Effects of diabetes family history and exercise training on the expression of adiponectin and leptin and their receptors

The daughters of patients with diabetes have reduced insulin sensitivity index (ISI) scores compared with women with no family history of diabetes, but their ISI increase more in response to exercise training(1). The present study aimed to determine whether differences between these groups in exercise-induced changes in circulating adiponectin and leptin concentrations and expression of their genes and receptors in subcutaneous adipose tissue (SAT), could explain differences in the exercise-induced changes in ISI between women with and without a family history of diabetes

Contemporary Risk of Hip Fracture in Type 1 and Type 2 Diabetes:A National Registry Study From Scotland

The purpose of this study was to compare contemporary risk of hip fracture in type 1 and type 2 diabetes with the nondiabetic population. Using a national diabetes database, we identified those with type 1 and type 2 diabetes who were aged 20 to 84 years and alive anytime from January 1, 2005 to December 31, 2007. All hospitalized events for hip fracture in 2005 to 2007 for diabetes patients were linked and compared with general population counts. Age- and calendar-year-adjusted incidence rate ratios were calculated by diabetes type and sex. One hundred five hip fractures occurred in 21,033 people (59,585 person-years) with type 1 diabetes; 1421 in 180,841 people (462,120 person-years) with type 2 diabetes; and 11,733 hip fractures over 10,980,599 person-years in the nondiabetic population (3.66 million people). Those with type 1 diabetes had substantially elevated risks of hip fracture compared with the general population incidence risk ratio (IRR) of 3.28 (95% confidence interval [CI] 2.52–4.26) in men and 3.54 (CI 2.75–4.57) in women. The IRR was greater at younger ages, but absolute risk difference was greatest at older ages. In type 2 diabetes, there was no elevation in risk among men (IRR 0.97 [CI 0.92–1.02]) and the increase in risk in women was small (IRR 1.05 [CI 1.01–1.10]). There remains a substantial elevation relative risk of hip fracture in people with type 1 diabetes, but the relative risk is much lower than in earlier studies. In contrast, there is currently little elevation in overall hip fracture risk with type 2 diabetes, but this may mask elevations in risk in particular subgroups of type 2 diabetes patients with different body mass indexes, diabetes duration, or drug exposure

The UK medical education database (UKMED) what is it?:Why and how might you use it?

The development of UKMED has not been directly funded by but has received support from the General Medical Council and Medical Schools Council as well as staff time from all participating organisations.Peer reviewedPublisher PD

The astrobiology primer: An outline of general knowledge - Version 1, 2006

Peer reviewe

MR fluoroscopy in vascular and cardiac interventions (review)

Vascular and cardiac disease remains a leading cause of morbidity and mortality in developed and emerging countries. Vascular and cardiac interventions require extensive fluoroscopic guidance to navigate endovascular catheters. X-ray fluoroscopy is considered the current modality for real time imaging. It provides excellent spatial and temporal resolution, but is limited by exposure of patients and staff to ionizing radiation, poor soft tissue characterization and lack of quantitative physiologic information. MR fluoroscopy has been introduced with substantial progress during the last decade. Clinical and experimental studies performed under MR fluoroscopy have indicated the suitability of this modality for: delivery of ASD closure, aortic valves, and endovascular stents (aortic, carotid, iliac, renal arteries, inferior vena cava). It aids in performing ablation, creation of hepatic shunts and local delivery of therapies. Development of more MR compatible equipment and devices will widen the applications of MR-guided procedures. At post-intervention, MR imaging aids in assessing the efficacy of therapies, success of interventions. It also provides information on vascular flow and cardiac morphology, function, perfusion and viability. MR fluoroscopy has the potential to form the basis for minimally invasive image–guided surgeries that offer improved patient management and cost effectiveness

Conductivity, temperature, and depth measurements at the RMS Titanic wreck and Nargeolet-Fanning Ridge, Northwest Atlantic, in summer 2022

To gain information on the physical parameters of deep water in the Northwest Atlantic, CTD measurements were taken during seven dives to the RMS Titanic wreck (front of bow approx. 41.7330181, -49.9460561; 3816 m water depth) and one dive to the Nargeolet-Fanning Ridge (approx. 41.5980514, -49.4386889; 2896 m water depth) during the OceanGate expedition aboard the AHTS Horizon Arctic, 15 June - 25 July 2022. The CTD measurements of the water column down to a maximum water depth of 3853 m were conducted using a Valeport MIDAS SVX2 6000 unit attached to the submersible Titan for the duration of each dive and provided standard data for conductivity, temperature, and pressure. Conductivity and temperature data were used to compute salinity

Total alkalinity and dissolved inorganic carbon measurements at the RMS Titanic wreck and Nargeolet-Fanning Ridge, Northwest Atlantic, in summer 2022

To gain information on the chemical parameters of deep water in the Northwest Atlantic, water samples were taken using a Niskin bottle deployed at five stations at the RMS Titanic wreck site (stations: 0075, 0079, 0080, 0081, 0082 - deepest samples at station 0081: 41.7335576, -49.9467401, 3831 m water depth) and at one station at the Nargeolet-Fanning Ridge (station 0083: 41.5975604, -49.439188, 2870 m water depth) during the OceanGate expedition aboard AHTS Horizon Arctic, 15 June - 25 July 2022. A total of 20 water subsamples were collected and analysed for total alkalinity (TA) and dissolved inorganic carbon (DIC). TA was analysed using an Apollo SciTech AS-ALK2 alkalinity titrator and DIC was analysed using an Apollo SciTech AS-C3 inorganic carbon analyser. The aragonite saturation state was calculated using the CO2SYS system (Lewis and Wallace, 1998)

Manual physical therapy and exercise versus electrophysical agents and exercise in the management of plantar heel pain: A multicenter randomized clinical trial

STUDY DESIGN: Randomized clinical trial. OBJECTIVE: To compare the effectiveness of 2 different conservative management approaches in the treatment of plantar heel pain. BACKGROUND: There is insufficient evidence to establish the optimal physical therapy management strategies for patients with heel pain, and little evidence of long-term effects. METHODS: Patients with a primary report of plantar heel pain underwent a standard evaluation and completed a number of patient self-report questionnaires, including the Lower Extremity Functional Scale (LEFS), the Foot and Ankle Ability Measure (FAAM), and the Numeric Pain Rating Scale (NPRS). Patients were randomly assigned to be treated with either an electrophysical agents and exercise (EPAX) or a manual physical therapy and exercise (MTEX) approach. Outcomes of interest were captured at baseline and at 4-week and 6-month follow-ups. The primary aim (effects of treatment on pain and disability) was examined with a mixed-model analysis of variance (ANOVA). The hypothesis of interest was the 2-way interaction (group by time). RESULTS: Sixty subjects (mean [SD] age, 48.4 [8.7] years) satisfied the eligibility criteria, agreed to participate, and were randomized into the EPAX (n = 30) or MTEX group (n = 30). The overall group-by-time interaction for the ANOVA was statistically significant for the LEFS (P = .002), FAAM (P = .005), and pain (P = .043). Between-group differences favored the MTEX group at both 4-week (difference in LEFS, 13.5; 95% Cl: 6.3,20.8) and 6-month (9.9; 95% Cl: 1.2,18.6) follow-ups. CONCLUSION: The results of this study provide evidence that MTEX is a superior management approach over an EPAX approach in the management of individuals with plantar heel pain at both the short- and long-term follow-ups. Future studies should examine the contribution of the different components of the exercise and manual physical therapy programs