Gestational weight gain in adolescents: a comparison to the new Institute of Medicine recommendations.

STUDY OBJECTIVE: To examine the gestational weight gain distributions of healthy adolescents with optimal birth outcomes and compare them to the current 2009 Institute of Medicine (IOM) recommendations. DESIGN: Secondary data analysis to conduct a population-based, cross-sectional study. SETTING: The Central and Finger Lakes regions of New York state (Perinatal Database System). PARTICIPANTS: 6995 adolescents with healthy singleton pregnancies (1996 to 2002). MAIN OUTCOME MEASURES: Percentiles of the gestational weight gain distributions were compared within body mass index (BMI) groups categorized using 2 different classification schemes: adolescent BMI percentiles and adult BMI cut-points. We compared these distributions overall and within racial and age groups. RESULTS: The gestational weight gain distribution does not differ considerably when BMI is classified using adolescent or adult cutoffs. Adolescents have good birth outcomes across a wider gestational weight gain range than recommended by the Institute of Medicine regardless of how pre-pregnancy weight status is categorized. For example, overweight adolescents by adult cutoffs have a range of gestational weight gain from 5.0 kg to 30.0 kg, and overweight adolescents by percentile cutoffs have a range from 5.4 kg to 29.5 kg, whereas the IOM range is 7.5-11.5 kg. Black and young adolescents have a similar distribution to their white and older counterparts. CONCLUSION: Practitioners can safely use the new IOM gestational weight gain ranges to monitor weight gain in pregnant adolescent patients using adult BMI classifications. Future research should examine the range of gestational weight gain in adolescents considering a broader scope of birth and maternal outcomes.

Effects of lipids and lipid-lowering therapy on hemostatic factors in patients with myocardial infarction.

BACKGROUND: The risk of cardiovascular disease (CVD) is associated with specific hemostatic markers and lipid profiles, and evidence indicates that there are associations between lipid profiles and the levels of certain hemostatic factors. The disturbances in hemostasis and the risk of CVD can be ameliorated by lipid-lowering therapy. OBJECTIVE: We investigated the associations of lipid profiles with factor (F)VIIa, von Willebrand factor (VWF), D-dimer and plasminogen activator inhibitor-1 (PAI-1), and examined whether lipid-lowering statin therapy would affect the levels of these hemostatic markers. PATIENTS AND METHODS: This cross-sectional study analyzed 1045 postmyocardial infarction patients. RESULTS: In multivariate regression analyses (without adjusting for clinical covariates) HDL-cholesterol (HDL-C) and HDL size were independent and significant predictors of FVIIa; HDL size was a predictor of VWF; HDL size, HDL-C and LDL size were predictors of D-dimer; and triglyceride and HDL size were predictors of PAI-1. After adjusting for clinical covariates, HDL-C, lipoprotein (Lp)(a), apolipoprotein B (apoB) and warfarin were independent and significant predictors of FVIIa; HDL size, age, diabetes mellitus, insulin, race and warfarin were predictors of VWF; HDL-C, HDL size, LDL size, age, warfarin, hypertension and gender were predictors of D-dimer; and triglyceride, HDL size, body mass index, insulin and hypertension were predictors of PAI-1. Patients on statin therapy had significantly lower levels of D-dimer than those who were not on this therapy. CONCLUSION: There are significant associations of lipid profiles with hemostatic factors, the directions of which suggest novel pathways by which dyslipidemia may contribute to coronary heart disease.

Survival after HLA-identical allogeneic peripheral blood stem cell and bone marrow transplantation for hematologic malignancies: meta-analysis of randomized controlled trials.

The impact of peripheral blood stem cell transplantation (PBSCT) on survival relative to bone marrow transplantation (BMT) remains poorly defined. Several randomized controlled trials (RCTs) comparing HLA-matched related PBSC- and BMT for patients with hematologic malignancies have been published, yielding differing results. We conducted a meta-analysis of published RCTs to more precisely estimate the effect of PBSCT on survival. Seven trials that assessed survival were identified and included in our analysis. Using a fixed effects model, and combining the results of all seven trials, the summary odds ratio for mortality after PBSCT was 0.81 (95% CI, 0.62-1.05) when compared to BMT. Subgroup analysis revealed no association between the median PBSCT 34+ cell dose and relative risk for morality after PBSCT. However, there was an association between the proportion of patients enrolled with advanced-stage disease and the summary odds ratio for mortality. The pooled estimate was 0.64 for studies where patients with intermediate/advanced disease comprised at least 25% of enrollment, and was 1.07 for the studies enrolling a smaller proportion. This finding substantiates results from previously published studies that have demonstrated a survival advantage with PBSCT limited to patients with advanced disease.

(+)-epi-Alpha-bisabolol [correction of bisbolol] is the wound-healing principle of Peperomia galioides: investigation of the in vivo wound-healing activity of related terpenoids.

Bioassay-guided investigation of the ethanol extract of Peperomia galioides using a tensile strength method in mice as a monitor led to the isolation of epi-alpha-bisabolol (1) (ED(50) 155 microg/mL). An in vivo healing study of selected commercially available monoterpenoids yielded two bioactive compounds, alpha-bisabolol (2) and alpha-terpineol (3) (ED(50) of 228 and 240 microg/g mouse[corrected], respectively).

A survey of traditional medicinal plants from the Callejón de Huaylas, Department of Ancash, Perú.

The medicinal uses of local flora from the Callejón de Huaylas, Department of Ancash, northeastern Perú, are reported. This geographical area has an old tradition of herbal healing. A total of 33 species have been documented through interactions with village elders, traditional doctors and herbalists. Of the 33 medicinal plant species surveyed in the Callejón de Huaylas, six have not been previously reported, seven have received only minor phytochemical coverage in the literature, and the medicinal uses of seven other plants have not been corroborated with traditional medicinal reports from around the world. The traditional medicinal uses of six medicinal plants have been corroborated with previously published reports but their biological activities have yet to be confirmed in the laboratory. The medicinal uses of four other plants have been corroborated with previously published reports and their biological activities have been confirmed in the laboratory. The purported medicinal use of three plant species could not be confirmed in the laboratory.

Evaluation of the wound-healing activity of selected traditional medicinal plants from Perú.

Folk medicine practitioners in Perú employ plant preparations as wound-healing agents on superficial and internal wounds (gastric ulcers). The results of a scientific evaluation of the wound-healing activity of nine plants found in the Amazon jungle near Iquitos and in the Andes mountains is presented. The species studied were: Peperomia galioides, Mentzelia cordifolia, Mutisia acuminata, Himatanthus sucuuba, Spondias mombin, Eleutherine bulbosa, Muehlenbeckia tamnifolia, Anredera diffusa and Jatropha curcas. These plants have also been examined for their toxicological properties, their effect on blood pressure, smooth muscle and capillary permeability. Significant wound-healing activity was detected in Peperomia galioides, Anredera diffusa and Jatropha curcas. Extracts from Peperomia galioides and Anredera diffusa had no effect on cell proliferation and did not exhibit mutagenic activity.