Elevated tissue omega-3 fatty acid status prevents age-related glucose intolerance in fat-1 transgenic mice

The objective of this study was to investigate the impact of elevated tissue omega-3 (n-3) polyunsaturated fatty acids (PUFA) status on age-related glucose intolerance utilizing the fat-1 transgenic mouse model, which can endogenously synthesize n-3 PUFA from omega-6 (n-6) PUFA. Fat-1 and wild-type mice, maintained on the same dietary regime of a 10% corn oil diet, were tested at two different ages (2months old and 8months old) for various glucose homeostasis parameters and related gene expression. The older wild-type mice exhibited significantly increased levels of blood insulin, fasting blood glucose, liver triglycerides, and glucose intolerance, compared to the younger mice, indicating an age-related impairment of glucose homeostasis. In contrast, these age-related changes in glucose metabolism were largely prevented in the older fat-1 mice. Compared to the older wild-type mice, the older fat-1 mice also displayed a lower capacity for gluconeogenesis, as measured by pyruvate tolerance testing (PTT) and hepatic gene expression of phosphoenolpyruvate carboxykinase (PEPCK) and glucose 6 phosphatase (G6Pase). Furthermore, the older fat-1 mice showed a significant decrease in body weight, epididymal fat mass, inflammatory activity (NFκ-B and p-IκB expression), and hepatic lipogenesis (acetyl-CoA carboxylase (ACC) and fatty acid synthase (FAS) expression), as well as increased peroxisomal activity (70-kDa peroxisomal membrane protein (PMP70) and acyl-CoA oxidase1 (ACOX1) expression). Altogether, the older fat-1 mice exhibit improved glucose homeostasis in comparison to the older wild-type mice. These findings support the beneficial effects of elevated tissue n-3 fatty acid status in the prevention and treatment of age-related chronic metabolic diseases

Clinicopathological and molecular characterization of gastroesophageal junction (GEJ) adenocarcinoma before age of 40 years

Gastroesophageal junction (GEJ) adenocarcinoma are uncommon before age of 40 years. While certain clinical, pathological and molecular features of GEJ adenocarcinoma in older patients have been extensively studied, these characteristics in the younger population remain to be determined. In the recent literature, a high sensitivity and specificity for the detection of dysplasia and esophageal adenocarcinoma was demonstrated by using multicolor fluorescence in situ hybridization (FISH) DNA probe set specific for the locus specific regions 9p21 (p16), 20q13.2 and Y chromosome. We evaluated 663 patients with GEJ adenocarcinoma and further divided them into 2 age-groups of or= 50 years, rispectively. FISH with selected DNA probe for Y chromosome, locus 9p21 (p16), and locus 20q13.2 was investigated with formalin fixed and parassin embedded tissue from surgical resections of 17 younger and 11 older patients. Signals were counted in > 100 cells with each given histopathological category. The chromosomal aberrations were then compared in the 2 age-groups with the focus on uninvolved squamous and columnar epithelium, intestinal metaplasia (Barrett's mucosa), glandular dysplasia, and adenocarcinoma. Comparisons were performed by the X2 test, Fisher's exact test, Student's t-test and Mann-Whitney U-test as appropriate. Survival was estimated by the Kaplan-Meier method with univariate analysis by the log-rank. Significance was taken at the 5% level. There was no difference in the surgical technique applied in both age groups and most patients underwent Ivor Lewis esophagectomy. Among clinical variables there was a higher incidence of smocking history in older patient group. We identified a progressive loss of Y chromosome from benign squamos epithelium to Barrett's mucosa and glandular dysplasia, and, ultimately, to a near complete loss in adenocarcinoma in both age groups. The young group revealed significantly more losses of 9p21 in both benign and neoplastic cells when compared to the older patients group. In addition, we demonstrated an increase in the percentage of cells showing gain of locus 20q13.2 with progression from benign epithelium through dysplasia to adenocarcinoma with almost the same trend in both the young and the older patients. When compared with the older age-group, younger patients with GEJ adenocarcinoma possess similar known demographics, environmental factors, clinical, and pathologic characteristics. The most commonly detected genetic aberrations of progressive Y chromosomal loss, 9p21 locus loss, and 20q13 gains were similar in the younger and older patients. However the rate of loss of 9p21 is significantly higher in young patients, in both the benign and the neoplastic cells. The loss of 9p21, and possibly, the subsequent inactivation of p16 gene may be one of the molecular mechanisms responsible for the accelerated neoplastic process in young patients.

Studio e validazione di una nuova metodica per la valutazione dello stato di forma

We observed 82 healthy subjects, from both sexes, aged between 19 and 77 years. All subjects performed two different tests: for being scientifically acknowledged, the first one was used as a reference and it was a stress test (CPX). During the entire test, heart rate and gas exchange were recorded continuously; the second, the actual object of this study, was a submaximal test (TOP). Only heart rate was recorded continuously. The main purpose was to determinate an index of physical fitness as result of TOP. CPX test allowed us to individuate anaerobic threshold. We used an incremental protocol of 10/20 Watt/min, different by age. For our TOP test we used an RHC400 UPRIGHT BIKE, by Air Machine. Each subject was monitored for heart frequency. After 2 minutes of resting period there was a first step: 3 minutes of pedalling at a constant rate of 60 RPM, (40 watts for elder subjects and 60 watts for the younger ones). Then, the subject was allowed to rest for a recovery phase of 5 minutes. Third and last step consisted of 3 minutes of pedalling again at 60 RPM but now set to 60 watts for elder subjects and 80 watts for the young subjects. Finally another five minutes of recovery. A good correlation was found between TOP and CPX results especially between punctua l heart rate reserve (HRR’) and anaerobic threshold parameters such as Watt, VO2, VCO2 . HRR’ was obtained by subtracting maximal heart rate during TOP from maximal theoretic heart rate (206,9-(0,67*age)). Data were analyzed through cluster analysis in order to obtain 3 homogeneous groups. The first group contains the least fit subjects (inactive, women, elderly). The other groups contain the “average fit” and the fittest subjects (active, men, younger). Concordance between test resulted in 83,23%. Afterwards, a linear combinations of the most relevant variables gave us a formula to classify people in the correct group. The most relevant result is that this submaximal test is able to discriminate subjects with different physical condition and to provide information (index) about physical fitness through HRR’. Compared to a traditional incremental stress test, the very low load of TOP, short duration and extended resting period, make this new method suitable to very different people. To better define the TOP index, it is necessary to enlarge our subject sample especially by diversifying the age range.

Rapporti tra tettonica e clima durante l'esumazione nelle Alpi Centrali. Evidenze dalla termocronologia e dall'analisi strutturale lungo il traforo ferroviario del Sempione

(U-Th)/He and fission-track analyses of apatite along deep-seated tunnels crossing high-relief mountain ranges offer the opportunity to investigate climate and tectonic forcing on the topographic evolution. In this study, the thermochronologic analysis of a large set of samples collected in the Simplon railway tunnel (western-central Alps; Italy and Switzerland) and along its surface trace, coupled with kinematic and structural analysis of major fault zones intersecting the tunnel, constrains the phenomena controlling the topographic and structural evolution, during the latest stage of exhumation of the Simplon Massif, and the timing in which they operated. The study area is located at the western margin of the Lepontine metamorphic dome where a complex nappe-stack pertaining to the Penninic and Ultrahelvetic domains experienced a fast exhumation from the latest Oligocene onward. The exhumation was mainly accommodated by a west-dipping low-angle detachment (the Simplon Fault Zone) which is located just 8 km to the west of the tunnel. However, along the section itself several faults related to two principal phases both with important dip-slip kinematics have been detected. Cooling rates derived from our thermocronological data vary from about 10 °C/Ma at about 10 Ma to about 35 °C/Ma in the last 5 Ma. Such increase in the cooling rate corresponds to the most important climatic change recorded in the northern hemisphere in the last 10 Ma, i.e. the shift to wetter conditions at the end of the Messinian salinity crisis and the inception of glacial cycles in the northern hemisphere. In addition, (U-Th)/He and fission-track age patterns lack of important correlation with the topography suggesting that the present-day relief morphology is the result of recent erosional dynamics. More in details, the (U-Th)/He tunnel ages show an impressive uniformity at 2 Ma, whereas cooling rates calculated at 1 Ma increase towards the two major valleys. This indicates a focusing of erosive processes in the valleys which led to the shaping of present-day topography. Structural analysis documents the presence of two phases of brittle deformation postdating the metamorphic phases in the area. The first one is directly related to the last phase of activity along the Simplon Fault Zone and is characterized by extension towards SO and vertical shortening. The young one is characterized by extension towards NO and horizontal shortening in a along the NE-SO direction. Structures related to the first phase of brittle deformation generate important variations in the older ages' dataset, until 3 Ma, suggesting that tectonics controlled rocks exhumation up to that age. Structures related to the second phase generate some variations also in the younger age dataset, highlighting the activity of faults bordering the massif and suggesting a continuous activity also after 2 Ma. However, most of (U-Th)/He tunnel ages, varying slightly around 2 Ma, document that the Simplon area has experienced primarily erosional exhumation in this time span. In conclusion, all our data suggest that in the central Italian Alps the climatic signal gradually overrode the tectonic effects after about 5 Ma, as a consequence of the climatic instability started at end of Messinian salinity crisis and improved by the onset of glaciations in the northern hemisphere.

Analyse der Einweisungsdiagnose in einer universitären Schmerzambulanz unter dem besonderen Aspekt des Anteils therapiebedürftiger psychischer Störungen bei Patienten mit Rückenschmerzen, Morbus Sudeck, Phantomschmerzen sowie

Es wurde eine retrograde Analyse von Patientenakten der Schmerzambulanzder Klinik für Anästhesiologie der Universitätsklinik Mainz durchgeführt, indie alle Patienten mit bestimmten Einschlußkriterien derBehandlungsjahrgänge1996 und 1997 aufgenommen wurden.Dies waren die vier Diagnosegruppen multilokuläre Schmerzen,Rückenschmerzen, Phantomschmerz und Morbus Sudeck (SRD). Das Ziel dervorliegenden Arbeit war die Frage nach der Häufigkeit von Psychotherapie alsergänzende Therapieempfehlung seitens der Schmerzambulanz herauszuarbeiten.Psychotherapie (ambulant, stationär, Bestandteil vonRehabilitationsaufenthalten) in vielgestaltiger Weise wurde häufigerempfohlen, 1. je länger die Schmerzerkrankung bestand,2. je jünger die Patienten waren,3. je länger sie arbeitsunfähig waren,4. wenn belastende biographische Ereignisse festgestellt werden konnten5. je höher das Chronifizierungsstadium nach Gerbershagen war. Im Einzelnenspielten die zeitlichen Aspekte der Erkrankung, Lokalisationseinflüsse sowieAspekte vorheriger Behandlungen und schmerzbedingter Krankenhausaufenthalteeine besondere Rolle.6. wenn Patienten nicht berentet waren.

Erasmo come Ercole nell'adagio Herculei labores

Il lavoro consiste nella traduzione dell’adagio 2001, Herculei labores con commento delle righe 1-116, che comprendono il racconto della fatica di Ercole contro l’idra di Lerna e le interpretazioni che Erasmo ne fornisce per introdurre la filologia come impresa erculea in chiave autobiografica. L’introduzione ha lo scopo di presentare una sintesi degli elementi notevoli del commento e alcune osservazioni sull’autorappresentazione di sé dell’umanista. Erasmo fa dell’identificazione con Ercole un topos della propria descrizione in chiave ironica, ma si propone anche come emulo di Girolamo, di cui cura l’edizione delle lettere. Questo lavoro prende in considerazione infine il ritratto di Erasmo dipinto da Holbein e custodito a Longford Castle in relazione al testo dell’adagio, al quale allude con la scritta in primo piano, ΗΡΑΚΛΕΙΟΙ ΠΟΝΟΙ.

Acute coronary syndromes in young patients: Presentation, treatment and outcome

Background: Acute coronary syndromes (ACS) in very young patients have been poorly described. We therefore evaluate ACS in patients aged 35 years and younger. Methods: In this prospective cohort study, 76 hospitals treating ACS in Switzerland enrolled 28,778 patients with ACS between January 1, 1997, and October 1, 2008. ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). Results: 195 patients (0.7%) were 35 years old or younger. Compared to patients N35 years, these patients were more likely to present with chest pain (91.6% vs. 83.7%; P=0.003) and less likely to have heart failure (Killip class II to IV in 5.2% vs. 23.0%; Pb0.001). STEMI was more prevalent in younger than in older patients (73.1% vs. 58.3%; Pb0.001). Smoking, family history of CAD, and/or dyslipidemia were important cardiovascular risk factors in young patients (prevalence 77.2%, 55.0%, and 44.0%). The prevalence of overweight among young patients with ACS was high (57.8%). Cocaine abuse was associated with ACS in some young patients. Compared to older patients, young patients were more likely to receive early percutaneous coronary interventions and had better outcome with fewer major adverse cardiac events. Conclusions: Young patients with ACS differed from older patients in that the younger often presented with STEMI, received early aggressive treatment, and had favourable outcomes. Primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in adolescence.

Favourable long-term outcome after immediate treatment of neonatal hyperammonemia due to N-acetylglutamate synthase deficiency

INTRODUCTION: N-Acetylglutamate synthase (NAGS) deficiency is a rare urea cycle disorder, which may present in the neonatal period with severe hyperammonemia and marked neurological impairment. CASE REPORT: We report on a Turkish family with a patient who died due to hyperammonemia in the neonatal period. Reduced activity of NAGS and carbamyl phosphate synthetase were found at autopsy. A second child who developed hyperammonemia on the second day of life was immediately treated with arginine hydrochloride, sodium benzoate and protein restriction. After NAGS deficiency was suspected by enzyme analysis, sodium benzoate was replaced by N-carbamylglutamate (NCG). A third child who developed slight hyperammonemia on the third day of life was treated with NCG before enzyme analysis confirmed reduced NAGS activity. Neither of the patients developed hyperammonemia in the following years. After the human NAGS gene was identified, mutation analysis revealed that the older sibling on NCG therapy was homozygous for a 971G>A (W324X) mutation. The parents and the younger sibling were heterozygous. Therapy was continued in the older sibling until now without any adverse effects and favourable neurodevelopment outcome. In the younger sibling, therapy was stopped without any deterioration of urea cycle function. CONCLUSION: NAGS deficiency can be successfully treated with NCG and arginine hydrochloride with favourable outcome. Molecular diagnostic rather than enzyme analysis should be used in patients with suspected NAGS deficiency.

Prediction accuracy of young and middle-aged adults in memory for familiar and unfamiliar texts

This study investigated the influence of age, familiarity, and level of exposure on the metamemorial skill of prediction accuracy on a future test. Young (17 to 23 years old) and middle-aged adults (35 to 50 years old) were asked to predict their memory for text material. Participants made predictions on a familiar text and an unfamiliar text, at three different levels of exposure to each. The middle-aged adults were superior to the younger adults at predicting performance. This finding indicates that metamemory may increase from youth to middle age. Other findings include superior prediction accuracy for unfamiliar compared to familiar material, a result conflicting with previous findings, and an interaction between level of exposure and familiarity that appears to modify the main effects of those variables.

Aggressive Behaviour of Different Social and Demographic Groups in Post-Totalitarian Society

The project looked at aggressiveness in different age and social groups of modern post-totalitarian society, beginning with the hypotheses that the greatest risk groups are teenagers and the unemployed, and that there is a link between aggression and the level of meaningfulness of life. The groups studied comprised about 200 persons from urban areas of eastern Ukraine, including schoolchildren, students, white collar workers, self-employed persons, the unemployed and pensioners. Workers in industry were not included as this group has virtually disappeared in Ukraine at present since most enterprises have ceased to work and most workers have moved into the groups of the unemployed or self-employed. Participants were divided into age groups of 13-14, 16-17, 18-22, 24-45, 46-60 and over 60, with each group including approximately equal number of men and women. Research methods included Buss-Darky techniques, the "hand test" (E. Wagner), the "non-existent animal" technique, a Rozenzweig picture frustration study, purpose-in-life tests and an interview. The Buss-Darky test showed that schoolchildren have the highest level of aggression, followed by students. These groups have high indexes in virtually all types of aggression, including its open form. The self-employed have relatively lower indexes, although they are more likely to manifest it openly, while such open manifestations are less likely among white-collar workers, pensioners and the unemployed. The least aggressive were the unemployed and pensioners, although the latter had a relatively high level of hostility. In terms of age, aggression was shown to decrease with age, which Ms. Ivanova attributes to the still imperfect control mechanisms of teenagers and their less mature personalities. Among the younger groups girls showed a slightly higher level of aggression, although this situation was reversed among older people. The risk groups inclined to manifest open forms of aggressiveness can therefore be seen to be teenagers and students. Other tests used show aggressiveness as a feature of the current state, rather than as an inherent feature and the results obtained were somewhat different. In the interviews, all adults referred to the increased aggressiveness in society and most stated that they themselves had become more aggressive and bad-tempered. The ability of individuals to adapt to their social environment was also investigated and schoolchildren turned out to have the lowest adaptation index and the unemployed the highest. MS. Ivanova attributes that latter, rather surprising, result to the fact that the constant frustrations facing the unemployed force them to actively seek ways and means of adapting in order to survive. The final aspect considered was the possible connection between human aggressiveness and the meaningfulness of life. Here the groups with the most meaningful lives were the self-employed and pensioners. The latter result, again rather surprising, was attributed to the desire of people who have already lived the greater part of their lives to place more weight on what they have already done, in order to prove to themselves that they have not lived in vain. The hypothesis that aggressiveness is conversely related to the meaningfulness of life was only partially confirmed. In the two extreme cases (schoolchildren and pensioners) this was indeed the case, but the remaining groups did not show any such connection. From the data obtained, Ms. Ivanova concluded that life in modern post-totalitarian society does indeed foster a rise in people's aggressiveness, and this was supported by the fact that indexes of aggressiveness proved to be higher than the norm. Her original hypothesis as to the groups in society most at risk from open aggression confirmed in the case of teenagers but not of the unemployed, who had relatively low aggressiveness indexes and the highest degree of adaptation.

Prevalence, incidence and distribution of erosion

There is some evidence that the presence of erosion is growing steadily. Because of different scoring systems, samples and examiners, it is difficult to compare and judge the outcome of the studies. Preschool children aged between 2 and 5 years showed erosion on deciduous teeth in 6-50% of the subjects. Young schoolchildren (aged 5-9) already had erosive lesions on permanent teeth in 14% of the cases. In the adolescent group (aged between 9 and 17) 11-100% of the young people examined showed signs of erosion. Incidence data (= increase of subjects with erosion) evaluated in three of these studies were 12% over 2 years, 18% over 5 years and 27% over 1.5 years. In adults (aged between 18 and 88), prevalence data ranged between 4 and 82%. Incidence data are scarce; only one study was found and this showed an incidence of 5% for the younger and 18% for the older examined group (= increase of tooth surfaces with erosion). Prevalence data indicated that males had somewhat more erosive tooth wear than females. The distribution of erosion showed a predominance of occlusal surfaces (especially mandibular first molars), followed by facial surfaces (anterior maxillary teeth). Oral erosion was frequently found on maxillary incisors and canines. Overall, prevalence data are not homogeneous. Nevertheless, there is already a trend for more pronounced rate of erosion in younger age groups. Therefore, it is important to detect at-risk patients early to initiate adequate preventive measures.

Health risk appraisal in older people 3: prevalence, impact, and context of pain and their implications for GPs

BACKGROUND: Pain is a common experience in later life. There is conflicting evidence of the prevalence, impact, and context of pain in older people. GPs are criticised for underestimating and under-treating pain. AIM: To assess the extent to which older people experience pain, and to explore relationships between self-reported pain and functional ability and depression. DESIGN OF STUDY: Secondary analysis of baseline data from a randomised controlled trial of health risk appraisal. SETTING: A total of 1090 community-dwelling non-disabled people aged 65 years and over were included in the study from three group practices in suburban London. METHOD: Main outcome measures were pain in the last 4 weeks and the impact of pain, measured using the 24-item Geriatric Pain Measure; depression symptoms captured using the 5-item Mental Health Inventory; social relationships measured using the 6-item Lubben Social Network Scale; Basic and Instrumental Activities of Daily Living and self-reported symptoms. RESULTS: Forty-five per cent of women and 34% of men reported pain in the previous 4 weeks. Pain experience appeared to be less in the 'oldest old': 27.5% of those aged 85 years and over reported pain compared with 38-53% of the 'younger old'. Those with arthritis were four times more likely to report pain. Pain had a profound impact on activities of daily living, but most of those reporting pain described their health as good or excellent. Although there was a significant association between the experience of pain and depressed mood, the majority of those reporting pain did not have depressed mood. CONCLUSION: A multidimensional approach to assessing pain is appropriate. Primary care practitioners should also assess the impact of pain on activities of daily living.

Cellular telephone use and time trends in brain tumour mortality in Switzerland from 1969 to 2002

A rising concern exists that with the widespread use of mobile communication technologies, the incidence of brain tumours may increase. On the basis of data from the Swiss national mortality registry from 1969 to 2002, annual age-standardized brain tumour mortality rates per 100,000 person-years were calculated using the European standard population. Time trend analyses were performed by the Poisson regression for six different age groups in men and women separately. The study period was divided into two intervals: before and after 1987, when the analogue mobile technology was introduced in Switzerland. Age-standardized brain tumour mortality rates ranged between 3.7 and 6.7 for men and 2.5 and 4.4 for women per 100,000 person-years. For the whole study period, a significant increase in brain tumour mortality was observed for men and women in the older age groups (60-74 and 75+ years) but not in the younger ones in whom mobile phone use was more prevalent. Time trend analyses restricted to data from 1987 onwards revealed relatively stable brain tumour mortality rates in all age groups. For instance, the annual change in brain tumour mortality rate for the 45-59-year age group was -0.3% (95% confidence interval: -1.7; 1.1) for men and -0.4% (95% confidence interval:-2.2; 1.3) for women. We conclude that after the introduction of mobile phone technology in Switzerland, brain tumour mortality rates remained stable in all age groups. Our results suggest that mobile phone use is not a strong risk factor in the short term for mortality from brain tumours. Ecological analyses like this, however, are limited in their ability to reveal potentially small increases in risk for diseases with a long latency period.

Catch-up growth in autosomal dominant isolated growth hormone deficiency (IGHD type II)

OBJECTIVE: Data on the GH-induced catch-up growth of severely GH-deficient children affected by monogenetic defects are missing. PATIENTS: Catch-up growth of 21 prepubertal children (6 females, 15 males) affected with IGHD type II was analyzed in a retrospective chart review. At start of therapy, mean age was 6.2 years (range, 1.6-15.0), mean height SDS was -4.7 (-7.6 to -2.2), mean IGF-I SDS was -6.2 (-10.1 to -2.2). GH was substituted using a mean dose of 30.5microg/kg*d. RESULTS: Catch-up growth was characterized by a mean height gain of +0.92, +0.82, and +0.61 SDS after 1, 2, and 3 years of GH therapy, respectively. Mean height velocities were 10.7, 9.2 and 7.7cm/year during the first three years. Mean duration of complete catch-up growth was 6 years (3-9). Mean height SDS reached was -0.97 (-2.3 to +1.1), which was within the range of the estimated target height of -0.60 SDS (-1.20 to -0.15). The younger and shorter the children were at start of therapy the better they grew during the first year independent of the dose. Mean bone age was delayed at start by 2.1 years and progressed by 2.5 years during the first two years of therapy. Incomplete catch-up growth was caused by late initiation or irregular administration of GH in four cases. CONCLUSIONS: Our data suggest that GH-treated children with severe IGHD show a sustained catch-up growth over 6 years (mean) and reach their target height range. This response to GH is considered to be characteristic for young children with severe growth retardation due to IGHD.