Moderate-to-vigorous physical activity modifies the relationship between sedentary time and sarcopenia: the Tromsø Study 2015–2016

Background: Sarcopenia is an age-related muscle disease primarily characterized by reductions in muscle strength that increases the risk of falls, fractures, cognitive impairment, and mortality. Exercise is currently preferred in prevention and treatment, but it is unknown how different habitual physical activity and sedentary behaviour patterns associate with sarcopenia status. The purpose of the present study was to compare associations of these patterns with probable sarcopenia in older adults. Methods: In 3653 community-dwelling participants (51% women) aged 60–84 years from the seventh survey of the Tromsø Study, we assessed objective physical activity and sedentary behaviour collected over 8 days (ActiGraph wGT3X-BT Accelerometer), grip strength (Jamar+ Digital Dynamometer), five-repetition chair stands, and self-reported disease. We combined tertiles of sedentary (SED) time and moderate-to-vigorous physical activity (MVPA) to create nine different activity profiles (SEDHIGH, SEDMOD, and SEDLOW combined with MVPAHIGH, MVPAMOD, or MVPALOW). Multiple logistic regression models were used to examine how these profiles associated with probable sarcopenia, defined by low handgrip strength and/or slow chair stands time according to the revised European Working Group on Sarcopenia in Older People criteria. Results: Probable sarcopenia was present in 227 (6.2%) participants. Men with probable sarcopenia had on average 35.3 min more SED time and 20 min less MVPA compared with participants without sarcopenia (P HIGH–MVPALOW reference activity profile (714.2 min SED/day and 10.4 min MVPA/day), the SEDHIGH–MVPAMOD profile (697.1 min SED/day and 31.5 min MVPA/day) had significantly lower odds ratio (OR) for probable sarcopenia (OR 0.17, 95% confidence interval [CI] 0.08–0.35), while the SEDLOW–MVPALOW profile (482.9 min SED/day and 11.0 min MVPA/day) did not (OR 0.72, 95% CI 0.47–1.11). These findings were not influenced by age, sex, smoking, or self-reported diseases, and higher levels of MVPA did not further decrease ORs for probable sarcopenia. Conclusions: Older adults who achieve moderate amounts of MVPA have reduced odds for probable sarcopenia, even when they have high sedentary time. Those with low sedentary time did not have reduced odds for probable sarcopenia when they also had low amounts of MVPA. These findings need confirmation in longitudinal studies but suggest that interventions for preventing sarcopenia should prioritize increasing MVPA over reducing sedentary behaviour

The epidemiology and factors associated with nocturnal enuresis among boarding and daytime school children in southeast of Turkey: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Nocturnal enuresis is an important problem among young children living in Turkey. The purpose of this study was to determine the possible differences in the prevalence of enuresis between children in boarding school and daytime school and the association of enuresis with sociodemographic factors.</p> <p>Methods</p> <p>This was a cross-sectional survey. A total of 562 self-administered questionnaires were distrubuted to parents from two different types of schools. One of them was a day-time school and the other was a boarding school. To describe enuresis the ICD-10 definition of at least one wet night per month for three consecutive months was used. Chi-square test and a logistic regression model was used to identify significant predictive factors for enuresis.</p> <p>Results</p> <p>The overall prevalence of nocturnal enuresis was 14.9%. The prevalence of nocturnal enuresis declined with age. Of the 6 year old children 33.3% still wetted their beds, while the ratio was 2.6% for 15 years-olds. There was no significant difference in prevalence of nocturnal enuresis between boys and girls (14.3% versus 16. 8%). Enuresis was reported as 18.5% among children attending day time school and among those 11.5% attending boarding school (p < 0.05). Prevalence of enuresis was increased in children living in villages, with low income and with positive family history (p < 0.05). After multivariate analysis, history of urinary tract infection (OR = 2.02), age (OR = 1.28), low monthly income (OR = 2.86) and family history of enuresis (OR = 3.64) were factors associated with enuresis. 46.4% of parents and 57.1% of enuretic children were significantly concerned about the impact of enuresis.</p> <p>Conclusion</p> <p>Enuresis was more frequent among children attending daytime school when compared to boarding school. Our findings suggest that nocturnal enuresis is a common problem among school children, especially with low income, smaller age, family history of enuresis and history of urinary tract infection. Enuresis is a pediatric public health problem and efforts at all levels should be made such as preventive, etiological and curative.</p

Incontinence in Individuals with Rett Syndrome: A Comparative Study

Frequency and type of incontinence and its association with other variables were assessed in females with Rett Syndrome (RS) (n = 63), using an adapted Dutch version of the ‘Parental Questionnaire: Enuresis/Urinary Incontinence’ (Beetz et al. 1994). Also, incontinence in RS was compared to a control group consisting of females with non-specific (mixed) intellectual disability (n = 26). Urinary incontinence (UI) (i.e., daytime incontinence and nocturnal enuresis) and faecal incontinence (FI) were found to be common problems among females with RS that occur in a high frequency of days/nights. UI and FI were mostly primary in nature and occur independent of participants’ age and level of adaptive functioning. Solid stool, lower urinary tract symptoms and urinary tract infections (UTI’s) were also common problems in females with RS. No differences in incontinence between RS and the control group were found, except for solid stool that was more common in RS than in the control group. It is concluded that incontinence is not part of the behavioural phenotype of RS, but that there is an increased risk for solid stool in females with RS

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

The dynamic mitochondria network in neurodegeneration

Conference Theme: Nature and Nurture in Brain FunctionsMitochondrial fragmentation due to fission/fusion imbalance has often been linked to mitochondrial dysfunction and apoptosis in neurodegeneration. It is traditionally believed that once the morphology of mitochondria shifts away from its physiological tubular form, mitochondria becomes defective and downstream apoptotic signalling pathways are triggered. In this study, we explored the dynamic changes in mitochondrial network in neurodegeneration. Our study showed that at early stages of neurodegeneration, beta-amyloid (Ab ) induced morphological changes in mitochondria where they become granular shape which was distinct from the conventional round and fragmented mitochondria in terms of both morphology and function. In addition, we demonstrated that accumulation of mitochondrial reactive oxygen species triggered granular mitochondria formation, while mitoTEMPO (a mitochondria-targeted superoxide scavenger) restored tubular mitochondrial morphology within Ab -treated neurons. Interestingly, modulations of mitochondria fission and fusion by genetic and pharmacological means not only attenuated the induction of granular mitochondria but also diminished mitochondrial superoxide levels in Ab -treated neurons. This study demonstrates a unique reciprocal relationship between mitochondrial dynamics and reactive oxygen species and provides a new possible therapeutic target at early stages of neurodegenerative disease pathogenesis. This study is supported by HMRF02131956, HKU Alzheimer’s Disease Research Network, and generous donation from Ms. Kit-Wan Chow

The aqueous extract from anti-aging Ganoderma lucidum inhibits beta-amyloid peptide-induced neurotoxicity

Program/Poster no. 826.11/CC29Ganoderma lucidum (Lingzhi) is an anti-aging oriental medicine that has been used for centuries in China to promote health. Numerous studies have reported the immunoregulatory and anti-tumor activities of G. lucidum. Although G. lucidum exhibits a wide array of effects on cancer and immune system, only few biological effects are known in the nervous system. We, therefore, take initiative to investigate its potential neuroprotective effects. Our results demonstrated that aqueous extract of G. lucidum exhibited neuroprotective effects against β-amyloid peptide (Aβ), 6-hydroxdopamine (6-OHDA) and staurosporine in differentiated human neuroblastoma SH-SY5Y. Since Aβ peptide plays significant roles in pathogenesis of Alzheimer’s disease, we have further investigated the neuroprotective effects of G. lucidum against Aβ toxicity by using primary cultures of cortical neurons. Pre-treatment of G. lucidum aqueous extract significantly attenuated Aβ-induced DEVD- (caspase-3 like) cleavage activities in a dose-dependent manner. In addition, aqueous extract of G. lucidum attenuated Aβ-induced synaptotoxicity by examining pre-synaptic synaptophysin immunoreactivity. Furthermore, treatment of G. lucidum aqueous extract attenuated the phosphorylation of c-Jun N-terminal kinase (JNK), c-Jun II and p38 MAPK in Aβ-stressed neurons. Together our previous study on anti-aging oriental medicine, G. lucidum is another example exhibiting neuroprotective effects and potential to be developed as neuroprotective agent

Inhibitory effects of β-amyloid peptide neurotoxicity by the aqueous extracts from Verbena officinalis

Verbena officinialis (Verbenaceae) is a perennial plant which has been used as herbal medicine or health supplement in both Western and Eastern countries for centuries. It has been used to treat acute dysentery, enteritis, amenorrhea and depression without much knowledge about biological mechanisms. In view of its wide array of biological effects, we hypothesized that V. officinalis can exert cytoprotective effects on cells of central nervous system. In vitro cell culture model of primary cortical neurons were used to examine the neuroprotective effects of V. officinalis against toxins/biological stresses. Pre-treatment of aqueous extracts of V. officinalis significantly attenuated the toxicity of beta-amyloid (Aβ) peptide and reducing agent dithiothreitol. Since Aβ peptide plays important roles in pathogenesis of Alzheimer’s disease (AD), we have further explored the neuroprotection of V. officinalis against Aβ. Treatment of V. officinalis attenuated Aβ-triggered DEVD-and VDVAD- cleavage activities in dose-dependent manner. Furthermore, V. officinialis attenuated the phosphorylation of both interferon-inducing protein kinase (PKR) and c-Jun N–terminal kinase (JNK) in Aβ-treated neurons. Taken together, we have proved our hypothesis by showing the novel neuroprotective effects of V. officinalis. As V. officinalis has long been used for many years to be a folk medicine, our study may provide a lead for its potential to be a neuroprotective agent against neuronal loss in AD. Supported by SWL and MSY are supported by postgraduate studentship from The University of Hong Kong. The study is partially supported by HKU Seed Funding for Basic Research (2004 & 2005) to RCCC

Neuroprotection and herbal medicine: experience form Verbeba Officinalisin Protecting Neurons from Beta-amyloid peptide toxicity

Conference Theme: A Global Challenge for the 21st Centur