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Peripheral arterial disease (PAD) is a growing public health burden. The development and progression of PAD is influenced by vascular risk factor management and lifestyle changes. However, public awareness of PAD is low compared with other conditions such as heart disease and stroke, which have been the subject of widespread public health campaigns. This study aimed to determine current levels of PAD awareness among hospital patients.This cross-sectional, tertiary hospital-based, descriptive study was conducted over 6 months in 2019. Two investigators administered the survey in face-to-face interviews to patients attending 3 different hospital-based settings including vascular clinics (VC), cardiology clinics (CVC), and Emergency Department (ED).A total of 150 patients were interviewed. Participants demonstrated low overall awareness of vascular disease (32% PAD and 21% AAA) compared to cardiovascular disease including stroke (71%) and myocardial infarction (63%). Awareness of PAD was higher in vascular patients (51%) compared to CVC and ED patients (p=0.01). Of the total population, 77% and 71% identified the contributory role of smoking and limited exercise to the development of PAD respectively. VC patients were more informed of intermittent claudication (78%) and amputation (80%) (p 0.01) compared to CVC and ED patients.In the global drive to reduce vascular morbidity, this study highlights the poor knowledge of PAD among the public. In addition, there is poor awareness about the incidence, risk factors and complications of PAD. These results highlight the need for accessible and easily understood information regarding PAD in both the clinic setting and public health campaigns.

Background: Obesity is characterized by chronic inflammation, immune dysregulation, and alteration of gene expression, associated with type 2 diabetes mellitus and cardiovascular disease. The degree to which these changes occur in childhood obesity is not fully defined. Aims and Methods: The aim was to investigate the effect of childhood obesity on immune cell frequency, macrophage activation, cytokine production, and specific regulators of metabolic gene expression. Profiling was performed on peripheral blood from 29 obese and 20 nonobese children using real-time PCR, ELISA, and flow cytometry. Results: Fasting glucose was similar in both groups, but there was a higher degree of insulin resistance in obese subjects (homeostasis model of assessment for insulin resistance, 4.8 vs 0.84; P .001). Soluble CD163, a marker of macrophage polarization to a proinflammatory profile, was elevated in the obese compared to nonobese children (135 vs 105 ng/mL; P .03). Invariant natural killer T cells were reduced in the obese children (CD3 T cells, 0.31 vs 0.53%; P .001). Cytokine profiling revealed significantly elevated TNF- (6.7 vs 5.1 pg/mL; P .01) and leptin (1186 vs 432 pg/mL; P .001) and reduced adiponectin (884 vs 1321 pg/mL; P .001) in obese compared to nonobese children. Stimulation of peripheral blood mononuclear cells from obese children resulted in higher levels of IL-1 (2100 vs 1500 pg/mL; P .018). There was a 4-fold increase in expression of microRNA33a (P .001) and a 3-fold increase in microRNA33b (P .017) in obese children. Conclusion: Childhood obesity is associated with changes in immune cell frequency, inflammatory environment, and regulation of metabolic gene expression. These changes have been causally linked to the onset of metabolic disease in adulthood and suggest the future trajectory of obese children to the development of type 2 diabetes mellitus and premature cardiovascular disease

Objective Nasalance measures were compared for speech stimuli of four different lengths. Design The standard for comparison was a 44-syllable passage. The 44-syllable passage was compared to a 17-syllable passage, a 6-syllable sentence, and a 2-syllable word. All stimuli were devoid of nasal consonants and were composed only of low pressure consonants and vowels. Setting Academic and clinical craniofacial center. Subjects The subjects were 20 children at risk for velopharyngeal dysfunction and 5 children without history of communication disorder. Main outcome measure(s) The main outcome measures were the nasalance scores associated with speech samples of different lengths. Results The results showed that comparable measures of nasalance can be obtained using stimuli as short as a six-syllable sentence. Both the 17-syllable and the 6-syllable stimulus achieved high criterion validity, indicating that stimuli of that length could be substituted for the longer 44-syllable passage. The two-syllable word, however, had significantly lower criterion validity and could not be used to obtain valid estimates of nasalance. Conclusion Valid assessment of nasalance can be achieved with speech samples as short as six syllables.

Review on the link between miR-107 dyregulation and TLR4 inflammation in type 2 diabetes. miRNAs are small noncoding RNAs that act as regulators of gene expression. Dysregulation of miRNAs has been shown to contribute to multiple disease processes. It has become apparent that miRNAs play a key role in the innate immune response, whereby a large number of miRNAs have been demonstrated to be regulated by TLRs, key initiators of the innate immune response to infection. Recently, the LPS receptor, TLR4, has been shown to down-regulate miR-107 in macrophages. In addition, miR-107 has been demonstrated to be dysregulated in murine and rodent models of obesity and insulin resistance, respectively, with miR-107 contributing to both conditions. With obesity and inflammation being so intrinsically associated, the link between the miR-107 expression levels, inflammation, and insulin resistance may be of particular importance in metabolic diseases. The decrease in miR-107 in response to TLR4 may be an attempt to limit insulin resistance, a feature of obesity-related inflammation. If this process is impaired, disease, such as T2D, might persist. This review aims to discuss a possible link between the molecular phenomena of obesity and inflammation and the role that miR-107 may contribute to these processes.