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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
201

Análise de componentes esparsos locais com aplicações em ressonância magnética funcional / Local sparse component analysis: an application to funcional magnetic resonance imaging

Vieira, Gilson 13 October 2015 (has links)
Esta tese apresenta um novo método para analisar dados de ressonância magnética funcional (FMRI) durante o estado de repouso denominado Análise de Componentes Esparsos Locais (LSCA). A LSCA é uma especialização da Análise de Componentes Esparsos (SCA) que leva em consideração a informação espacial dos dados para reconstruir a informação temporal de fontes bem localizadas, ou seja, fontes que representam a atividade de regiões corticais conectadas. Este estudo contém dados de simulação e dados reais. Os dados simulados foram preparados para avaliar a LSCA em diferentes cenários. Em um primeiro cenário, a LSCA é comparada com a Análise de Componentes Principais (PCA) em relação a capacidade de detectar fontes locais sob ruído branco e gaussiano. Em seguida, a LSCA é comparada com o algoritmo de Maximização da Expectativa (EM) no quesito detecção de fontes dinâmicas locais. Os dados reais foram coletados para fins comparativos e ilustrativos. Imagens de FMRI de onze voluntários sadios foram adquiridas utilizando um equipamento de ressonância magnética de 3T durante um protocolo de estado de repouso. As imagens foram pré-processadas e analisadas por dois métodos: a LSCA e a Análise de Componentes Independentes (ICA). Os componentes identificados pela LSCA foram comparados com componentes comumente reportados na literatura utilizando a ICA. Além da comparação direta com a ICA, a LSCA foi aplicada com o propósito único de caracterizar a dinâmica das redes de estado de repouso. Resultados simulados mostram que a LSCA é apropriada para identificar fontes esparsas locais. Em dados de FMRI no estado de repouso, a LSCA é capaz de identificar as mesmas fontes que são identificadas pela ICA, permitindo uma análise mais detalhada das relações entre regiões dentro de e entre componentes e sugerindo que muitos componentes identificados pela ICA em FMRI durante o estado de repouso representam um conjunto de componentes esparsos locais. Utilizando a LSCA, grande parte das fontes identificadas pela ICA podem ser decompostas em um conjunto de fontes esparsas locais que não são necessariamente independentes entre si. Além disso, as fontes identificadas pela LSCA aproximam muito melhor o sinal temporal observado nas regiões representadas por seus componentes do que as fontes identificadas pela ICA. Finalmente, uma análise mais elaborada utilizando a LSCA permite estimar também relações dinâmicas entre os componentes previamente identificados. Assim, a LSCA permite identificar relações clássicas bem como relações causais entre componentes do estado de repouso. As principais implicações desse resultado são que diferentes premissas permitem decomposições aproximadamente equivalentes, entretanto, critérios menos restritivos tais como esparsidade e localização permitem construir modelos mais compactos e biologicamente mais plausíveis. / This thesis presents Local Sparse Component Analysis (LSCA), a new method for analyzing resting state functional magnetic resonance imaging (fMRI) datasets. LSCA, a extension of Sparse Component Analysis (SCA), takes into account data spatial information to reconstruct temporal sources representing connected regions of significant activity. This study contains simulation data and real data. The simulated data were prepared to evaluate the LSCA in different scenarios. In the first scenario, the LSCA is compared with Principal Component Analysis (PCA) for detecting local sources under Gaussian white noise. Then, LSCA is compared with the expectation maximization algorithm (EM) for detecting the dynamics of local sources. Real data were collected for comparative and illustrative purposes. FMRI images from eleven healthy volunteers were acquired using a 3T MRI scanner during a resting state protocol. Images were preprocessed and analyzed using LSCA and Independent Components Analysis (ICA). LSCA components were compared with commonly reported ICA components. In addition, LSCA was applied for characterizing the dynamics of resting state networks. Simulated results have shown that LSCA is suitable for identifying local sparse sources.For real resting state FMRI data, LSCA is able to identify the same sources that are identified using ICA, allowing detailed functional connectivity analysis of the identified regions within and between components. This suggests that ICA resting state networks can be further decomposed into local sparse components that are not necessarily independent from each other. Moreover, LSCA sources better represent local FMRI signal oscillations than ISCA sources. Finally, brain connectivity analysis shows that LSCA can identify both instantaneous and causal relationships between resting state components. The main implication of this study is that independence and sparsity are equivalent assumptions in resting state FMRI. However, less restrictive criteria such as sparsity and source localization allow building much more compact and biologically plausible brain connectivity models.
202

Physiological Aberrations in Patients with Schizophrenia

Nilsson, Björn January 2009 (has links)
In schizophrenia, subtle aberrations in the brain cause functional disturbances like psychotic symptoms and social disability. There are, however, also disturbances outside the CNS indicating a systemic manifestation in the disease. The aim of the present thesis was to gain deeper understanding of the pathophysiological mechanisms underlying schizophrenia with a particular interest in peripheral and systemic manifestations with relevance for the increased risk of obesity and metabolic complications seen in the disease. Therefore, resting energy expenditure (REE), physical capacity, and relevant body composition variables were measured in patients with schizophrenia and in healthy controls. Also niacin skin flush response and electrodermal activity (EDA) were studied. Patients with schizophrenia exhibited significantly lower REE expressed as kJ/kg, and also lower values compared with predicted levels than the controls. The difference could not be attributed to medication or variations in body composition between the two groups. There was a gender difference with the lowest levels found in male patients. Male patients exhibited significantly lower physical capacity in terms of predicted maximal oxygen uptake capacity and faster increase in respiratory quotient than male controls. The oral niacin test revealed a significantly delayed skin flush reaction in patients compared with controls. The patients also exhibited lower EDA response. There was a significant association in response patterns for the niacin and the EDA tests in the patients, but not in controls. In a test-retest study in patients there was acceptable stability for EDA measures but low test-retest stability for niacin variables. The previously found association in responses for the two tests was, however, replicated. The results gain support for the concept of schizophrenia as a disease with systemic manifestations including metabolic dysregulation. The findings add to the understanding of the weight gain and the increased risk for cardiovascular morbidity seen in this condition.
203

Vilometabolism hos barn och ungdomar med Cerebral Pares : En deskriptiv korrelationsstudie

Karlsson, Maria, Arborén, Charlotte January 2013 (has links)
Background: Cerebral Palsy is usually divided into three subgroups: ataxic, spastic and dyskinetic, where children and adolescents can, because of misestimation in nutrition and energy intake, suffer from weight problems. Aim: To compare calculations with equations with the individual's measured RMR in the subgroups, to see if any equation is more suitable. This could be used as a tool to calculate the resting metabolism at times when it is not possible to perform clinical measurements. Method: The RMR has been measured in 37 children and adolescents aged 3-15 years through indirect respiratory calorimetry. Those values have been compared with calculations from five equations. The results were then analyzed in order to find if any equation is better to apply for calculating resting metabolism for each subgroup. Results: The ataxic group was overestimated by 56.5% of the calculated values. WHO/FAO/UNU’s equation indicates a significantly strong correlation between the measured and calculated values (r=0.85, p<0.05). The spastic group was underestimated by 53.3%. There is significance for all equations, however it is a relatively low correlation (r=0.63–0.66, p=0.02–0.03). The dyskinetic group was underestimated by 95%. There was no significant association between clinically measured values and the calculated resting metabolism (r=0.21–0.45, p=0.26–0.61). Conclusion: The equations are not reliable for calculation of energy need for all subgroups. There is a substantial risk of over- and underestimation, therefore awareness of the equations insufficiency is needed. Studies should be performed with additional basic data, and with more equations. Especially equations including further variables that involves the body composition. / Bakgrund: Cerebral Pares brukar delas in i undergrupper: ataktisk, spastisk och dyskinetisk, där barn och ungdomar kan, beroende på felskattningar av näringsintag och energiberäkning, lida av över- eller undervikt. Syfte: Att jämföra uträkningar med ekvationer med individernas uppmätta vilometabolism i de tre undergrupperna, för att se om någon ekvation lämpar sig bättre. Detta skulle kunna ge ett verktyg för att kunna räkna ut vilometabolismen vid de tillfällen då det inte är möjligt att utföra kliniska mätningar. Metod: Mätningar av vilometabolismen har utförts på 37 barn och ungdomar i åldern 3-15 år genom indirekt respiratorisk kalorimetri. Värdena har jämförts med uträkningar från fem ekvationer. Resultatet har sedan analyserats, för att hitta någon ekvation som är bättre lämpad för att räkna ut vilometabolismen, för respektive undergrupp. Resultat: Den ataktiska gruppen överskattades i 56,5% av uträkningarna av vilometabolism. WHO/FAO/UNUs ekvation påvisar ett signifikant starkt samband mellan det uppmätta och uträknade värdena (r=0,85, p<0,05). Den spastiska gruppen underskattades 53,3% av de uträknade värdena. Det föreligger signifikans för alla ekvationer, dock ett relativt lågt samband (r=0,63–0,66, p=0,02–0,03). Den dyskinetiska gruppen underskattades i 95 %. Det förelåg inget signifikant samband mellan kliniskt uppmätt och uträknad vilometabolism (r=0,21–0,45, p=0,26–0,61). Slutsats: Ekvationerna är inte tillförlitliga för uträkning av energibehov för alla undergrupper. Risk för över- och underskattning är överhängande, och en ökad medvetenhet om ekvationernas ofullständighet måste belysas. Studier bör göras med större underlag och med fler ekvationer. Framförallt ekvationer med fler variabler som tar hänsyn till kroppssammansättning.
204

Nitellopsis obtusa (Desv.) J. Groves ląstelių atsakas į alochtoninius stresorius – Fagus sylvatica L. ir Quercus robur L. lapų paklotės ekstraktus / Nitellopsis obtusa (Desv.) J. Groves cell response to allochtonous stressors of Fagus sylvatica L. and Quercus robur L. leaf litter extracts

Grigutytė, Reda 27 May 2010 (has links)
Grindžiant sąsajas tarp ežero ir paežerės ekosistemų ir remiantis tuo, kad medžių lapų paklotės irimo produktai yra alochtoninės ištirpusios organinės anglies (IOA) šaltinis, buvo tiriamas paprastojo buko (Fagus sylvatica L.) ir paprastojo ąžuolo (Querqus robur L.) lapų vandeninių ekstraktų poveikis žvaigždėtojo maurašakio (Nitellopsis obtusa (Desv.) J. Groves) ląstelei fermentiniu, plazmalemos ir ląstelės gyvybingumo lygmeniu. Koncentracinėmis ir laiko priklausomybėmis parodyta, kad ekstraktai, tarp jų ir gauti per 30 dienų savaiminio lapų irimo, sukelia oksidacinio streso fermentų aktyvumo ir ląstelės membranos potencialo pakitimus bei ląstelių žūtį – taip preziumuojamas priežastinis ryšys tarp ankstyvųjų reakcijų ir letalumo. Santykinai jautresnės reakcijos vyko fermentiniame lygmenyje, negrįžtamiems ląstelės membranos ramybės potencialo pokyčiams ir mirtingumui aptikti reikia didesnių nei aptinkamų gamtiniuose vandens telkiniuose IOA koncentracijų arba ilgesnės poveikio trukmės. Tai leidžia manyti, kad paklotės lapai yra svarbus aplinkos veiksnys, turintis įtakos vandens augalijos rūšinei įvairovei gėlavandenėse ekosistemose. / Aqueous extracts of common beech (Fagus sylvatica L.) and European oak (Quercus robur L.) leaves from leaf litter were used as allochthonous source of dissolved organic carbon (DOC) to investigate cell response of starry stonewort (Nitellopsis obtusa (Desv.) J. Groves) at enzymatic, cell membrane and whole cell levels. Dose and time dependent exposure experiments with leaf litter extracts including 30 day leaf litter degradation ones, were carried out to show activity modulations of oxidative stress enzymes, cell resting potential (RP) and survivorship. Charophytes manifested a certain level of antioxidative resilience depending on the DOC source. Relatively more sensitive reactions were detected at enzymatic level, however, to identify irreversible cell RP changes and lethality, higher than those of natural aquatic bodies DOC concentrations or prolonged exposure were needed. Changes in activities of oxidative stress enzymes and cell membrane potential invoked by extracts predicted cell mortality, which allowed us to presume causality between more sensitive initial reactions and lethality. By linking lake and lake shore ecosystems it was concluded that beech and oak leaf litter has the potential to adversely affect algae and, thus, might eventually be important environmental factor impacting aquatic vegetation species diversity in freshwater ecosystems.
205

Nitellopsis obtusa (desv.) J. Groves cell response to allochtonous stressors of fagus sylvatica l. And quercus robur l. Leaf litter extracts / Nitellopsis obtusa (Desv.) J. Groves ląstelių atsakas į alochtoninius stresorius – Fagus sylvatica L. ir Quercus robur L. lapų paklotės ekstraktus

Grigutytė, Reda 27 May 2010 (has links)
Aqueous extracts of common beech (Fagus sylvatica L.) and European oak (Quercus robur L.) leaves from leaf litter were used as allochthonous source of dissolved organic carbon (DOC) to investigate cell response of starry stonewort (Nitellopsis obtusa (Desv.) J. Groves) at enzymatic, cell membrane and whole cell levels. Dose and time dependent exposure experiments with leaf litter extracts including 30 day leaf litter degradation ones, were carried out to show activity modulations of oxidative stress enzymes, cell resting potential (RP) and survivorship. Charophytes manifested a certain level of antioxidative resilience depending on the DOC source. Relatively more sensitive reactions were detected at enzymatic level, however, to identify irreversible cell RP changes and lethality, higher than those of natural aquatic bodies DOC concentrations or prolonged exposure were needed. Changes in activities of oxidative stress enzymes and cell membrane potential invoked by extracts predicted cell mortality, which allowed us to presume causality between more sensitive initial reactions and lethality. By linking lake and lake shore ecosystems it was concluded that beech and oak leaf litter has the potential to adversely affect algae and, thus, might eventually be important environmental factor impacting aquatic vegetation species diversity in freshwater ecosystems. / Grindžiant sąsajas tarp ežero ir paežerės ekosistemų ir remiantis tuo, kad medžių lapų paklotės irimo produktai yra alochtoninės ištirpusios organinės anglies (IOA) šaltinis, buvo tiriamas paprastojo buko (Fagus sylvatica L.) ir paprastojo ąžuolo (Querqus robur L.) lapų vandeninių ekstraktų poveikis žvaigždėtojo maurašakio (Nitellopsis obtusa (Desv.) J. Groves) ląstelei fermentiniu, plazmalemos ir ląstelės gyvybingumo lygmeniu. Koncentracinėmis ir laiko priklausomybėmis parodyta, kad ekstraktai, tarp jų ir gauti per 30 dienų savaiminio lapų irimo, sukelia oksidacinio streso fermentų aktyvumo ir ląstelės membranos potencialo pakitimus bei ląstelių žūtį – taip preziumuojamas priežastinis ryšys tarp ankstyvųjų reakcijų ir letalumo. Santykinai jautresnės reakcijos vyko fermentiniame lygmenyje, negrįžtamiems ląstelės membranos ramybės potencialo pokyčiams ir mirtingumui aptikti reikia didesnių nei aptinkamų gamtiniuose vandens telkiniuose IOA koncentracijų arba ilgesnės poveikio trukmės. Tai leidžia manyti, kad paklotės lapai yra svarbus aplinkos veiksnys, turintis įtakos vandens augalijos rūšinei įvairovei gėlavandenėse ekosistemose.
206

Comorbidity, body composition and the progression of advanced colorectal cancer

Lieffers, Jessica Unknown Date
No description available.
207

ERF and scale-free analyses of source-reconstructed MEG brain signals during a multisensory learning paradigm

Zilber, Nicolas 10 March 2014 (has links) (PDF)
The analysis of Human brain activity in magnetoencephalography (MEG) can be generally conducted in two ways: either by focusing on the average response evoked by a stimulus repeated over time, more commonly known as an ''event-related field'' (ERF), or by decomposing the signal into functionally relevant oscillatory or frequency bands (such as alpha, beta or gamma). However, the major part of brain activity is arrhythmic and these approaches fail in describing its complexity, particularly in resting-state. As an alternative, the analysis of the 1/f-type power spectrum observed in the very low frequencies, a hallmark of scale-free dynamics, can overcome these issues. Yet it remains unclear whether this scale-free property is functionally relevant and whether its fluctuations matter for behavior. To address this question, our first concern was to establish a visual learning paradigm that would entail functional plasticity during an MEG session. In order to optimize the training effects, we developed new audiovisual (AV) stimuli (an acoustic texture paired with a colored visual motion) that induced multisensory integration and indeed improved learning compared to visual training solely (V) or accompanied with acoustic noise (AVn). This led us to investigate the neural correlates of these three types of training using first a classical method such as the ERF analysis. After source reconstruction on each individual cortical surface using MNE-dSPM, the network involved in the task was identified at the group-level. The selective plasticity observed in the human motion area (hMT+) correlated across all individuals with the behavioral improvement and was supported by a larger network in AV comprising multisensory areas. On the basis of these findings, we further explored the links between the behavior and scale-free properties of these same source-reconstructed MEG signals. Although most studies restricted their analysis to the global measure of self-similarity (i.e. long-range fluctuations), we also considered local fluctuations (i.e. multifractality) by using the Wavelet Leader Based Multifractal Formalism (WLBMF). We found intertwined modulations of self-similarity and multifractality in the same cortical regions as those revealed by the ERF analysis. Most astonishing, the degree of multifractality observed in each individual converged during the training towards a single attractor that reflected the asymptotic behavioral performance in hMT+. Finally, these findings and their associated methodological issues are compared with the ones that came out from the ERF analysis.
208

The relationship between resting metabolic rate and body composition in adolescents from different ethnicity : the PAHL–Study / Hoops V.L.

Hoops, Vicky Louise January 2011 (has links)
Obesity in children and adolescents is on the rise and is a major risk factor for chronic disease, thus posing one of the greatest public health challenges for the 21st century. Although adolescent obesity is increasing in all ethnic groups, its prevalence is higher in non–Caucasian populations. A possible explanation for ethnic differences in the development of obesity could be ethnic differences in resting metabolic rate (RMR). A low RMR would pre–dispose an ethnic group to obesity. In South Africa limited research has been published with regards to body composition (BC) and RMR in adolescents and the possible association of RMR with BC. The first aim of this study, therefore, was to determine differences in BC and RMR between 14 year old black and Caucasian South African adolescents from the Tlokwe municipality of the North West Province, South– Africa. The second aim was to investigate whether significant relationships between the body composition characteristics body mass index (BMI), percentage body fat (%BF), fat free mass (FFM) and RMR exist in this group. The baseline data of participants in the Physical Activity and Health Longitudinal Study (PAHLS) was used. Anthropometric measurements included stature, body mass, triceps and subscapular skinfolds, and waist girth to determine BMI, %BF, FFM and waist–to–height ratio (WHTR). RMR was measured by the FitMate Pro Indirect Calorimetry (Cosmed). An independent t–test was used to compare the two groups (black vs. Caucasian, boys and girls respectively) with regards to body composition and RMR. Pearson correlation coefficients (adjusted for gender and ethnicity) were calculated, to study the relationship between RMR and body composition. Significant difference levels were set at p<0.05. The present cross–sectional results revealed significant differences in BC and RMR in black and Caucasian adolescents of the Tlokwe municipality, with Caucasian adolescents of both genders having a higher RMR and FFM compared to their counterpart black adolescents. The results further indicated that Caucasian adolescents were significantly (p<0.05) taller, heavier and had a higher %BF, WHTR, FFM and RMR than the black adolescents of both genders. Boys of both ethnicities had a higher RMR than the girls, with black girls having the lowest RMR. Both underweight and overweight/obesity were present in both ethnic groups and genders emphasizing the double burden of disease prevalent in South Africa. The overweight/obese group of both ethnicities had a higher FFM and RMR than the normal and underweight group. After adjusting for gender and ethnicity a high non–significant negative relationship was observed between RMR and FFM in the overweight group. The reasons for these persistent differences in ethnic groups for RMR in adolescents are not clear. A positive association between anthropometric indicators of BC and RMR influenced by gender and ethnicity was indicated. Whether the observed ethnic differences in RMR predict future weight gain and obesity awaits the results of longitudinal analyses. It is suggested that intervention programmes be implemented focusing on the prevention of obesity in adolescents, but especially black adolescent girls, as they are indicated to be the group more prone to obesity. These results supported the literature findings and identified the need for longitudinal data regarding RMR and BC in adolescents. The PAHL–Study will continue to follow–up these adolescents over a period of time as some of the conclusions made will further be cleared, including whether the observed ethnic differences in RMR predict future weight gain and obesity. / Thesis (M.Sc. (Biokinetics))--North-West University, Potchefstroom Campus, 2012.
209

The relationship between resting metabolic rate and body composition in adolescents from different ethnicity : the PAHL–Study / Hoops V.L.

Hoops, Vicky Louise January 2011 (has links)
Obesity in children and adolescents is on the rise and is a major risk factor for chronic disease, thus posing one of the greatest public health challenges for the 21st century. Although adolescent obesity is increasing in all ethnic groups, its prevalence is higher in non–Caucasian populations. A possible explanation for ethnic differences in the development of obesity could be ethnic differences in resting metabolic rate (RMR). A low RMR would pre–dispose an ethnic group to obesity. In South Africa limited research has been published with regards to body composition (BC) and RMR in adolescents and the possible association of RMR with BC. The first aim of this study, therefore, was to determine differences in BC and RMR between 14 year old black and Caucasian South African adolescents from the Tlokwe municipality of the North West Province, South– Africa. The second aim was to investigate whether significant relationships between the body composition characteristics body mass index (BMI), percentage body fat (%BF), fat free mass (FFM) and RMR exist in this group. The baseline data of participants in the Physical Activity and Health Longitudinal Study (PAHLS) was used. Anthropometric measurements included stature, body mass, triceps and subscapular skinfolds, and waist girth to determine BMI, %BF, FFM and waist–to–height ratio (WHTR). RMR was measured by the FitMate Pro Indirect Calorimetry (Cosmed). An independent t–test was used to compare the two groups (black vs. Caucasian, boys and girls respectively) with regards to body composition and RMR. Pearson correlation coefficients (adjusted for gender and ethnicity) were calculated, to study the relationship between RMR and body composition. Significant difference levels were set at p<0.05. The present cross–sectional results revealed significant differences in BC and RMR in black and Caucasian adolescents of the Tlokwe municipality, with Caucasian adolescents of both genders having a higher RMR and FFM compared to their counterpart black adolescents. The results further indicated that Caucasian adolescents were significantly (p<0.05) taller, heavier and had a higher %BF, WHTR, FFM and RMR than the black adolescents of both genders. Boys of both ethnicities had a higher RMR than the girls, with black girls having the lowest RMR. Both underweight and overweight/obesity were present in both ethnic groups and genders emphasizing the double burden of disease prevalent in South Africa. The overweight/obese group of both ethnicities had a higher FFM and RMR than the normal and underweight group. After adjusting for gender and ethnicity a high non–significant negative relationship was observed between RMR and FFM in the overweight group. The reasons for these persistent differences in ethnic groups for RMR in adolescents are not clear. A positive association between anthropometric indicators of BC and RMR influenced by gender and ethnicity was indicated. Whether the observed ethnic differences in RMR predict future weight gain and obesity awaits the results of longitudinal analyses. It is suggested that intervention programmes be implemented focusing on the prevention of obesity in adolescents, but especially black adolescent girls, as they are indicated to be the group more prone to obesity. These results supported the literature findings and identified the need for longitudinal data regarding RMR and BC in adolescents. The PAHL–Study will continue to follow–up these adolescents over a period of time as some of the conclusions made will further be cleared, including whether the observed ethnic differences in RMR predict future weight gain and obesity. / Thesis (M.Sc. (Biokinetics))--North-West University, Potchefstroom Campus, 2012.
210

Metabolism and body composition in chronic inflammatory arthritis : prevention and intervention through pharmaceutical and physical means

Metsios, Giorgos S. January 2007 (has links)
Background: Rheumatoid arthritis (RA) is characterised by excessive production of tumour necrosis factor alpha (TNFα). This leads to rheumatoid cachexia, a condition characterised by increased resting energy expenditure (REE) and loss of fat-free mass (FFM) leading to functional disability, decreased strength and balance. The aims of this research work was to: a) to develop a new REE equation in order to continuously monitor abnormal changes in REE in the RA population, b) to investigate if smoking further enhances hypermetabolism and c) to examine if the new anti-TNFα medication reverses this metabolic abnormality. Methods: 68 patients with RA were assessed for demographic and anthropometrical characteristics, REE (indirect calorimetry), body composition (bioelectrical impedance), and disease activity [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), disease activity score 28 (DAS28) and health assessment questionnaire (HAQ)]. 20 of the total 68 patients, about to start anti-TNFα therapy, underwent the exact same aforementioned procedures but on three separate occasions (Baseline: two weeks prior to anti-TNFα treatment, Time-1 and Time-2: two weeks and three months, respectively, after the drug had been introduced. Results: Study 1: Based on FFM and CRP, a new equation was developed which had a prediction power of R2=0.76. The new equation revealed an almost identical mean with measured REE (1645.2±315.2 and 1645.5±363.1 kcal/day, p>0.05), and a correlation coefficient of r=0.87 (p=0.001). Study 2: Smokers with RA demonstrated significantly higher REE (1513.9±263.3 vs. 1718.1±209.2 kcal/day; p=0.000) and worse HAQ (1.0±0.8 vs. 1.7±0.8; p=0.01) compared to age and FFM matched RA non-smokers. The REE difference was significantly predicted by the interaction smoking/gender (p=0.04). Study 3: Significant increases were observed in REE (p=0.002), physical activity (p=0.001) and protein intake (p=0.001) between the three times of assessment. Moreover, disease activity significantly reduced [ESR (p=0.002), DAS28 (p=0.000), HAQ (p=0.000) and TNFα (p=0.024)] while FFM and total body fat did not change (both at p>0.05). Physical activity and protein intake were found to be significant within-subject factors for the observed REE elevation after 12-weeks on anti-TNFα treatment (p=0.001 and p=0.024, respectively). Conclusions: Findings from the first study revealed that the newly developed REE equation provides an accurate prediction of REE in RA patients. Moreover, the results from the second study showed that cigarette smoking further increases REE in patients with RA and has a negative impact on patients’ self-reported functional status. Finally, our data from the third study suggest that REE remains elevated not because of the maintenance of the RA-related hypermetabolism but due to the concomitant significant increases in physical activity and protein intake.

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