Psychological stress and other potential triggers for recurrences of herpes simplex virus eye infections

Objective To assess psychological stress and other factors as possible triggers of ocular herpes simplex virus (HSV) recurrences. Design A prospective cohort study nested in a randomized, placebo-controlled, clinical trial. Setting Fifty-eight community-based or university sites. Participants Immunocompetent adults (N = 308), aged 18 years or older, with a documented history of ocular HSV disease in the prior year and observed for up to 15 months. Exposure Variables Psychological stress, systemic infection, sunlight exposure, menstrual period, contact lens wear, and eye injury recorded on a weekly log. The exposure period was considered to be the week before symptomatic onset of a recurrence. Main Outcome Measure The first documented recurrence of ocular HSV disease, with exclusion of cases in which the exposure week log was completed late after the onset of symptoms. Results Thirty-three participants experienced a study outcome meeting these criteria. Higher levels of psychological stress were not associated with an increased risk of recurrence (rate ratio, 0.58; 95% confidence interval, 0.32-1.05; P = .07). No association was found between any of the other exposure variables and recurrence. When an analysis was performed including only the recurrences (n = 26) for which the exposure week log was completed late and after symptom onset, there was a clear indication of retrospective overreporting of high stress (P = .03) and systemic infection (P = .01). Not excluding these cases could have produced incorrect conclusions due to recall bias. Conclusions Psychological stress does not appear to be a trigger of recurrences of ocular HSV disease. If not accounted for, recall bias can substantially overestimate the importance of factors that do not have a causal association with HSV infection

Iron-fortified milk can improve iron status in young women with low iron stores

A considerable proportion of the populations of developing and industrialised nations does not meet the recommended daily allowance for iron and are thus at risk of chronic iron-deficiency anaemia. In a placebo-controlled, double-blind study we investigated whether supplementation with iron-enriched milk can improve the iron status in young women with low iron stores. Sixty-two women aged 20-36 years with serum ferritin concentrations </= 22 μg/l were given 400 ml/d of commercial milk (reference milk; n = 30) or milk enriched with 1.75 mg/100 ml micro-compartmented iron and 10 mg/100 ml vitamin C (Fe-milk; n = 32) as part of their habitual diets for 8 weeks. The Fe-milk was found to increase ferritin concentrations from 13.3 ± 6.9 μg/l (mean ± SD) to 17.7 ± 11.8 μg/l after 8 weeks, whereas the reference milk resulted in a decline from 12.6 ± 6.8 μg/l to 10.6 ± 8.1 μg/l (p = 0.01). After 8 weeks haemoglobin was higher in women receiving Fe-milk (135.5 ± 1.0) than in women receiving reference milk (131.4 ± 1.5 g/l; p = 0.03). Conclusion: Milk enriched with micro-compartmented iron and vitamin C can increase depleted iron stores in reproductive age women

Body mass index, waist circumference, and cardiometabolic risk factors in young and middle-aged Chinese women

Objective: To assess the associations between body mass index (BMI), waist circumference (WC), and cardiometabolic risk factors in young and middle-aged Chinese women. Methods: A total of 3011 women (1938 young women, 1073 middle-aged women), who visited our health care center for a related health checkup, were eligible for study. BMI and WC were measured. The subjects were divided into normal and overweight/obesity groups based on BMI, and normal and abdominal obesity groups based on WC. Cardiometabolic variables included triglyceride (TG), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), and blood pressure (BP). Results: The prevalence of overweight/obesity was significantly higher in middle-aged women (32.4%) than in young women (12.0%). The prevalence of abdominal obesity was also higher in middle-aged women (60.3%) than in young women (36.2%). There were significant differences in the comparison of all related cardiometabolic variables between different BMI (or WC) categories in young and middle-aged women groups, respectively. After adjustment for age, partial correlation analysis indicated that both BMI and WC were correlated significantly with all related cardiometabolic variables. After adjustment for age and WC, although the correlation coefficient r′ was attenuated, BMI was still correlated significantly with all related cardiometabolic variables in young and middle-aged women. After adjustment for age and BMI, partial correlation analysis showed that WC was correlated significantly with TG, FBG, HOMA-IR, and HDL-C in young women and significantly with TG, HOMA-IR, and HDL-C in middle-aged women. Conclusions: The prevalence of overweight/obesity and abdominal obesity was high in Chinese young and middle-aged women. BMI was a better predictor of cardiovascular disease and diabetes than WC in young and middle-aged women, and moreover, measurement of both WC and BMI may be a better predictor of cardiovascular disease and diabetes mellitus than BMI or WC alone

Obesity, obstructive sleep apnea, and cardiovascular risk

Obesity is a major risk factor for cardiovascular disease, the number one killer of Americans. It is also a major risk factor for obstructive sleep apnea, which is rising in the US population as the obesity epidemic continues. Obstructive sleep apnea, in turn, has been implicated as a risk factor for hypertension, glucose dysregulation, and cardiovascular disease. Understanding the pathophysiologic links and the common-soil hypothesis for these rapidly growing disorders is of paramount importance for developing strategic therapeutic and preventive plans. This article discusses the associations of obesity, obstructive sleep apnea, and cardiovascular disease, highlighting the pathophysiologic mechanisms, including increased oxidative stress, endothelial dysfunction, and inflammation