Physical Activity During Pregnancy and Subsequent Risk of Preeclampsia and Gestational Hypertension: A Case Control Study

Physical activity (PA) is hypothesized to reduce the risk of preeclampsia, but few epidemiologic studies have simultaneously evaluated leisure time PA (LTPA), sedentary activity, occupational activity, and non-occupational, non-leisure time PA. Thus, we assessed the independent and combined effects of these different types of PA during pregnancy on preeclampsia and gestational hypertension risk

A probabilistic sampling method (PSM) for estimating geographic distance to health services when only the region of residence is known

<p>Abstract</p> <p>Background</p> <p>The need to estimate the distance from an individual to a service provider is common in public health research. However, estimated distances are often imprecise and, we suspect, biased due to a lack of specific residential location data. In many cases, to protect subject confidentiality, data sets contain only a ZIP Code or a county.</p> <p>Results</p> <p>This paper describes an algorithm, known as "the probabilistic sampling method" (PSM), which was used to create a distribution of estimated distances to a health facility for a person whose region of residence was known, but for which demographic details and centroids were known for smaller areas within the region. From this distribution, the median distance is the most likely distance to the facility. The algorithm, using Monte Carlo sampling methods, drew a probabilistic sample of all the smaller areas (Census blocks) within each participant's reported region (ZIP Code), weighting these areas by the number of residents in the same age group as the participant. To test the PSM, we used data from a large cross-sectional study that screened women at a clinic for intimate partner violence (IPV). We had data on each woman's age and ZIP Code, but no precise residential address. We used the PSM to select a sample of census blocks, then calculated network distances from each census block's centroid to the closest IPV facility, resulting in a distribution of distances from these locations to the geocoded locations of known IPV services. We selected the median distance as the most likely distance traveled and computed confidence intervals that describe the shortest and longest distance within which any given percent of the distance estimates lie. We compared our results to those obtained using two other geocoding approaches. We show that one method overestimated the most likely distance and the other underestimated it. Neither of the alternative methods produced confidence intervals for the distance estimates. The algorithm was implemented in R code.</p> <p>Conclusions</p> <p>The PSM has a number of benefits over traditional geocoding approaches. This methodology improves the precision of estimates of geographic access to services when complete residential address information is unavailable and, by computing the expected distribution of possible distances for any respondent and associated distance confidence limits, sensitivity analyses on distance access measures are possible. Faulty or imprecise distance measures may compromise decisions about service location and misdirect scarce resources.</p

Computerized image analysis: Estimation of breast density on mammograms

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134888/1/mp6640.pd

The Production of Bioethanol Fermentation Substrate from Eucheuma cottonii Seaweed through Hydrolysis by Cellulose Enzyme

AbstractThe aim of this research was to produce high reduction sugar component of bioethanol fermentation substrate using E. cottonii seaweed. The dried E. cottonii was taken from Buton district, South East Sulawesi. The seaweed was hydrolyzed using cellulose for 24hours with various enzyme concentrations (19, 36, and 52 AU) and temperatures (40 and 50°C). The reduction sugar was analyzed by Nelson-Somogy Method then statistical significance test (t-test) was processed by using SPSS software. The results showed that the reduction sugar was 8.045mg/mL, obtained during 12hours of hydrolysis process using 36 AU cellulose at 50°C. However, this hydrolysis result was not significantly different (tested by t-test analysis) with the result shown by 19 AU cellulose enzyme hydrolysis at 50°C temperature which produce 7.937mg/mL of reduction sugar component

Work, Leisure-Time Physical Activity, and Risk of Preeclampsia and Gestational Hypertension

Few studies of preeclampsia have assessed physical activity level, yet recent evidence suggests that the pathologic mechanisms in preeclampsia are similar to those in cardiovascular disease, for which physical activity is shown to be protective. The authors assessed the independent and combined effects of work and regular leisure-time physical activity (LTPA) during early pregnancy on risk of de novo preeclampsia (n = 44) and gestational hypertension (n = 172) among women recruited from 13 obstetric practices in the New Haven, Connecticut, area between 1988 and 1991. Control subjects were normotensive throughout pregnancy (n = 2,422). Information on time at work spent sitting, standing, and walking and on LTPA before and during pregnancy was collected via face-to-face interviews. Logistic regression analyses suggested that women who engaged in any regular LTPA regardless of caloric expenditure (adjusted odds ratio (aOR) = 0.66, 95% confidence interval (CI): 0.35, 1.22), were unemployed (aOR = 0.64, 95% CI: 0.21, 2.00), or had nonsedentary jobs (aOR = 0.71, 95% CI: 0.37, 1.36) were at decreased risk of preeclampsia. Analyses of gestational hypertension showed no indication of a protective effect of workplace activity, LTPA, or unemployment. Consistent with other studies, these data suggest that regular physical activity during pregnancy may reduce preeclampsia risk. employment; exercise; hypertension; motor activity; pre-eclampsia; pregnancy Abbreviations: aOR, adjusted odds ratio; CI, confidence interval; LTPA, leisure-time physical activity. Preeclampsia is a disease specific to human pregnancy, marked by hypertension and proteinuria. Despite decades of preventive efforts, preeclampsia remains a leading cause of maternal and perinatal morbidity and mortality worldwide (1). Research into its epidemiology and pathophysiology suggests that preeclampsia is a condition of heterogeneous causes characterized by a two-stage disease process (1). The first stage is punctuated by shallow, insufficient placentation, which is likely immune mediated (2), followed by systemic activation and disruption of the vascular endothelium with progression to the maternal syndrome (stage 2) (3). Oxidative stress is regarded as the mechanism most likely to cause endothelial dysfunction characteristic of preeclamptic pregnancies (4). Findings from the epidemiologic literature provide rational support for this mechanistic model. Factors consistent with an immune-based etiology include the higher risk after partner change among multiparous women with no prior preeclampsia (5-8), a short duration of sexual activity with the baby&apos;s father at the time of conception (9), and conception aided by donor insemination or embryos (10, 11), as well as a protective effect of abortion among nulliparous women who conceive again with the same father (12). Numerous lines of evidence implicate oxidative stress as a causal mechanism. Cardiovascular disease and preeclampsia share both a common disease pathway (i.e., endothelial activation) and many of the same constitutional risk factors, including hypertension, dyslipidemia, insulin resistance, an

Genetic Risk Score for Essential Hypertension and Risk of Preeclampsia

Preeclampsia is a hypertensive complication of pregnancy characterized by novel onset of hypertension after 20 weeks gestation, accompanied by proteinuria. Epidemiological evidence suggests that genetic susceptibility exists for preeclampsia; however, whether preeclampsia is the result of underlying genetic risk for essential hypertension has yet to be investigated. Based on the hypertensive state that is characteristic of preeclampsia, we aimed to determine if established genetic risk scores (GRSs) for hypertension and blood pressure are associated with preeclampsia

Dense breast stromal tissue shows greatly increased concentration of breast epithelium but no increase in its proliferative activity

INTRODUCTION: Increased mammographic density is a strong risk factor for breast cancer. The reasons for this are not clear; two obvious possibilities are increased epithelial cell proliferation in mammographically dense areas and increased breast epithelium in women with mammographically dense breasts. We addressed this question by studying the number of epithelial cells in terminal duct lobular units (TDLUs) and in ducts, and their proliferation rates, as they related to local breast densities defined histologically within individual women. METHOD: We studied deep breast tissue away from subcutaneous fat obtained from 12 healthy women undergoing reduction mammoplasty. A slide from each specimen was stained with the cell-proliferation marker MIB1. Each slide was divided into (sets of) areas of low, medium and high density of connective tissue (CT; highly correlated with mammographic densities). Within each of the areas, the numbers of epithelial cells in TDLUs and ducts, and the numbers MIB1 positive, were counted. RESULTS: The relative concentration (RC) of epithelial cells in high compared with low CT density areas was 12.3 (95% confidence interval (CI) 10.9 to 13.8) in TDLUs and 34.1 (95% CI 26.9 to 43.2) in ducts. There was a much smaller difference between medium and low CT density areas: RC = 1.4 (95% CI 1.2 to 1.6) in TDLUs and 1.9 (95% CI 1.5 to 2.3) in ducts. The relative mitotic rate (RMR; MIB1 positive) of epithelial cells in high compared with low CT density areas was 0.59 (95% CI 0.53 to 0.66) in TDLUs and 0.65 (95% CI 0.53 to 0.79) in ducts; the figures for the comparison of medium with low CT density areas were 0.58 (95% CI 0.48 to 0.70) in TDLUs and 0.66 (95% CI 0.44 to 0.97) in ducts. CONCLUSION: Breast epithelial cells are overwhelmingly concentrated in high CT density areas. Their proliferation rate in areas of high and medium CT density is lower than that in low CT density areas. The increased breast cancer risk associated with increased mammographic densities may simply be a reflection of increased epithelial cell numbers. Why epithelium is concentrated in high CT density areas remains to be explained

Future possibilities in the prevention of breast cancer: Luteinizing hormone-releasing hormone agonists

The cyclic production of estrogen and progesterone by the premenopausal ovary accounts for the steep rise in breast cancer risk in premenopausal women. These hormones are breast cell mitogens. By reducing exposure to these ovarian hormones, agonists of luteinizing hormone-releasing hormone (LHRH) given to suppress ovarian function may prove useful in cancer prevention. To prevent deleterious effects of hypoestrogenemia, the addition of low-dose hormone replacement to the LHRH agonist appears necessary. Pilot data with such an approach indicates it is feasible and reduces mammographic densities

The association of AGTR2 polymorphisms with preeclampsia and uterine artery bilateral notching is modulated by maternal BMI

On behalf of the SCOPE consortiumIntroductionThis study aimed to determine the association of AGTR1 and AGTR2 polymorphisms with preeclampsia and whether these are affected by environmental factors and fetal sex.MethodsOverall 3234 healthy nulliparous women, their partners and babies were recruited prospectively to the SCOPE study in Adelaide and Auckland. Data analyses were confined to 2121 Caucasian parent-infant trios, among whom 123 had preeclamptic pregnancies. 1185 uncomplicated pregnancies served as controls. DNA was extracted from buffy coats and genotyped by utilizing the Sequenom MassARRAY system. Doppler sonography on the uterine arteries was performed at 20 weeks' gestation.ResultsFour polymorphisms in AGTR1 and AGTR2 genes, including AGTR1 A1166C, AGTR2 C4599A, AGTR2 A1675G and AGTR2 T1134C, were selected and significant associations were predominately observed for AGTR2 C4599A. When the cohort was stratified by maternal BMI, in women with BMI ≥ 25 kg/m(2), the AGTR2 C4599A AA genotype in mothers and neonates was associated with an increased risk for preeclampsia compared with the CC genotype [adjusted OR 2.1 (95% CI 1.0-4.2) and adjusted OR 3.0 (95% CI 1.4-6.4), respectively]. In the same subset of women, paternal AGTR2 C4599A A allele was associated with an increased risk for preeclampsia and uterine artery bilateral notching at 20 weeks' gestation compared with the C allele [adjusted OR 1.9 (95% CI 1.1-3.3) and adjusted OR 2.1 (95% CI 1.3-3.4), respectively].ConclusionAGTR2 C4599A in mothers, fathers and babies was associated with preeclampsia and this association was only apparent in pregnancies in which the women had a BMI ≥ 25 kg/m(2), suggesting a gene-environment interaction.A. Zhou, G.A. Dekker, E.R. Lumbers, S.Y. Lee, S.D. Thompson, L.M.E. McCowan, C.T. Robert

Greatly increased occurrence of breast cancers in areas of mammographically dense tissue

INTRODUCTION: Mammographic density is a strong, independent risk factor for breast cancer. A critical unanswered question is whether cancers tend to arise in mammographically dense tissue (i.e. are densities directly related to risk or are they simply a marker of risk). This question cannot be addressed by studying invasive tumors because they manifest as densities and cannot be confidently differentiated from the densities representing fibrous and glandular tissue. We addressed this question by studying ductal carcinoma in situ (DCIS), as revealed by microcalcifications. METHOD: We studied the cranio-caudal and the mediolateral-oblique mammograms of 28 breasts with a solitary DCIS lesion. Two experienced radiologists independently judged whether the DCIS occurred in a mammographically dense area, and determined the density of different areas of the mammograms. RESULTS: It was not possible to determine whether the DCIS was or was not in a dense area for six of the tumors. Of the remaining 22 lesions, 21 occurred in dense tissue (test for difference from expected taken as the percentage of density of the 'mammographic quadrant' containing DCIS; P < 0.0001). A preponderance of DCIS (17 out of 28) occurred in the mammographic quadrant with the highest percentage density. CONCLUSION: DCIS occurs overwhelmingly in the mammographically dense areas of the breast, and pre-DCIS mammograms showed that this relationship was not brought about by the presence of the DCIS. This strongly suggests that some aspect of stromal tissue comprising the mammographically dense tissue directly influences the carcinogenic process in the local breast glandular tissue