version). Data were analysed by descriptive statistics and partial correlation analysis. Results - Data analysis comprised 683 participants (63% female; response rate: 77%). The results revealed a total physical activity score of 2661 MET-min/week and a total median HPLP II score of 2.67. The total physical activity score (r=0.190), total walking (r=0.187) and total vigorous-intensity (r=0.241) sub scores were significantly positive correlated with the total HPLP II; total physical activity score (r=0.179; r=0.362), total walking (r=0.167; r=0.210) and total vigorous-intensity sub scores (r=0.177; r=0.5) with stress management and physical exercise, while total walking was correlated with health responsibility (r=0.133) and spiritual growth (r=0.187). A significant negative correlation was observed between total sitting and physical exercise (r=-0.172), and stress management (r=-0.136). Conclusion - The results revealed a moderate level of physical activity and health-promoting life style. A low intensity level of physical activity was correlated with the health-promoting life style subscales - health responsibility and spiritual growth. The results could help physical education experts and health care providers to design health-promoting programs that support healthy options among students.

Effect of different types of exercise on sleep quality of elderly subjects

Objective/BackgroundThere are still many gaps in research concerning the effect of different physical training modalities on sleep quality in the elderly population. Thus, the objective of the present study was to compare the quality of sleep of hypertensive elderly subjects submitted to two types of training (ie, aerobic exercise alone or combined aerobic and resistance training). Patients/MethodsParticipants aged 60–75 years were randomized to three groups: aerobic group (AG), combined aerobic and resistance group (ARG), and control untrained group (CG). Training lasted ten consecutive weeks with 30 uninterrupted sessions. The actigraph (Actiwatch Minimitter Company, INC – Sunriver, OR, USA) was placed on the non-dominant wrist and activities were monitored continuously while being recorded at one minute intervals. The participants kept the device for a period of 96 hours before the first and last training sessions. ResultsThere was a reduction in sleep fragmentation index of 18.9 for AG and 13 for ARG (p < 0.01) and the sleep efficacy was improved in the exercise groups, with a 5.6% increase for AG (p = 0.02) and a 6.1% increase for ARG (p = 0.01). After training, percentage of minutes motionless was increased by 8.2% for AG and by 6.9% for ARG (p < 0.01), indicating improved sleep quality. A reduction in total activity score during sleep was observed for AG and ARG (p < 0.01). ConclusionsThe two types of exercise performed for ten weeks similarly improved sleep quality, thus reducing the fragmentation index, the percentage of minutes in motion and total activity score, and increasing sleep efficacy.