Breastfeeding: How is it related to food insecurity and other factors among low-income mothers?

A cross-sectional study was conducted to (1) examine breastfeeding initiation and continuation rates, and; (2) investigate association between food insecurity and breastfeeding status, among low-income mothers. Mothers of infants two-months or younger were recruited from a local pediatric clinic serving primarily low-income families. Upon giving consent, mothers were interviewed in-person or over the phone in either English or Spanish. Of the total 92 mothers interviewed, 90% initiated breastfeeding, but only 24% were doing exclusive breastfeeding at 2 months of infant's age. After controlling for socio-demographics, it was found that food-insecure mothers were less likely to continue with breastfeeding (ß = -1.51, p = .024). Future research is warranted to understand pathways through which food insecurity affects breastfeeding and how this disparity can be prevented to ensure a safe and secure start for infants worldwide.

Strength, power, and coactivation in children with developmental coordination disorder.

Strength, power, and coactivation levels were measured during knee extension and flexion tasks in 20 children (13 males, 7 females) with developmental coordination disorder (DCD) and 20 age-matched control children (12 males, 8 females). Participants were classified according to results obtained on the McCarron Assessment of Neuromuscular Development, with each group including two age levels: 6 to 7 and 9 to 10 years. Tasks were performed on a Biodex dynamometer under isometric and isokinetic conditions with surface EMG recorded from the vastus lateralis and biceps femoris muscles. Significant effects of group and age were observed for the measures of peak torque (isometric and isokinetic) and power, with the decreased power in the group with DCD being more apparent at higher velocities. A lower flexor-extensor percentage was recorded for the group with DCD but only under isokinetic conditions. From a neuromuscular perspective, the group with DCD had increased levels of coactivation (RMS agonist:RMS antagonist) during the isometric flexion and isokinetic extension actions. Possible causes of the strength and power deficits observed in children with DCD are discussed.

Fractioned reflex and reaction time in children with developmental coordination disorder.

The patellar tendon reflex (PTR) and simple visual reaction time (RT) were fractionated and compared in 40 subjects with developmental coordination disorder (DCD) and normal coordination (NC) in two age groups. Four equal groups of subjects, 6 years DCD (6DCD), 6 years NC (6NC), 9 years DCD (9DCD), and 9 years NC (9NC) were compared using ANOVA for the main effects of coordination and age. PTR and its components of reflex latency and motor time were not significantly affected by the level of coordination; however, a significant coordination by age interaction (p < .05) revealed an increased motor time in the 6DCD group. RT, premotor time, and motor time were all significantly (p < .05) increased in children with DCD; the increased RT and premotor time support earlier findings, whereas the increased motor time has not previously been found. These findings suggest that the processing of reflexive and volitional responses by children with DCD differs from that of their NC peers.

Perceived personal immunity to the consequences of drinking alcohol: the relationship between behavior and perception.

Heavy drinkers, moderate drinkers, light drinkers, and nondrinkers were asked to rate a variety of negative health and social consequences of using alcohol. Subjects made probability ratings for fictional others who were heavy, moderate, or light drinkers or nondrinkers. Subjects also made probability ratings for themselves as hypothetical heavy, moderate, or light drinkers or nondrinkers and for themselves actually. A pattern of perceived personal immunity was found across groups. Subjects rated fictional others and themselves as hypothetical drinkers to be more likely to experience negative consequences than their actual selves. All groups of subjects (heavy, moderate, and light drinkers and abstainers) rated their actual chances of experiencing negative consequences to be approximately equal. In contrast, heavy drinkers saw the effects of drinking for other heavy drinkers as less likely than did subjects who had light or abstinent drinking patterns who rated fictional heavy drinkers. These findings suggest that individuals who drink more tend to deny the potential harm that may result from alcohol consumption. Short-term social consequences were viewed as most likely to occur. Long-term consequences were perceived as least likely to occur.

Peer-group association and adolescent tobacco use.

Mosbach & Leventhal (1988) examined the relation of cigarette smoking to peer-group identification in rural Wisconsin adolescents. They found that among dirts (problem-prone youth), regulars (average youth), hot-shots (good social or academic performers), and jocks (athletes), youth most likely to smoke were dirts and hot-shots. We performed a replication with a Southern California cohort and also for use of smokeless tobacco. We hypothesized that jocks would be the main users of smokeless tobacco. We identified the same groups and an additional one, skaters (skateboarders or surfers). As Mosbach & Leventhal found, cigarettes were used most by dirts. Contrary to their results, but consistent with other research, we found that hot-shots were least likely to smoke. Contrary to our prediction, we found that skaters and dirts were more likely to use smokeless tobacco than were jocks. Our data show that both tobacco forms are used by problem-prone youth.

A phase II study of ifosfamide in the treatment of recurrent sarcomas in young people.

We have evaluated the activity of ifosfamide in 75 patients with recurrent sarcomas and pediatric solid tumors. All patients had previously received cyclophosphamide in combination with other chemotherapeutic agents. Ifosfamide was administered as a continuous 5 day infusion at a dose of 1800 mg per M2, except in the last 14 patients who received the drug as a daily one hour infusion at the same dose level. Partial response was observed in 9 of 20 patients with Ewing's sarcoma, 2 of 9 patients with rhabdomyosarcoma, 3 of 17 patients with osteogenic sarcoma and 4 of 29 patients with various other neoplasms. A further 6 patients had stable disease, defined as the absence of progression for at least 6 cycles of therapy. Thus overall response rate was 24%, with the highest response rate of 45% being observed in Ewing's sarcoma. Toxicity was acceptable, although there was quite marked leucopenia (median nadir 700) with less profound thrombocytopenia (median nadir 87,000). Sepsis occurred in 3 patients but no patient died as a result of infection. Hematuria occurred in 43% of patients who did not receive mesna, and in 26% of patients who did, although prior pelvic irradiation was found to be a significant risk factor for hematuria. Only 1 of 14 patients without prior pelvic irradiation or hematuria developed hemorrhagic cystitis when treated with ifosfamide and mesna. Confusional states developed in 6 patients. We conclude that ifosfamide is an active agent in patients with relapsed sarcomas and childhood solid tumors, even when such patients have been previously treated with cyclophosphamide.

Muscle phosphofructokinase deficiency: two cases with unusual polysaccharide accumulation and immunologically active enzyme protein.

Two patients with phosphofructokinase (PFK) deficiency had exercise intolerance and increased serum activity of creatine kinase; one presented with hemolytic anemia, hyperuricemia, and gouty arthritis. The glycogen concentration in the muscle of these patients was about twice normal. PFK activity was virtually absent in muscle, but antibodies against the M subunits of the normal human PFK showed cross-reacting material in muscle from both patients. The PFK level in red blood cells, studied in one case, was lower than normal in the patient and both parents. Morphologically, there was extensive deposition of normal glycogen underneath the sarcolemma and in the intermyofibrillar space. In addition, 2% to 3% of the myofibers contained hyaline, PAS-positive, diastase-resistant inclusions that had a filamentous fine structure; histochemical reactions suggested an insoluble form of glycogen. Similar inclusions have not been described previously in PFK deficiency. Accumulation of an abnormal polysaccharide in muscle may be due to a second undiscovered enzymatic defect or may be a metabolic consequence of PFK deficiency.

Behçet's disease and treatment with colchicine.

A case of Behçet's disease characterized by anterior uveitis, arthritis, oral, genital, and cutaneous lesions, as well as gastrointestinal involvement, all documented over a 10-month period, is presented. Less commonly appreciated complications, such as pyoderma gangrenosum, hidradenitis suppurativa, perianal fistula, and persisting leukocytosis, were among striking clinical features of the patient's history. Remission of cutaneous lesions and no recurrence of ocular or gastrointestinal manifestations occurred with 0.6 mg oral colchicine twice daily in a period of 5 weeks.

Complications of closed capsulotomies after augmentation mammaplasty.

In a series of patients who underwent closed rupture of fibrous capsules surrounding mammary prostheses, 3 patients developed hematomas or rupture of the implant, with or without infection. These complications and their management are discussed. Closed capsulotomy is a valuable procedure, simple to apply and easy to learn, but it is not devoid of complications.

use of F(ab')2 fragment in experimental skin transplantation for burns.

In a series of experiments involving approximately 500 animals, burned rats were administered the F(ab')2 fragment of antidonor IgG to study the survival of incompatible skin allografts. No prolongation was noted when treatment consisted of antidonor F(ab')2 fragment alone. This was true whether the fragment was raised against donor spleen cells of donor skin, whether the skin allograft was partial or full thickness and whether the systemic treatment of the recipients was preceded by a period of incubation of the graft in F(ab')2 fragment or not. Significant prolongation of survival was noted when the fragment was raised against both donor and recipient histocompatibility antigen and when the donor skin was incubated in steroids as well as in F(ab')2 fragment prior to grafting. Additional findings included the confirmation of prolonged allograft survival by increasing burn size and the prolongation of allograft survival by the presence of intact eschar.

Cosmetic advantages of augmenting the hypoplastic breast via the transaxillary route.

Augmentation mammoplasty by the transaxillary approach is an acceptable and safe technique with few complications. Proper preoperative planning and attention to surgical detail result in symmetrical and natural appearing breasts. The major advantage is related to the present female attire and desires to have a concealed scar. In about 3 months the incision is hardly noticeable and the woman is very pleased.

Medullary thyroid carcinoma.

Medullary thyroid carcinoma is an infrequent and unusual malignancy. Since its description 15 years ago, many new features have developed. Many biologically active compounds which are directly related to the different symptoms of the disease have been recovered from the tumors. A familial incidence is noted, and there is an increased association with other tumors and their behavior. The cell of origin is the parafollicular cell, which secretes calcitonin and is responsible for the unusual behavior of medullary thyroid carcinoma. Treatment is primiarily surgical. Four cases are presented and the syndrome reviewed.