Physical Activity and Adiposity Markers at Older Ages: Accelerometer Vs Questionnaire Data

Physical activity is critically important for successful aging, but its effect on adiposity markers at older ages is unclear as much of the evidence comes from self-reported data on physical activity. We assessed the associations of questionnaire-assessed and accelerometer-assessed physical activity with adiposity markers in older adults

Infections with cytomegalovirus and other herpesviruses in 121 liver transplant recipients: Transmission by donated organ and the effect of OKT3 antibodies

One hundred twenty-one adult liver transplant recipients were studied for the incidence, risk factors, and morbidity associated with herpesviruses infections after transplantation. The overall incidence of infection was 59% for cytomegalovirus (CMV), 35% for herpes simplex virus (HSV), 25% for Epstein-Barr virus (EBV), and 7% for varicella-zoster virus (VZV). Primary CMV infection occurred in 46% and reactivation CMV infection in 67% of the susceptible recipients. Symptomatic and disseminated CMV diseases were more common when patients developed primary infection (P .10). Although most HSV infections were oral or genital reactivations, three cases of HSV hepatitis occurred - one was primary infection. Symptomatic reactivations of HSV were observed in 53% of HSV-seropositive recipients who received OKT3, versus 31% of seropositive recipients who did not receive OKT3 (P = .05)

Extrafine beclomethasone/formoterol in severe COPD patients with history of exacerbations

The FORWARD study is a randomised, double-blind trial that compares the efficacy and safety of 48 weeks treatment with extrafine beclomethasone dipropionate/formoterol fumarate (BDP/FOR), 100/6 μg pMDI, 2 inhalations BID, vs. FOR 12 μg pMDI, 1 inhalation BID, in severe COPD patients with a history of exacerbations. Co-primary endpoints were exacerbation rate over 48 weeks and pre-dose morning FEV1 at 12 weeks. The ITT population included 1186 patients (69% males, mean age 64 years) with severe airflow limitation (mean post-bronchodilator FEV1 42% predicted). Salbutamol as rescue therapy, theophylline and tiotropium (if stable regimen prior to screening) were allowed. Compared to FOR, BDP/FOR: (1) reduced the exacerbation rate (rate ratio: 0.72 [95% confidence interval 0.62–0.84], p < 0.001); (2) improved pre-dose morning FEV1 (mean difference: 0.069 L [0.043–0.095] p < 0.001); (3) prolonged the time to first exacerbation; (4) improved the SGRQ total score. The percentage of patients with adverse events was similar (52.1% with BDP/FOR and 49.2% with FOR). Pneumonia incidence was low, slightly higher with BDP/FOR (3.8%) than with FOR (1.8%). No difference for laboratory values, ECG or vital signs. Extrafine BDP/FOR significantly reduces the exacerbation rate and improves lung function of patients with severe COPD and history of exacerbations as compared to FOR alone

Health-seeking behaviour of tuberculosis patients and related factors in the central region of Ghana

The health seeking behaviour of TB patients and health service related barriers have been cited to have an influence on the management of the disease in countries with high incidence of TB. Using close and open-ended questionnaires, an assessment of the health seeking behaviour of 302 TB patients selected from 24 DOTS centres in six districts in the Central  Region of Ghana was carried out. Under service-related barriers, distance from home to DOTS centre significantly impacted on the management of TB among sufferers (p=0.025). Though not significant, patients  acknowledged the good reception by staff at treatment centres with 99.3% of them being comfortable with staff and services provided at centres. Majority (46.7%) of patients perceived TB to be caused by the oral route while only 9.3% knew the causative agent to be bacteria. Compared with males, quite a number of women did not have adequate knowledge on TB (p&lt;0.05). More than half of the respondents sought treatment elsewhere as first point of treatment before reporting to the DOTS centre. Health insurance played an important role in the health seeking behaviour of respondents; 45.9% of TB patients with health insurance visited the health facility as 1st provider whilst 49.4% without health insurance visited prayer camps (p=0.001). Our study has revealed that factors such as staff  attitude, distance to treatment centres, gender, employment and education are key factors that affect the health-seeking behaviour of TB patients in the Central Region of GhanaKeywords: Tuberculosis, Health, barriers, Central Regio