Change in physical activity level and clinical outcomes in older adults with knee pain: a secondary analysis from a randomised controlled trial

BACKGROUND: Exercise interventions improve clinical outcomes of pain and function in adults with knee pain due to osteoarthritis and higher levels of physical activity are associated with lower severity of pain and higher levels of physical functioning in older adults with knee osteoarthritis in cross-sectional studies. However, to date no studies have investigated if change in physical activity level during exercise interventions can explain clinical outcomes of pain and function. This study aimed to investigate if change in physical activity during exercise interventions is associated with future pain and physical function in older adults with knee pain. METHODS: Secondary longitudinal data analyses of a three armed exercise intervention randomised controlled trial. Participants were adults with knee pain attributed to osteoarthritis, over the age of 45 years old (n = 514) from Primary Care Services in the Midlands and Northwest regions of England. Crude and adjusted associations between absolute change in physical activity from baseline to 3 months (measured by the self-report Physical Activity Scale for the Elderly (PASE)) and i) pain ii) physical function (Western Ontario and McMaster Universities Osteoarthritis Index) and iii) treatment response (OMERACT-OARSI responder criteria) at 3 and 6 months follow-up were investigated using linear and logistic regression. RESULTS: Change in physical activity level was not associated with future pain, function or treatment response outcomes in crude or adjusted models at 3 or 6 months (P > 0.05). A 10 point increase in PASE was not associated with pain β = - 0.01 (- 0.05, 0.02), physical function β = - 0.09 (- 0.19, 0.02) or likelihood (odds ratio) of treatment response 1.02 (0.99, 1.04) at 3 months adjusting for sociodemographics, clinical covariates and the trial intervention arm. Findings were similar for 6 month outcome models. CONCLUSIONS: Change in physical activity did not explain future clinical outcomes of pain and function in this study. Other factors may be responsible for clinical improvements following exercise interventions. However, the PASE may not be sufficiently responsive to measure change in physical activity level. We also recommend further investigation into the responsiveness of commonly used physical activity measures. TRIAL REGISTRATION: ( ISRCTN93634563 ). Registered 29th September 2011

Qualidade de vida de pacientes mastectomizadas: uma revisão integrativa

A mama é um órgão que possui fundamental importância no corpo feminino, tanto para função reprodutora, quanto na imagem que a mulher tem de si mesma. Estudos relatam que a perda da mama gera dificuldades de adaptação a realidade e de imagem corporal, além de dificuldades físicas. O objetivo do estudo trata-se de verificar alterações de qualidade de vida em pacientes submetidas à mastectomia devido ao câncer de mama e possíveis intervenções para melhoria desta qualidade de vida. Trata-se de uma revisão integrativa onde foram selecionados   15 artigos por busca ativa nas bases de dados “PUBMED”, “SCIELO”, “LILACS”, “LATINDEX”. Como critério de busca como usados os seguintes unitermos: “qualidade de vida”; “mastectomizadas”. A presente pesquisa demonstrou que em todos os artigos analisados havia um prejuízo na qualidade de vida e sexualidade de pacientes submetidas à mastectomia. Observou-se, também, que a qualidade de vida melhorava quando a mobilidade daquela paciente era maior e a mesma podia exercer suas funções diárias, no trabalho e domésticas. Outrossim, os piores escores encontrados pelos estudos na qualidade de vidas de pacientes mastectomizadas foram: emocional e físico. Outro fator observado foi que pacientes submetidas à reconstrução mamária apresentaram melhor qualidade de vida, devido ao fator autoestima, autoimagem, prazer com o próprio corpo e com as vestimentas. Além disso, verificou-se que a fisioterapia pode ser um grande fator aliado para melhora da mobilidade, do edema e da função motora em geral, contribuindo para incremento no escore de aptidão física destas pacientes

Towards a biologically available strontium isotope baseline for Ireland

Strontium isotopes are used in archaeology, ecology, forensics, and other disciplines to study the origin of artefacts, humans, animals and food items. Strontium in animal and human tissues such as bone and teeth originates from food and drink consumed during life, leaving an isotopic signal corresponding to their geographical origin (i.e. where the plants grew, the animals grazed and the drinking water passed through). To contextualise the measurements obtained directly on animal and human remains, it is necessary to have a sound baseline of the isotopic variation of biologically available strontium in the landscape. In general, plants represent the main source of strontium for humans and animals as they usually contain much higher strontium concentrations than animal products (meat and milk) or drinking water. The observed difference between the strontium isotope composition of geological bedrock, soils and plants from the same locality warrants direct measurement of plants to create a reliable baseline. Here we present the first baseline of the biologically available strontium isotope composition for the island of Ireland based on 228 measurements on plants from 140 distinct locations. The isoscape shows significant variation in strontium isotope composition between different areas of Ireland with values as low as 0.7067 for the basalt outcrops in County Antrim and values of up to 0.7164 in the Mourne Mountains. This variability confirms the potential for studying mobility and landscape use of past human and animal populations in Ireland. Furthermore, in some cases, large differences were observed between different types of plants from the same location, highlighting the need to measure more than one plant sample per location for the creation of BASr baselines.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Copy number variations and founder effect underlying complete IL-10Rβ deficiency in Portuguese kindreds.

International audienceMutations in interleukin-10 receptor (IL-10R) genes are one cause of very early-onset inflammatory bowel disease with perianal lesions, which can be cured by hematopoietic stem cell transplantation. Using a functional test, which assesses responsiveness of peripheral monocytes to IL-10, we identified three unrelated Portuguese patients carrying two novel IL-10RB mutations. In the three patients, sequencing of genomic DNA identified the same large deletion of exon 3 which precluded protein expression. This mutation was homozygous in two patients born from consanguineous families and heterozygous in the third patient born from unrelated parents. Microsatellite analysis of the IL10RB genomic region revealed a common haplotype in the three Portuguese families pointing to a founder deletion inherited from a common ancestor 400 years ago. In the third patient, surface expression of IL-10R was normal but signaling in response to IL-10 was impaired. Complementary DNA sequencing and next-generation sequencing of IL10RB locus with custom-made probes revealed a ≈ 6 Kb duplication encompassing the exon 6 which leads to a frameshift mutation and a loss of the TYK2-interacting Box 2 motif. Altogether, we describe two novel copy number variations in IL10RB, one with founder effect and one preserving cell surface expression but abolishing signaling

Rhesus negative males have an enhanced IFNγ-mediated immune response to influenza A virus

International audienceThe Rhesus D antigen (RhD) has been associated with susceptibility to several viral infections. Reports suggest that RhD-negative individuals are better protected against infectious diseases and have overall better health. However, potential mechanisms contributing to these associations have not yet been defined. Here, we used transcriptomic and genomic data from the Milieu Interieur cohort of 1000 healthy individuals to explore the effect of Rhesus status on the immune response. We used the rs590787 SNP in the RHD gene to classify the 1000 donors as either RhD-positive or -negative. Whole blood was stimulated with LPS, polyIC, and the live influenza A virus and the NanoString human immunology panel of 560 genes used to assess donor immune response and to investigate sex-specific effects. Using regression analysis, we observed no significant differences in responses to polyIC or LPS between RhD-positive and -negative individuals. However, upon sex-specific analysis, we observed over 40 differentially expressed genes (DEGs) between RhD-positive ( n = 384) and RhD-negative males ( n = 75) after influenza virus stimulation. Interestingly these Rhesus-associated differences were not seen in females. Further investigation, using gene set enrichment analysis, revealed enhanced IFNγ signalling in RhD-negative males. This amplified IFNγ signalling axis may explain the increased viral resistance previously described in RhD-negative individuals