The influence of anxiety on the progression of disability

OBJECTIVES: To determine the influence of anxiety on the progression of disability and examine possible mediators of the relationship. DESIGN: Community-based observational study. SETTING: Women's Health and Aging Study I, a prospective observational study with assessments every 6 months for 3 years. PARTICIPANTS: One thousand two functionally limited women aged 65 and older. MEASUREMENTS: Anxiety symptoms were assessed using four questions from the Hopkins Symptom Checklist (nervous or shaky, avoidance of certain things, tense or keyed up, fearful). Participants who reported experiencing two or more of these symptoms at baseline were considered anxious. Anxiety as a predictor of the onset of four types of disability was examined using Cox proportional hazards models. Three models were tested: an unadjusted model, a model adjusted for confounding variables (age, race, vision, number of diseases, physical performance, depressive symptoms), and a mediational model (benzodiazepine and psychotropic medication use, physical activity, emotional support). RESULTS: Nineteen percent of women reported two or more symptoms of anxiety at baseline. Unadjusted models indicate that anxiety was associated with a greater risk of worsening disability: activity of daily living (ADL) disability (relative risk (RR)=1.40, 95% confidence interval (CI)=1.10-1.79), mobility disability (RR=1.41, 95% CI=1.06-1.86), lifting disability (RR=1.54, 95% CI=1.20-1.97), and light housework disability (RR=1.77, 95% CI=1.32-2.37). After adjusting for confounding variables, anxiety continued to predict the development of two types of disability: ADL disability (RR=1.41, 95% CI=1.08-1.84) and light housework disability (RR=1.56, 95% CI=1.14-2.14). Finally, benzodiazepine and psychotropic medication use, physical activity, and emotional support were not significant mediators of the effect of anxiety on the development of a disability. CONCLUSION: Anxiety is a significant risk factor for the progression of disability in older women. Studies are needed to determine whether treatment of anxiety delays or prevents disabilit

Effect of light, food additives and heat on the stability of sorghum 3-deoxyanthocyanins in model beverages.

This work aimed to evaluate the stability of sorghum 3-deoxyanthocyanins (DXA) in model beverages (pH 3.5) elaborated with crude sorghum phenolic extract, containing ascorbic acid and sulphite, under fluorescent light exposure and subjected to heat treatment. There was no significant difference in the DXA degradation during storage under light exposure (24.16%) and absence of light (20.72%). DXA degradation did not differ in the presence of ascorbic acid during storage under light exposure (23.99-25.38%) and absence of light (19.87-21.74%). The addition of sulphite caused an initial bleaching reaction, but as a reversible reaction, the anthocyanin content was higher on the last day of storage compared to the first day. There were no significant differences in total anthocyanin content of all treatments subjected to the heat treatment (80 °C for 5 and 25 min). Thus, crude DXA are very stable under light, additives and heat, and may be useful as natural food colourants

Correlates of anxiety symptoms in physically disabled older women

OBJECTIVE: The authors describe characteristics that are associated with chronic anxiety symptoms and examine the use of anxiolytic and antidepressant medications in physically disabled women with and without symptoms of anxiety. METHODS: Participants were 791 physically disabled women age 65+ years who participated in the Women's Health and Aging Study for 2-3 years. Anxiety symptoms were measured with four questions from the Hopkins Symptom Checklist, and women were categorized as having no anxiety, intermittent anxiety, and chronic anxiety symptoms. Health-related characteristics, medications, physical functioning, physical activity, and psychosocial variables were also measured. RESULTS: Forty-nine percent of women reported no anxiety symptoms; 41% reported intermittent symptoms; and 10% reported chronic symptoms of anxiety. Depressive symptoms and lack of emotional support were significant correlates of intermittent anxiety symptoms, whereas depressive symptoms, negative life events, and lack of emotional support were significant correlates of chronic anxiety symptoms. Over the course of 3 years, 20.3% of women with no anxiety, 33.0% of women with intermittent anxiety, and 48.7% of women with chronic anxiety symptoms took anxiolytic and/or antidepressant medications. CONCLUSION: Anxiety symptoms are common among disabled older women. Psychosocial variables were significantly different in women with intermittent or chronic anxiety symptoms, versus women without anxiet

Anxiety, depression and disability across the lifespan

The authors examined the relationship between anxiety, depression, and physical disability, after controlling for demographic and health variables, in a sample of 374 adults ages 18-94. Results indicate that anxiety, depression, and comorbid anxiety and depression are associated with higher levels of disability, after controlling for factors such as age, gender, income, self-rated health, number of medical conditions, and number of physician visits in the past year. Furthermore, anxiety, depression, and comorbid anxiety and depression have a differential effect on disability according to age, with older adults with any of these symptoms reporting higher levels of disability than younger adults. These findings suggest that physicians working with older adults should assess for and treat anxiety as well as depressive symptoms

Obesity and onset of significant depressive symptoms: results from a prospective community-based cohort study of older men and women

OBJECTIVE: Although several cross-sectional studies have linked obesity and depression, less is known about their longitudinal association and about the relative influence of obesity subtypes. We prospectively examined whether (abdominal) obesity increased the risk of onset of depression in a population-based sample of older persons. METHOD: Participants were 2540 non-depressed well-functioning white and black persons, aged 70–79 years, enrolled in the Health ABC Study, an ongoing prospective community-based cohort study. Overall obesity was assessed by body mass index and percent body fat (measured by dual energy x-ray absorptiometry), whereas abdominal obesity measures included waist circumference, sagittal diameter, and visceral fat (measured by computer tomography). Onset of significant depressive symptoms was defined as a Center for Epidemiological Studies Depression 10-item score ≥ 10 at any annual follow-up over 5 years and/or new antidepressant medication use. Persistent depression was defined as depression at two consecutive follow-up visits. RESULTS: Over 5 years, significant depressive symptoms emerged in 23.7% of initially non-depressed persons. In men, both overall (BMI: HR per SD increase=1.20, 95%CI=1.03–1.40) and abdominal obesity (visceral fat: HR per SD increase=1.19, 95%CI=1.07–1.33) predicted onset of depressive symptoms after adjustment for sociodemographics. When BMI and visceral fat were adjusted for each other, only visceral fat was significantly associated with depression onset (HR=1.18, 95%CI=1.04–1.34). Stronger associations were found for persistent depressive symptoms. No associations were found in women. CONCLUSION: This study shows that obesity, in particular visceral fat, increases the risk of onset of significant depressive symptoms in men. These results suggest that specific mechanisms might relate visceral fat to the onset of depression

Jejunal perforation caused by abdominal angiostrongyliasis Perfuração jejunal causada por angiostrongilíase abdominal

The authors describe a case of abdominal angiostrongyliasis in an adult patient presenting acute abdominal pain caused by jejunal perforation. The case was unusual, as this affliction habitually involves the terminal ileum, appendix, cecum or ascending colon. The disease is caused by the nematode Angiostrongylus costaricensis, whose definitive hosts are forest rodents while snails and slugs are its intermediate hosts. Infection in humans is accidental and occurs via the ingestion of snail or slug mucoid secretions found on vegetables, or by direct contact with the mucus. Abdominal angiostrongyliasis is clinically characterized by prolonged fever, anorexia, abdominal pain in the right-lower quadrant, and peripheral blood eosinophilia. Although usually of a benign nature, its course may evolve to more complicated forms such as intestinal obstruction or perforation likely to require a surgical approach. Currently, no efficient medication for the treatment of abdominal angiostrongyliasis is known to be available. In this study, the authors provide a review on the subject, considering its etiopathogeny, clinical picture, diagnosis and treatment.<br>Os autores descrevem caso de angiostrongilíase abdominal em doente adulto que se manifestou como abdômen agudo devido à perfuração de alça jejunal, evento raro, uma vez que esta afecção geralmente envolve o íleo terminal, apêndice, ceco ou cólon ascendente. A doença é causada pelo nematódeo Angiostrongylus costaricensis cujos hospedeiros definitivos são roedores silvestres e os hospedeiros intermediários são caracóis e caramujos. A infecção em humanos é acidental e ocorre pela ingestão de secreção mucóide destes invertebrados presentes em vegetais ou por contato direto com o muco. A angiostrongilíase abdominal é clinicamente caracterizada pela presença de febre prolongada, anorexia, dor no quadrante inferior direito do abdômen e eosinofilia periférica. Embora a doença seja de natureza benigna, seu curso pode evoluir para formas complicadas como a obstrução ou perfuração intestinais que necessitam de tratamento cirúrgico. Atualmente, não há tratamento medicamentoso eficaz para a angiostrongilíase abdominal. Neste estudo, os autores realizam uma revisão desta afecção em relação à sua etiopatogenia, quadro clínico diagnóstico e tratamento

Efeito da fitase e xilanase sobre o desempenho e as características ósseas de frangos de corte alimentados com dietas contendo farelo de arroz Effect of phytase and xilanase on the performance and bone characteristics of broiler chicks fed diets with rice bran

O presente trabalho foi conduzido com o objetivo de verificar o efeito do uso da fitase e xilanase no desempenho e na deposição óssea de minerais em frangos de corte alimentados com dietas contendo 15% de farelo de arroz, baixo fósforo disponível e sem suplementação de ferro, cobre, zinco e manganês. A fitase utilizada foi da marca comercial Natuphos 5000 e a xilanase, da marca Avizyme 1300. O delineamento experimental foi inteiramente casualizado, em esquema fatorial 4x2+1. A dieta controle foi composta por níveis adequados de nutrientes, sem farelo de arroz e sem enzimas. As dietas dos demais tratamentos foram formuladas com 15% de farelo de arroz, contendo baixo fósforo disponível (40% do recomendado) e sem suplementação inorgânica de Fe, Cu, Zn e Mn, com quatro níveis de fitase (0, 400, 800 e 1.200 FTU/kg), com ou sem xilanase (1 kg/t). As variáveis estudadas aos 21 e 42 dias de idade foram desempenho e cinzas, P, Zn, Fe, Mn e Cu na tíbia. O peso vivo e consumo de ração aumentaram de maneira significativa com a adição de fitase, enquanto que a conversão alimentar não foi afetada, tanto aos 21 como aos 42 dias. O melhor nível de fitase foi de 1.105 e 1.023 FTU/kg para melhor desempenho, aos 21 e 42 dias de idade, respectivamente. A xilanase não afetou significativamente o peso vivo e o consumo de ração, porém melhorou significativamente a conversão alimentar nas duas idades avaliadas, em função de menor consumo de ração nas aves que receberam xilanase. Os níveis de fitase promoveram aumento linear nos teores de cinzas e fósforo da tíbia e não afetaram a deposição de Zn, Fe, Mn e Cu, nas duas idades estudadas. A xilanase não afetou os parâmetros avaliados na tíbia.<br>The present work was designed to verify the effect of the use of phytase and xylanase upon the performance and bone deposition of minerals in broiler diets containing 15% of rice bran, low available phosphorus and without supplementation of iron, zinc, copper and manganese. The phytase utilized was the Natuphos 5000 and the xylanase Avizyme 1300. The experimental design was the completely randomized and the analysis of variance in a 4x2+1 factorial scheme. The control diet was made up of adequate levels of all nutrients without rice bran and without enzymes. The diets of the other treatments were formulated with 15% of rice bran with low available phosphorus (40% of the recommended) and without inorganic supplementation of Fe, Cu, Zn and Mn with four levels of phytase (0, 400, 800 and 1,200 units/kg) with or without xylanase (1kg/t). The variables analyzed at 21 and 42 days of age were performance and ash, P, Zn, Fe, Mn and Cu in the tibia. Live weight and feed intake increased significantly with supplementation of phytase whereas feed conversion was not affected both at 21 and 42 days. The best level of phytase of 1.105 and 1.023 FTU/kg for better performance was reached at 21 and 42 days, respectively. The xylanase did not affect significantly live weight and feed intake. Therefore the data shown a significant improvement in feed conversion at the two ages evaluated provided by lower feed intake by the birds fed diets supplemented with xylanase. The phytase levels shown a linear increase in the contents of ash and phosphorus in the tibia and did not affect the deposition of Zn, Fe, Mn and Cu in the two studied ages. The xylanase did not have any effect on the parameters evaluated in the tibia