Subcutaneous adipose tissue fatty acid desaturation in adults with and without rare adipose disorders

<p>Abstract</p> <p>Background</p> <p>Elevated stearoyl-CoA desaturase activity has been described in obese states, with an increased desaturation index (DI) suggesting enhanced lipogenesis. Differences in the DI among various phenotypes of abnormal adiposity have not been studied. Abnormal accumulation of subcutaneous adipose tissue occurs in rare adipose disorders (RADs) including Dercum's disease (DD), multiple symmetric lipomatosis (MSL), and familial multiple lipomatosis (FML). Examining the DI in subcutaneous fat of people with DD, MSL and FML may provide information on adipose tissue fatty acid metabolism in these disorders. The aims of this pilot study were: 1) to determine if differences in adipose tissue DIs are present among RADs, and 2) to determine if the DIs correlate to clinical or biochemical parameters.</p> <p>Methods</p> <p>Subcutaneous adipose tissue was obtained from human participants with DD (n = 6), MSL (n = 5), FML (n = 8) and obese Controls (n = 6). Fatty acid composition was determined by gas chromatography/mass spectrometry. The DIs (palmitoleic/palmitic, oleic/stearic, vaccenic/stearic ratios) were calculated from the gas chromatogram peak intensities. SCD1 gene expression was determined. Spearman's correlations between the DIs and available clinical or biochemical data were performed.</p> <p>Results</p> <p>In DD subjects, the vaccenic/stearic index was lower (<it>p </it>< 0.05) in comparison to Controls. Percent of total of the saturated fatty acid myristic acid was higher in DD compared with Controls and FML. Percent of monounsaturated vaccenic acid in DD trended lower when compared with Controls, and was decreased in comparison to FML. In MSL, total percent of the polyunsaturated fatty acids was significantly lower than in the Control group (<it>p </it>< 0.05). In the total cohort of subjects, the palmitoleic/palmitic and oleic/stearic DIs positively correlated with age, BMI, and percent body fat.</p> <p>Conclusions</p> <p>The positive associations between the DIs and measures of adiposity (BMI and percent body fat) support increased desaturase activity in obesity. The lower vaccenic/stearic DI in DD SAT compared with Controls suggests presence of other factors involved in fat accumulation in addition to lifestyle. Other mechanisms driving fat accumulation in DD such as inflammation or lymphatic dysfunction should be investigated.</p

Concordance of Illness Representations: The Key to Improving Care of Medically Unexplained Symptoms

How can effective patient-provider relationships be developed when the underlying cause of the health condition is not well understood and becomes a point of controversy between patient and provider? This problem underlies the difficulty in treating medically unexplained symptoms and syndromes (MUS; e.g., fibromyalgia, chronic fatigue syndrome), which primary care providers consider to be among the most difficult conditions to treat.1 This difficulty extends to the patient-provider relationship which is characterized by discord over MUS.1 In this article, we argue that the key to improving the patient provider relationship is for the patient and provider to develop congruent illness perceptions about MUS

Patterns of sedentary behaviour and physical activity in people following curative intent treatment for non-small cell lung cancer

This study aimed to compare patterns of sedentary behaviour (SB) and physical activity (PA) in people following curative intent treatment for non-small cell lung cancer (NSCLC) with healthy controls. Participants 6-10 weeks following lobectomy for NSCLC and healthy controls wore two activity monitors for 7 days. Waking hours were divided into time spent in SB (<1.5 metabolic equivalent of tasks (METs)), light intensity PA (LIPA ≥ 1.5 to <3.0METs) and moderate-to-vigorous intensity PA (≥3.0METs). Daily steps were also recorded. Data were available in 20 participants with NSCLC (13 females; 68 ± 10 years) and 20 healthy controls (13 females; 69 ± 5 years). The NSCLC group accumulated a greater percentage of time in SB in uninterrupted bouts ≥30 minutes (49% vs. 42%; p = 0.048). Further, the NSCLC group spent a lower percentage of waking hours in LIPA (21 ± 9% vs. 26 ± 8%; p = 0.04) and accumulated a lower percentage of time in this domain in uninterrupted bouts ≥10 minutes (13% vs. 19%; p = 0.025). The NSCLC group also had a lower daily step count (8863 ± 3737 vs. 11,856 ± 3024 steps/day; p = 0.009). Time spent in moderate-to-vigorous intensity PA was similar in both groups (p = 0.92). People following curative intent treatment for NSCLC spend more time in prolonged bouts of SB at the expense of LIPA

Prevalence of Noise-Induced Hearing Loss in Student Musicians

Abstract: This study describes the prevalence and characteristics of noise-induced hearing loss (NIHL) in student musicians (N = 329) aged 18-25 years. Students completed a questionnaire regarding exposures before a hearing assessment. NIHL was defined by the presence of a notch 15 dB in depth at 4000 or 6000 Hz relative to the best preceding threshold. Overall prevalence of NIHL was 45%, with 78% of notches occurring at 6000 Hz. The proportion of the total population with bilateral notching at any frequency was 11.5%, mostly occurring at 6000 Hz. There was a significant increase in the frequency of notching in students who reported more than two hours per day of personal practice. There were no significant associations for instrument group or other noise exposures. The data suggest that susceptibility to NIHL among students of music is not uniform and cannot be ascribed solely to the instrument played and other exposures. Students with bilateral losses tend to have deeper notches and may represent a group that has an inherent predisposition to NIHL. Sumario Este estudio describe la prevalencia y las características de la hipoacusia inducida por ruido (NIHL) en estudiantes de música (N = 329) con edades entre 18 y 25 años. Los estudiantes completaron un cuestionario sobre exposición a ruido antes de la evaluación auditiva. Se definió NIHL como la presencia de una muesca de 15dB en 4000 o 6000Hz con relación al mejor umbral precedente. La prevalencia general de NIHL fue de 44%, con 78% de las muescas en 6,000 Hz. La proporción de la población total con muescas bilaterales en cualquier frecuencia fue de 11.5%, en su mayoría a 6,000 Hz. Hubo un incremento significativo en la frecuencia de la muescas en los estudiantes que reportaban más de dos horas al día de práctica profesional. No hubo una asociación significativa con grupos de instrumentos u otra exposición a ruido. Los datos sugieren que la susceptibilidad a NIHL entre los estudiantes de música no es uniforme y no puede atribuirse solamente al instrumento tocado o a otras exposiciones. Los estudiantes con pérdida bilateral tienden a tener muescas más profundas y pueden representar un grupo que tenga una predisposición inherente a la NIHL. Keywords: Noise-induced hearing loss, Music-related hearing loss, Prevalence of hearing loss, Predisposition Article: Noise-induced hearing loss (NIHL) is the most prevalent sensorineural hearing loss after presbycusis. Prevalence of NIHL increases with continued exposure and advancing age. The prevention of NIHL will require a better understanding of its prevalence in the population and contributing exposure factors. NIHL can be caused by a single traumatic impulse sound but is more typically caused by repeated exposures to high intensity sound. According to NIOSH recommendations for the prevention of NIHL, high intensity sound exposure involves a time-intensity trade-off that begins with an allowable eight-hour exposure at 85 dBA, decreasing the time exposed by half for every three dB increase in intensity. Sound exposure measurements in music students and music teachers document exposure levels over 85 dB

Sound level measurements in music practice rooms.

Average sound levels and percentage of daily dose of noise exposure were measured in the practice rooms of a university school of music, with the primary objective of determining whether sound levels in student practice rooms were high enough to warrant concern for hearing conservation. A secondary objective was to determine whether any instrument group was at higher risk for music-induced hearing loss due to exposure levels. Students representing 4 instrument groups were tested: brass, wind, string and voice. Measurements were taken using a dosimeter or DoseBadge clipped to the shoulder during 40 students’ individual practice sessions. These readings provided average exposure levels as well as the percentage of total allowed exposure (dose) obtained during the practice session. The mean measurement time for this study was 47 minutes (SD = 22). Mean sound levels measured averaged 87-95 dB(A) (SD = 3.5-5.9). Mean average levels for the brass players were significantly higher than other instrument groups. Using the mean duration of daily practice reported by the participants to estimate dose, 48% would exceed the allowable sound exposure. Implications for professional musicians are discussed, including the need for 12-hour breaks and the use of musicians’ earplugs. The implementation of a Hearing Protection Policy in the School of Music will also be discussed

Frequency and temporal resolution in elderly listeners with good and poor word recognition.

There is a subgroup of elderly listeners with hearing loss who can be characterized by exceptionally poor speech understanding. This study examined the hypothesis that the poor speech-understanding performance of some elderly listeners is associated with disproportionate deficits in temporal resolution and frequency resolution, especially for complex signals. Temporal resolution, as measured by gap detection, and frequency resolution, as measured by the critical ratio, were examined in older listeners with normal hearing, older listeners with hearing loss and good speech-recognition performance, and older listeners with hearing loss and poor speech-recognition performance. Listener performance was evaluated for simple and complex stimuli and for tasks of added complexity. In addition, syllable recognition was assessed in quiet and noise. The principal findings were that older listeners with hearing loss and poor word-recognition performance did not perform differently from older listeners with hearing loss and good word recognition on the temporal resolution measures nor on the spectral resolution measures for relatively simple stimuli. However, frequency resolution was compromised for listeners with poor word-recognition abilities when targets were presented in the context of complex signals. Group differences observed for syllable recognition in quiet were eliminated in the noise condition. Taken together, the findings support the hypothesis that unusual deficits in word- recognition performance among elderly listeners were associated with poor spectral resolution for complex signals

Preventing Hearing Loss.

Faculty and students in schools of music spend major portions of their time in environments (e.g., practice rooms, rehearsal rooms, and teaching studios) with sound levels that may put them at risk of noise-induced hearing loss (NIHL). NIHL is caused by exposure to loud sound levels, typically for prolonged and/or repeated periods of time. NIHL is characterized by a sharp decrease in hearing sensitivity between 3000-6000 Hz, called a noise notch, with a return to better sensitivity at the frequencies above the notch. The National Institute of Occupational Safety and Health (NIOSH) defines acoustic overexposure with a time/intensity trade-off. NIOSH recommendations state that 85 decibels (dB) is a sound level sufficient to warrant a hearing protection program. Their recommendations suggest that an individual may be exposed to 85 dB for 8 hours without risk to hearing damage, which is equal to a 100% dose of noise for that day. For every 3 decibels increase in intensity, the time allowed for exposure is cut in half. Anything over a 100% dose per day exceeds the NIOSH guidelines for noise exposure and may put someone at risk for noise-induced hearing loss. The following studies were undertaken with music students and faculty members to determine the amount of noise exposure musicians were experiencing in their daily routines

"It Seems that Everyone in My Family Loses Their Hearing!" Results of a Study of Hereditary Factors in Adult-Onset Hearing Loss.

Gallaudet University, the University of Maryland School of Medicine, and SHHH are completing a study to determine the extent to which genetic factors are involved in hearing loss that occurs in adulthood. This study, the first of its kind, is funded by the National Institute on Deafness and Other Communication Disorders, National Institutes of Health. The results of the first phase of this study are described in this article

Mentoring Graduate Clinicians: Learning from who you are.

Developing student clinicians in professional fields often focus on externals, such as processing incoming information and mastering technical skills. Informal and formal faculty mentoring can help student clinicians to integrate these external skills into their self-concept as clinicians. The authors describe the development of mentors as well as make recommendations for how the mentoring process should operate

Association between pain, radiographic severity, and centrally‐mediated symptoms in women with knee osteoarthritis

Objective To examine the relationship between pain, radiographic severity, and a common set of co‐occurring centrally‐mediated symptoms (fatigue, sleep quality, and depression) in women with knee osteoarthritis. Methods Participants underwent knee radiographs, and had repeated assessments of pain severity and other centrally‐mediated symptoms during a 5‐day home monitoring period. To examine associations between pain severity (the average of pain over the home monitoring period), measures of osteoarthritis radiographic severity (Kellgren/Lawrence grade, minimum joint space width), centrally‐mediated symptoms, and demographics (age) were used. Symptoms of fatigue, sleep efficiency, and depression were used in a composite measure representing centrally‐mediated symptoms. Results Using a series of linear regression models in which each variable was entered hierarchically (n = 54), the final model showed that 27% of the variance in pain severity was explained by age, radiographic severity, and centrally‐mediated symptoms. Centrally‐mediated symptoms explained an additional 10% of the variance in pain severity after the other 2 variables were entered. Conclusion Both radiographic severity and centrally‐mediated symptoms were independently and significantly associated with pain severity in women with knee osteoarthritis. In addition to more severe radiographic features, women with higher centrally‐mediated symptoms had greater pain severity. Treatments for women with symptomatic knee osteoarthritis may be optimized by addressing both peripheral and central sources of pain.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/88108/1/20583_ftp.pd