Response to Acute Psychophysical Stress and 24-Hour Glycemic Control in Healthy Older People

We examined the relation between stress reactivity and 24 h glycemic control in 17 inactive, healthy older people (≥60 years) under both a novel psychophysical stress and a seated control condition. Plasma cortisol was measured over the course of the stress and recovery periods. Glycemic control was determined over the subsequent 3 h from an oral glucose tolerance test (OGTT) and over 24 h via continuous glucose monitoring (CGM). We observed significant (P < 0.05) elevations in perceived stress, cardiovascular activity, and peak cortisol response at 30 min (10.6 ± 3.1 versus 8.6 ± 2.6 μg·dL −1 , resp.) during the stress compared with the control condition; however, 3 h OGTT glucose and insulin responses were similar between conditions. The CGM data suggested a 30-40 min postchallenge delay in peak glucose response and attenuated glucose clearance over the 6 h following the stress condition, but these alterations were not statistically significant. Healthy older people may demonstrate minimal disruption in metabolic resiliency following everyday psychological stress

Response to Acute Psychophysical Stress and 24-Hour Glycemic Control in Healthy Older People

We examined the relation between stress reactivity and 24 h glycemic control in 17 inactive, healthy older people (≥60 years) under both a novel psychophysical stress and a seated control condition. Plasma cortisol was measured over the course of the stress and recovery periods. Glycemic control was determined over the subsequent 3 h from an oral glucose tolerance test (OGTT) and over 24 h via continuous glucose monitoring (CGM). We observed significant (P<0.05) elevations in perceived stress, cardiovascular activity, and peak cortisol response at 30 min (10.6±3.1 versus 8.6±2.6 μg·dL−1, resp.) during the stress compared with the control condition; however, 3 h OGTT glucose and insulin responses were similar between conditions. The CGM data suggested a 30–40 min postchallenge delay in peak glucose response and attenuated glucose clearance over the 6 h following the stress condition, but these alterations were not statistically significant. Healthy older people may demonstrate minimal disruption in metabolic resiliency following everyday psychological stress

Abdominal Obesity in Older Women: Potential Role for Disrupted Fatty Acid Reesterification in Insulin Resistance

Context: Excess abdominal adiposity is a primary factor for insulin resistance in older age

Serum vitamin D levels and risk of prevalent tuberculosis, incident tuberculosis and tuberculin skin test conversion among prisoners

Abstract Poor vitamin D status has been associated with tuberculosis (TB); whether poor status is cause or consequence of disease is uncertain. We conducted a case-control study and two nested case-control studies to determine whether vitamin D levels were associated with active TB, tuberculin skin test (TST) conversion, and risk of progression to the active TB in prisoners in Brazil. In multivariable conditional logistic regression, subnormal vitamin D levels (OR, 3.77; 95% CI, 1.04–13.64) were more likely in prisoners with active TB. In contrast, vitamin D was not found to be a risk factor for either TST conversion (OR, 2.49; 95% CI, 0.64–9.66) or progression to active disease (OR, 0.59; 95% CI, 0.13–2.62). Black race (OR, 11.52; 95% CI, 2.01–63.36), less than 4 years of schooling (OR, 2.70; 95% CI, 0.90–8.16), cigarette smoking (OR, 0.23; 95% CI, 0.06–0.79) were identified as risk factors for TST conversion. Risk of progression to active TB was found to be associated with cigarette smoking (OR, 7.42; 95% CI, 1.23–44.70). Our findings in the prison population show that poor vitamin D status is more common in individuals with active TB, but is not a risk factor for acquisition of latent TB or progression to active TB

Leg glucose and protein metabolism during an acute bout of resistance exercise in humans

The present study investigated the responses of leg glucose and protein metabolism during an acute bout of resistance exercise. Seven subjects (5 men, 2 women) were studied at rest and during a strenuous lower body resistance exercise regimen consisting of &sim;8 sets of 10 repetitions of leg press at &sim;75% 1 repetition maximum and 8 sets of 8 repetitions of knee extensions at &sim;80% 1 repetition maximum. l-[ring-2H5]phenylalanine was infused throughout the study for measurement of phenylalanine rates of appearance, disappearance, protein synthesis, and protein breakdown across the leg. Femoral arterial and venous blood samples were collected at rest and during exercise for determination of leg blood flow, concentrations of glucose, lactate, alanine, glutamine, glutamate, leucine, and phenylalanine, and phenylalanine enrichments. Muscle biopsies were obtained at rest and immediately after exercise. Leg blood flow was nearly three times (P less than 0.009) higher and glucose uptake more than five times higher (P = 0.009) during exercise than at rest. Leg lactate release was 86 times higher than rest during the exercise bout. Although whole body phenylalanine rate of appearance, an indicator of whole body protein breakdown, was reduced during exercise; leg phenylalanine rate of appearance, rate of disappearance, protein synthesis, and protein breakdown did not change. Arterial and venous alanine concentrations and glutamate uptake were significantly higher during exercise than at rest. We conclude that lower body resistance exercise potently stimulates leg glucose uptake and lactate release. In addition, muscle protein synthesis is not elevated during a bout of resistance exercise

The Impact of Ventilation and Early Diagnosis on Tuberculosis Transmission in Brazilian Prisons

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2017-06-06T12:40:30Z No. of bitstreams: 1 Urrego J The impact of ventilation....pdf: 1153577 bytes, checksum: 95797857548916ef7fe2d91a260efbcf (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-06-06T13:05:14Z (GMT) No. of bitstreams: 1 Urrego J The impact of ventilation....pdf: 1153577 bytes, checksum: 95797857548916ef7fe2d91a260efbcf (MD5)Made available in DSpace on 2017-06-06T13:05:14Z (GMT). No. of bitstreams: 1 Urrego J The impact of ventilation....pdf: 1153577 bytes, checksum: 95797857548916ef7fe2d91a260efbcf (MD5) Previous issue date: 2015Foundation for the Development of Teaching, Science, and Technology of the State of Mato Grosso do Sul (0067/12 and 0059/13); Secretariat of Health Surveillance, Brazilian Ministry of Health (20/2013); Ciências sem Fronteiras Program of the Brazilian National Research Council; Fogarty Global Health Equity Scholars Program (NIH 1 R25 TW009338); Jan A. J. Stolwijk Fellowship at the Yale School of Public Health (to J.U.); and National Institute of Allergy and Infectious Disease (K01 AI104411 to J.R.A.)Yale School of Public Health. New Haven, CTYale School of Public Health. New Haven, CT / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilHospital Universitário de Dourados. Dourados, MS, BrasilHospital Universitário de Dourados. Dourados, MS, BrasilHospital Universitário de Dourados. Dourados, MS, BrasilYale School of Public Health. New Haven, CTStanford University School of Medicine. Stanford, CAUniversidade Federal da Grande Dourados. Faculdade de Ciências da Saúde. Dourados, MS, BrasilPrisoners have among the highest incidence of tuberculosis (TB) globally. However, the contribution of the prison environment on transmission is not well understood and structural characteristics have received little attention as effective epidemiological interventions in TB control. We evaluated architectural characteristics and estimated ventilation rates in 141 cells in three prisons in central west Brazil using steady-state exhaled carbon dioxide (CO2) levels. We used a modified Wells-Riley equation to estimate the probability of infection for inmates sharing a cell with an infectious case and projected the impact of interventions, including early diagnosis and improved ventilation. Overall, prison cells were densely populated (mean 2.1 m(2) per occupant) and poorly ventilated, with only three cells meeting World Health Organization (WHO) standards for per-person ventilation (60 L/s) applied in infection control settings. In the absence of interventions, projected mean risk of infection was 78.0% during a 6-month period. Decreasing time-to-diagnosis by 25% reduced transmission risk by 8.3%. Improving ventilation to WHO standards decreased transmission by 38.2%, whereas optimizing cross-ventilation reduced transmission by 64.4%. Prison environments promote high infection risk over short-time intervals. In this context, enhanced diagnostics have a limited impact on reducing transmission. Improving natural ventilation may be required to effectively control TB in prisons