Predictive role of high sensitivity troponin T within four hours from presentation of acute coronary syndrome in elderly patients

Previous studies indicate that the introduction of high-sensitivity troponin T (HsTnT) as a diagnostic tool for chest pain patients in the emergency department (ED) creates a high rate of false-positive tests. In the present study, we aimed to evaluate if the diagnostic performance of HsTnT for acute coronary syndrome (ACS) up to 3-4 h after presentation in elderly patients can be improved

Cross-sectional and prospective impact of reallocating sedentary time to physical activity on children's body composition.

BACKGROUND: The amount of time children spend in sedentary behaviours may have adverse health effects. OBJECTIVE: To examine the substitution effects of displacing a fixed duration of sedentary time with physical activity (PA) on children's body composition. METHODS: We included 386 children (197 boys). Outcomes were body mass index, waist circumference, total body fat mass and trunk fat mass assessed by dual-energy X-ray absorptiometry. Sedentary time and PA were measured with accelerometers. Data were analysed by isotemporal analyses estimating the effect of reallocating 15 and 30 min d-1 of sedentary time into light (light physical activity), and moderate-to-vigorous (MVPA) PA on body composition. RESULTS: Reallocating 15 and 30 min d-1 of sedentary time into MVPA was negatively associated with body fatness in cross-sectional analyses. Prospectively, reallocating 30 min of sedentary time into 30 min of MVPA was negatively associated with waist circumference (β = -1.11, p  0.05) with body fatness outcomes. CONCLUSIONS: Substituting sedentary time with MVPA using isotemporal analysis is associated with positive effects on body composition.The study was supported by the Portuguese Foundation of Science and Technology. Support/grant: PTDC/DES/108372/2008

Criterion validity of a 10-category scale for ranking physical activity in Norwegian women.

BACKGROUND: Accurate measurement of physical activity (PA) is critical to establish dose-response relationships with various health outcomes. We compared the self-administered PA questionnaire from the Norwegian Women and Cancer Study (NOWAC) with a criterion method in middle-aged Norwegian women. METHODS: A sample of 177 randomly recruited healthy women attended two clinical visits approximately 4-6 months apart. At each visit, the women completed the NOWAC PA questionnaire (NOPAQ), rating their overall PA level on a 10-category scale (1 being a "very low" and 10 being a "very high" PA level) and performed an 8-minute step-test to estimate aerobic fitness (VO2max). After each visit, the women wore a combined heart rate and movement sensor for 4 consecutive days of free-living. Measures of PA obtained from the combined heart rate and movement sensor, which were used as criterion, included individually calibrated PA energy expenditure (PAEE), acceleration, and hours/day of moderate-to-vigorous intensity PA (MVPA). These were averaged between visits and compared to NOPAQ scores at visit 2. RESULTS: Intra-class correlation coefficients for objective measures from both free-living periods were in the range of 0.65-0.87 (P < 0.001), compared to 0.62 (P < 0.001) for NOPAQ. There was a moderate but significant (P < 0.001) Spearman's rank correlation coefficient in the range of 0.36-0.46 between NOPAQ and objective measures of PA. Linear trends for the association between the NOPAQ rating scale with PAEE, hours/day of MVPA and VO2max (P < 0.001) were also demonstrated. CONCLUSIONS: Self-reported PA level measured on a 10-category scale appears valid to rank PA in a female Norwegian population.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Ingen evidens för rutinmässig rektalpalpation vid akut buk.

A critical note regarding that the Health and Social Care Inspectorate criticized a physician for not conducting a digital rectal examination

Patterns and correlates of objectively measured free-living physical activity in adults in rural and urban Cameroon.

BACKGROUND: Urbanisation in sub-Saharan Africa is changing lifestyles and raising non-communicable disease burden. Understanding the underlying pattern of physical activity and its correlates may inform preventive interventions. We examined correlates of objectively-measured physical activity in rural and urban Cameroon. METHODS: Participants were 544 adults resident in rural (W-156, M-89) or urban (W-189, M-110) regions. Physical activity was measured using individually-calibrated combined heart rate and movement sensing over seven continuous days. Sociodemographic data were collected by self-report. Independent associations of sociodemographic correlates with physical activity energy expenditure (PAEE) or moderate-to-vigorous physical activity (MVPA) were analysed in multivariate regression models. RESULTS: Rural dwellers were significantly more active than their urban counterparts (PAEE: 58.0 vs 42.9 kJ/kg/day; MVPA: 107 vs 62 min/day; MVPA of 150 min/week in >10 min bouts: 62 vs 39%) and less sedentary (923 vs 1026 min/day); p<0.001. There was no significant seasonal difference (dry vs rainy) in activity in urban dwellers whereas in rural dwellers activity was higher during dry seasons compared to rainy seasons (p<0.001). Age, obesity and education showed significant inverse associations with activity. Urban dwellers who considered themselves adequately active were only as active as rural dwellers who thought they were not adequately active. CONCLUSIONS: This is the first study providing data on sociodemographic patterning of objectively-measured physical activity in rural and urban sub-Saharan Africa. Age, urban residence, obesity and higher educational level are important correlates of lower levels of physical activity. These suggest targets for public health interventions to improve physical activity in Cameroon.This research was supported by the Wellcome Trust (074786/Z/04/Z) and the Medical Research Council Epidemiology Unit (MC_UU_12015/3).This is the final published version. It first appeared at http://jech.bmj.com/content/early/2015/04/03/jech-2014-205154.long