Alien Registration- Poulin, Blanche C. (Augusta, Kennebec County)

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Bone mineral density in patients with inherited bone marrow failure syndromes.

BackgroundPatients with inherited bone marrow failure syndromes (IBMFS) may have several risk factors for low bone mineral density (BMD). We aimed to evaluate the prevalence of low BMD in IBMFS and determine the associated risk factors.MethodsPatients with IBMFS with at least one dual-energy X-ray absorptiometry (DXA) scan were evaluated. Diagnosis of each IBMFS, Fanconi anemia (FA), dyskeratosis congenita, Diamond-Blackfan anemia, and Shwachman-Diamond syndrome was confirmed by syndrome-specific tests. Data were gathered on age, height, and clinical history. DXA scans were completed at the lumbar spine, femoral neck, and forearm. BMD was adjusted for height (HAZ) in children (age ≤20 years). Low BMD was defined as a BMD Z-score and HAZ ≤-2 in adults and children, respectively, in addition to patients currently on bisphosphonate therapy.ResultsNine of thirty-five adults (26%) and eleven of forty children (27%) had low BMD. Adults with FA had significantly lower BMD Z-scores than those with other diagnoses; however, HAZ did not vary significantly in children by diagnosis. Risk factors included hypogonadism, iron overload, and glucocorticoid use.ConclusionsAdults and children with IBMFS have high prevalence of low BMD. Prompt recognition of risk factors and management are essential to optimize bone health

A Model To Measure Supination And Pronation Of The Foot Over Different Levels Of Physiological Stress Using An In-Shoe Force Monitoring System

The purpose of this study was to create a diagnostic model of supination and pronation of the foot using vertical ground reaction forces. A size adjustable capacitive transducer retaining 960 individual pressure cells was used to assess orthopaedic parameters of gait cyale timing and vertical ground reaction forces. A pilot sample of five males were used for this model. The subjects were exposed to six experimental conditions. These being; a) a walk, b) jog, c) walk on treadmill, and d) three levels of perceived exertion (mild, moderate and hard running). Perceived exertion was measured with the Borg (RPE) scale. All subjects were measured in the same brand of athletic shoe to control for intershoe differences. The ptonation/supination model was determined by medial/lateral force and timing measurements of the calcaneus, forefoot prominence, arch, the first and fifth metatarsal heads and the toe off (end of gait cycle). Results indicated bi-Iateral differences in the medial and lateral force measurements of the calcaneus. Timing in this area was slightly different. Medial to lateral timing pronation was evidenced in the treadmill walking and moderate running condition. As well, the loading of the first and fifth metatarsal heads as a percentage of the gait cycle did not change over the running conditions. The preliminary results of five subjects provides for limited support of a vertical ground reaction model to assess pronation and supination. Further research with techniques such as high speed photography will allow for clarification of this model

DYNAMIC MEASUREMENT OF FORCE WITHIN THE SHOE DURING CONDITIONS OF PERCEIVED EXERTION

INTRODUCTION Athletics and recreation are becoming a very large component of modem day society. Now, more than ever, more people are becoming very active and involved in recreational pursuits that include aerobics and running/jogging. The resultant increase in activity has lead to a noted increase in injuries (Nigg, 1985; Mckenzie et al., 1985). James et al (cited in Cavanagh, 1990), in a study of 180 injured runners identified three categories of running injury problem areas. These areas being: a) training errors; b)anatomic factors (biomechanics); and c) shoes and surfaces. Two thirds of these injuries were accounted for by training errors (increased mileage or increased intensity). Training errors concerning sudden increases in mileage or intensity tend to subject the body to new or greater than expected physiological stressors. Voloshin and Wosk (1981), have investigated the relationship between heel strike shock wave transmission and joint degeneration in walking subjects. Taken one step further, the implications of damage to the muscle-skeletal system by running is noted by Cavanagh (1990). This combined with the Nigg et al. (1983) data that suggests a relationship between the hardness of the athletic (running) surface and the incidence of injury has serious implications for the recreational runner/athlete. Clarke et al. (1985) have highlighted the possible injurious force involved in tibial accelerations that are the result of the runner taking longer strides. Since most people retain a constant stride frequency, as velocity increases, the athlete tends to increase their stride length. The resultant increase in stride length increases impact forces at the joint. This combined with the increase of ground reaction forces with higher running speeds (Munro et al., 1987) identifies high impact forces as a major factor to be considered when investigating the causal nature of running injuries. Research into the type of shoe and ground reaction forces has been equivocal. Nigg and Bahlsen (1988) have stated that shoes with the hardest mid soles elicit the lowest maximal vertical forces. Conversely other research has indicated that shoe hardness is related to higher (vertical) loading rates. Listed above are a number of factors involved in the prediction of running injuries. Further research is needed to discover the causative factors involved in etiology of sport medicine running injuries. An analysis of running shoes, in particular the vertical ground reaction forces, may account for dynamic patterns of gait. Running at different levels of perceived exertion may elicit clues as to the biomechanics patterns that may be injurious to runners. For example, the gait of a runner at the beginning of the run may be markedly different from the gait at the end of the run. Variables such as intensity and distance will greatly affect the athlete's form as they become more tired. Thus, the number of running injuries (2/3 of Clarke's population) as a result of improper training may be the function of bad form (gait mechanics). An analysis under different levels of exertion will identify patterns of pressure with the foot that may have implications for the construction and design of athletic footwear as well as training methods for runners. This study was an attempt to understand the dynamic of in-shoe vertical ground reaction forces within the shoe under differing levels of perceived exertion. Research in the area of running shoe forces may lead to the development of a better product that will decrease the rate and type of running injuries

fMRI Randomized Study of Mental and Motor Task Performance and Cortisol Levels to Potentiate Cortisol as a New Diagnostic Biomarker.

Cortisol is an important hormone in the protective stress response system, the Hypothalamus-Pituitary-Adrenal (HPA axis). It becomes especially salient in immune suppression syndromes such as multiple sclerosis and Cushing’s disease. Fatigue is a common symptom and mental and motor tasks are difficult and labored. The role of cortisol is mental and motor tasks and the recruitment of key brain regions in completion of these tasks is explored together with functional magnetic resonance imaging in healthy participants. Cortisol levels were found to be higher and had greater reduction in levels during mental versus motor tasks. Recruitment of brain stem and hypothalamus regions, important in cortisol activity, was affected differently. At low cortisol levels, mental task participants had less activity in the regions than their physical task counterparts. When cortisol levels were higher, widerspread recruitment of these brain regions was seen in the mental task participants, and for the physical task participants, the spread was at comparative low levels of cortisol. It is concluded that cortisol is implicated in these brain regions supporting the Thompson Cortisol Hypothesis and that brain region recruitment is likely to be dependent upon factors including cortisol levels as well as perception of stress in the task. It is suggested that mental tasks are perceived more stressful than physical but demand higher cortisol levels to promote wider spread brain region activity. Implication for neurological disease includes the use of cortisol in the proposed development of a potential new diagnostic biomarker for early detection of neurological sequelae

IGOB131, a novel seed extract of the West African plant Irvingia gabonensis, significantly reduces body weight and improves metabolic parameters in overweight humans in a randomized double-blind placebo controlled investigation

<p>Abstract</p> <p>Background</p> <p>A recent in vitro study indicates that IGOB131, a novel seed extract of the traditional West African food plant <it>Irvingia gabonensis</it>, favorably impacts adipogenesis through a variety of critical metabolic pathways including PPAR gamma, leptin, adiponectin, and glycerol-3 phosphate dehydrogenase. This study was therefore aimed at evaluating the effects of IGOB131, an extract of <it>Irvingia gabonensis</it>, on body weight and associated metabolic parameters in overweight human volunteers.</p> <p>Methods</p> <p>The study participants comprised of 102 healthy, overweight and/or obese volunteers (defined as BMI > 25 kg/m²) randomly divided into two groups. The groups received on a daily basis, either 150 mg of IGOB131 or matching placebo in a double blinded fashion, 30–60 minutes before lunch and dinner. At baseline, 4, 8 and 10 weeks of the study, subjects were evaluated for changes in anthropometrics and metabolic parameters to include fasting lipids, blood glucose, C-reactive protein, adiponectin, and leptin.</p> <p>Results</p> <p>Significant improvements in body weight, body fat, and waist circumference as well as plasma total cholesterol, LDL cholesterol, blood glucose, C-reactive protein, adiponectin and leptin levels were observed in the IGOB131 group compared with the placebo group.</p> <p>Conclusion</p> <p><it>Irvingia gabonensis </it>administered 150 mg twice daily before meals to overweight and/or obese human volunteers favorably impacts body weight and a variety of parameters characteristic of the metabolic syndrome. This is the first double blind randomized placebo controlled clinical trial regarding the anti-obesity and lipid profile modulating effects of an <it>Irvingia gabonensis </it>extract. The positive clinical results, together with our previously published mechanisms of gene expression modulation related to key metabolic pathways in lipid metabolism, provide impetus for much larger clinical studies. <it>Irvingia gabonensis </it>extract may prove to be a useful tool in dealing with the emerging global epidemics of obesity, hyperlipidemia, insulin resistance, and their co-morbid conditions.</p> <p>Trial registration</p> <p>ClinicalTrials.gov NCT00645775</p

Anti-inflammatory, anthropometric and lipomodulatory effects Dyglomera® (aqueous extract of Dichrostachys glomerata) in obese patients with metabolic syndrome

Background: Increased visceral fat, dyslipidemia and increased markers of inflammation and coagulation are cardiovascular risk factors commonly encountered in obese people with metabolic syndrome. Previous studies have shown that ground Dichrostachys glomerata (DG), a spice used in Western Cameroon, can have beneficial effects on inflammation and various other cardiovascular disease risk factors. The purpose of the present study was to evaluate the effects of Dyglomera®, an aqueous extract of DG (standardized to NLT 10% polyphenols) on certain anthropometric, biochemical (including pro-inflammatory and pro-thrombotic states) and hemodynamic parameters in obese patients with metabolic syndrome. Methods: The study was an 8-week randomized, double-blind, placebo-controlled trial involving 116 males and 202 females aged between 24 and 58 years. Participants were randomly divided into two groups: treatment and placebo. Capsules containing the active treatment (200 mg Dyglomera®) or placebo (200 mg maize powder) were administered 30–60 minutes before lunch and dinner throughout the study period. Various biochemical (namely, blood glucose, lipid profile, pro-inflammatory and pro-thrombotic markers), anthropometric and hemodynamic parameters were measured at baseline and after 4 and 8 weeks of treatment.Results: At the end of the study, the Dyglomera® group showed statistically significant differences in all 16 parameters compared to baseline values. Changes in BMI and waist circumference were accompanied by changes in biochemical parameters, with the exception of adiponectin levels which were not correlated to waist circumference and PAI-1 values. The results confirm the hypothesis that Dyglomera®, the aqueous extract of DG, has anti-inflammatory properties, and is effective in reducing cardiovascular disease risk factors associated with metabolic syndrome in obese human subjects