The Effects of Perceived Stress and Attitudes toward Menopause and Aging on Symptoms of Menopause

As part of a longitudinal study of midlife women, the aim of this investigation was to describe the intensity of menopausal symptoms in relation to level of perceived stress in a woman’s life and her attitudes toward menopause and aging. Data were collected on 347 women between the ages of 40–50 in Northern California who began the study while pre-menopausal. Women self identified as African American, European American, or Mexican/Central American. Data collected over 3 time points in the first 12 months were used for this analysis. An investigatordeveloped tool for perception of specific types of stress was used. Attitudes toward menopause and aging were measured using the Attitudes Toward Menopause and Attitude Toward Aging Checklists. Attitudes toward aging and menopause, perceived stress, and income were related to intensity of symptoms. There was no ethnic group difference in perceived stress or attitude toward menopause. However, European and African Americans had a more positive attitude toward aging than Mexican/Central Americans. A lower income, higher perceived stress, a more negative attitude toward aging, and a more positive attitude toward menopause influenced menopausal symptom experience

A qualitative exploration of the effect of visual field loss on daily life in home-dwelling stroke survivors

Objective: To explore the effect of visual field loss on the daily life of community-dwelling stroke survivors. Design: A qualitative interview study. Participants: Adult stroke survivors with visual field loss of at least six months’ duration. Methods: Semi-structured interviews were conducted with a non-purposive sample of 12 stroke survivors in their own homes. These were recorded, transcribed verbatim and analyzed with the framework method, using an inductive approach. Results: Two key analytical themes emerged. ‘Perception, experience and knowledge’ describes participant’s conflicted experience of having knowledge of their impaired vision but lacking perception of that visual field loss and operating under the assumption that they were viewing an intact visual scene when engaged in activities. Inability to recognize and deal with visual difficulties, and experiencing the consequences, contributed to their fear and loss of self-confidence. ‘Avoidance and adaptation’ were two typologies of participant response to visual field loss. Initially, all participants consciously avoided activities. Some later adapted to vision loss using self-directed head and eye scanning techniques. Conclusions: Visual field loss has a marked impact on stroke survivors. Stroke survivors lack perception of their visual loss in everyday life, resulting in fear and loss of confidence. Activity avoidance is a common response, but in some, it is replaced by self-initiated adaptive techniques

Free radical activity of PM10: iron-mediated generation of hydroxyl radicals.

The purpose of this study was to test the hypothesis that particulate matter < or = 10 microns in aerodynamic diameter (PM10) particles have the ability to generate free radical activity at their surface. We collected PM10 filters from the Edinburgh, United Kingdom, Enhanced Urban Network sampling site, removed particles from the filter, and tested their ability to cause free radical damage to supercoiled plasmid DNA. We found that the PM10 particles did cause damage to the DNA that was mediated by hydroxyl radicals, as shown by inhibition of the injury with mannitol. The PM10-associated hydroxyl radical activity was confirmed using a high-performance liquid chromatography-based assay to measure the hydroxyl radical adduct of salicylic acid. Desferrioxamine abolished the hydroxyl radical-mediated injury, which suggests that iron was involved. Analysis of PM10 filters confirmed the presence of large amounts of iron and leaching studies confirmed that the PM10 samples could release substantial amounts of Fe(III) and lesser amounts of Fe(II). To investigate the size of the particles involved in the hydroxyl radical injury, we centrifuged the suspension of PM10 to clarity, tested the clear supernatant, and found that it had all of the suspension activity. We conclude, therefore, that the free radical activity is derived either from a fraction that is not centrifugeable on a bench centrifuge, or that the radical generating system is released into solution

Age-dependent elastin degradation is enhanced in chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is primarily a lung condition characterised by the presence of persistent airflow limitation resulting from inflammation, remodelling of small airways, and emphysema. It is well-recognised that the impacts of COPD extend beyond the lung with many patients suffering systemic manifestations such as cardiovascular diseases that affect morbidity and mortality [1]. “Accelerated ageing” has been proposed as a mechanism that underlies many of the pulmonary and extrapulmonary consequences of COPD [2, 3]. It is thought that a decline in organ function is a feature of ageing in response to the accumulation of cell and molecular damage, and in the case of COPD, noxious inhalants such as tobacco smoke increase this damage, thus accelerating the ageing process, leading to the development of COPD. With the exception of lung function decline, however, evidence indicating that tobacco smoking or COPD accelerates age-associated deterioration remains scarce

Validity of physical activity monitors during daily life in patients with COPD.

Symptoms during physical activity (PA) and physical inactivity are COPD. Our aim was to evaluate the validity and usability of six activity in patients with COPD against the doubly labelled water (DLW) indirect calorimetry method.Eighty COPD patients (age 68+/-6 years, FEV1 57+/-19% predicted) recruited in four centres each wore simultaneously three or six commercially available monitors validated in chronic conditions for consecutive days. A priori validity criteria were defined. These ability to explain total energy expenditure (TEE) variance through regression analysis, using TEE as the dependent variable with total body (TBW) plus several PA monitors outputs as independent variables; and with DLW measured activity energy expenditure (AEE).The Actigraph GT3X DynaPort MoveMonitor best explained the majority of the TEE variance not explained by TBW (53% and 70% respectively) and showed the most correlations with AEE (r=0.71 p<0.001, r=0.70 p<0.0001, of this study should guide users in choosing valid activity monitors for or for clinical use in patients with chronic diseases such as COPD

Miscellaneous Problems

Contains reports on eight research projects

Characterisation of COPD heterogeneity in the ECLIPSE cohort

Background Chronic obstructive pulmonary disease (COPD) is a complex condition with pulmonary and extra-pulmonary manifestations. This study describes the heterogeneity of COPD in a large and well characterised and controlled COPD cohort (ECLIPSE). Methods We studied 2164 clinically stable COPD patients, 337 smokers with normal lung function and 245 never smokers. In these individuals, we measured clinical parameters, nutritional status, spirometry, exercise tolerance, and amount of emphysema by computed tomography. Results COPD patients were slightly older than controls and had more pack years of smoking than smokers with normal lung function. Co-morbidities were more prevalent in COPD patients than in controls, and occurred to the same extent irrespective of the GOLD stage. The severity of airflow limitation in COPD patients was poorly related to the degree of breathlessness, health status, presence of co-morbidity, exercise capacity and number of exacerbations reported in the year before the study. The distribution of these variables within each GOLD stage was wide. Even in subjects with severe airflow obstruction, a substantial proportion did not report symptoms, exacerbations or exercise limitation. The amount of emphysema increased with GOLD severity. The prevalence of bronchiectasis was low (4%) but also increased with GOLD stage. Some gender differences were also identified. Conclusions The clinical manifestations of COPD are highly variable and the degree of airflow limitation does not capture the heterogeneity of the disease

Quercetin prevents progression of disease in elastase/LPS-exposed mice by negatively regulating MMP expression

Abstract Background Chronic obstructive pulmonary disease (COPD) is characterized by chronic bronchitis, emphysema and irreversible airflow limitation. These changes are thought to be due to oxidative stress and an imbalance of proteases and antiproteases. Quercetin, a plant flavonoid, is a potent antioxidant and anti-inflammatory agent. We hypothesized that quercetin reduces lung inflammation and improves lung function in elastase/lipopolysaccharide (LPS)-exposed mice which show typical features of COPD, including airways inflammation, goblet cell metaplasia, and emphysema. Methods Mice treated with elastase and LPS once a week for 4 weeks were subsequently administered 0.5 mg of quercetin dihydrate or 50% propylene glycol (vehicle) by gavage for 10 days. Lungs were examined for elastance, oxidative stress, inflammation, and matrix metalloproteinase (MMP) activity. Effects of quercetin on MMP transcription and activity were examined in LPS-exposed murine macrophages. Results Quercetin-treated, elastase/LPS-exposed mice showed improved elastic recoil and decreased alveolar chord length compared to vehicle-treated controls. Quercetin-treated mice showed decreased levels of thiobarbituric acid reactive substances, a measure of lipid peroxidation caused by oxidative stress. Quercetin also reduced lung inflammation, goblet cell metaplasia, and mRNA expression of pro-inflammatory cytokines and muc5AC. Quercetin treatment decreased the expression and activity of MMP9 and MMP12 in vivo and in vitro, while increasing expression of the histone deacetylase Sirt-1 and suppressing MMP promoter H4 acetylation. Finally, co-treatment with the Sirt-1 inhibitor sirtinol blocked the effects of quercetin on the lung phenotype. Conclusions Quercetin prevents progression of emphysema in elastase/LPS-treated mice by reducing oxidative stress, lung inflammation and expression of MMP9 and MMP12.http://deepblue.lib.umich.edu/bitstream/2027.42/78260/1/1465-9921-11-131.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78260/2/1465-9921-11-131.pdfPeer Reviewe