This study was performed to evaluate whether baseline acute and chronic prostate inflammation among men with an initial negative biopsy for prostate cancer (PCa) increased the risk of subsequent PCa detection in a clinical trial with systematic biopsies. A retrospective analysis was performed of 6238 men aged 50 years to 75 years with prostate-specific antigen levels between 2.5 ng/mL and 10 ng/mL and a prior negative biopsy in the REduction by DUtasteride of PCa Events study who completed a 2-year biopsy. PCa, acute prostateinflammation, and chronic prostate inflammation were assessed by central review. The results showed that acute and chronic inflammation and both were detected in 46 baseline biopsies (1%), 3931 baseline biopsies (63%), and 892 baseline biopsies (14%), respectively. At the 2-year biopsy, the prevalence of PCa was 14% (N = 900 patients). On univariable and multivariable analysis, both acute and chronic inflammation were found to be significantly associated with a lower PCarisk (acute univariable: odds ratio [OR], 0.65 [P < .001] and multivariable: OR, 0.75 [P = .012] and chronic univariable: OR, 0.61 [P < .001] and multivariable: OR, 0.65 [P < .001]). At the time of 4-year biopsy, only acute inflammation was found to be associated with a lower PCa risk. Cancer, December 2013. PMID: 24323568

In this study, 31 patients were randomized to an early start group (ESG) or a delayed start group (DSG) exercise program. The ESG underwent a rigorous formal group exercise program for 1 h, three days/week, for 48 weeks. The DSG participated in this identical exercise program from weeks 24-48. Outcome measures included the Unified Parkinson’s Disease Rating Scale (UPDRS), Walking Test (get-up-and-go), and the Beck Depression Inventory. The results did not show improvement in total UPDRS scores with early exercise. At week 48, the mean change from baseline total UPDRS score was 6.33 in the ESG versus 5.13 in the DSG (p = 0.58). However, patients randomized to the ESG scored significantly better on the Beck Depression Inventory, with a mean improvement of 1.07 points relative to those in the DSG (p = 0.04). The authors conclude that long-term, group exercise programs are feasible in the Parkinson’s disease population, with excellent adherence and minimal drop out. While the outcome measures used in the study did not provide strong evidence that exercise has a neuroprotective effect on motor function, earlier participation in a group exercise program had a significant effect on symptoms of depression. Parkinsonism Relat Disord, October 2013. PMID: 24209458

This study aimed to determine whether gender affects the myocardial metabolic response to lipid lowering in T2DM, and whether altering lipid [fatty acid (FA) or triglyceride] delivery to the heart would lower the elevated myocardial lipid metabolism associated with T2DM, and whether decreasing lipid delivery improves diastolic dysfunction in T2DM. The authors studied 78 T2DM patients (43 women) with positron emission tomography, echocardiography, and whole body tracer studies before and 3 months after randomization to metformin (MET), metformin + rosiglitazone (ROSI), or metformin + Lovaza (LOV). The results showed that in men, MET decreased FA clearance, which was linked to increased plasma FA levels, myocardial FA utilization and oxidation, and lower myocardial glucose utilization. In women, ROSI increased FA clearance, thereby decreasing plasma FA levels and myocardial FA utilization. Although LOV did not change triglyceride levels, it improved diastolic function, particularly in men. Group and gender also interacted in determining myocardial glucose uptake. Thus, in T2DM, different therapeutic regimens impact myocardial metabolism and diastolic function in a gender-specific manner. This suggests that gender should be taken into account when designing a patient’s diabetes treatment. Am J Physiol Heart Circ Physiol, December 2013. PMID: 24043256

In this study, a questionnaire was distributed to hospital-recruited patients with primary sclerosing cholangitis (PSC). The results showed that a lower proportion of patients with PSC were daily coffee drinkers than control subjects, both currently (76% vs 86%; odds ratio [OR], 0.52) and at the age of 18 years (35% vs 49%; OR, 0.58). The associations were mainly attributed to differences observed in men. Twenty percent of the patients were ever (current or former) daily smokers compared with 43% of control subjects (OR, 0.33). Ever daily smoking before PSC diagnosis was associated with older age at diagnosis (42 years vs 32 years). Ever daily smoking and being a coffee drinker at the age of 18 years were independently and negatively associated with PSC. Fewer female patients with PSC than control subjects reported ever use of hormonal contraception. Among female patients, there was a strong correlation between increasing number of children before the diagnosis of PSC and increasing age at diagnosis (r = 0.63). The authors conclude that coffee consumption and smoking might protect against development of PSC. In women, the disease might be influenced by hormonal factors. Clin Gastroenterol Hepatol, September 2013. PMID: 24076415

This open-label, randomized, multicenter clinical trial of parallel groups used blinded endpoint design, and was conducted in 24 teaching hospitals in Spain involving 194 patients with resistant hypertension and an apnea-hypopnea index (AHI) of 15 or higher. The interventions were CPAP or no therapy while maintaining usual blood pressure control medication. The primary end point was the change in 24-hour mean blood pressure after 12 weeks. The results showed that 194 patients were randomly assigned to receive CPAP or no CPAP. When the changes in blood pressure over the study period were compared between groups, the CPAP group achieved a greater decrease in 24-hour mean blood pressure (3.1 mm Hg) and 24-hour DBP (3.2 mm Hg), but not in 24-hour SBP compared with the control group. Moreover, the percentage of patients displaying a nocturnal blood pressure dipper pattern at the 12-week follow-up was greater in the CPAP group than in the control group (35.9% vs 21.6%; adjusted odds ratio [OR], 2.4). There was a significant positive correlation between hours of CPAP use and the decrease in 24-hour mean blood pressure (r = 0.29, P = .006), SBP (r = 0.25; P = .02), and DBP (r = 0.30, P = .005). JAMA, December 2013. PMID: 24327037

In this study, nine phthalates and six parabens were determined in 170 personal care products (PCPs) (41 rinse-off and 109 leave-on), including 20 baby care products collected from Albany, New York. The results showed that phthalates were less frequently found in rinse-off PCPs but were more frequently found in perfumes (detection frequency of 100% for diethyl phthalate [DEP], 67% for dibutyl phthalate [DBP]), skin toners (90% for DEP), and nail polishes (90% for DBP). Parabens were found in 40% of rinse-off products and 60% of leave-on products. The highest concentrations of DEP, DBP, methyl- (MeP), ethyl- (EtP), propyl- (PrP), and butyl parabens (BuP) were on the order of 1000 μg per gram of the product. The calculated dermal intake of phthalates from PCPs was lower for infants and toddlers than for adult females. The calculated maximum daily exposure dose of MeP, EtP, and PrP from PCPs ranged between 58.6 and 766 μg/kg-bw/day for infants and toddlers, which was 3 times higher than that calculated for adult females. PCPs are an important source of human exposure to parabens; the contribution of PCPs to phthalate exposure is low, except for DEP. Environ Sci Technol, November 2013. PMID: 24261694

organochlorine sweetener (OC) that is a common ingredient in the food supply. Sucralose interacts with chemosensors in the alimentary tract that play a role in sweet taste sensation and hormone secretion. In rats, sucralose ingestion was shown to increase the expression of the efflux transporter P-glycoprotein (P-gp) and two cytochrome P-450 (CYP) isozymes in the intestine. P-gp and CYP are key components of the presystemic detoxification system involved in first-pass drug metabolism. The effect of sucralose on first-pass drug metabolism in humans is unknown. In rats, sucralose alters the microbial composition in the gastrointestinal tract (GIT), with relatively greater reduction in beneficial bacteria. The identity and safety profile of these putative sucralose metabolites are not known at this time. Sucralose and one of its hydrolysis products were found to be mutagenic at elevated concentrations in several testing methods. Cooking with sucralose at high temperatures was reported to generate chloropropanols, a potentially toxic class of compounds. Both human and rodent studies demonstrated that sucralose may alter glucose, insulin, and glucagon-like peptide 1 (GLP-1) levels. Taken together, these findings indicate that sucralose is not biologically inert. J Toxicol Environ Health B Crit Rev. 2013. PMID: 24219506

This cohort study followed 2235 healthy men aged 45-59 starting in 1979, in Caerphilly, UK. During the following 30 years, incident diabetes, vascular disease, cancer, and death were recorded, and cognitive state was determined. The results showed that men who followed four or five of the healthy lifestyle behaviours (non-smoking, an acceptable BMI, a high fruit and vegetable intake, regular physical activity, and low/moderate alcohol intake) had an odds ratio (OR) and confidence intervals (CI) for diabetes, corrected for age and social class, of 0.50. For vascular disease the OR was 0.50, and there was a delay in vascular disease events of up to 12 years. Cancer incidence was not significantly related to lifestyle although there was a reduction associated with non-smoking (OR: 0.65). All cause mortality was reduced in men following four or five behaviours (OR 0.40). The OR for men following four or five healthy behaviours was 0.36 for cognitive impairment, and 0.36 for dementia. The adoption of a healthy lifestyle by men was low and appears not to have changed during the subsequent 30 years. The authors conclude that a healthy lifestyle is associated with increased disease-free survival and reduced cognitive impairment. PLoS One, December 2013. DOI: 10.1371/journal.pone.0081877

This population-based study examined cobalamin status and incident fractures in elderly men (n = 790) with an average follow-up of 5.9 years. This study aimed to determine whether serum cobalamins or holotranscobalamin (holoTC: the metabolic active cobalamin) predict incident fractures. Men participating in the Gothenburg part of the population-based Osteoporotic Fracturs in Men (MrOS) Sweden cohort and without ongoing vitamin B medication were included in the study (age range 70- 81 years). The results showed that 110 men sustained X-ray verified fractures including 45 men with clinical vertebral fractures. The risk of fracture (adjusted for age, smoking, BMI, BMD, falls, prevalent fracture, tHcy, cystatin C, 25-OH-vitamin D, intake of calcium, and physical activity, increased per each standard deviation decrease in cobalamins (HR 1.38; 95 % CI, 1.11-1.72) and holoTC (HR, 1.26; 95 % CI, 1.03-1.54), respectively. Men in the lowest quartile of cobalamins and holoTC had an increased risk of all fracture (cobalamins, HR = 1.67 (95 % CI, 1.06-2.62); holoTC, HR = 1.74 (95 % CI, 1.12-2.69)). No associations between folate or tHcy and incident fractures were seen. The authors conclude that low levels of holoTC and cobalamins predict incident fracture in elderly men. Osteoporos Int, October 2013. PMID: 24129588

Multiple Sclerosis (MS) is associated with vitamin D deficiency. This study examined some of the immunological effects of vitamin D on the prevention of MS in a mouse model. Pharmacologic targeting of T helper (TH) cell trafficking poses an attractive opportunity for amelioration of autoimmune diseases. The bioactive form of vitamin D, 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], has been shown to prevent experimental autoimmune encephalomyelitis, a mouse model of MS, via an incompletely understood mechanism. In this study, the authors systematically examined 1,25(OH)2D3 effects on TH cells during their migration from the lymph nodes to the CNS. The results showed that myelin-reactive TH cells are successfully generated in the presence of 1,25(OH)2D3, secrete proinflammatory cytokines, and do not preferentially differentiate into suppressor T cells. These cells are able to leave the lymph node, enter the peripheral circulation, and migrate to the s.c. immunization sites. However, TH cells from 1,25(OH)2D3-treated mice are unable to enter the CNS parenchyma but are instead maintained in the periphery. Upon treatment cessation, mice rapidly develop experimental autoimmune encephalomyelitis, demonstrating that 1,25(OH)2D3 prevents the disease only temporarily likely by halting TH cell migration into the CNS. Proc Natl Acad Sci U S A, December 2013. PMID: 24324134