MedWorm: Expenditures

Leptin in Anorexia and Cachexia Syndrome

Clinical and Developmental Immunology — Wed, 08 Feb 2012 11:20:54 +0100

Leptin is a product of the obese (OB) gene secreted by adipocytes in proportion to fat mass. It decreases food intake and increases energy expenditure by affecting the balance between orexigenic and anorexigenic hypothalamic pathways. Low leptin levels are responsible for the compensatory increase in appetite and body weight and decreased energy expenditure (EE) following caloric deprivation. The anorexia-cachexia syndrome is a complication of many chronic conditions including cancer, chronic obstructive pulmonary disease, congestive heart failure, chronic kidney disease, and aging, where the decrease in body weight and food intake is not followed by a compensatory increase in appetite or decreased EE. Crosstalk between leptin and inflammatory signaling known to be activated in these condi...

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Report: Drug costs to rise 3% to 5% this year

Drug Topics - Top News — Tue, 07 Feb 2012 05:00:00 +0100

U.S. drug expenditures remained relatively flat in 2011, but a new report projects that drug costs will rise between 3% and 5% across all healthcare settings this year. . (Source: Drug Topics - Top News)

Cardiac natriuretic peptides act via p38 MAPK to induce the brown fat thermogenic program in mouse and human adipocytes

Journal of Clinical Investigation — Mon, 06 Feb 2012 18:32:05 +0100

The ability of mammals to resist body fat accumulation is linked to their ability to expand the number and activity of “brown adipocytes” within white fat depots. Activation of β-adrenergic receptors (β-ARs) can induce a functional “brown-like” adipocyte phenotype. As cardiac natriuretic peptides (NPs) and β-AR agonists are similarly potent at stimulating lipolysis in human adipocytes, we investigated whether NPs could induce human and mouse adipocytes to acquire brown adipocyte features, including a capacity for thermogenic energy expenditure mediated by uncoupling protein 1 (UCP1). In human adipocytes, atrial NP (ANP) and ventricular NP (BNP) activated PPARγ coactivator-1α (PGC-1α) and UCP1 expression, induce...

Soymorphin-5, a soy-derived {mu}-opioid peptide, decreases glucose and triglyceride levels through activating adiponectin and PPAR{alpha} systems in diabetic KKAy mice

AJP: Endocrinology and Metabolism — Fri, 03 Feb 2012 05:00:00 +0100

Soymorphin-5 (YPFVV) derived from soybean β-conglycinin β-subunit is a μ-opioid agonist peptide having anxiolytic-like activity. Here, we show that soymorphin-5 improves glucose and lipid metabolism after long-term oral administration to KKAy mice, a type 2 diabetes model animal. Soymorphin-5 inhibited hyperglycemia without an increase in plasma insulin levels in KKAy mice. Soymorphin-5 also decreased plasma and liver triglyceride (TG) levels and liver weight, suggesting that soymorphin-5 improved lipid metabolism. Soymorphin-5 increased plasma adiponectin concentration and liver mRNA expression of AdipoR2, a subtype of adiponectin receptor that is involved in stimulating the peroxisome proliferator-activated receptor (PPAR)α pathway and fatty acid β-oxidation. The ...

Approaches for quantifying energy intake and %calorie restriction during calorie restriction interventions in humans: the multicenter CALERIE study

AJP: Endocrinology and Metabolism — Fri, 03 Feb 2012 05:00:00 +0100

Calorie restriction (CR) is a component of most weight loss interventions and a potential strategy to slow aging. Accurate determination of energy intake and %CR is critical when interpreting the results of CR interventions; this is most accurately achieved using the doubly labeled water method to quantify total energy expenditure (TEE). However, the costs and analytical requirements of this method preclude its repeated use in many clinical trials. Our aims were to determine 1) the optimal TEE assessment time points for quantifying average energy intake and %CR during long-term CR interventions and 2) the optimal approach for quantifying short-term changes in body energy stores to determine energy intake and %CR during 2-wk DLW periods. Adults randomized to a CR intervention in the multice...

Correction

Journal of Allergy and Clinical Immunology — Wed, 01 Feb 2012 05:00:00 +0100

With regard to the February 2011 article entitled “The burden of adult asthma in the United States: Evidence from the Medical Expenditure Panel Survey” (J Allergy Clin Immunol 2011;127:363-9.e3), several numbers need to be corrected. First, the initial sentence of the Results section, both in the abstract and in the body of the article, should read “Of 44,795 adults, 1,935 reported an encounter for asthma.” Second, in , the Proportion rows for all headings other than “Adult MEPS total” are incorrect as given. A corrected version of the Table appears below: (Source: Journal of Allergy and Clinical Immunology)

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Interleukin‐6 Receptor α is Co‐localised with Melanin‐Concentrating Hormone in Human and Mouse Hypothalamus

Journal of Neuroendocrinology — Wed, 01 Feb 2012 05:00:00 +0100

AbstractInterleukin‐6 (IL‐6) deficient mice develop mature‐onset obesity. Furthermore, intracerebroventricular administration of IL‐6 increases energy expenditure suggesting that IL‐6 centrally regulates energy homeostasis. To investigate whether it would be possible for IL‐6 to directly influence the energy homeostasis via hypothalamic regulation in humans and rodents, we mapped the distribution of the ligand binding IL‐6 receptor α (IL‐6Rα) in this brain region.In the human hypothalamus, the IL‐6Rα‐immunoreactivity was detected in perikarya and first order dendrites of neurones. The IL‐6Rα‐immunoreactive (IR) neurones were observed posterior to the level of the interventricular foramen. There, IL‐6Rα‐IR neurones were located in the lateral hypothalamic, p...

Dietary obesity-associated Hif1{alpha} activation in adipocytes restricts fatty acid oxidation and energy expenditure via suppression of the Sirt2-NAD+ system [Research Papers]

Genes and Development — Wed, 01 Feb 2012 05:00:00 +0100

Dietary obesity is a major factor in the development of type 2 diabetes and is associated with intra-adipose tissue hypoxia and activation of hypoxia-inducible factor 1α (HIF1α). Here we report that, in mice, Hif1α activation in visceral white adipocytes is critical to maintain dietary obesity and associated pathologies, including glucose intolerance, insulin resistance, and cardiomyopathy. This function of Hif1α is linked to its capacity to suppress β-oxidation, in part, through transcriptional repression of sirtuin 2 (Sirt2) NAD+-dependent deacetylase. Reduced Sirt2 function directly translates into diminished deacetylation of PPAR coactivator 1α (Pgc1α) and expression of β-oxidation and mitochondrial genes. Importantly, visceral adipose tiss...

Rare adipose disorders (RADs) masquerading as obesity.

Acta Pharmacologica Sinica — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Herbst KL Abstract Rare adipose disorders (RADs) including multiple symmetric lipomatosis (MSL), lipedema and Dercum's disease (DD) may be misdiagnosed as obesity. Lifestyle changes, such as reduced caloric intake and increased physical activity are standard care for obesity. Although lifestyle changes and bariatric surgery work effectively for the obesity component of RADs, these treatments do not routinely reduce the abnormal subcutaneous adipose tissue (SAT) of RADs. RAD SAT likely results from the growth of a brown stem cell population with secondary lymphatic dysfunction in MSL, or by primary vascular and lymphatic dysfunction in lipedema and DD. People with RADs do not lose SAT from caloric limitation and increased energy expenditure alone. In order to improve recogn...

Mechanical efficiency and force–time curve variation during repetitive jumping in trained and untrained jumpers

European Journal of Applied Physiology — Tue, 31 Jan 2012 16:46:33 +0100

Abstract Mechanical efficiency (ME), the ratio between work performed and energy expenditure, is a useful criterion in determining the roles of stored elastic energy and chemically deduced energy contributing to concentric performance in stretch-shortening cycle movements. Increased force production during the eccentric phase has been shown to relate to optimal muscle-tendon unit (MTU) length change and thus optimization of usage of stored elastic energy. This phenomenon, as previously reported, is reflected by higher jump heights and ME. The purpose of this investigation was to determine if ME may be different between trained and untrained jumpers and thus be accounted for by variation in force production in the eccentric phase as a reflection of usage of stored elastic e...

Drug Costs Will Rise as Much as 7 Percent in Some Settings in 2012

Drugs.com - Pharma News — Tue, 31 Jan 2012 13:15:11 +0100

ASHP's Annual Projection Forecasts Expenditures for Drugs in Outpatient, Clinics, and Hospital Settings BETHESDA, Md. — Costs for medications will continue to rise in 2012 by as much as seven percent, according to a report published online... (Source: Drugs.com - Pharma News)

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NSF Releases 2012 Science and Engineering Indicators

Public Policy Reports — Tue, 31 Jan 2012 12:37:03 +0100

Worldwide expenditures on research and development (R&D) have increased dramatically over the past decade, but the United State’s lead is slipping, according to the National Science Foundation’s (NSF) recently released Science and Engineering Indicators 2012. The report highlights major developments in international and U.S. science and technology. The combined R&D investments of 10 Asian nations, including China, India, and Japan, now match U.S. expenditures on science at about $400 billion a year. Most of the growth in Asia was driven by China, where R&D spending grew by 28 percent between 2008 and 2009. In the U.S., science expenditures declined by 0.3 percent over the same period. The decline in domestic spending was due to reduced funding by private industry, ...

An exploratory study of activity in veterans with Parkinson’s disease

Journal of Neurology — Tue, 31 Jan 2012 07:10:04 +0100

Abstract Movement disorder specialists have limited information on the specifics of how patients with Parkinson’s disease (PD) spend their time. We deemed it important to examine the relationships among activity and daily energy expenditure (DEE), non-motor symptoms, and body mass index in veterans with PD who were outpatients at a Veterans Affairs medical center. In this exploratory study, we mailed demographic and activity questionnaires and gathered data on 100 patients. Activity was categorized into five domains and three intensity levels, and DEE was measured in kilocalories. Light activities accounted for 64.9% of DEE (9.1 h), moderate activities for 32.9% (2.1 h), and vigorous activities for 2.2% (0.1 h) of DEE. Television viewing comprised 10.6% (2...

PGC-1α and exercise in the control of body weight

International Journal of Obesity — Tue, 31 Jan 2012 05:00:00 +0100

PGC-1α and exercise in the control of body weight International Journal of Obesity advance online publication, January 31, 2012. doi:10.1038/ijo.2012.12 Authors: S Summermatter & C Handschin (Source: International Journal of Obesity)

No adverse effects of statins on muscle function and health‐related parameters in the elderly: An exercise study

Scandinavian Journal of Medicine and Science in Sports — Tue, 31 Jan 2012 05:00:00 +0100

The aim of the present study was to investigate the effects of a repeated bout of eccentric exercise on health‐related parameters and muscle performance on subjects undergoing atorvastatin therapy. Twenty‐eight elderly men participated in the investigation and were assigned either in a control (n = 14) or in a statin therapy group (n = 14). All participants performed two isokinetic eccentric exercise bouts separated by 3 weeks. Muscle damage indices, resting energy expenditure, substrate metabolism, lipid and lipoprotein profile, as well as insulin sensitivity, were evaluated before and after eccentric. No differences in muscle function were observed between the two groups either at rest or after exercise. Eccentric exercise increased resting energy expenditure, increased fat o...

Physical Activity and Exercise in the Regulation of Human Adipose Tissue Physiology

Physiological Reviews — Tue, 31 Jan 2012 05:00:00 +0100

Physical activity and exercise are key components of energy expenditure and therefore of energy balance. Changes in energy balance alter fat mass. It is therefore reasonable to ask: What are the links between physical activity and adipose tissue function? There are many complexities. Physical activity is a multifaceted behavior of which exercise is just one component. Physical activity influences adipose tissue both acutely and in the longer term. A single bout of exercise stimulates adipose tissue blood flow and fat mobilization, resulting in delivery of fatty acids to skeletal muscles at a rate well-matched to metabolic requirements, except perhaps in vigorous intensity exercise. The stimuli include adrenergic and other circulating factors. There is a period following an exercise bout wh...

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Net Energy Expenditure of Gravity-Independent High-Speed Resistive Exercise Done by Women

Aviation, Space, and Environmental Medicine — Mon, 30 Jan 2012 13:55:03 +0100

(Source: Aviation, Space, and Environmental Medicine)

Lifestyle physical activity among urban Palestinians and Israelis: a cross-sectional comparison in the Palestinian-Israeli Jerusalem risk factor study

BMC Public Health - Latest articles — Mon, 30 Jan 2012 05:00:00 +0100

This study aimed to determine the prevalence of insufficient PA and its socio-demographic correlates among urban Palestinians in comparison with Israelis. Methods: An age-sex stratified random sample of Palestinians and Israelis aged 25-74 years living in east and west Jerusalem was drawn from the Israel National Population Registry: 970 Palestinians and 712 Israelis participated. PA in a typical week was assessed by the Multi-Ethnic Study of Atherosclerosis (MESA) questionnaire. Energy expenditure (EE), calculated in metabolic equivalents (METs), was compared between groups for moderate to vigorous-intensity physical activity (MVPA), using the Wilcoxon rank-sum test, and for domain-specific prevalence rates of meeting public health guidelines and all-domain insufficient PA. Correlates of ...

Cost puts dental care out of reach

Health News - UPI.com — Sat, 28 Jan 2012 06:24:48 +0100

SAN FRANCISCO, Jan. 28 (UPI) -- Dental expenses were among the highest out-of-pocket health expenditures for U.S. consumers in 2008, researchers say. (Source: Health News - UPI.com)

Total US healthcare expenditure reached $US2.6 trillion in 2010

PharmacoEconomics and Outcomes News — Fri, 27 Jan 2012 15:13:30 +0100

(Source: PharmacoEconomics and Outcomes News)

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[What can medicine expect from health economics?]

Der Urologe. Ausg. A — Fri, 27 Jan 2012 05:00:00 +0100

Authors: Bismarck E, Schmitz-Dräger BJ, Schöffski O Abstract Medicine has changed dramatically in the past ten decades thanks to the introduction of innovative diagnostic and therapeutic procedures. However, besides the unmistakable advances achieved in medicine, the costs of all health care systems have risen dramatically. In contrast to the escalation in expenditures, only moderate gains in proceeds have been accomplished. This situation requires that future financial resources be judiciously expended. The field of health economics has set as its goal the analysis of medical measures in terms of costs and benefits to be able to provide information on these parameters to those involved in the public health sector. The emerging problems are diverse and extend from assessment of e...

An Innovative Approach to Pharmacy Management in a State Correctional System

Journal of Correctional Health Care — Fri, 27 Jan 2012 05:00:00 +0100

Numerous models are employed for medication distribution and pharmacy services management in correctional facilities. Since 2003, the University of Rhode Island College of Pharmacy and the Rhode Island Department of Corrections (RIDOC) have collaborated on a pharmacy management program designed to better integrate medical care, improve medication utilization, and reduce pharmaceuticals costs. The program introduced staff education, waste-reduction strategies, treatment protocols, and a responsive formulary system. RIDOC pharmaceutical expenditures grew at a rate of approximately 1.5% Per Inmate Per Year from 2003 to 2009, considerably below the annual pharmaceutical inflation rate. Analyses of projected and actual drug spending indicate that RIDOC benefited from savings of almost $5 millio...

NHS Diabetes report: Inpatient care for people with diabetes- the economic case for change

NeLM - News — Thu, 26 Jan 2012 05:00:00 +0100

Source: NHS Diabetes Area: News This paper examines the health economic evidence relating to inpatient care in diabetes in England and assesses the potential for quality and productivity improvements. The following topics are covered: . Section I examines policy on inpatient care for diabetes, and published evidence on the quality of care and on the potential to improve outcomes and productivity. . Section II sets out an economic model which estimates absolute and excess expenditure on diabetes, the cost of specialist diabetes inpatient teams, and the potential savings through use of such teams. . Section III looks in more detail at areas of inpatient care where there may be potential to increase quality and productivity. (Source: NeLM - New...

Heart Health at Midlife and Alzheimer’s Disease

Psychology Today Food and Diet Center — Wed, 25 Jan 2012 21:29:39 +0100

An estimated 5.4 million persons have Alzheimer's disease and there are up to 14.9 million unpaid caregivers for persons with the disease. Annual expenditures for the disorder top $183 billion. Alzheimer's disease is devastating for persons affected by the disorder. It also is a great source of anxiety for midlife adults.read more (Source: Psychology Today Food and Diet Center)

Assessment of Fracture Risk

Current Osteoporosis Reports — Wed, 25 Jan 2012 06:52:38 +0100

Abstract Osteoporosis-related fractures (low-trauma, fragility fractures) are associated with significant morbidity, mortality, and health care expenditure worldwide. In the absence of a defining fracture, the diagnosis of osteoporosis is based on the World Health Organization’s T-score criteria using central dual-energy x-ray absorptiometry (DXA). Paradoxically, the majority of those patients who will sustain a low-trauma fracture do not meet the T-score definition of osteoporosis. Conversely, younger individuals with bone density in the osteoporotic range but no other risk factors have relatively low fracture rates and yet are frequently considered candidates for osteoporosis therapies. The limited accuracy of bone density testing alone to predict fractures has led to ...

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Brown adipose tissue oxidative metabolism contributes to energy expenditure during acute cold exposure in humans

Journal of Clinical Investigation — Tue, 24 Jan 2012 19:12:02 +0100

Brown adipose tissue (BAT) is vital for proper thermogenesis during cold exposure in rodents, but until recently its presence in adult humans and its contribution to human metabolism were thought to be minimal or insignificant. Recent studies using PET with 18F-fluorodeoxyglucose (18FDG) have shown the presence of BAT in adult humans. However, whether BAT contributes to cold-induced nonshivering thermogenesis in humans has not been proven. Using PET with 11C-acetate, 18FDG, and 18F-fluoro-thiaheptadecanoic acid (18FTHA), a fatty acid tracer, we have quantified BAT oxidative metabolism and glucose and nonesterified fatty acid (NEFA) turnover in 6 healthy men under controlled cold exposure conditions. All subjects displayed substantial NEFA and glucose uptake upon cold exposure. Furthermore,...

Public expenditure: thirteenth report of session 2010-12 - volume I: report, together with formal minutes, oral and written evidence

The Kings Fund - Health Management Specialist Collection — Tue, 24 Jan 2012 14:39:57 +0100

This was an enquiry into the Nicholson Challenge which required the NHS to save £20bn. It criticises the NHS for taking short-term measures to make these savings but suggest that a more sustainable approach is needed. It identifies service integration over management change as a key example of this. Report Volume II: additional written evidence House of Commons Health Select Committee - news (Source: The Kings Fund - Health Management Specialist Collection)

Hydroxypropylated distarch phosphate versus unmodified tapioca starch: fat oxidation and endurance in C57BL/6J mice

European Journal of Applied Physiology — Tue, 24 Jan 2012 07:33:09 +0100

Abstract An RS4-type resistant starch is a chemically modified starch that shows reduced availability in comparison to the corresponding unmodified starch. Hydroxypropylated distarch phosphate (HDP) is an RS4-type resistant starch that increases energy expenditure and prevents high-fat diet-induced obesity through increased hepatic fatty acid oxidation. The aim of this study was to clarify the acute effects of HDP from tapioca starch (HPdTSP) on physical performance in mice. Male C57BL/6J mice were used to examine the effects of a single administration of 2 mg/g body weight HPdTSP or unmodified tapioca starch (TS) on postprandial responses in serum metabolic parameters, running endurance capacity on a treadmill, whole-body energy metabolism during exercise, activity o...

Kansas Bioscience Authority audit slams former CEO Thornton

bizjournals.com Health Care:Pharmaceuticals headlines — Mon, 23 Jan 2012 23:32:48 +0100

An independent audit finds that former Kansas Bioscience Authority CEO Tom Thornton wiped files and other information from his agency-issued laptop after resigning. The KBA released the results of the forensic audit on Monday. Accounting firm BKD LLP, based in Springfield, Mo., conducted the audit. “Overall, the forensic audit affirms that the KBA’s investment process is diligent, and it makes no significant findings or exceptions related to KBA expenditures or conflicts of interest,” KBA Chairman Dan Watkins said in a release... (Source: bizjournals.com Health Care:Pharmaceuticals headlines)

Diagnosis of Neuropathy: Comment on "Tests and Expenditures in the Initial Evaluation of Peripheral Neuropathy" [Invited Commentary]

Archives of Internal Medicine — Mon, 23 Jan 2012 05:00:00 +0100

(Source: Archives of Internal Medicine)

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Regulation and limitations to fat oxidation during exercise.

The Journal of Physiology — Mon, 23 Jan 2012 05:00:00 +0100

Authors: Jeppesen J, Kiens B Abstract Fatty acids (FA) as fuel for energy utilization during exercise originate from different sources: FA transported in the circulation either bound to albumin or as triacylglycerol (TG) carried by very low density lipoproteins (VLDL) and FA from lipolysis of muscle TG stores (IMTG). Despite a high rate of energy expenditure during high intensity exercise the total fatty acid oxidation is suppressed to below that observed during moderate intensity exercise. Although this has been known for many years, the mechanisms behind this phenomenon are still not fully elucidated. A failure of adipose tissue to deliver sufficient fatty acids to exercising muscle has been proposed, but evidence is emerging that factors within the muscle might be of more import...

Healthcare expenditure in the United States of America in the last year of life: where ethics, medicine and economics collide?

International Journal of Clinical Practice — Sat, 21 Jan 2012 14:00:01 +0100

(Source: International Journal of Clinical Practice)

Impact and cost-effectiveness of family Fitness Zones: A natural experiment in urban public parks. - Cohen DA, Marsh T, Williamson S, Golinelli D, McKenzie TL.

SafetyLit: All (Unduplicated) — Sat, 21 Jan 2012 12:05:52 +0100

We evaluated the impact of outdoor exercise equipment (FZ, Fitness Zones) in 12 parks serving diverse populations. We used the System for Observing Play and Recreation in Communities (SOPARC) to assess use and estimate energy expenditure prior to and twice... (Source: SafetyLit: All (Unduplicated))

Nutritional, Physiological, and Perceptual Responses During a Summer Ultraendurance Cycling Event

Journal of Strength and Conditioning Research — Sat, 21 Jan 2012 10:29:33 +0100

Armstrong, LE, Casa, DJ, Emmanuel, H, Ganio, MS, Klau, JF, Lee, EC, Maresh, CM, McDermott, BP, Stearns, RL, Vingren, JL, Wingo, JE, Williamson, KH, and Yamamoto, LM. Nutritional, physiological, and perceptual responses during a summer ultraendurance cycling event. J Strength Cond Res 26(2): 307–318, 2012—Despite the rapid growth of mass participation road cycling, little is known about the dietary, metabolic, and behavioral responses of ultraendurance cyclists. This investigation describes physiological responses, perceptual ratings, energy balance, and macronutrient intake of 42 men (mean ± SD; age, 38 ± 6 years; height, 179.7 ± 7.1 cm; body mass, 85.85 ± 14.79 kg) and 6 women (age, 41 ± 4 years; height, 168.0 ± 2.9 cm; body mass, 67.32 ± 7.21 kg) during a summer 164-km road cy...

Effects of Dynamic Stretching on Energy Cost and Running Endurance Performance in Trained Male Runners

Journal of Strength and Conditioning Research — Sat, 21 Jan 2012 10:29:33 +0100

Zourdos, MC, Wilson, JM, Sommer, BA, Lee, S-R, Park, Y-M, Henning, PC, Panton, LB, and Kim, J-S. Effects of dynamic stretching on energy cost and running endurance performance in trained male runners. J Strength Cond Res 26(2): 335–341, 2012—The purpose of this study was to examine the effects of dynamic stretching on running energy cost and endurance performance in trained male runners. Fourteen male runners performed both a 30-minute preload run at 65% V̇O2max and a 30-minute time trial to assess running energy cost and performance, respectively. The subjects repeated both the trials after either 15 minutes of dynamic stretching (i.e., experimental condition) or quiet sitting (i.e., control condition) while the order was balanced between the subjects to avoid any order effect. The t...

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Energy cost and body centre of mass’ 3D intracycle velocity variation in swimming

European Journal of Applied Physiology — Fri, 20 Jan 2012 07:05:33 +0100

Abstract The purpose of this study was to examine the relationship between the energy cost (C) and the 3D intracycle velocity variation (IVV; swimming direction—x, vertical—y and lateral—z axes) throughout the 200 m front crawl event. Ten international level swimmers performed a maximal 200 m front crawl swim followed by 50, 100 and 150 m bouts at the same pace as in the 200 m splits. Oxygen consumption was measured during the bouts and blood samples were collected before and after each one. The C was calculated for each 50 m lap as the ratio of the total energy expenditure (three energy pathways) to the distance. A respiratory snorkel and valve system with low hydrodynamic resistance was used to measure pulmonary ventilation and to collect bre...

Evaluation of the long-term effects of gastric inhibitory polypeptide-ovalbumin conjugates on insulin resistance, metabolic dysfunction, energy balance and cognition in high-fat-fed mice.

The British Journal of Nutrition — Fri, 20 Jan 2012 05:00:00 +0100

Authors: Irwin N, Montgomery IA, Flatt PR Abstract The effects of active immunisation with gastric inhibitory polypeptide (GIP) or (proline3)GIP-ovalbumin conjugates on insulin resistance, metabolic dysfunction, energy expenditure and cognition were examined in high-fat-fed mice. Normal mice were injected (subcutaneously) once every 14 d for 98 d with GIP-ovalbumin conjugates, with transfer to a high-fat diet on day 21. Active immunisation resulted in GIP antibody generation and significantly (P < 0·01 to P < 0·001) reduced circulating non-fasting plasma insulin concentrations compared to high-fat control mice from day 70 onwards. The glycaemic responses to intraperitoneal glucose or nutrient ingestion were significantly improved in all treated mice, with correspondin...

The Effects of Incretins on Energy Homeostasis: Physiology and Implications for the Treatment of Type 2 Diabetes Mellitus and Obesity.

Current Vascular Pharmacology — Fri, 20 Jan 2012 05:00:00 +0100

Authors: Karras S, Goulis DG, Mintziori G, Katsiki N, Tzotzas T Abstract Energy homeostasis in mammalians is a teleological process regulated by the interplay between caloric intake and energy expenditure. Incretins are a significant component of the complex homeostatic network regulating the metabolic state in humans. This narrative review will focus on the basic concepts regarding incretin physiology and their regulatory feedback mechanisms affecting energy homeostasis. In this context, glucagon-like peptide 1 (GLP-1) promotes satiety and weight loss through centrally and peripherally mediated pathways. On the other hand, gastric inhibitory peptide (GIP) is implicated in energy storage by its actions on adipose tissue. Understanding this biological model requires a holistic appro...

Triiodothyronine stimulates glucose transport in bone cells

Endocrine — Thu, 19 Jan 2012 07:01:10 +0100

Abstract Thyroid hormones increase energy expenditure and bone turnover in vivo. To study whether 3,3′,5-triiodo-l-thyronine (T3) stimulates the uptake of glucose in osteoblastic cells, PyMS (a cell line derived from rat bone) cells were kept in serum-free culture medium and treated with T3. We measured [1-14C]-2-deoxy-d-glucose (2DG) uptake and looked for expression of the high-affinity glucose transporters GLUT1 and GLUT3 by northern and western analysis. T3 did not influence the cell number but slightly (1.3-fold) increased the protein content of the cell cultures. 2DG uptake was low in serum-deprived cell cultures and was increased by T3 (up to 2.5-fold at 1 nmol l−1 after 4 days) in a dose- and time-dependent manner. Triiodothyronine at 1 nmol&nbs...

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

International Journal of Behavioral Nutrition and Physical Activity — Thu, 19 Jan 2012 05:00:00 +0100

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...

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Finding and fixing diagnosis errors: can triggers help?

Quality and Safety in Health Care — Thu, 19 Jan 2012 05:00:00 +0100

Imagine conferring with your clinician colleagues and being handed a plateful of all of your missed and delayed diagnoses. But, imagine further that, rather than a nightmare of ghosts returning to haunt you in the form of malpractice claims, sanctions by regulatory boards, insurers pouncing on needless expenditures or hordes (yes, there would be large numbers) of angry finger-pointing patients and families, the experience would instead bring a dream of supportive feedback and learning. Imagine the ways such an idealised non-threatening consultation and conference might be designed to minimise defensiveness and maximise introspection, learn lessons, and rethink habits and standard practices. Rather than prompting incredulous exclamations of "you missed that?!" or "what were you thinking?!",...

Pro/con debate: Are barrier precautions cost-effective in improving patient outcomes in the intensive care unit?

Critical Care — Thu, 19 Jan 2012 05:00:00 +0100

You are responsible for a large medical surgical ICU. Your hospital administration has been very focused on reducing rates of hospital-acquired infections particularly in the wake of increasing public attention. However, it is time for budget preparation and your financial officer is concerned about the escalating costs associated with patient isolation and barrier precautions/personal protective equipment. Having become aware of the high costs associated with these interventions, you start to wonder about the wisdom of spending so much in this area. Your hospital administration wants your direction on next year's expenditures. You are debating whether the expense is worthwhile and advise your hospital administration accordingly. (Source: Critical Care)

Declines in Employer‐Sponsored Insurance between 2000 and 2008: Examining the Components of Coverage by Firm Size

Health Services Research — Tue, 17 Jan 2012 05:00:00 +0100

ObjectiveTo examine trends in employer‐sponsored health insurance coverage rates and its associated components between 2000 and 2008, to provide a baseline for later evaluations of the Affordable Care Act, and to provide information to policy makers as they design the implementation details of the law.Data SourcesPrivate sector employer data from the 2000, 2001, and 2008 Medical Expenditure Panel Survey‐Insurance Component (MEPS‐IC).Study DesignWe examine time trends in employer offer, eligibility, and take‐up rates. We add a new dimension to the literature by examining dependent coverage and decomposing its trends. We investigate heterogeneity in trends by firm size.Data CollectionThe MEPS‐IC is an annual survey, sponsored by the Agency for Healthcare Research and Quality and co...

Polarity Analysis

Homoeopathic Links — Tue, 17 Jan 2012 05:00:00 +0100

Homoeopathic Links 2011; 24: 217-221DOI: 10.1055/s-0031-1280281SummaryThe paper at hand presents the polarity analysis – the most recent method used to find a homeopathic remedy. Polarity analysis is the further development of Boenninghausen's concept of contraindications, a concept that allows for a precise remedy selection with little expenditure of time. This practical approach will be illustrated by studying the case of a patient suffering from a masked depression in Duchenne muscular dystrophy. Further, the basic considerations regarding the reliability of homeopathic remedy selection will be discussed.[...]© Sonntag Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KGArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Homoeopathic Links)

Development and Implementation of a Piperacillin-Tazobactam Extended Infusion Guideline

Journal of Pharmacy Practice — Tue, 17 Jan 2012 05:00:00 +0100

Administration of β-lactam antibiotics by extended infusion optimizes the pharmacodynamic properties and bactericidal activity of these agents resulting in a potential improvement in patient outcomes and reduction in drug expenditure. Consequently, a pharmacist-led piperacillin-tazobactam extended 4-hour infusion guideline was implemented hospital-wide at a 500-bed academic medical center. Each piperacillin-tazobactam infusion was prospectively monitored for 5 weeks to ensure accurate administration and identify barriers to guideline adherence. Overall, a total of 103 patients received 1215 doses of piperacillin-tazobactam by extended infusions. In all, 98% of the doses were administered at the correct extended infusion rate and 94% of the doses were given at the scheduled time. There...

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Appropriate Use of Screening and Diagnostic Tests to Foster High-Value, Cost-Conscious Care.

Annals of Internal Medicine — Tue, 17 Jan 2012 05:00:00 +0100

Authors: Qaseem A, Alguire P, Dallas P, Feinberg LE, Fitzgerald FT, Horwitch C, Humphrey L, Leblond R, Moyer D, Wiese JG, Weinberger S Abstract Reader Survey: Which testing scenarios are low value? Unsustainable rising health care costs in the United States have made reducing costs while maintaining high-quality health care a national priority. The overuse of some screening and diagnostic tests is an important component of unnecessary health care costs. More judicious use of such tests will improve quality and reflect responsible awareness of costs. Efforts to control expenditures should focus not only on benefits, harms, and costs but on the value of diagnostic tests-meaning an assessment of whether a test provides health benefits that are worth its costs or harms. To begin to ide...

Cannabinoid signalling regulates inflammation and energy balance: The importance of the brain-gut axis.

Brain, Behavior, and Immunity — Tue, 17 Jan 2012 05:00:00 +0100

Authors: Cluny NL, Reimer RA, Sharkey KA Abstract Energy balance is controlled by centres of the brain which receive important inputs from the gastrointestinal tract, liver, pancreas, adipose tissue and skeletal muscle, mediated by many different signalling molecules. Obesity occurs when control of energy intake is not matched by the degree of energy expenditure. Obesity is not only a state of disordered energy balance it is also characterized by systemic inflammation. Systemic inflammation is triggered by the leakage of bacterial lipopolysaccharide through changes in intestinal permeability. The endocannabinoid system, consisting of the cannabinoid receptors, endogenous cannabinoid ligands and their biosynthetic and degradative enzymes, plays vital roles in the control of energy b...

Home monitoring for heart failure management

ICMCC: The International Council on Medical and Care Compunetics — Mon, 16 Jan 2012 19:10:53 +0100

Source: Bui AL, Fonarow GC. Journal of the American College of Cardiology, 59(2) Content: With a prevalence of 5.8 million in the United States alone, heart failure (HF) is a common syndrome associated with substantial morbidity, mortality, and healthcare expenditures. Close to 1 million HF hospitalizations occur annually in the United States, with the majority [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

Antiretroviral Medication and HIV Prevention: New Steps Forward and New Questions.

Annals of Internal Medicine — Mon, 16 Jan 2012 05:00:00 +0100

Authors: Mayer KH, Krakower D Abstract During the past 2 years, several pivotal clinical trials have proven that the use of antiretrovirals by HIV-infected and at-risk uninfected persons can decrease the probability of HIV being transmitted sexually. The initial chemoprophylaxis studies evaluated tenofovir administered topically or orally (with or without emtricitabine). However, multiple questions remain. Some subsequent primary prevention studies did not replicate the results of the initial studies, raising questions about differences in the behaviors of participants in each study (in particular about medication adherence), as well as whether pharmacologic or local mucosal factors might explain the variable efficacy estimates. Other antiretrovirals and delivery systems are being ...

Spending growth slows again

Managed Healthcare Executive Magazine Online — Sun, 15 Jan 2012 04:07:37 +0100

A slowing of the growth in use of healthcare goods and services contributed to a second year of slow health spending growth in 2010, according to federal analysts. A number of factors combined to make 2009 and 2010 the two slowest growth rates in 51-year history of National Health Expenditure Accounts estimates. (Source: Managed Healthcare Executive Magazine Online)

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24-h Core Temperature in Obese and Lean Men and Women.

Obesity — Thu, 12 Jan 2012 05:00:00 +0100

This study investigated core temperature in obese and lean individuals at rest, during 20-min exercise, during sleep, and after food consumption. Twelve lean (18.5-24.9 kg/m(2)) and twelve obese (30.0-39.9 kg/m(2)) healthy participants, ages 25-40 years old, were admitted overnight in a clinical research unit. Females were measured in the follicular menstrual phase. Core temperature was measured every minute for 24 h using the CorTemp system, a pill-sized sensor that measures core temperature while in the gastrointestinal tract and delivers the measurement via a radio signal to an external recorder. Core temperature did not differ significantly between the obese and lean individuals at rest, postmeals, during exercise, or during sleep (P > 0.5), but core temperature averaged over the en...

Cost-cutting capital investment proposals in chronic pain management

Journal of Clinical Anesthesia — Thu, 12 Jan 2012 05:00:00 +0100

Several cost-saving and cost-containment studies have focused on reducing unnecessary costs through practice modifications during the perioperative period . In chronic pain management, cost-cutting proposals involving capital investments rather than clinical decision-making must be considered. Cost-cutting investment decisions are intended to improve cost-effectiveness and efficiency by reducing labor or material costs . To reduce costs and improve revenue cycle management in the hospital ambulatory and emergency department settings, self-serve, digital, touch screen kiosks have been implemented . These kiosks expedite the check-in process by allowing patients to preregister, make payments, and update information . In the chronic pain management setting, these functions may be accomplished...

Impact of Body Reserves on Energy Expenditure, Water Flux, and Mating Success in Breeding Male Northern Elephant Seals

Physiological and Biochemical Zoology — Wed, 11 Jan 2012 22:29:35 +0100

Physiological and Biochemical Zoology, Volume 85, Issue 1, Page 11-20, January 2012. (Source: Physiological and Biochemical Zoology)

Nutritional rehabilitation increases the resting energy expenditure of malnourished children with severe cerebral palsy

Developmental Medicine and Child Neurology — Wed, 11 Jan 2012 06:00:37 +0100

This study provided support for the hypothesis that the low REE found in malnourished children with CP is partly due to a low energy intake. (Source: Developmental Medicine and Child Neurology)

The impact of social policy on changes in professional practice within learning disability services: different standards for children and adults? A two-part examination: Part 2. professional services under the coalition: the trends continue apace

Journal of Intellectual Disabilities — Wed, 11 Jan 2012 05:00:00 +0100

This article, written one year into the Coalition government, argues that its policies – especially the large-scale reduction in public expenditure, but also the decline in support for inclusion of children in mainstream education, the rapid growth of academies, and proposals for the reorganization of the NHS – have exacerbated the trends identified earlier. In addition, local authorities, though outwardly compliant, have variously interpreted their responsibilities under the personalization agenda, in particular in relation to individual budgets, and this has resulted in assessments of need being based on ‘service hours’ rather than service quality and staff qualifications. (Source: Journal of Intellectual Disabilities)

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Central Nervous System Mechanisms Linking the Consumption of Palatable High-Fat Diets to the Defense of Greater Adiposity.

Cell Metabolism — Wed, 11 Jan 2012 05:00:00 +0100

Authors: Ryan KK, Woods SC, Seeley RJ Abstract The central nervous system (CNS) plays key role in the homeostatic regulation of body weight. Satiation and adiposity signals, providing acute and chronic information about available fuel, are produced in the periphery and act in the brain to influence energy intake and expenditure, resulting in the maintenance of stable adiposity. Diet-induced obesity (DIO) does not result from a failure of these central homeostatic circuits. Rather, the threshold for defended adiposity is increased in environments providing ubiquitous access to palatable, high-fat foods, making it difficult to achieve and maintain weight loss. Consequently, mechanisms by which nutritional environments interact with central homeostatic circuits to influence the thresh...

Low turnover osteoporosis in sheep induced by hypothalamic‐pituitary disconnection

Journal of Orthopaedic Research — Tue, 10 Jan 2012 05:00:00 +0100

AbstractThe hypothalamus is of critical importance in regulating bone remodeling. This is underscored by the fact that intracerebroventricular‐application of leptin in ewe leads to osteopenia. As a large animal model of osteoporosis, this approach has some limitations, such as high technical expenditure and running costs. Therefore we asked if a surgical ablation of the leptin signaling axis would have the same effects and would thereby be a more useful model. We analyzed the bone phenotype of ewe after surgical hypothalamo‐pituitary disconnection (HPD + OVX) as compared to control ewe (OVX) after 3 and 12 months. Analyses included histomorphometric characterization, micro‐CT and measurement of bone turnover parameters. Already 3 months after HPD we found osteopenic ewe with a si...

Growth, metabolic partitioning, and the size of microorganisms [Ecology]

Proceedings of the National Academy of Sciences — Tue, 10 Jan 2012 05:00:00 +0100

Population growth rate is a fundamental ecological and evolutionary characteristic of living organisms, but individuals must balance the metabolism devoted to biosynthesis and reproduction against the maintenance of existing structure and other functionality. Here we present a mathematical model that relates metabolic partitioning to the form of growth. The model captures the observed growth trajectory of single cells and individuals for a variety of species and taxa spanning prokaryotes, unicellular eukaryotes, and small multicellular eukaryotes. Our analysis suggests that the per-unit costs of biosynthesis and maintenance are conserved across prokaryotes and eukaryotes. However, the relative metabolic expenditure on growth and maintenance of whole organisms clearly differentiates taxa: p...

Adenosine A(2A) receptor antagonism and genetic deletion attenuate the effects of dopamine D(2) antagonism on effort-based decision making in mice.

Neuropharmacology — Tue, 10 Jan 2012 05:00:00 +0100

Authors: Pardo M, Lopez-Cruz Bch L, Valverde O, Ledent C, Baqi Y, Müller CE, Salamone JD, Correa M Abstract Brain dopamine (DA) and adenosine interact in the regulation of behavioral activation and effort-related processes. In the present studies, a T-maze task was developed in mice for the assessment of effort-related decision making. With this task, the two arms of the maze have different reinforcement densities, and a vertical barrier is positioned in the arm with the higher density (HD), presenting the animal with an effort-related challenge. Under control conditions mice prefer the HD arm, and climb the barrier to obtain the larger amount of food. The DA D(2) receptor antagonist haloperidol decreased selection of the HD arm and increased selection of the arm with the low dens...

PhD studentship, University of Nottingham

Society for Endocrinology — Mon, 09 Jan 2012 12:00:00 +0100

Via www.jobs.ac.uk. A PhD studentship entitled 'The endocrine and dietary regulation of brown adipose tissue' is open for applications at the School of Clinical Sciences, University of Nottingham. The project will be in collaboration with the Cardiometabolic Disease Research Foundation, Los Angeles, USA. The studentship aims to develop novel interventions aimed at promoting brown adipose tissue (BAT) function. It has recently been established that BAT function can be promoted by individual dietary compounds which can be quantified using novel imaging techniques. A number of landmark discoveries have identified the period from prior to birth extending up to and beyond puberty as a key window for developmental endocrine influences on the risk of becoming obese and developing diabetes. There...

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Proteins, not sugar, increase energy expenditure

NaturalNews.com — Mon, 09 Jan 2012 06:00:00 +0100

A study published in the November issue of the science journal Neuron subverts the commonly held belief that consuming sugar can make you feel more energetic. Researchers at the University of Cambridge reveal that protein is responsible for activating cells that keep... (Source: NaturalNews.com)

Reducing The Impact Of Diabetes: Is Prevention Feasible Today, Or Should We Aim For Better Treatment? [Lifestyle Interventions]

Health Affairs — Mon, 09 Jan 2012 05:00:00 +0100

Type 2 diabetes prevention studies have shown that the onset of the disease can be delayed or prevented, chiefly by weight loss. But the current efforts to establish community-based lifestyle modification programs will not be very effective in preventing diabetes, largely because most overweight or obese people cannot maintain weight loss over time. A complex environment is driving greater food consumption along with less energy expenditure, making maintenance of weight loss extremely difficult. To improve the likelihood of achieving populationwide success in reducing the obesity pandemic, we need a better understanding of the biological processes that underlie the balance between intake and expenditure of energy. In the meantime, once diabetes develops, we can greatly reduce the likelihoo...

Medicaid Expansion Under Health Reform May Increase Service Use And Improve Access for Low-Income Adults With Diabetes [Implications For Medicaid]

Health Affairs — Mon, 09 Jan 2012 05:00:00 +0100

Medicaid’s key role in financing diabetes care will grow when many low-income uninsured people with diabetes gain eligibility to the program in 2014 under the Affordable Care Act. Using a national data set to describe current health care use and spending among the nonelderly, low-income adult population, we found that adult Medicaid beneficiaries with diabetes had total annual per capita health expenditures more than three times higher ($14,229 versus $4,568) than those of adult beneficiaries without diabetes. At the same time, Medicaid facilitates financial protection and care access among beneficiaries with diabetes. Low-income adults with diabetes who were uninsured used fewer services, spent more out of pocket, and reported worse access than did their peers who were covered by Me...

Growth In US Health Spending Remained Slow In 2010; Health Share Of Gross Domestic Product Was Unchanged From 2009 [National Health Spending]

Health Affairs — Mon, 09 Jan 2012 05:00:00 +0100

Medical goods and services are generally viewed as necessities. Even so, the latest recession had a dramatic effect on their utilization. US health spending grew more slowly in 2009 and 2010—at rates of 3.8 percent and 3.9 percent, respectively—than in any other years during the fifty-one-year history of the National Health Expenditure Accounts. In 2010 extraordinarily slow growth in the use and intensity of services led to slower growth in spending for personal health care. The rates of growth in overall US gross domestic product (GDP) and in health spending began to converge in 2010. As a result, the health spending share of GDP stabilized at 17.9 percent. (Source: Health Affairs)

Monsanto spends whopping $2 million in third quarter 2011 lobbying federal government

NaturalNews.com — Fri, 06 Jan 2012 06:00:00 +0100

If you have ever wondered how the biotechnology industry has been able to develop the cozy and unquestioning relationship with the federal government that it has today, you need not look much further than Big Biotech's lobbying expenditures. According to a recent Bloomberg... (Source: NaturalNews.com)

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An evaluation of the uk food standards agency's salt campaign

Health Economics — Fri, 06 Jan 2012 05:00:00 +0100

Dietary Influences on Nonexercise Physical Activity and Energy Expenditure in C57BL/6J Mice

Journal of Food Science — Fri, 06 Jan 2012 05:00:00 +0100

Abstract: It is well established that the lack of physical activity can lead to weight gain or obesity. However, there is limited information on influences of diet components on physical activity. Thus the purpose of this study was to investigate the role of major dietary components on energy expenditure by affecting nonexercise physical activity in C57BL/6J mice. All mice were assigned to 1 of the following 4 dietary groups based on their body weight and baseline physical activity; low fat/normal protein, high fat/normal protein, low fat/low protein, or low fat/high protein. After 3 mo, the highest weight gain was observed in animals fed with high‐fat/normal‐protein diet, and the caloric intake was significantly lower in low‐fat/high‐protein diet‐fed mice compared to other gr...

CTRP1 Activates AMPK to Enhance Fatty Acid Oxidation [Metabolism]

Journal of Biological Chemistry — Fri, 06 Jan 2012 05:00:00 +0100

We previously described the adipokine CTRP1, which has up-regulated expression following exposure to the anti-diabetic drug rosiglitazone and increased circulating levels in adiponectin-null mice (Wong, G. W., Krawczyk, S. A., Kitidis-Mitrokostas, C., Revett, T., Gimeno, R., and Lodish, H. F. (2008) Biochem. J. 416, 161–177). Although recombinant CTRP1 lowers blood glucose in mice, its physiological function, mechanisms of action, and roles in metabolic stress remain unknown. Here, we show that circulating levels of CTRP1 are strikingly reduced in diet-induced obese mice. Overexpressing CTRP1 in transgenic mice improved insulin sensitivity and decreased high-fat diet-induced weight gain. Reduced adiposity resulted from enhanced fatty acid oxidation and energy expenditure, effects mediate...

The Role of Physical Therapists in Smoking Cessation: Opportunities for Improving Treatment Outcomes.

Physical Therapy — Fri, 06 Jan 2012 05:00:00 +0100

Authors: Pignataro RM, Ohtake PJ, Swisher A, Dino G Abstract This excerpt was created in the absence of an abstractTobacco use constitutes one of the greatest threats to public health worldwide. As a preventable cause of mortality and chronic disease, tobacco use in the United States results in an estimated 443,000 deaths each year through both direct exposure and secondhand smoke.(1) An additional 8,600,000 people across the nation have chronic illness due to smoking.(1) As physical therapists, we must realize that tobacco use impacts all areas of our practice, including cardiovascular, musculoskeletal, neurological, and integumentary health throughout the lifespan. In order to provide optimal care for the clients we serve, it is essential for physical therapists to screen for tob...

Tribal child welfare. Interim final rule.

Fed Regist — Fri, 06 Jan 2012 05:00:00 +0100

Authors: Abstract The Administration for Children and Families (ACF) is issuing this interim final rule to implement statutory provisions related to the Tribal title IV-E program. Effective October 1, 2009, section 479B(b) of the Social Security Act (the Act) authorizes direct Federal funding of Indian Tribes, Tribal organizations, and Tribal consortia that choose to operate a foster care, adoption assistance and, at Tribal option, a kinship guardianship assistance program under title IV-E of the Act. The Fostering Connections to Success and Increasing Adoptions Act of 2008 requires that ACF issue interim final regulations which address procedures to ensure that a transfer of responsibility for the placement and care of a child under a State title IV-E plan to a Tribal title IV-E...

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The impact of snake bite on household economy in Bangladesh.

Tropical Doctor — Thu, 05 Jan 2012 05:00:00 +0100

Authors: Hasan SM, Basher A, Molla AA, Sultana NK, Faiz MA Abstract The present study aims to assess the different types of costs for treatment of snake bite patients, to quantify household economic impact and to understand the coping mechanisms required to cover the costs for snake bite patients in Bangladesh. The patients admitted to four tertiary level hospitals in Bangladesh were interviewed using structured questionnaires including health-care-related expenditures and the way in which the expenditures were covered. Of the snakes which bit the patients, 54.2% were non-venomous, 45.8% were venomous and 42.2% of the patients were given polyvalent antivenom. The total expenditure related to snake bite varies from US$4 (US$1 = Taka 72) to US$2294 with a mean of US$124 and the mean ...

Home Monitoring for Heart Failure Management

Journal of the American College of Cardiology — Wed, 04 Jan 2012 18:27:39 +0100

With a prevalence of 5.8 million in the United States alone, heart failure (HF) is a common syndrome associated with substantial morbidity, mortality, and healthcare expenditures. Close to 1 million HF hospitalizations occur annually in the United States, with the majority of these resulting from worsening congestion in patients previously diagnosed with HF. An estimated $37.2 billion is spent each year on HF in the United States. These statistics emphasize the need to develop and implement more effective strategies to assess, monitor, and treat HF. It has also become increasingly apparent that interventions geared toward identifying and monitoring subclinical congestion would be of value in the home management of chronic HF. Earlier identification and treatment of congestion together with...

Lipid accumulation in overweight type 2 diabetic subjects: relationships with insulin sensitivity and adipokines

Acta Diabetologica — Wed, 04 Jan 2012 07:00:27 +0100

Abstract Adipokines are known to play a fundamental role in the etiology of obesity, that is, in the impaired balance between increased feeding and decreased energy expenditure. While the adipokine-induced changes of insulin resistance in obese diabetic and nondiabetic subjects are well known, the possible role of fat source in modulating insulin sensitivity (IS) remains controversial. The aim of our study was to explore in overweight type 2 diabetic patients (T2DM) with metabolic syndrome IS in different energy storage conditions (basal and dynamic) for relating it to leptin and adiponectin. Sixteen T2DM (5/11 F/M; 59 ± 2 years; 29.5 ± 1.1 kg/m2) and 16 control (CNT 5/11; 54 ± 2; 29.1 ± 1.0) underwent an oral glucose to...

Hypothalamic mTOR pathway mediates thyroid hormone‐induced hyperphagia in hyperthyroidism

The Journal of Pathology — Wed, 04 Jan 2012 05:00:00 +0100

AbstractHyperthyroidism is characterised by rats increased energy expenditure and marked hyperphagia. The alterations of thermogenesis linked to hyperthyroidism are associated to dysregulation of hypothalamic AMPK and fatty acid metabolism; however, the central mechanisms mediating hyperthyroidism‐induced hyperphagia remain largely unclear. Here, we demonstrate that hyperthyroid rats exhibit marked upregulation of the hypothalamic mammalian target of rapamycin (mTOR) signalling pathway associated with increased mRNA levels of agouti‐related protein (AgRP) and neuropeptide Y (NPY), and decreased mRNA levels of proopiomelanocortin (POMC) in the arcuate nucleus of the hypothalamus (ARC), an area where mTOR colocalizes with thyroid hormone receptor alpha (TR I). Central administration of t...

Calories Raise Body Fat When People Overeat, Not Protein

Health News from Medical News Today — Tue, 03 Jan 2012 21:00:00 +0100

In a study published in the January 4 issue of JAMA, researchers assessed 25 healthy individuals who were randomized to different levels of overconsumption on protein diets whilst living in a controlled setting. They found that those who consumed the low-protein diet gained less weight compared with those eating normal and high protein diets. Furthermore, they established that calories alone and not protein seemed to contribute to increases in body fat and that protein did contribute to changes in energy expenditure and lean body mass... (Source: Health News from Medical News Today)

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Study of the Cost-Benefit Analysis of Electronic Medical Record Systems in General Hospital in China

Journal of Medical Systems — Tue, 03 Jan 2012 06:44:45 +0100

We presented a net financial cost-benefit analysis of implementing electronic medical record systems in general hospital in China. The data, which were obtained from studies of the general hospital and the published literature, collected from 15 consecutive fiscal months from May 1, 2009 to August 30, 2010. We performed a perspective cost-benefit study to analyze the financial effects of EMR system implementing. The reference strategy for comparisons was the traditional paper-based medical record. The net financial benefits or costs for a 6-year period were calculated. All data were adjusted for inflation. The totally assessed net benefit from implementing an EMR system for a 6-year period was $559,025 in the general hospital. Benefits accrue primarily from savings in new medical rec...

G protein-coupled receptors: Case builds for TGR5 as metabolic syndrome target

Nature Reviews Drug Discovery — Tue, 03 Jan 2012 05:00:00 +0100

Nature Reviews Drug Discovery 11, 22 (2012). doi:10.1038/nrd3638 Author: Katrin Legg Activation of TGR5, a G protein-coupled receptor for bile acids, has been linked to both improved glycaemic control and enhanced energy expenditure. Now, the discovery by Pols and colleagues, reported in Cell Metabolism, that activation of TGR5 also protects against the development of atherosclerosis (Source: Nature Reviews Drug Discovery)

Historical perspectives in fat cell biology: the fat cell as a model for the investigation of hormonal and metabolic pathways

AJP: Cell Physiology — Tue, 03 Jan 2012 05:00:00 +0100

For many years, there was little interest in the biochemistry or physiology of adipose tissue. It is now well recognized that adipocytes play an important dynamic role in metabolic regulation. They are able to sense metabolic states via their ability to perceive a large number of nervous and hormonal signals. They are also able to produce hormones, called adipokines, that affect nutrient intake, metabolism and energy expenditure. The report by Rodbell in 1964 that intact fat cells can be obtained by collagenase digestion of adipose tissue revolutionized studies on the hormonal regulation and metabolism of the fat cell. In the context of the advent of systems biology in the field of cell biology, the present seems an appropriate time to look back at the global contribution of the fat cell t...

Advanced Dementia: State of the Art and Priorities for the Next Decade.

Annals of Internal Medicine — Tue, 03 Jan 2012 05:00:00 +0100

This article outlines the current understanding of advanced dementia and identifies research priorities for the next decade. Research over the past 25 years has largely focused on describing the experience of patients with advanced dementia. This work has delineated abundant opportunities for improvement, including greater recognition of advanced dementia as a terminal illness, better treatment of distressing symptoms, increased access to hospice and palliative care services, and less use of costly and aggressive treatments that may be of limited clinical benefit. Addressing those opportunities must be the overarching objective for the field in the coming decade. Priority areas include designing and testing interventions that promote high-quality, goal-directed care; health policy research...

A New Strategy for the Implementation of an Aerobic Training Session

Journal of Strength and Conditioning Research — Sun, 01 Jan 2012 06:00:00 +0100

The objectives were to propose a new strategy for adjusting aerobic training variables based on the eighth American College of Sports Medicine (ACSM) guidelines and maximal aerobic power (V̇O2max) and to establish energy expenditure (EE) recommendations for training, which depend on a subject's body mass (BM). Exclusively based on aerobic training recommendations that are available in the ACSM guidelines, 16 equally partitioned subcategories were created from the slope of a linear regression between the lower (16.4 ml·kg−1·min−1) and upper (61.2 ml·kg−1·min−1) limits of V̇O2max percentile tables and all aerobic variables (intensity: 30–85%Reserve, duration: 60–300 min·wk−1, frequency: 3–5 d·wk−1, and EE: 1,000–4,000 kcal·wk−1). ACSM's EE (EEACSM) recommendati...

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Effect of Whole-Body Electromyostimulation on Energy Expenditure During Exercise

Journal of Strength and Conditioning Research — Sun, 01 Jan 2012 06:00:00 +0100

This study clearly demonstrates the additive effect of WB-EMS on EE in moderately trained subjects during low-intensity resistance exercise training. Although this effect was statistically significant, the fast and significant reductions of body fat observed in recent studies suggest that the effect of WB-EMS on EE may still be underestimated by indirect calorimetry because of the inability of indirect calorimetry to accurately assess EE during “above–steady state conditions.” Although from a statistically point of view WB-EMS clearly impacts EE, the relatively small effect did not suggest a broad application of this device in this area. However, taking other positive outcomes of this technology into account, WB-EMS may be a time-saving option at least for subjects unwilling or unabl...

Physiological Comparisons Between Aquatic Resistance Training Protocols With and Without Equipment

Journal of Strength and Conditioning Research — Sun, 01 Jan 2012 06:00:00 +0100

de Souza, AS, Pinto, SS, Kanitz, AC, Rodrigues, BM, Alberton, CL, da Silva, EM, and Kruel, LFM. Physiological comparisons between aquatic resistance training protocols with and without equipment. J Stength Cond Res 26(1): 276–283, 2012—The purpose of the present study was to compare the physiological responses of oxygen uptake (V̇O2) and energy expenditure (EE) in two different aquatic resistance training protocols performed with three sets of 20 seconds (3 × 20) and six sets of 10 seconds (6 × 10) and with and without Speedo Resistance Equipment. Ten young healthy women volunteers, familiar with exercises in an aquatic environment, participated in this study. The four separate protocols were randomly selected and performed at a 48-hour interval by the same instructor. The total tim...

[Comment] Drivers of the cost of cancer care

The Lancet Oncology — Sun, 01 Jan 2012 05:00:00 +0100

The Lancet Oncology Commission provides some excellent insights into the different drivers that shape cancer care, including imaging, radiography, surgery and hospital services, and drugs. However, the cost of drugs has dominated the subsequent press response and much of the commentary. This focus has arisen despite the Commission stating that the cost of drugs accounted for only about 13% of total US health-care expenditure in 2009. A similar percentage has been calculated for the cost of cancer care in New Zealand, where in a 6-year review the cost of drugs accounted for 10% of the total cost of cancer care per patient. (Source: The Lancet Oncology)

[News] Cancer services insulated from Irish austerity

The Lancet Oncology — Sun, 01 Jan 2012 05:00:00 +0100

“I know this is an exceptional event. But we live in exceptional times. And we face an exceptional challenge.” The words of Taoiseach Enda Kenny during the first televised address by an Irish leader in almost 30 years, as he sought to prepare the ground for an austerity budget that would, he said, pave the way for a “4-year path to recovery”. Just over a year since the previous administration, which imposed its own round of deeply unpopular austerity measures, was forced to accept an €85 billion rescue package from the European Union, the first day of an extraordinary 2-day budget saw Public Expenditure Minister Brendan Howlin announce €543 million in cuts to the health service in an effort to claw Ireland's budget deficit back to the 3% limit set by the European Union's Maastr...

Paying for hospital care: the experience with implementing activity-based funding in five European countries.

Health Economics, Policy, and Law — Sun, 01 Jan 2012 05:00:00 +0100

Authors: O'Reilly J, Busse R, Häkkinen U, Or Z, Street A, Wiley M Abstract Following the US experience, activity-based funding has become the most common mechanism for reimbursing hospitals in Europe. Focusing on five European countries (England, Finland, France, Germany and Ireland), this paper reviews the motivation for introducing activity-based funding, together with the empirical evidence available to assess the impact of implementation. Despite differences in the prevailing approaches to reimbursement, the five countries shared several common objectives, albeit with different emphasis, in moving to activity-based funding during the 1990s and 2000s. These include increasing efficiency, improving quality of care and enhancing transparency. There is substantial cross-country va...

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Impact and cost-effectiveness of family Fitness Zones: A natural experiment in urban public parks.

Health and Place — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Cohen DA, Marsh T, Williamson S, Golinelli D, McKenzie TL Abstract We evaluated the impact of outdoor exercise equipment (FZ, Fitness Zones) in 12 parks serving diverse populations. We used the System for Observing Play and Recreation in Communities (SOPARC) to assess use and estimate energy expenditure prior to and twice after FZ installation. Park use increased more in FZ parks than in 10 control parks that did not get equipment, but the difference was not statistically significant. However, self-reports of being a new park user increased more in FZ parks, and estimated energy expenditure in FZ parks was higher at both follow-ups than at baseline. Installing Fitness Zones appears to be cost-effective (10.5 cents/MET increase) and most successful in parks in densely popul...

Reducing harm in healthcare through understanding the ‘human factor’

Trends in Urology, Gynaecology and Sexual Health — Sun, 01 Jan 2012 05:00:00 +0100

AbstractThere is accumulating evidence that, in spite of advances in modern medicine, error remains a potent source of death, disability and wasted expenditure. John Reynard believes that a reduction in preventable medical errors can be achieved through improved communication and an understanding of the human factors involved in generating potential mistakes. Copyright © 2012 John Wiley & Sons (Source: Trends in Urology, Gynaecology and Sexual Health)

Physical activity and exercise in the regulation of human adipose tissue physiology.

Physiological Reviews — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Thompson D, Karpe F, Lafontan M, Frayn K Abstract Physical activity and exercise are key components of energy expenditure and therefore of energy balance. Changes in energy balance alter fat mass. It is therefore reasonable to ask: What are the links between physical activity and adipose tissue function? There are many complexities. Physical activity is a multifaceted behavior of which exercise is just one component. Physical activity influences adipose tissue both acutely and in the longer term. A single bout of exercise stimulates adipose tissue blood flow and fat mobilization, resulting in delivery of fatty acids to skeletal muscles at a rate well-matched to metabolic requirements, except perhaps in vigorous intensity exercise. The stimuli include adrenergic and other c...

Validation of indirect calorimetry for measurement of energy expenditure in healthy volunteers undergoing pressure controlled non-invasive ventilation support

Journal of Clinical Monitoring and Computing — Fri, 30 Dec 2011 07:09:10 +0100

Abstract The aim of this validation study was to assess the reliability of gas exchange measurement with indirect calorimetry among subjects who undergo non-invasive ventilation (NIV). Oxygen consumption (VO2) and carbon dioxide production (VCO2) were measured in twelve healthy volunteers. Respiratory quotient (RQ) and resting energy expenditure (REE) were then calculated from the measured VO2 and VCO2 values. During the measurement period the subjects were breathing spontaneously and ventilated using NIV. Two different sampling air flow values 40 and 80 l/min were used. The gas leakage from the measurement setup was assessed with a separate capnograph. The mean weight of the subjects was 93 kg. Their mean body mass index was 29 (range 22–40) kg/m2. There wa...

Shared Decision-Making and Health Care Expenditures Among Children With Special Health Care Needs

PEDIATRICS — Fri, 30 Dec 2011 05:00:00 +0100

Children with special health care needs (CSHCN) account for more than one-third of pediatric health care costs. Little is known regarding the impact of shared decision-making (SDM) over time on child health care expenditures and utilization. In a national sample, we found that increasing SDM was associated with decreased health care costs and utilization for CSHCN. Results support prospective studies to determine if pediatric interventions to foster SDM reduce the financial burden of caring for CSHCN. (Read the full article) (Source: PEDIATRICS)

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Alteration of hypothalamic cellular dynamics in obesity

Journal of Clinical Investigation — Thu, 29 Dec 2011 11:17:32 +0100

The number of people who suffer from obesity and one or more of its adverse complications is rapidly increasing. It is becoming clear that diet, exercise, and other lifestyle modifications are insufficient strategies to combat this growing problem. Greater understanding of the mechanisms controlling our desire to feed and our ability to balance energy intake with energy expenditure are key to the development of pharmacological approaches for treating obesity. Although great strides have been made in our understanding of how the hypothalamus regulates feeding and energy balance, much less is known about how obesity affects the structure of the hypothalamus. The authors of two papers in this issue of the JCI have addressed this issue by examining the effects of obesity on neurons and glia in...

Survival Is Not Enough

Journal of Renal Nutrition — Thu, 29 Dec 2011 05:37:04 +0100

Survival is not enough is a yearly international event started in 2007 in Naples, Italy, in the week of the World Kidney Day to discuss the needs of renal patients and the quality of life of a category of patients living a machine-dependent life. Renal patients and their associations, philosophers, economists, nephrologists, and health care managers are enrolled to discuss about the possibility to grant the best cures and care without reducing the quality and the quantity of the services the patients need. Various quests have arisen for (1) a new cadre of managers capable of keeping health accounts in balance without cutting expenditure but by reducing waste of resources, (2) the promotion of prevention as the only measure capable of reducing costs in the long run, and (3) the promotion of...

Essential Role of Protein Tyrosine Phosphatase 1B in Obesity‐Induced Inflammation and Peripheral Insulin Resistance During Aging

Aging Cell — Thu, 29 Dec 2011 05:00:00 +0100

In this study, we have evaluated the role of PTP1B in the development of aging‐associated obesity, inflammation and peripheral insulin resistance by assessing metabolic parameters at 3 and 16 months in PTP1B‐/‐ mice maintained on mixed genetic background (C57Bl/6J x 129Sv/J). Whereas fat mass and adipocyte size were increased in wild‐type control mice at 16 months, these parameters did not change with aging in PTP1B‐/‐ mice. Increased levels of pro‐inflammatory cytokines, crown‐like structures and hypoxia‐inducible factor (HIF)‐1α were observed only in adipose tissue from 16‐month old wild‐type mice. Similarly, islet hyperplasia and hyperinsulinemia were observed in wild‐type mice with aging‐associated obesity, but not in PTP1B‐/‐ animals. Leanness in 16‐...

Hormone and metabolite changes associated with extended breeding fasts in male northern elephant seals (Mirounga angustirostris).

Thu, 29 Dec 2011 05:00:00 +0100

Authors: Crocker DE, Ortiz RM, Houser DS, Webb PM, Costa DP Abstract We measured metabolic hormones and several key metabolites in breeding adult male northern elephant seals to examine the regulation of fuel metabolism during extended natural fasts of over 3months associated with high levels of energy expenditure. Males were sampled twice, early and late in the fast, losing an average of 23% of body mass and 47% of adipose stores between measurements. Males exhibited metabolic homeostasis over the breeding fast with no changes in glucose, non-esterified fatty acids, or blood urea nitrogen. Ketoacids increased over the fast but were very low when compared to other fasting species. Changes within individuals in total triiodothyronine (tT(3)) were positively related to daily energy e...

Evaluation of a Wearable Body Monitoring Device During Treadmill Walking and Jogging in Patients With Fibromyalgia Syndrome

Archives of Physical Medicine and Rehabilitation — Thu, 29 Dec 2011 01:24:28 +0100

Abstract: Munguía-Izquierdo D, Santalla A, Legaz-Arrese A. Evaluation of a wearable body monitoring device during treadmill walking and jogging in patients with fibromyalgia syndrome. Objective: To evaluate the reliability and validity of a body monitoring device against measures obtained from indirect calorimetry (IC) in patients with fibromyalgia syndrome (FMS) during various incremental exercise intensities. Design: Cross-sectional reliability and validity study. Setting: Testing was completed in a university exercise physiology laboratory. Participants: Women (N=25) with FMS, with a mean age ± SD of 48.6±8.4 years and a median symptom duration of 15 years (25th–75th percentiles, 10–23y), were recruited to the study. Interventions: Not applicable. Main Outcome Measure...

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Same-Sex Marriage Laws Reduce Doctor Visits And Health Care Costs For Gay Men

Health News from Medical News Today — Wed, 28 Dec 2011 08:00:00 +0100

Gay men are able to lead healthier, less stress-filled lives when states offer legal protections to same-sex couples, according to a new study examining the effects of the legalization of same-sex marriage in Massachusetts. The study, "Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment," is online in the American Journal of Public Health. "Our results suggest that removing these barriers improves the health of gay and bisexual men," said Mark L... (Source: Health News from Medical News Today)

Chest.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Authors: Quint L Abstract Chest computed tomography (CT) scans have been used with increasing frequency over the past two decades, both in patients with known diseases, as well as in screening situations (e.g. for lung cancer and coronary artery disease), leading to an explosion in the use of the modality. Approximately 3-24% of chest CT examinations show potentially significant incidental findings (incidentalomas) that require further evaluation or follow-up. Most of these findings are benign and clinically insignificant. Further evaluation or follow-up of such lesions may lead to large health care expenditures, extra radiation in healthy patients, unnecessary invasive procedures, patient anxiety, and patient morbidity. Therefore, it is highly important for radiologists to be educ...

Can imaging help improve the survival of cancer patients?

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Authors: Miles K Abstract Survival, quality-adjusted survival and mortality are important and related measures of outcome in cancer care. The impact of imaging on these outcomes can be ascertained from observational and modelling studies, frequently performed to evaluate cost-effectiveness. Examples where incorporation of imaging into cancer care can be shown to improve survival include breast cancer screening, characterization of solitary pulmonary nodules, staging of non-small cell lung cancer, treatment response assessment in Hodgkin lymphoma, postoperative surveillance of colorectal cancer and selective internal radiation therapy of colorectal liver metastases. Modelling suggests the greatest opportunities for improvements in survival through imaging detection of cancer may lie...

Endogenous technological change in medicine and its impact on healthcare costs: evidence from the pharmaceutical market in Taiwan

The European Journal of Health Economics — Mon, 26 Dec 2011 16:44:55 +0100

Abstract Although the technological change in medicine has been recognized widely as the major driver of rising healthcare costs, there is very little research that estimates this effect directly. This paper uses both a single-equation and a simultaneous equations approach to investigate empirically the interactive relationship between technological innovation and the growth of health expenditure in the context of the pharmaceutical market in Taiwan. Based on observing 182 therapeutic groups between 1997 and 2006, we find evidence to support the argument that technological innovation and health expenditure are determined simultaneously as technological innovation, and that the growth of health expenditure are endogenous rather than exogenous. Specifically, we find that the...

High-Risk Pregnancies - Telemedicine Can Save $186 Million In Medicaid Expenditure

Health News from Medical News Today — Mon, 26 Dec 2011 08:00:00 +0100

A new legislative proposal by The American Telemedicine Association (ATA) aims to expand the use of telemedicine for Medicaid enrollees with high-risk pregnancies and neonatal care needs. If the plan should be adopted, it would mean an improvement in providing care for people who are at-risk, whilst creating substantial long-term savings for the government as well as taxpayers. Avalere Health has been commissioned by ATA to appraise the proposal using Congressional Budget Office style cost estimating... (Source: Health News from Medical News Today)

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Targeted Loss of GHR Signaling in Mouse Skeletal Muscle Protects Against High-Fat Diet-Induced Metabolic Deterioration.

Diabetes — Sun, 25 Dec 2011 06:07:56 +0100

Authors: Vijayakumar A, Wu Y, Sun H, Li X, Jeddy Z, Liu C, Schwartz GJ, Yakar S, Leroith D Abstract Growth hormone (GH) exerts diverse tissue-specific metabolic effects that are not revealed by global alteration of GH action. To study the direct metabolic effects of GH in the muscle, we specifically inactivated the growth hormone receptor (ghr) gene in postnatal mouse skeletal muscle using the Cre/loxP system (mGHRKO model). The metabolic state of the mGHRKO mice was characterized under lean and obese states. High-fat diet feeding in the mGHRKO mice was associated with reduced adiposity, improved insulin sensitivity, lower systemic inflammation, decreased muscle and hepatic triglyceride content, and greater energy expenditure compared with control mice. The obese mGHRKO mice also h...

Oligoclonal Antibody Targeting Ghrelin Increases Energy Expenditure and Reduces Food Intake in Fasted Mice

Molecular Pharmaceutics — Fri, 23 Dec 2011 05:01:40 +0100

Molecular PharmaceuticsDOI: 10.1021/mp200376c (Source: Molecular Pharmaceutics)

Neuron-specific Deletion of a Single Copy of the Insulin-like Growth Factor-1 Receptor Gene Reduces Fat Accumulation during Aging

Hormone and Metabolic Research — Fri, 23 Dec 2011 05:00:00 +0100

Horm Metab ResDOI: 10.1055/s-0031-1298018Insulin, insulin-like growth factor-1 (IGF-1), and leptin signaling have been proposed to play an important role in regulating energy homeostasis. In order to specifically address the role of neuronal IGF-1 receptor (IGF-1R) signaling for energy expenditure and metabolism we used conditional mutagenesis. Deletion of one copy of the IGF-1R specifically in post-mitotic neurons (nIGF-1R+/ − ) does not result in growth retardation or skeletal abnormalities. Interestingly, male nIGF-1R+/ − mice accumulate less fat mass during aging accompanied with decreased leptin levels compared to wild-type littermates. Furthermore, male nIGF-1R+/ − mice present with increased locomotor activity and energy expenditure. In contrast, female nIGF-1R+/...

Control of energy homeostasis by amylin.

Cellular and Molecular Life Sciences : CMLS — Fri, 23 Dec 2011 05:00:00 +0100

Authors: Lutz TA Abstract Amylin is an important control of nutrient fluxes because it reduces energy intake, modulates nutrient utilization by inhibiting postprandial glucagon secretion, and increases energy disposal by preventing compensatory decreases of energy expenditure in weight-reduced individuals. The best investigated function of amylin which is cosecreted with insulin is to reduce eating by promoting meal-ending satiation. This effect is thought to be mediated by a stimulation of specific amylin receptors in the area postrema. Secondary brain sites to mediate amylin action include the nucleus of the solitary tract and the lateral parabrachial nucleus, which convey the neural signal to the lateral hypothalamic area and other hypothalamic nuclei. Amylin may also signal adi...

Obstructive sleep apnea and depression: a review. - Ejaz SM, Khawaja IS, Bhatia S, Hurwitz TD.

SafetyLit: All (Unduplicated) — Fri, 23 Dec 2011 01:13:53 +0100

Obstructive sleep apnea is a common sleep disorder associated with several medical conditions, increased risk of motor vehicle accidents, and overall healthcare expenditure. There is higher prevalence of depression in people with obstructive sleep apnea in... (Source: SafetyLit: All (Unduplicated))

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Health care expenditures for Medicaid‐covered males with haemophilia in the United States, 2008

Haemophilia — Thu, 22 Dec 2011 10:22:47 +0100

The objective of this study is to provide information on health care utilization and expenditures for publicly insured people with haemophilia in the United States in comparison with people with haemophilia who have ESI. Data from the MarketScan® Medicaid Multi‐State, Commercial and Medicare Supplemental databases were used for the period 2004−2008 to identify cases of haemophilia and to estimate medical expenditures during 2008. A total of 511 Medicaid‐enrolled males with haemophilia were identified, 435 of whom were enrolled in Medicaid for at least 11 months during 2008. Most people with haemophilia qualified for Medicaid based on ‘disability’. Average Medicaid expenditures in 2008 were $142,987 [median, $46,737], similar to findings for people with ESI. Average costs for m...

Keep it simple? Predicting primary health care costs with measures of morbidity and multimorbidity

NHS Networks — Thu, 22 Dec 2011 05:00:00 +0100

Such information is required in order to set capitation fees or budgets for general practices to cover their expenditure on providing primary care services. It is also useful to examine whether practices’ expenditure decisions vary equitably with patient characteristics. (Source: NHS Networks)

Diet For Retired Military Personnel Reduces Medical Costs

Health News from Medical News Today — Wed, 21 Dec 2011 18:00:00 +0100

According to a report published online in Preventive Medicine, a weight management intervention designed for military members who are inactive and retired, and their families, could improve their health in addition to lowering medical expenditures... (Source: Health News from Medical News Today)

Medicare Program; Independence at Home Demonstration Program

Federal Register updates via the Rural Assistance Center — Wed, 21 Dec 2011 15:48:59 +0100

This notice creates a new demonstration program for chronically ill Medicare beneficiaries to test a payment incentive and service delivery system that utilizes physician and nurse practitioner directed home-based primary care teams aimed at improving health outcomes and reducing expenditures, beginning December 21, 2011. (Source: Federal Register updates via the Rural Assistance Center)

Effect of silymarin on lipid and alcohol metabolism in mice following long‐term alcohol consumption

Journal of Food Biochemistry — Wed, 21 Dec 2011 05:00:00 +0100

This study offers another aspect of scientific evidence for silymarin on development of hepatoprotective agents. (Source: Journal of Food Biochemistry)

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Cytochrome P450 CYP2E1 knockout mice are protected against high fat diet induced obesity and insulin resistance.

American Journal of Physiology. Endocrinology and Metabolism — Tue, 20 Dec 2011 05:00:00 +0100

Authors: Zong H, Armoni M, Harel C, Karnieli E, Pessin JE Abstract Conventional (whole body) CYP2E1 knockout mice displayed protection against high fat diet induced weight gain, obesity and hyperlipidemia with increased energy expenditure despite normal food intake and spontaneous locomotor activity. In addition, the CYP2E1 knockout mice displayed a marked improvement in glucose tolerance on both a normal chow and high fat diet. Euglycemic-hyperinsulinemic clamps demonstrated a marked protection against high fat diet induced insulin resistance in CYP2E1 knockout mice with enhanced adipose tissue glucose uptake and insulin suppression of hepatic glucose output. In parallel, adipose tissue was protected against high fat diet induced pro-inflammatory cytokine production. Taken togethe...

Overexpression of FoxO1 in the Hypothalamus and Pancreas Causes Obesity and Glucose Intolerance.

Endocrinology — Tue, 20 Dec 2011 05:00:00 +0100

Authors: Kim HJ, Kobayashi M, Sasaki T, Kikuchi O, Amano K, Kitazumi T, Lee YS, Yokota-Hashimoto H, Susanti VY, Kitamura YI, Nakae J, Kitamura T Abstract Recent studies have revealed that insulin signaling in pancreatic β-cells and the hypothalamus is critical for maintaining nutrient and energy homeostasis, the failure of which are hallmarks of metabolic syndrome. We previously reported that forkhead transcription factor forkhead box-containing protein of the O subfamily (FoxO)1, a downstream effector of insulin signaling, plays important roles in β-cells and the hypothalamus when we investigated the roles of FoxO1 independently in the pancreas and hypothalamus. However, because metabolic syndrome is caused by the combined disorders in hypothalamus and pancreas, to elucidate the...

Patterns and trends of beverage consumption among children and adults in Great Britain, 1986-2009.

The British Journal of Nutrition — Tue, 20 Dec 2011 05:00:00 +0100

Authors: Ng SW, Ni Mhurchu C, Jebb SA, Popkin BM Abstract Many dietary recommendations include reduction of excessive intake of sugar-sweetened beverages (SSB) and other energy-rich beverages such as juices and alcohol. The present study examines surveys of both individual dietary intake data and household food expenditure surveys to provide a picture of patterns and trends in beverage intake and purchases in Great Britain from 1986 to 2009, and estimates the potential for pricing policy to promote more healthful beverage purchase patterns. In 2008-9, beverages accounted for 21, 14 and 18 % of daily energy intake for children aged 1·5-18 and 4-18 years, and adults (19-64 years), respectively. Since the 1990s, the most important shifts have been a reduction in consumption of high-...

Intervening on spontaneous physical activity to prevent weight regain in older adults: Design of a randomized, clinical trial

Contemporary Clinical Trials — Mon, 19 Dec 2011 05:00:00 +0100

This study is a randomized trial in older, obese men and women designed to test the hypothesis that adding a self-regulatory intervention (SRI), focused around self-monitoring of SPA, to a weight loss intervention will result in less weight and fat mass regain following weight loss than a comparable intervention that lacks this self-regulatory behavioral strategy. Participants (n=72) are randomized to a 5-month weight loss intervention with or without the addition of a behavioral component that includes an innovative approach to promoting increased SPA. Both groups then transition to self-selected diet and exercise behavior for a 5-month follow-up. Throughout the 10-month period, the SRI group is provided with an intervention designed to promote a SPA level that is equal to or greater than...

Gay Married Men Enjoy Better Health Than Single Gay Men

Health News from Medical News Today — Sun, 18 Dec 2011 20:00:00 +0100

Men in same-sex marriages enjoy better health, have fewer doctor visits and lower health care costs compared to other gay or bisexual men, researchers from the Mailman School of Public Health wrote in the American Journal of Public Health. They added that when states offer legal protections for same-sex marriages, as is the case in Massachusetts, gay men generally have lower overall levels of stress. The article is titled "Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment." Lead author, Mark L... (Source: Health News from Medical News Today)

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Altered glucose-stimulated insulin secretion in a mouse line with activated polyamine catabolism.

Transgenic Research — Sun, 18 Dec 2011 05:00:00 +0100

Authors: Cerrada-Gimenez M, Tusa M, Casellas A, Pirinen E, Moya M, Bosch F, Alhonen L Abstract Ubiquitous activation of polyamine catabolism has been demonstrated to have protective effects in mice on fat accumulation and insulin sensitivity/glucose tolerance in, both, normal conditions and after a high fat diet. We have analyzed the endocrine pancreas functionality in four months-old male mice overexpressing the rate limiting enzyme in the polyamine catabolism, spermidine/spermine N (1)-acetyltransferase (SSAT). The pancreatic SSAT activity was 37-fold elevated in the transgenic mice, which reduced the total pancreatic and islet pools of spermidine (71%) and spermine (69%), and increased putrescine and N (1)-acetyl spermidine. Reduction in the islet ATP levels ...

New Insights into Aromatherapy for Obesity: The Future

Journal of Pakistan Medical Students — Sat, 17 Dec 2011 05:00:00 +0100

This article has been peer reviewed. Article Submitted on: 10th December 2011 Article Accepted on: 15th December 2011 Funding Sources: None declared Correspondence to Muhammad Naeem, medical student Address: Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan Email Address: dowgrad2012@yahoo.com Editorial The Godzilla of obesity pandemic has resulted in the sudden increment of cardiometabolic disorders in nations where fast food consumption is rampant, and thus proves to be a predicament in current era of advanced medicine. In United States, 32% of adults are obese and since obesity is associated with significant health burden, it is thought that it will gulp upto 19.6% of gross domestic product (GDP) by the year 2016.[1] According to World Health Organization ...

Child growth in urban deprived settings: Does household poverty status matter? At which stage of child development?

Health and Place — Sat, 17 Dec 2011 05:00:00 +0100

Authors: Fotso JC, Madise N, Baschieri A, Cleland J, Zulu E, Kavao Mutua M, Essendi H Abstract This paper uses longitudinal data from two informal settlements of Nairobi, Kenya to examine patterns of child growth and how these are affected by four different dimensions of poverty at the household level namely, expenditures poverty, assets poverty, food poverty, and subjective poverty. The descriptive results show a grim picture, with the prevalence of overall stunting reaching nearly 60% in the age group 15-17 months and remaining almost constant thereafter. There is a strong association between food poverty and stunting among children aged 6-11 months (p<0.01), while assets poverty and subjective poverty have stronger relationships (p<0.01) with undernutrition at older age (2...

Africa: Should the Global Fund Try to Recover All 'Losses'?, Sub-Committee Asks

AllAfrica News: Health and Medicine — Fri, 16 Dec 2011 14:17:43 +0100

In a report to the Board, the Finance and Audit Committee's Sub-Committee on OIG Matters asks whether it is worth trying to recover "losses" from "ineligible" and "undocumented" expenditures from grants in the early rounds of funding, considering that these losses occurred some time ago, and the fact that, at the time, the Global Fund and the implementers were in "emergency mode." (Source: AllAfrica News: Health and Medicine)

2010/11 Programme Budgeting Data published

NHS Networks — Fri, 16 Dec 2011 05:00:00 +0100

Click here to access the webpage containing the tool. Scroll down to the section entitled 'Commissioner level expenditure data' where you will find a link to the new tool. The tool enables commissioners to identify: How they spend their allocation over 23 disease categories and their respective subcategories;How their disease category level expenditure is split across 12 care settings (2010-11 only) and;How their expenditure distribution pattern compares with other commissioners nationally, locally or with similar characteristics (Source: NHS Networks)

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Programme budgeting PCT benchmarking tool 2011

NeLM - News — Fri, 16 Dec 2011 05:00:00 +0100

Source: Department of Health (DH) Area: News The Department of Health has issued commissioner level programme budgeting data in the form of a benchmarking tool that enables commissioners to identify: . How they spend their allocation over 23 disease categories and their respective subcategories. . How their disease category level expenditure is split across 12 care settings (2010-11 only). . How their expenditure distribution pattern compares with other commissioners nationally, locally or with similar characteristics. (Source: NeLM - News)

Same-sex marriage laws reduce doctor visits and health care costs for gay men

EurekAlert! - Social and Behavioral Science — Thu, 15 Dec 2011 05:00:00 +0100

(Columbia University's Mailman School of Public Health) Gay men are able to lead healthier, less stress-filled lives when states offer legal protections to same-sex couples, according to a new study examining the effects of the legalization of same-sex marriage in Massachusetts. The study, "Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment," is online in the American Journal of Public Health. (Source: EurekAlert! - Social and Behavioral Science)

Peripheral oxytocin suppresses food intake and causes weight loss in diet-induced obese rats

AJP: Endocrinology and Metabolism — Thu, 15 Dec 2011 05:00:00 +0100

Growing evidence suggests that oxytocin plays an important role in the regulation of energy balance and that central oxytocin administration induces weight loss in diet-induced obese (DIO) animals. To gain a better understanding of how oxytocin mediates these effects, we examined feeding and neuronal responses to oxytocin in animals rendered obese following exposure to either a high-fat (HFD) or low-fat diet (LFD). Our findings demonstrate that peripheral administration of oxytocin dose-dependently reduces food intake and body weight to a similar extent in rats maintained on either diet. Moreover, the effect of oxytocin to induce weight loss remained intact in leptin receptor-deficient Koletsky (fak/fak) rats relative to their lean littermates. To determine whether systemically administere...

Reduced glycaemic and insulinaemic responses following trehalose and isomaltulose ingestion: implications for postprandial substrate use in impaired glucose-tolerant subjects.

The British Journal of Nutrition — Thu, 15 Dec 2011 05:00:00 +0100

Authors: van Can JG, van Loon LJ, Brouns F, Blaak EE Abstract The impact of slowly digestible sugars in reducing the risk of developing obesity and related metabolic disorders remains unclear. We hypothesised that such carbohydrates (CHO), resulting in a lower glycaemic and insulinaemic response, may lead to greater postprandial fat oxidation rates in subjects with impaired glucose tolerance (IGT). The present study intends to compare the postprandial metabolic responses to the ingestion of glucose (GLUC) v. trehalose (TRE) and sucrose (SUC) v. isomaltulose (IMU). In a randomised, single-blind, cross-over design, ten overweight IGT subjects were studied four times, following ingestion of different CHO drinks either at breakfast or in combination with a mixed meal at lunch. Before a...

Effects of Chronic Oral Rimonabant Administration on Energy Budgets of Diet-Induced Obese C57BL/6 Mice.

Obesity — Thu, 15 Dec 2011 05:00:00 +0100

Authors: Zhang LN, Gamo Y, Sinclair R, Mitchell SE, Morgan DG, Clapham JC, Speakman JR Abstract The endocannabinoids have been recognized as an important system involved in the regulation of energy balance. Rimonabant (SR141716), a selective inverse agonist of cannabinoid receptor 1 (CB1), has been shown to cause weight loss. However, its suppressive impact on food intake is transient, indicating a likely additional effect on energy expenditure. To examine the effects of rimonabant on components of energy balance, we administered rimonabant or its vehicle to diet-induced obese (DIO) C57BL/6 mice once daily for 30 days, by oral gavage. Rimonabant induced a persistent weight reduction and a significant decrease in body fatness across all depots. In addition to transiently reduced foo...

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Medicaid Takes Up More of State Budgets, Analysis Finds

NYT — Wed, 14 Dec 2011 21:20:11 +0100

The program accounted for 21.9 percent of all state expenditures in 2009 and 22.3 percent in 2010, and education is getting a smaller slice of the pie. (Source: NYT)

Protocol for the modeling the epidemiologic transition study: a longitudinal observational study of energy balance and change in body weight, diabetes and cardiovascular disease risk

BMC Public Health - Latest articles — Wed, 14 Dec 2011 05:00:00 +0100

DiscussionMETS will provide insight on the relative contribution of physical activity and diet to excess weight, age-related weight gain and incident glucose impairment in five populations' samples of young adults at different stages of economic development. These data should be useful for the development of empirically-based public health policy aimed at the prevention of obesity and associated chronic diseases. (Source: BMC Public Health - Latest articles)

Mate Tea (Ilex paraguariensis) Promotes Satiety and Body Weight Lowering in Mice: Involvement of Glucagon-Like Peptide-1.

Biological and Pharmaceutical Bulletin — Tue, 13 Dec 2011 19:42:03 +0100

In this study, to verify the mode of action of mate on FI and consequently on BW, we examined the anorexic effects of mate on the appetite and satiety markers glucagon-like peptide 1 (GLP-1) and leptin in high-fat diet-fed ddY mice. GLP-1 is a peptide signal generated by the gastrointestinal tract, which regulates appetite and influences BW, whereas leptin is an afferent signal from the periphery to the brain in a homeostatic feedback loop that regulates adipose tissue mass, thus leading to decreased appetite and FI and increased energy expenditure. Chronic administration of mate (50, 100 mg/kg) for 3 weeks significantly reduced FI, BW, and ameliorated blood fats, liver fats, and adipose tissue. Mate induced significant increases in GLP-1 levels and leptin levels compared with the control....

Cancer survival rates 'threatened by rising cost'

NHS News Feed — Mon, 12 Dec 2011 16:45:00 +0100

“Cancer survival rates could fall because of a rise in the cost of diagnosis and treatment over the next 10 years,” the Daily Express warns today. Other papers, including the Daily Mail claim that treating patients at home instead of in hospital could stop cancer treatments from “bankrupting” the UK’s healthcare system. The papers have each chosen to make stark warnings based on different aspects of the same report. The report, which projects the UK’s cancer treatment costs in 2021, was published by the private healthcare insurance company, Bupa. The report calculates that last year 318,000 people in the UK were diagnosed with cancer, with an overall cost for cancer care of £9.4 billion across NHS, private and voluntary sectors. By 2021 the number of new cancer cases is predic...

Overweight or Obese Patients Have Higher Health Care Expenditures

MedlinePlus Health News — Mon, 12 Dec 2011 11:53:18 +0100

Source: Agency for Healthcare Research and Quality Related MedlinePlus Pages: Obesity, Obesity in Children (Source: MedlinePlus Health News)

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HCUP: Inpatient hospital stays feed rising medical costs

Cardiovascular Business News — Mon, 12 Dec 2011 11:03:48 +0100

Healthcare expenditures in the U.S. are astronomical, and according to a statistical brief by the Healthcare Cost and Utilization Project (HCUP), inpatient hospital costs could be the culprit. In fact, the brief outlined that in 2009 alone there were 39.4 million inpatient stays in U.S. community hospitals, which resulted in a $361.5 billion price tag. (Source: Cardiovascular Business News)

Healthcare expenditures for males with haemophilia and employer‐sponsored insurance in the United States, 2008

Haemophilia — Mon, 12 Dec 2011 05:00:00 +0100

The objective of this study is to estimate average annual health care expenditures for people with hemophilia covered by employer‐sponsored insurance, stratified according to the influence of age, type of hemophilia [A (factor VIII deficiency) versus B (factor IX)], presence of neutralizing alloantibody inhibitors and exposure to blood‐borne viral infections. Data from the MarketScan® Commercial and Medicare Research Databases were used for the period 2002–2008 to identify cases of hemophilia and to estimate mean and median medical expenditures during 2008. A total of 1,164 males with hemophilia were identified with continuous enrollment during 2008, 933 with hemophilia A and 231 with hemophilia B. Mean health care expenditures were $155,136 [median $73,548]. Mean costs for 30 (3%) ...

The DOPPS Practice Monitor for US Dialysis Care: Trends Through April 2011

American Journal of Kidney Diseases — Mon, 12 Dec 2011 05:00:00 +0100

More than 380,000 people receive maintenance dialysis for the treatment of end-stage kidney failure in the United States. In 2008, Medicare expenditures for dialysis patients totaled $22 billion, or 4.8% of the total Medicare budget. The new end-stage renal disease prospective payment system (PPS), a program begun by the US Centers for Medicare & Medicaid Services in January 2011, is intended to control dialysis costs through bundled payments (that is, fewer dialysis-related medications and services are now separately billable). The Quality Incentive Program, beginning in 2012 with the evaluation of dialysis unit clinical data collected in 2010, is the first Medicare program that ties provider or facility payments to performance, as defined by meeting particular quality measures. (Source: ...

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Measurement of human energy expenditure, with particular reference to field studies: an historical perspective

European Journal of Applied Physiology — Sat, 10 Dec 2011 16:55:38 +0100

This article reviews developments in each of these domains. Particular reference is made to their impact upon the continuing search for valid field estimates of activity patterns and energy expenditures, as required by the applied physiologist, ergonomist, sports scientist, nutritionist and epidemiologist. Early observers sought to improve productivity in demanding employment. Direct observation and filming of workers were supplemented by monitoring of heart rates, ventilation and oxygen consumption. Such methods still find application in ergonomics and sport, but many investigators are now interested in relationships between habitual physical activity and chronic disease. Even sophisticated questionnaires still do not provide valid information on the absolute energy expenditures ass...

Functional Recovery of a Patient With Anorexia Nervosa: Physical Intervention in the Acute Hospital Setting.

Physical Therapy — Fri, 09 Dec 2011 05:00:00 +0100

DISCUSSION:/b>Physical therapy as a part of the acute hospital multi-disciplinary plan of care may have benefitted this patient with AN who experienced impaired mobility. This case report highlights key factors in the clinical decision-making process, including physiologic, behavioral, and intervention factors that minimized kilocalorie expenditure. PMID: 22156027 [PubMed - as supplied by publisher] (Source: Physical Therapy)

Tumor necrosis factor‐alpha (TNF‐α) is a therapeutic target for impaired cutaneous wound healing

Wound Repair and Regeneration — Thu, 08 Dec 2011 05:00:00 +0100

AbstractImpaired wound healing states lead to substantial morbidity and cost with treatment resulting in an expenditure of billions of dollars per annum in the US alone. Both chronic wounds and impaired acute wounds are characterized by excessive inflammation, enhanced proteolysis, and reduced matrix deposition. These confounding factors are exacerbated in the elderly, in part, as we report here, related to increased local and systemic tumor necrosis factor‐alpha (TNF‐α) levels. Moreover, we have used a secretory leukocyte protease inhibitor (SLPI) null mouse model of severely impaired wound healing and excessive inflammation, comparable to age‐related delayed human healing, to demonstrate that topical application of anti‐TNF‐α neutralizing antibodies blunts leukocyte recruitme...

Medical loss ratio requirements under the Patient Protection and Affordable Care Act. Final rule with comment period.

Fed Regist — Wed, 07 Dec 2011 05:00:00 +0100

Authors: Abstract This final rule with comment period revises the regulations implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act in order to address the treatment of "mini-med" and expatriate policies under these regulations for years after 2011; modify the way the regulations treat ICD-10 conversion costs; change the rules on deducting community benefit expenditures; and revise the rules governing the distribution of rebates by issuers in group markets. PMID: 22165170 [PubMed - in process] (Source: Fed Regist)

TGR5 Activation Inhibits Atherosclerosis by Reducing Macrophage Inflammation and Lipid Loading.

Cell Metabolism — Wed, 07 Dec 2011 05:00:00 +0100

Authors: Pols TW, Nomura M, Harach T, Lo Sasso G, Oosterveer MH, Thomas C, Rizzo G, Gioiello A, Adorini L, Pellicciari R, Auwerx J, Schoonjans K Abstract The G protein-coupled receptor TGR5 has been identified as an important component of the bile acid signaling network, and its activation has been linked to enhanced energy expenditure and improved glycemic control. Here, we demonstrate that activation of TGR5 in macrophages by 6α-ethyl-23(S)-methylcholic acid (6-EMCA, INT-777), a semisynthetic BA, inhibits proinflammatory cytokine production, an effect mediated by TGR5-induced cAMP signaling and subsequent NF-κB inhibition. TGR5 activation attenuated atherosclerosis in Ldlr(-/-)Tgr5(+/+) mice but not in Ldlr(-/-)Tgr5(-/-) double-knockout mice. The inhibition of lesion formation ...

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NPY and MC4R Signaling Regulate Thyroid Hormone Levels during Fasting through Both Central and Peripheral Pathways.

Cell Metabolism — Wed, 07 Dec 2011 05:00:00 +0100

Authors: Vella KR, Ramadoss P, Lam FS, Harris JC, Ye FD, Same PD, O'Neill NF, Maratos-Flier E, Hollenberg AN Abstract Fasting-induced suppression of the hypothalamic-pituitary-thyroid (HPT) axis is an adaptive response to decrease energy expenditure during food deprivation. Previous studies demonstrate that leptin communicates nutritional status to the HPT axis through thyrotropin-releasing hormone (TRH) in the paraventricular nucleus (PVN) of the hypothalamus. Leptin targets TRH neurons either directly or indirectly via the arcuate nucleus through pro-opiomelanocortin (POMC) and agouti-related peptide/neuropeptide Y (AgRP/NPY) neurons. To evaluate the role of these pathways in vivo, we developed double knockout mice that lack both the melanocortin 4 receptor (MC4R) and NPY. We sh...

Chronic Intake of Fractionated Yellow Pea Flour Reduces Postprandial Energy Expenditure and Carbohydrate Oxidation

Journal of Medicinal Food — Tue, 06 Dec 2011 15:24:41 +0100

Journal of Medicinal Food Dec 2011, Vol. 14, No. 12: 1654-1662. (Source: Journal of Medicinal Food)

Personal social services expenditure and unit costs: 2010-11 (provisional)

NHS Networks — Tue, 06 Dec 2011 05:00:00 +0100

This report contains provisional information on the money spent on adult social care by councils with adult social services responsibilities during 2010-11. (Source: NHS Networks)

Validation of the SenseWear armband in circuit resistance training with different loads

European Journal of Applied Physiology — Mon, 05 Dec 2011 17:40:29 +0100

Abstract The use of the SenseWear™ armband (SWA), an objective monitor of physical activity, is a relatively new device used by researchers to measure energy expenditure. These monitors are practical, relatively inexpensive and easy-to-use. The aim of the present study was to assess the validity of SWAs for the measurement of energy expenditure (EE) in circuit resistance training (CRT) at three different intensities in moderately active, healthy subjects. The study subjects (17 females, 12 males) undertook CRT at 30, 50 and 70% of the 15 repetition maximum for each exercise component wearing an SWA as well as an Oxycon Mobile (OM) portable metabolic system (a gold standard method for measuring EE). The EE rose as exercise intensity increased, but was underestimated by th...

Economic Benefits of Bariatric Surgery

Obesity Surgery — Mon, 05 Dec 2011 06:33:01 +0100

The objective of this work was to evaluate the economic benefits of bariatric surgery and to relate the costs to the impact on the health of the individual. A historic cohort study was conducted, with review of medical charts of 194 patients who fulfilled the inclusion criteria for the study. The costs for medications, professional care, and examinations in the pre- and postoperative periods were analyzed, taking into consideration the comorbidities DM2, SAH, and dyslipidemia. The study demonstrated a reduction in the medical costs in the course of the postoperative period, in relation to expenses for medications, professional care, and examinations in the preoperative period. Comparing the preoperative expenses with different times in the postoperative period, a statistically signif...

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Stimulation of the hypothalamic ventromedial nuclei by pituitary adenylate cyclase-activating polypeptide induces hypophagia and thermogenesis

AJP: Regulatory, Integrative and Comparative Physiology — Mon, 05 Dec 2011 05:00:00 +0100

Numerous studies have demonstrated that the hypothalamic ventromedial nuclei (VMN) regulate energy homeostasis by integrating and utilizing behavioral and metabolic mechanisms. The VMN heavily express pituitary adenylate cyclase-activating polypeptide (PACAP) type I receptors (PAC1R). Despite the receptor distribution, most PACAP experiments investigating affects on feeding have focused on intracerebroventricular administration or global knockout mice. To identify the specific contribution of PACAP signaling in the VMN, we injected PACAP directly into the VMN and measured feeding behavior and indices of energy expenditure. Following an acute injection of PACAP, nocturnal food intake was significantly reduced for 6 h after injections without evidence of malaise. In addition, PACAP-induced s...

Higher education does not protect against firework-related injuries: A review of the economic burden and the risk factors of firework-related injuries in the capital of Iran

Public Health — Mon, 05 Dec 2011 05:00:00 +0100

Summary: Objective: To examine the incidence and risk factors of firework-related injuries during the Last Wednesday Eve Festival in Tehran, Iran, with a focus on the association of socio-economic status and educational level with the use of fireworks and the incidence of firework-related injury.Study design: Cross-sectional household survey.Methods: Using a random cluster sampling approach, a household survey was conducted in Greater Tehran in April 2008. During a structured interview with an adult member of the household, questions were asked about the use of fireworks and any firework-related injuries sustained by household members during the preceding festival. Data were gathered on expenditure on fireworks, medical treatment of firework-related injuries, length of hospital stay for th...

Medical Male Circumcision In East And South Africa Is Effective In Preventing HIV

Health News from Medical News Today — Sat, 03 Dec 2011 18:00:00 +0100

In eastern and southern Africa, expanding voluntary medical male circumcision (VMMC) for preventing HIV can help stem the spread of the disease at an individual, community and population level. In addition, VMMC can lead to significant expenditure savings for nations, according to a collection of novel reports published Nov. 29 in PLoS Medicine and PLoS ONE, in association with the Joint United Nations Program on HIV/AIDS (UNAIDS) and the United States President's Emergency Plan for Aids Relief (PEPFAR)... (Source: Health News from Medical News Today)

Re-patterning of Skeletal Muscle Energy Metabolism by FIT2 [Lipids]

Journal of Biological Chemistry — Fri, 02 Dec 2011 05:00:00 +0100

Triacylglyceride stored in cytosolic lipid droplets (LDs) constitutes a major energy reservoir in most eukaryotes. The regulated turnover of triacylglyceride in LDs provides fatty acids for mitochondrial β-oxidation and ATP generation in physiological states of high demand for energy. The mechanisms for the formation of LDs in conditions of energy excess are not entirely understood. Fat storage-inducing transmembrane protein 2 (FIT2/FITM2) is the anciently conserved member of the fat storage-inducing transmembrane family of proteins implicated to be important in the formation of LDs, but its role in energy metabolism has not been tested. Here, we report that expression of FIT2 in mouse skeletal muscle had profound effects on muscle energy metabolism. Mice with skeletal muscle-specific ove...