Intergenerational transfer of psychosocial risk in women with childhood histories of aggression, withdrawal, or aggression and withdrawal.

Intergenerational transfer of risk between mothers and children, based on mothers' childhood aggression and social withdrawal, was examined in an inner-city sample. Each of the 3 studies reported involved a subset of the 909 female participants in the Concordia Longitudinal Risk Project, initiated when the participants were of school age. Using medical records, Study 1 (n = 853) focused on prediction of teen motherhood, delivery complications during childbirth, multiparity, and close spacing of births. Study 2 (n = 428) examined pathways to school dropout and teen parenthood. Study 3 (n = 89) involved prediction of observed parent and child behavior from mothers' childhood characteristics. Mothers' childhood aggression was consistently predictive of negative outcomes in each area of intergenerational risk, especially when combined with social withdrawal and low levels of academic achievement. Education was protective: Mothers' years of schooling predicted positive outcomes.

Adrenal pseudocyst: report of two cases.

Adrenal cysts are uncommon lesions. The authors discuss two cases of adrenal pseudocyst, and its classification and possible pathogenesis and complications. The role of radiologic findings in preoperative evaluation of renal/suprarenal masses also is detailed.

Reliability and validity of judgments of the integrity of the anterior cruciate ligament of the knee using the Lachman's test.

This study assessed the intratester and intertester reliability and the validity of judgments of the integrity of the anterior cruciate ligament (ACL) based on the use of the Lachman's test. End-feel and tibial translation judgments made during the Lachman's test were also assessed. Patients with unilateral knee problems (N = 32), 13 of whom had documented ACL damage, were examined by two physical therapists and two orthopedic surgeons. Intratester Kappa values for whether the test was positive or negative were .44 for physical therapists, .60 for orthopedic surgeons, and .51 for all examiners. Intertester Kappa values were .69 for the therapists, .61 for the surgeons, and .42 for all examiners. The predictive value of a positive test was 47% for all examiners, whereas the predictive value of a negative test was 70%. Results indicate that Lachman's test judgments have limited reliability and may be more useful for predicting that a patient does not have an ACL injury than for predicting that the ACL is injured. [Cooperman JM, Riddle, DL, Rothstein JM: Reliability and validity of judgments of the integrity of the anterior cruciate ligament of the knee using the Lachman's test.

Comparison of total costs of administering calcium polycarbophil and psyllium mucilloid in an institutional setting.

The total cost of administering calcium polycarbophil per unit dose (two tablets) was compared with that of administering psyllium mucilloid (one packet dissolved in 8 oz of water) in 20 elderly nursing-home residents. Times for printing labels, checking and initialing labels, gathering materials needed, and preparing and administering the medications were recorded during at least 50 observations in each treatment group. Total cost included nurses' and pharmacists' time, materials, and medications. Calcium polycarbophil doses were prepared and administered more quickly (mean, 49.5 sec) than psyllium mucilloid (105.3 sec). The mean cost of preparing and administering a unit dose was 28.2 for calcium polycarbophil tablets and 59.9 for psyllium mucilloid. The results suggest that the use of calcium polycarbophil tablets would save time and money in institutions in which laxatives are frequently administered.

Riboflavin metabolism in the hypothyroid newborn.

In the hypothyroid rat the flavin adenine dinucleotide (FAD) content of the liver is similar to that observed in rats maintained on a riboflavin-deficient diet. Thyroxine regulates the enzyme flavin kinase. Human adults with hypothyroidism have levels of erythrocyte glutathione reductase (EGR), an FAD-containing enzyme, in the range indicative of riboflavin deficiency, which can be corrected with thyroxine therapy. In the present study six newborns with severe congenital hypothyroidism because of athyrosis, ectopic thyroidism, or congenital hypothyroidism with Down's syndrome had normal levels of EGR, and treatment with thyroxine had no effect on these levels.

Riboflavin metabolism in the hypothyroid human adult.

It had been shown that thyroxine regulates the conversion of riboflavin to riboflavin mononucleotide and flavin adenine dinucleotide (FAD) in laboratory animals. In the hypothyroid rat, the flavin adenine dinucleotide level of the liver decreases to levels observed in riboflavin deficiency. We have shown that in six hypothyroid human adults, the activity of erythrocyte glutathione reductase, an accessible FAD-containing enzyme, is decreased to levels observed during riboflavin deficiency. Thyroxine therapy resulted in normal levels of this enzyme while the subjects were on a controlled dietary regimen. This demonstrates that thyroid hormone regulates the enzymatic conversion of riboflavin to its active coenzyme forms in the human adult.

Nutritional deficiencies in institutionalized mentally retarded and physically disabled individuals.

The folic acid, riboflavin, and vitamin A status of 150 individuals in a hospital for mentally retarded persons was examined. Because many of the subjects were incontinent, it was necessary to use blood samples. Folic acid deficiency was determined from plasma levels and from examination of stained peripheral blood smears for megaloblastic changes in the leucocytes. Riboflavin deficiency was determined from estimation of erythrocyte glutathione reductase and vitamin A in plasma by a colorimetric method. Twenty percent of the subjects had evidence of folic acid deficiency, 17% had evidence of riboflavin deficiency, and none had vitamin A deficiency.

Effect of diet on vitamin deficiencies in retarded individuals receiving drugs.

A population of mentally retarded and physically disabled individuals on long-term therapy with anticonvulsant drugs had a high prevalence of folic acid and riboflavin deficiency, 20% and 17%, respectively, as they entered an institution devoted to their care. Their previous diet was probably nutritionally marginal, as it was cooked and prepared to baby food consistency, and milk was rarely given. They were fed in the recumbent position, resulting in frequent vomiting. In this institution, a carefully planned dietary regimen that was adequate in essential nutrients was fed by trained personnel. Drug therapy was continued. After a year no signs of folic acid or riboflavin deficiency were evident. We conclude that these weak vitamin antagonists may precipitate deficiencies on marginally adequate diets. A good dietary regimen prevented the appearance of these vitamin deficiencies.

Case studies: isolated strain of the tensor fasciae latae.

Three cases of isolated strains of the tensor fasciae latae muscle are reviewed. Objective and subjective findings, including the differentiation between iliotibial band and tensor fasciae latae are discussed. Conservative measures of treatment and the technique of stretching the tensor fasciae latae are described. The importance of examining this muscle in the evaluation of the contractile elements of the hip is stressed.J Orthop Sports Phys Ther 1985;5(4):201-203.

The folate in human milk.

In previous studies of the folate content of human milk, samples were prepared for assay by a method that resulted in a turbid solution that was then assayed by a turbidimetric microbiological method. We have used an improved microbiological assay in which the milks were treated with rennin to precipitate casein and heated in a buffered ascorbate to coagulate lactalbumin and lactoglobulin. Milks were obtained serially from nursing mothers for periods ranging from 1 day to 6 months postpartum. The results showed that the folate in human milk has few glutamate residues since treatment with a purified folate conjugase preparation release no additional folate activity for Lactobacillus casei. Colostrum is relatively low in folate, but milk folate increases as lactation proceeds. During each stage of lactation there was great variation in milk folate content among the women. In the case of a folate-deficient woman, supplementation with folic acid resulted in a prompt increase in milk folate level.

Riboflavin deficiency in an adolescent population in New York City.

An adolescent population ranging in age from 13 to 19 years and of a low socioeconomic status in New York City was surveyed for riboflavin deficiency. Deficiency was determined from estimation of erythrocyte glutathione reductase activity, an accurate reflector of riboflavin nutritional status. The overall prevalence of deficiency among those not on vitamin supplements was 26.6%. The prevalence did not depend on sex or age. There was a correlation between milk consumption and riboflavin nutritional status. The prevalence was highest among those consuming less than 1 cup/week and least among those taking 3 or more cups a day. The latter group was comparable in this respect to those receiving daily vitamin supplements. Adolescents are at a high risk for nutritional deficiencies because of their notoriously poor dietary habits, and the estimation of riboflavin deficiency may be an indicator of overall nutritional status.

Nutrition in the pathogenesis of alcoholic pancreatitis.

The pathogenesis of chronic alcoholic pancreatitis is unclear. Some European studies have shown that alcoholics who develop pancreatitis consume a diet richer in protein and fat than normal controls. The infrequency of alcoholic cirrhosis in patients with alcoholic pancreatitis in these studies was explained by this enhanced nutritional intake protecting the liver but not the pancreas. In this study we evaluated by an oral recall method the nutritional intake of patients with alcoholic pancreatitis or alcoholic cirrhosis prior to the onset of symptomatology and compared the data with established norms. Our data did not confirm the European observation that pancreatitis patients consume amounts of protein and fat, more than the general population and more than alcoholics with cirrhosis. Furthermore, the combined incidence of cirrhosis and pancreatitis was not infrequent. Our observations do not disprove that a high fat and/or protein diet predispose to pancreatitis but suggest that such a diet is not a prerequisite for alcoholics to develop pancreatitis.