Single-step production of autologous bovine platelet concentrate for clinical applications in cattle.

Platelet concentrate (PC) is an alternative therapy to treat mastitis in dairy cattle and is an alternative treatment for reproduction problems such as endometritis. Unfortunately, double-centrifugation processing methods described are time-consuming, require specialized laboratory equipment, and are usually done in a heterologous way, which risks herd health. To overcome this limitation, we evaluated single-step bovine PC processing methods readily applicable to a farm setting using an autologous conditioned plasma (ACP) production system. We investigated the hematologic findings, cytokines, and growth factors of the obtained PC samples. Autologous conditioned plasma was prepared using whole blood (WB) from 4 cows (group 1) using single-step centrifugation and 16 different processing methods. The 2 protocols that yielded the highest ratio of platelet to white blood cell (WBC) concentration were ACP-1 [720 × g (2,200 rpm), 5 min] and ACP-2 [929 × g (2,500 rpm), 3 min]. They were subsequently reproduced and compared using WB from 8 cows (group 2). Hematologic findings were quantified, IL-1ß (cytokine) and growth factors [platelet-derived growth factor (PDGF), transforming growth factor (TGF)-ß, bovine fibroblast growth factor (b-FGF)] were measured, and enrichment factors were compared between samples and processing methods. Hematological characteristics and platelet enrichment varied markedly among tested protocols and all were statistically different from WB. Protocol ACP-2 resulted in significantly greater platelet enrichment (mean 169% of WB) than ACP-1 (125% of WB). We found no significant difference between the 2 ACP preparation protocols with regard to leukocyte reduction (7.53-9.75% WBC compared with WB) or growth factor enrichment (124-125% PDGF, 95-100% TGF-ß, 102-104% b-FGF, and 56-74% IL-1ß compared with WB). In conclusion, both ACP protocols yielded a platelet concentration shown to promote healing for clinical applications in cattle, and the ACP-2 protocol resulted in a greater degree of platelet enrichment. Therefore, this protocol could be used for ACP production for clinical applications in cattle.

MRTF specifies a muscle-like contractile module in Porifera.

Muscle-based movement is a hallmark of animal biology, but the evolutionary origins of myocytes are unknown. Although believed to lack muscles, sponges (Porifera) are capable of coordinated whole-body contractions that purge debris from internal water canals. This behavior has been observed for decades, but their contractile tissues remain uncharacterized with respect to their ultrastructure, regulation, and development. We examine the sponge Ephydatia muelleri and find tissue-wide organization of a contractile module composed of actin, striated-muscle myosin II, and transgelin, and that contractions are regulated by the release of internal Ca2+ stores upstream of the myosin-light-chain-kinase (MLCK) pathway. The development of this contractile module appears to involve myocardin-related transcription factor (MRTF) as part of an environmentally inducible transcriptional complex that also functions in muscle development, plasticity, and regeneration. As an actin-regulated force-sensor, MRTF-activity offers a mechanism for how the contractile tissues that line water canals can dynamically remodel in response to flow and can re-form normally from stem-cells in the absence of the intrinsic spatial cues typical of animal embryogenesis. We conclude that the contractile module of sponge tissues shares elements of homology with contractile tissues in other animals, including muscles, indicating descent from a common, multifunctional tissue in the animal stem-lineage.

Sub-organism (acetylcholinesterase activity), population (survival) and chemical concentration responses reinforce mechanisms of antagonism associated with malathion toxicity.

Within human modified ecosystems the effects of individual stressors are difficult to establish amid co-occurring biological processes, environmental gradients and other stressors. Coupled examination of several endpoints across different levels of organisation may help elucidate the individual and combined effects of stressors and interactions. Malathion is a commonly used organophosphate pesticide that contaminates freshwaters and has strong negative effects on aquatic biota. However, both other stressors (e.g. increased sediment) and common ecosystem components (e.g. macrophytes and variable pH) can reduce the aqueous concentrations of malathion, reducing its toxic effects. We conducted a fully orthogonal bioassay to examine how pH (at 7 and 7.8) and sorptive processes (across two levels of kaoline clay 0 and 24 g L-1) affected aqueous malathion concentrations and toxicity in an aquatic invertebrate genus. Survival and acetylcholinesterase activity as a sub-organism response were examined in the mayfly Coloburiscoides spp. (Ephemeroptera; Coluburiscidae). Measured aqueous malathion concentrations decreased with increased pH and in the presence of kaolin clay. Survival declined with increasing malathion concentrations and exposure period. Results further identify that antagonism of malathion toxicity was associated with both pH (alkaline hydrolysis) and effects associated with sediment independent of pH (driven by sorptive processes). However, model predictions varied associated with target and measured concentrations and concentrations examined. Antagonistic effects were most apparent using subset target malathion concentrations because of the dominant effect of malathion at high concentrations. Acetylcholinesterase activity, identified repression occurred across all treatments and did not identify antagonistic interactions, but these results were similar to survival responses at the time points examined (i.e. 120 h). Examination of chemistry, acetylcholinesterase, and survival, affords greater understanding of stressor effects and their interactions. Measured malathion concentrations may underestimate effects on aquatic biota; not because of synergism among stressors, but because of strong effects despite antagonism.

Same-day Discharge after Subcutaneous Implantable Cardioverter-defibrillator Implantation is Safe and Cost-effective.

The feasibility and safety of same-day discharge after transvenous implantable cardioverter-defibrillator implantation is well-established. However, subcutaneous ICDs (S-ICDs) are now increasingly being implanted, and the feasibility, safety, and potential cost savings associated with same-day discharge after S-ICD placement has not been widely investigated. In a small cohort of patients (n = 24) who underwent S-ICD implantation at our institution, 54% were successfully discharged on the same day as their implant procedure. Procedure-related complications were not apparent in this sampling and the reduction in health care costs was high, suggesting this protocol has immense benefit in today's health care environment. As such, same-day discharge of S-ICD patients is appropriate to consider and should receive further attention.

Routine exercise-based cardiac rehabilitation does not increase aerobic fitness: A CARE CR study.

BACKGROUND: Recent evidence suggests that routine exercise-based cardiac rehabilitation (CR) may not lead to a substantial increase in estimated peak oxygen uptake (V̇O2peak). This could reduce the potential benefits of CR and explain why CR no longer improves patient survival in recent studies. We aimed to determine whether routine exercise-based CR increases V̇O2peak using gold-standard maximal cardiopulmonary exercise testing (CPET), and to quantify the exercise training stimulus which might be insufficient in patients undertaking CR. METHODS: We studied the effects of a routine, twice weekly, exercise-based CR programme for eight weeks (intervention group) compared with abstention from supervised exercise training (control group) in patients with coronary heart disease. The primary outcome was V̇O2peak measured using CPET. We also measured changes in body composition using dual X-ray absorptiometry, carotid intima-media thickness, hs-CRP and N-terminal pro B-type natriuretic peptide at baseline, 10 weeks and 12 months. We also calculated the Calibre 5-year all-cause mortality risk score. RESULTS: Seventy patients (age 63.1 SD10.0 years; BMI 29.2 SD4.0 kg·m-2; 86% male) were recruited (n = 48 intervention; n = 22 controls). The mean aerobic exercise training duration was 23 min per training session, and the mean exercise training intensity was 45.9% of heart rate reserve. V̇O2peak was 23·3 ml·kg-1·min-1 at baseline, and there were no changes in V̇O2peak between groups at any time point. The intervention had no effect on any of the secondary endpoints. CONCLUSION: Routine CR does not lead to an increase in V̇O2peak and is unlikely to improve long-term physiological outcomes.

Biological interactions mediate context and species-specific sensitivities to salinity.

Toxicants have both sub-lethal and lethal effects on aquatic biota, influencing organism fitness and community composition. However, toxicant effects within ecosystems may be altered by interactions with abiotic and biotic ecosystem components, including biological interactions. Collectively, this generates the potential for toxicant sensitivity to be highly context dependent, with significantly different outcomes in ecosystems than laboratory toxicity tests predict. We experimentally manipulated stream macroinvertebrate communities in 32 mesocosms to examine how communities from a low-salinity site were influenced by interactions with those from a high-salinity site along a gradient of salinity. Relative to those from the low-salinity site, organisms from the high-salinity site were expected to have greater tolerance and fitness at higher salinities. This created the potential for both salinity and tolerant-sensitive organism interactions to influence communities. We found that community composition was influenced by both direct toxicity and tolerant-sensitive organism interactions. Taxon and context-dependent responses included: (i) direct toxicity effects, irrespective of biotic interactions; (ii) effects that were owing to the addition of tolerant taxa, irrespective of salinity; (iii) toxicity dependent on sensitive-tolerant taxa interactions; and (iv) toxic effects that were increased by interactions. Our results reinforce that ecological processes require consideration when examining toxicant effects within ecosystems.This article is part of the theme issue 'Salt in freshwaters: causes, ecological consequences and future prospects'.

Estimated peak functional capacity: an accurate method for assessing change in peak oxygen consumption after cardiac rehabilitation?

OBJECTIVE: Cardiopulmonary exercise testing (CPET) is the 'gold standard' method of determining VO2peak . When CPET is unavailable, VO2peak may be estimated from treadmill or cycle ergometer workloads and expressed as estimated metabolic equivalents (METs). Cardiac rehabilitation (CR) programmes use estimated VO2peak (METs) to report changes in cardiorespiratory fitness (CRF). However, the accuracy of determining changes in VO2peak based on estimated functional capacity is not known. METHODS: A total of 27 patients with coronary heart disease (88·9% male; age 59·5 ± 10·0 years, body mass index 29·6 ± 3·8 kg m-2 ) performed maximal CPET before and after an exercise-based CR intervention. VO2peak was directly determined using ventilatory gas exchange data and was also estimated using the American College of Sports Medicine (ACSM) leg cycling equation. Agreement between changes in directly determined VO2peak and estimated VO2peak was evaluated using Bland-Altman limits of agreement (LoA) and intraclass correlation coefficients. RESULTS: Directly determined VO2peak did not increase following CR (0·5 ml kg-1 min-1 (2·7%); P = 0·332). Estimated VO2peak increased significantly (0·4 METs; 1·4 ml kg-1  min-1 ; 6·7%; P = 0·006). The mean bias for estimated VO2peak versus directly determined VO2peak was 0·7 ml kg-1  min-1 (LoA -4·7 to 5·9 ml  kg-1  min-1 ). Aerobic efficiency (ΔVO2 /ΔWR slope) was significantly associated with estimated VO2peak measurement error. CONCLUSION: Change in estimated VO2peak derived from the ACSM leg cycling equation is not an accurate surrogate for directly determined changes in VO2peak . Our findings show poor agreement between estimates of VO2peak and directly determined VO2peak . Applying estimates of VO2peak to determine CRF change may over-estimate the efficacy of CR and lead to a different interpretation of study findings.

Cerebrospinal Fluid Analysis in Recumbent Adult Dairy Cows With or Without Spinal Cord Lesions.

BACKGROUND: Diagnosis of central nervous system (CNS) lesions in recumbent dairy cattle (RDC) is challenging because neurologic examination is limited and medical imaging often is challenging or unrewarding. Cerebrospinal fluid (CSF) analysis is useful in the diagnosis of CNS disorders in cattle. However, its utility in identifying spinal cord lesions in RDC remains to be evaluated. HYPOTHESIS/OBJECTIVES: We hypothesized that CSF analysis would discriminate between RDC with and without spinal cord lesions. ANIMALS: Twenty-one RDC with spinal cord lesions (RDC+) and 19 without (RDC-) were evaluated. METHODS: Spinal cord lesions were confirmed at necropsy. Signalment, clinical findings, and CSF results were compared retrospectively. Total nucleated cell count and differential, protein concentration, and red blood cell count in RDC+ and RDC- were compared. RESULTS: Neoplasia, trauma, and infectious processes were the most frequent spinal cord lesions identified. Cerebrospinal fluid protein concentrations and TNCC were significantly higher in RDC+ compared to RDC- (P = .0092 and P = .0103, respectively). Additionally, CSF protein concentrations and TNCC in RDC- were lower than previously published reference ranges. Using an interpretation rule based on CSF protein concentration and TNCC, it was possible to accurately identify 13 RDC with spinal cord lesions and 6 RDC without lesions. It was not possible to determine spinal cord status in the remaining 18 RDC. CONCLUSIONS AND CLINICAL IMPORTANCE: Cerebrospinal fluid analysis is valuable in the evaluation of spinal cord status in RDC. The prognosis associated with these findings remains to be determined.

Rooting depth and root depth distribution of Trifolium repens × T. uniflorum interspecific hybrids.

Background and aims Traits related to root depth distribution were examined in Trifolium repens × T. uniflorum backcross 1 (BC1) hybrids to determine whether root characteristics of white clover could be improved by interspecific hybridization. Methods Two white clover cultivars, two T. uniflorum accessions and two BC1 populations were grown in 1 -m deep tubes of sand culture. Maximum rooting depth and root mass distribution were measured at four harvests over time, and root distribution data were fitted with a regression model to provide measures of root system shape. Morphological traits were measured at two depths at harvest 3. Key Results Root system shape of the hybrids was more similar to T. uniflorum than to white clover. The hybrids and T. uniflorum had a higher rate of decrease in root mass with depth than white clover, which would result in higher proportions of root mass in the upper profile. Percentage total root mass at 100-200 mm depth was higher for T. uniflorum than white clover, and for Crusader BC1 than 'Crusader'. Roots of the hybrids and T. uniflorum also penetrated deeper than those of white clover. T. uniflorum had thicker roots at 50-100 mm deep than the other entries, and more of its fine root mass at 400-500 mm. The hybrids and white clover had more of their fine root mass higher in the profile. Consequently, T. uniflorum had a higher root length density at 400-500 mm than most entries, and a smaller decrease in root length density with depth. Conclusions These results demonstrate that rooting characteristics of white clover can be altered by hybridization with T. uniflorum, potentially improving water and nutrient acquisition and drought resistance. Root traits of T. uniflorum are likely to be adaptations to soil moisture and fertility in its natural environment.

Variability of automated carotid intima-media thickness measurements by novice operators.

Carotid intima-media thickness (C-IMT) measurements provide a non-invasive assessment of subclinical atherosclerosis. The aim of the study was to assess the inter- and intra-observer variability of automated C-IMT measurements undertaken by two novice operators using the Panasonic CardioHealth Station. Participants were free from cardio-metabolic disease, and each underwent serial bilateral C-IMT ultrasound measurements. Immediate interoperator measurement variability was calculated by comparing initial measurements taken by two operators. Immediate retest variability was calculated from two consecutive measurements and longer term variability was assessed by conducting a further scan 1 week later. Fifty apparently healthy participants (n = 20 females), aged 26·2 ± 5·0 years, were recruited. Operator 1 recorded a median (interquartile range) right and left-sided C-IMT of 0·471 mm (0·072 mm) and 0·462 mm (0·047 mm). Female's right and left C-IMT were 0·442 mm (0·049 mm) and 0·451 mm (0·063 mm), respectively. The limits of agreement (LoA) for immediate interoperator variability were -0·063 to 0·056 mm (mean bias -0·003 mm). Operator 1's immediate retest intra-operator LoA were -0·057 to 0·046 mm (mean bias was -0·005 mm). One-week LoA were -0·057 to 0·050 mm (mean bias -0·003 mm). Operator 2 recorded median right and left-sided C-IMT of 0·467 mm (0·089 mm) and 0·458 mm (0·046 mm) for males, respectively, whilst female measurements were 0·441 mm (0·052 mm) and 0·444 mm (0·054 mm), respectively. Operator 2's intra-operator immediate retest LoA were -0·056 to 0·056 (mean bias <-0·001 mm). Intra-operator LoA at 1 week were -0·052 to 0·068 mm (mean bias 0·008 mm). Novice operators produce acceptable short-term and 1-week inter- and intra-operator C-IMT measurement variability in healthy, young to middle-aged adults using the Panasonic CardioHealth Station.

Ex vivo electrical impedance measurements on excised hepatic tissue from human patients with metastatic colorectal cancer.

Point-wise ex vivo electrical impedance spectroscopy measurements were conducted on excised hepatic tissue from human patients with metastatic colorectal cancer using a linear four-electrode impedance probe. This study of 132 measurements from 10 colorectal cancer patients, the largest to date, reports that the equivalent electrical conductivity for tumor tissue is significantly higher than normal tissue (p < 0.01), ranging from 2-5 times greater over the measured frequency range of 100 Hz-1 MHz. Difference in tissue electrical permittivity is also found to be statistically significant across most frequencies. Furthermore, the complex impedance is also reported for both normal and tumor tissue. Consistent with trends for tissue electrical conductivity, normal tissue has a significantly higher impedance than tumor tissue (p < 0.01), as well as a higher net capacitive phase shift (33° for normal liver tissue in contrast to 10° for tumor tissue).

Polypharmacy and the Risk of Malnutrition among Independently-living Elderly Persons in Trinidad.

OBJECTIVE: In this study, we evaluated the association of polypharmacy and nutritional status among independently-living elderly persons attending the outpatient clinics at the Eric Williams Medical Sciences Complex (EWMSC). METHOD: Participants were recruited at the outpatient pharmacy at EWMSC. Face-to-face interviews were conducted using a questionnaire consisting of sociodemographic, health and nutritional status items. Anthropometry was taken using standard procedures. Participants gave oral and written consent prior to enrolment in the study. Participation was voluntary. The study wasapproved by the Ethics Committee, EWMSC. RESULTS: One hundred and three persons - polypharmacy (≥ 6 medications) = 57; non-polypharmacy (< 6 medications) = 46 persons) - participated in the study. There was no significant difference in the age, gender, weight, height, body mass index (BMI), mid-arm circumference, calf circumference, highest educational level achieved and marital status between the groups. The number of medications prescribed was significantly positively associated with the number of ailments (r = 0.56; p < 0.001) and the risk of malnutrition (r = 0.30; p = 0.006). Persons with polypharmacy were significantly more likely than their non-polypharmacy counterparts to be at increased risk for malnutrition (OR = 3.94, 95% CI: 1.52, 10.13; p = 0.004). This finding remained highly significant after simultaneous adjustment for age, gender, ethnicity, highest educational level achieved, marital status and number of diseases (p = 0.03). CONCLUSION: Among participants, polypharmacy and number of ailments were positively associated with an increased risk of malnutrition. Nonetheless, the mechanisms underlying these associations remain unclear.

Well Plate Circular Dichroism Reader for the Rapid Determination of Enantiomeric Excess.

Circular dichroism (CD) spectropolarimeters typically employ one photoelastic modulator. However, spectropolarimeters employing two or even four modulators are more versatile and can be used to subvert common measurement errors arising from imperfectly isotropic samples or sample holders. Small linear anisotropies that can cause large errors in CD measurement can be associated with multi-well sample holders. Thus, high-throughput CD analyses in multi-well plates have not yet been demonstrated. One such application is the determination of enantiomeric excess of a library of reaction products. Herein, a spectropolarimeter employing four photoelastic modulators and a translation stage was used to determine the enantiomeric excess of a family of chiral amine complexes much more rapidly than could be achieved with a robotic fluid injection system. These experiments are proof of concept for high-throughput CD analysis. In practice, commercially available glass bottomed well plates are sufficiently strain free such that a simple instrument with just one photoelastic modulator and a vertical optical train should be able to deliver the CD without special considerations given herein. On the other hand, polystyrene well plates cannot be used in this way.

Sustainability of a Curriculum-based Intervention on Dietary Behaviours and Physical Activity among Primary School Children in Trinidad and Tobago.

OBJECTIVES: Childhood obesity and poor lifestyle practices are emerging as major public health challenges in the Caribbean. Given the fact that a significant part of childhood is spent at school, curriculum-based interventions aimed at improving good dietary and physical activity patterns may provide a useful vehicle for mass inculcation of long-term healthy lifestyle practices. In this study, we evaluated the long-term impact of a brief curriculum based intervention on dietary behaviour, physical activity and knowledge level of primary schoolchildren. METHODS: The study was a randomized, controlled, school-based nutrition education and physical activity intervention. One hundred students each were then randomly assigned to the intervention (IVG) and non-intervention (NIVG) groups and followed-up for 18 months. Participants in the IVG group were exposed to a curriculum consisting of six one-hour modules followed by school-based activities geared at fostering healthy behaviours. Students in the non-intervention group did not receive any modules and were subject to the information available at school on a regular basis. RESULTS: In multivariate regression equations controlling for age, gender, body mass index (BMI) and baseline values, intervention was associated with lower intake of fried foods and sodas (p < 0.05) and higher knowledge scores (p < 0.01) 18 months later but not significantly associated with improved physical activity or lower BMI. CONCLUSIONS: In this study, participants in the intervention group reported significantly lower intakes of fried foods and sodas and higher knowledge scores than participants in the control group some 18 months post-intervention independent of age, gender, BMI, ethnicity and the intakes at baseline.

Validation of an ultrasound imaging technique of the tympanic bullae for the diagnosis of otitis media in calves.

BACKGROUND: Otitis media is a common disease in calves that can be subclinical, making antemortem on-farm diagnosis challenging. OBJECTIVES: To evaluate the sensitivity and specificity of ultrasonography of tympanic bullae for the diagnosis of clinical and subclinical otitis media and to evaluate the reproducibility of the technique. ANIMALS: Forty calves 19-50 days of age were selected from a veal calf farm. METHODS: Prospective study. Ultrasonography was first performed on the farm by ultrasonographer A (US A). Ultrasonography was repeated by ultrasonographer A (US A') and another ultrasonographer (US B) at the Centre Hospitalier Universitaire Vétérinaire. Images were later reread by both examiners and a diagnosis was recorded. The calves were euthanized and submitted for necropsy, and histopathologic diagnosis was used as the gold standard. RESULTS: Forty-five bullae were affected by otitis media and 35 bullae were normal. Sensitivity and specificity of the ultrasound technique ranged from 32 to 63% and 84 to 100%, respectively, depending on the examiner and classification of suspicious ultrasonography results. Kappa analysis to evaluate interobserver agreement between A' and B yielded a к value of 0.53. Agreement within the same examiner (A versus A') yielded a к value of 0.48, and real-time ultrasound versus rereading of recorded images for A' and B yielded к values of 0.58 and 0.75, respectively. CONCLUSIONS: Sensitivity and specificity of the ultrasound imaging technique are, respectively, low and high for diagnosis of clinical and subclinical otitis media in calves, with moderate reproducibility.

Good Cascade Impactor Practice (GCIP) and considerations for "in-use" specifications.

The multi-stage cascade impactor (CI) is widely used to determine aerodynamic particle size distributions (APSDs) of orally inhaled products. Its size-fractionating capability depends primarily on the size of nozzles of each stage. Good Cascade Impactor Practice (GCIP) requires that these critical dimensions are linked to the accuracy of the APSD measurement based on the aerodynamic diameter size scale. Effective diameter (Deff) is the critical dimension describing any nozzle array, as it is directly related to stage cut-point size (d50). d50 can in turn be determined by calibration using particles of known aerodynamic diameter, providing traceability to the international length standard. Movements in Deff within manufacturer tolerances for compendial CIs result in the worst case in shifts in d50 of <±10%. Stage mensuration therefore provides satisfactory control of measurement accuracy. The accurate relationship of Deff to d50 requires the CI system to be leak-free, which can be checked by sealing the apparatus at the entry to the induction port and isolating it from the vacuum source and measuring the rate of pressure rise before each use. Mensuration takes place on an infrequent basis compared with the typical interval between individual APSD determinations. Measurement of stage flow resistance (pressure drop; ΔPstage) could enable the user to know that the CI stages are fit for use before every APSD measurement, by yielding an accurate measure of Deff. However, more data are needed to assess the effects of wear and blockage before this approach can be advocated as part of GCIP.

Anthropometry and blood pressure changes in a caribbean adolescent population of african ancestry: an evaluation of longitudinal data using a multilevel mixed regression approach / Antropometría y cambios de presión sanguínea en una población adolescente caribeña de ascendencia africana: evaluación de datos longitudinales en un enfoque de regresión multinivel mixto

OBJECTIVE: The aim of this study was to determine the effect of growth pattern on blood pressure changes in an adolescent population of African ancestry based on longitudinal data and to compare this with estimates derived from cross-sectional data. METHODS: Participants had measurements of weight, height, blood pressure and percentage body fat taken annually using standardized procedures. Annual blood pressure and anthropometry velocities as well as one- and three-year interval gender specific tracking coefficients were computed. We investigated whether changes in blood pressure could be explained by measures of growth using a multilevel mixed regression approach. RESULTS: The results showed that systolic blood pressure (SBP) increased by 1.27 and 3.09 mmHg per year among females and males, respectively. Similarly, diastolic blood pressure (DBP) increased by 1.16 and 1.92 mmHg per year among females and males, respectively. Multilevel analyses suggested that weight, body mass index, percentage body fat and height were the strongest anthropometric determinants of blood pressure change in this population. The results also suggest that there are gender differences in the relative importance of these anthropometric measures with height playing a minor role in predicting blood pressure changes among adolescent females. With the exception of DBP at 18 years among females, there were no significant differences between mean blood pressure generated from cross-sectional and longitudinal data by age in both males and females. CONCLUSION: Anthropometric measures are important covariates of age-related blood pressure changes and cross-sectional data may provide a more cost-effective and useful proxy for generating age-related blood pressure estimates in this population.

OBJETIVO: El objetivo de este estudio fue determinar el efecto del patrón de crecimiento sobre los cambios de presión sanguínea en una población juvenil de ascendencia africana sobre la base de datos longitudinales, y comparar esto con los estimados derivados de los datos transversales. MÉTODOS: A los participantes se les hicieron mediciones de peso, altura, presión sanguínea, y porcentaje de grasa corporal, las cuales fueron realizadas anualmente mediante procedimientos estandarizados. Se computarizaron la presión sanguínea anual y las velocidades de la antropometría así como los coeficientes de rastreo específicos de género en intervalos de uno y tres años. Se investigó si los cambios de presión sanguínea podrían explicarse por las medidas de crecimiento, usando un enfoque de regresión multinivel mixto. RESULTADOS: Los resultados mostraron que la presión sanguínea sistólica (PSS) aumentaba en 1.27 y 3.09 mmHg por año entre las hembras y los varones respectivamente. De modo similar, la presión sanguínea diastólica (PSD) aumentaba en 1.16 y 1.92 mmHg por año entre las hembras y varones respectivamente. Los análisis multiniveles sugirieron que el peso, el índice de masa corporal, el porcentaje de grasa corporal y la altura, fueron los determinantes antropométricos más fuertes del cambio de presión sanguínea en esta población. Los resultados también sugieren que hay diferencias de género en la importancia relativa de estas mediciones antropométricas, siendo el caso que la altura juega un papel menor a la hora de predecir los cambios de presión sanguínea entre las adolescentes. Con excepción de la PSD a los 18 años entre las hembras, no hubo ninguna diferencia significativa entre la presión sanguínea promedio obtenida a partir de los datos transversales y longitudinales por edad, tanto en los varones como en las hembras. CONCLUSIÓN: Las medidas antropométricas son covariantes importantes de los cambios de presión sanguínea relacionadas con la edad. Los datos transversales pueden ofrecer un recurso útil y costo-efectivo para producir estimados de la presión sanguínea relacionada con la edad en esta población.

Anthropometry and blood pressure changes in a Caribbean adolescent population of African ancestry: an evaluation of longitudinal data using a multilevel mixed regression approach.

OBJECTIVE: The aim of this study was to determine the effect of growth pattern on blood pressure changes in an adolescent population of African ancestry based on longitudinal data and to compare this with estimates derived from cross-sectional data. METHODS: Participants had measurements of weight, height, blood pressure and percentage body fat taken annually using standardized procedures. Annual blood pressure and anthropometry velocities as well as one- and three-year interval gender specific tracking coefficients were computed. We investigated whether changes in blood pressure could be explained by measures of growth using a multilevel mixed regression approach. RESULTS: The results showed that systolic blood pressure (SBP) increased by 1.27 and 3.09 mmHg per year among females and males, respectively. Similarly, diastolic blood pressure (DBP) increased by 1.16 and 1.92 mmHg per year among females and males, respectively. Multilevel analyses suggested that weight, body mass index, percentage body fat and height were the strongest anthropometric determinants of blood pressure change in this population. The results also suggest that there are gender differences in the relative importance of these anthropometric measures with height playing a minor role in predicting blood pressure changes among adolescent females. With the exception of DBP at 18 years among females, there were no significant differences between mean blood pressure generated from cross-sectional and longitudinal data by age in both males and females. CONCLUSION: Anthropometric measures are important covariates of age-related blood pressure changes and cross-sectional data may provide a more cost-effective and useful proxy for generating age-related blood pressure estimates in this population.

[Sputum smear conversion during intensive TB treatment phase according to HIV status, in hospitalised patients in Togo]. / Négativation des frottis respiratoires selon le statut VIH à la phase intensive du traitement antituberculeux chez les patients hospitalisés au Togo.

METHOD: We prospectively studied patients with pulmonary TB, with or without HIV-1 co-infection, from December 1, 2007 to December 1, 2008. Two groups of patients naive for TB and antiretroviral treatment (group A: 96 co-infected TB/HIV and group B: 171 TB infected but HIV negative) were selected randomly. The CD4 count was assessed according to HIV status, and all patients received RHEZ TB treatment for 2 months. Pulmonary smear was assessed at two weeks, four weeks, six weeks, and eight weeks. RESULT: Two hundred and sixty seven patients were treated (26.6% of admissions). The mean age was 34.62 ± 11 years and the sex ratio was 1.3. A proportion of 35.75% patients were HIV co-infected with a median CD4 count at 157 cells per millimeter cube. The sputum smear conversion was obtained for more than 87.5% of patients in group A and 24.56% in group B at two weeks; 94% of patients in group A and 61.83% in group B at four weeks; 100% of patients in group A and 87.33% in group B at six weeks, and 100% of patients in group A and 96.77% in group B at eight weeks. P<0.05 at six weeks. CONCLUSION: HIV infected TB patients were more susceptible to treatment than TB/HIV infected patients in the first six weeks.