Influence of dental carcass maturity classification on carcass traits and tenderness of longissimus steaks from commercially fed cattle.

Two hundred beef carcasses were randomly selected by dental classification (zero, two, four, six, or eight permanent incisors) from a population of 11,136 carcasses harvested by a large commercial beef processor. Warner-Bratzler shear force and trained sensory panel evaluations of longissimus thoracis steaks as well as cooking and carcass traits were evaluated for differences among dental classes. No differences in Warner-Bratzler shear force (P = 0.60), sensory panel evaluations (P = 0.64) for tenderness, or percentage of total cooking loss (P = 0.73) were found among the five dental classes. Longissimus muscle color, USDA marbling score, hot carcass weight, adjusted fat thickness, longissimus muscle area, and USDA yield grade did not differ among the five dental classes. A significant dental classification x sex interaction indicated that heifers advanced in skeletal and overall maturity at a much faster rate than steers. An increase of intramuscular fat was associated (P < 0.05) with decreased shear force (r = -0.31), whereas darkening of the lean (r = 0.16), advancing lean maturity (r = 0.21), and increased evaporative cooking loss (r = 0.39) were associated (P < 0.05) with increased shear force values. Warner-Bratzler shear force measurements were not related to sensory panel overall tenderness scores. Carcass traits accounted for a relatively small proportion of the variation in tenderness of longissimus steaks, and dental classification was not related to tenderness.

A comparison of the USDA ossification-based maturity system to a system based on dentition.

Two studies using commercially fed cattle were conducted to determine the relationship of the USDA bone ossification-based maturity system to one based on the number of permanent incisors present at slaughter. These studies showed that 91.5 to 100% of cattle with zero permanent incisors (< 23.8 mo of age), 89.1 to 97.5% of cattle with two permanent incisors (23.8 to 30.4 mo of age), 75 to 82.2% of cattle with four permanent incisors (30.4 to 38.0 mo of age), 64 to 72.5% of cattle with six permanent incisors (38.0 to 45.3 mo of age), and 40% of cattle with eight permanent incisors (> 45.3 mo of age) were graded as A maturity by the USDA maturity classification system. Kappa tests revealed no statistical relationship between the dentition- and skeletal ossification-based maturity systems. Dentition-based maturity agreed with ossification/lean maturity for only 162 of 1,264 carcasses in Exp. 1 and only 54 of 200 carcasses in Exp. 2. Cattle with two, four, six, or eight permanent incisors were classified in more youthful categories of USDA bone ossification/lean maturity than they should have been. Male cattle were more likely to be misclassified into a younger age category by the USDA system than were female cattle. It seems that determining physiological maturity by number of permanent incisors rather than by the current USDA method of subjectively evaluating skeletal and lean maturity may prove to be a more accurate technique of sorting beef carcasses into less-variable age groups.

The effect of an exogenous fibrin clot on the regeneration of the triangular fibrocartilage complex: an in vivo experimental study in dogs.

The effect of an exogenous fibrin clot on the regeneration of the triangular fibrocartilage complex (TFCC) was examined in a dog model. In 12 mature dogs, bilateral TFCC resection was performed. The resulting defect was packed with an exogenous fibrin clot (experimental) while the contralateral side was left empty (control). Tissue regeneration was evaluated grossly and histologically at 6, 12, and 26 weeks. At each time period, the regenerated tissue in the fibrin clot-filled defect appeared more mature and more congruent with the adjacent cartilaginous surfaces than did the control (empty) defect. At 26 weeks, the clot regenerated tissue had the histological appearance of a normal TFCC with a homogeneous fibrocartilaginous matrix, regularly oriented collagen fibers, and normal integration with the adjacent support structures of the joint. The results of this study indicate that an exogenous fibrin clot could be used to promote a fibrocartilaginous repair tissue for a resected TFCC. Such therapy could be used in the arthroscopic treatment of TFCC injury and resection in an effort to improve postoperative outcome.

The assay of interleukin 4 in the serum of normal subjects and atopic patients using a novel immunoassay.

Interleukin 4 (IL-4) was measured in the serum of normals and mild atopic patients using a high sensitivity ELISA system involving an amplification stage. The method was found to have a limit of detection of 0.02 pg/ml after a square root transformation of the concentration data and to show good reproducibility with coefficients of variation between 11 and 14%. Recoveries of standard IL-4 from serum was greater than 90%. Markedly elevated levels of IL-4 were seen in the atopic groups compared with the normals. No association was found between total white cell counts, lymphocyte or eosinophil counts and serum IL-4 levels. This study demonstrates that serum IL-4 levels can distinguish between atopic subjects and normals, even in mild or symptomless disease. This may prove valuable in the management of atopic disorders.

Improving pain management in an acute care setting. The Crawford Long Hospital of Emory University experience.

PURPOSE: To identify which of three pain intensity measurement scales is most appropriate for use with patients admitted to the inpatient units of the study hospital. The following questions were addressed: Is one of the scales easier for most patients? Is the choice of scales influenced by nursing unit, age, education, race, SES, diagnosis, or type of pain experienced? Do patients perceive that a rating scale helps them describe their pain more effectively? SAMPLE: 267 patients admitted over a 3-week period completed a four-page questionnaire and demographic form distributed on admission. The primary admitting diagnosis for 39.5% of the sample reflected acute pain, 40.3% chronic pain, and 20.2 no pain. METHODS: Three pain rating scales were presented: two visual analogues (one contained a 100 mm line; the other contained six faces depicting graduated levels of distress); and a cognitive number rating scale. Each scale used a 0 (no pain) to 10 (worst pain possible) rating format. Patients completed the questionnaire by rating the intensity of pain experienced using each of the three scales once over the next 24 hours. The last page contained questions related to which of the scales was easiest to use, whether the scale was helpful or needed further explanation, and work and education information. The demographic form was completed from information contained in the patient record. FINDINGS: The scale selected most frequently was the visual analogue containing faces (48.6%), followed by the number (35.3%) and line scales (16.1%). None of the demographic information was found to significantly influence choice of preferred scale. A majority (85.8%) indicated a rating scale as helpful; only 13.6% indicated a need for further explanation. The means for pain intensity ranged from 5.09 to 5.75. The interval between pain ratings for the majority (> 71%) was less than 2 hours. Patients tended to tell the nurse about their pain when the intensity exceeded the midpoint on the scales. A reliability coefficient for the three scales was computed at alpha = 0.88. CONCLUSION: The use of rating scales for pain assessment in adult inpatient units was viewed positively by patients. Recommendations for incorporating self-ratings of pain intensity are set forth. Involving both patients and providers in the process is essential to improving both our processes and the outcomes achieved.

The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight.

This study investigated whether the addition of the high-intensity sweetener aspartame to a multidisciplinary weight-control program would improve weight loss and long-term control of body weight. One hundred sixty-three obese women were randomly assigned to consume or to abstain from aspartame-sweetened foods and beverages during 16 wk of a 19-wk weight-reduction program (active weight loss), a 1-y maintenance program, and a 2-y follow-up period. Women in both treatment groups lost approximately 10% of initial body weight (10 kg) during active weight loss. Among women assigned to the aspartame-treatment group, aspartame intake was positively correlated with percentage weight loss during active weight loss (r = 0.32, P < 0.01). During maintenance and follow-up, participants in the aspartame group experienced a 2.6% (2.6 kg) and 4.6% (4.6 kg) regain of initial body weight after 71 and 175 wk, respectively, whereas those in the no-aspartame group gained an average of 5.4% (5.4 kg) and 9.4% (9.4 kg), respectively. The aspartame group lost significantly more weight overall (P = 0.028) and regained significantly less weight during maintenance and follow-up (P = 0.046) than did the no-aspartame group. Percentage weight losses at 71 and 175 wk were also positively correlated with exercise (r = 0.32, P < 0.001; and r = 0.34, P < 0.01, respectively) and self-reported eating control (r = 0.37, P < 0.001; and r = 0.33, P < 0.01, respectively). These data suggest that participation in a multidisciplinary weight-control program that includes aspartame may facilitate the long-term maintenance of reduced body weight.

Energy and macronutrient consumption of elementary school children served modified lower fat and sodium lunches or standard higher fat and sodium lunches.

OBJECTIVE: To determine the energy and macronutrient consumption of elementary school children served modified lower fat and sodium or typical higher fat and sodium school lunches. DESIGN: The intervention school received lunches with < 30% of energy from fat and < 1000 mg sodium. The control school received typical lunches with 35% of energy from fat and > 1000 mg sodium. Served lunches were analyzed from menus and consumed lunches were analyzed using USDA plate waste methodology. SUBJECTS: Eighty intervention and 80 control subjects matched for ethnicity and economic status. RESULTS: Intervention school menus were significantly lower for energy, sodium, and fat compared to the control school. From analysis of plate waste, children from both schools consumed approximately 25% less energy than served (p < 0.05). Consumption of fat as a percentage of total energy and consumption of sodium was significantly less for the intervention compared to the control school. Compensation for the lower fat meals by the intervention school children (eating greater portions of high fat items) was not evident as the percentage of energy from fat consumed was only 1.3% greater than the percentage which was served. CONCLUSIONS: Lunch meals in this study were consumed as served. Intervention school children served lower fat and sodium meals consumed less fat and sodium than control school children and did not selectively eat only higher fat and sodium items.

Nutrition and physical activity program to attenuate obesity and promote physical and metabolic fitness in elementary school children.

Obesity and low levels of physical and metabolic fitness are risk factors for cardiovascular disease and diabetes. The purpose of this investigation was to attenuate obesity and improve physical and metabolic fitness in elementary school children. Schools have the opportunity, mechanisms, and personnel in place to deliver nutrition education, fitness activities, and a school food service that is nutritious and healthy. Cohorts from grades 3 to 5 in two school districts in rural Nebraska (Intervention/Control) participated in a 2-year study of physical activity and modified school lunch program. Data collection for aerobic capacity, body composition, blood chemistry, nutrition knowledge, energy intake, and physical activity was at the beginning and end of each year. Int received enhanced physical activity, grade specific nutrition education, and a lower fat and sodium school lunch program. Con continued with a regular school lunch and team sports activity program. At year 2, Int lunches had significantly less energy (9%), fat (25%), sodium (21%), and more fiber (17%). However, measures of 24-hour energy intake for Int and Con showed significant differences for sodium only. Physical activity in the classroom was 6% greater for Int compared to Con (p < 0.05) but physical activity outside of school was approximately 16% less for Int compared to Con (p < 0.05). Body weight and body fat were not different between schools for normal weight or obese children. No differences were found for cholesterol, insulin, and glucose; however, HDL cholesterol was significantly greater and cholesterol/HDL was significantly less for Int compared to Con (p < 0.05). It appears that compensation in both energy intake and physical activity outside of school may be responsible for the lack of differences between Int and Con.

Identification of antioxidants for prevention of peroxide-mediated oxidation of recombinant human ciliary neurotrophic factor and recombinant human nerve growth factor.

Peroxides present in non-ionic surfactants used to stabilize certain recombinant protein formulations (e.g. polysorbate 80) can result in the oxidative degradation of proteins. In this study, the ability of various pharmaceutically acceptable antioxidants to prevent the oxidative degradation of two therapeutic proteins, recombinant human Ciliary Neurotrophic Factor (rhCNTF) and recombinant human Nerve Growth Factor (rhNGF), caused by alkyl hydroperoxides and hydrogen peroxide was studied. For rhCNTF, the rank order of effectiveness of the antioxidants tested was: thiols (cysteine, glutathione, thioglycerol) >> thioethers (methionine). Other parenterally acceptable antioxidants (ascorbic acid, propyl gallate and sodium bisulfite) destabilized the protein. The thiol antioxidants (cysteine and glutathione) were also the most effective antioxidants for rhNGF; however, in contrast to rhCNTF, ascorbic acid did not destabilize rhNGF. The rank order of effective antioxidants for rhNGF was: thiols (cysteine, glutathione) > > thioethers (methionine) > ascorbic acid.

Influence of degree of obesity on loss of fat-free mass during very-low-energy diets.

This study examined the influence of initial degree of obesity on loss of fat-free mass (FFM). One hundred twelve obese females participated in a series of very-low-energy diet (VLED) clinical trials. Obesity groups were determined by three common methods: percent body fat, body mass index, and weight. Within each group, subjects were classified into low-, intermediate-, and high-obesity groups. As expected, the high-obesity group lost comparable amounts or more weight and more fat weight than the low- and intermediate-obesity classifications for each group. The high-obesity group lost approximately 2% more FFM (P < 0.05) compared with the low and intermediate group when subjects were grouped by body mass index and weight and showed no differences between classifications when subjects were grouped by percent body fat. No differences were found between classifications for ratios of FFM to weight loss regardless of how subjects were grouped. Thus, the degree of obesity does not seem to affect loss of FFM.

Very low calorie diet with concurrent versus delayed and sequential exercise.

Obese females undergoing very-low-calorie diet (VLCD) were studied for 12 weeks to determine the effects of concurrent vs delayed and sequential exercise. Subjects were assigned to one of six groups: control (C) n = 28; endurance exercise (EE) n = 18; weight training (WT) n = 26; endurance exercise plus weight training (EEWT) n = 21; control for 4 weeks with subsequent EE (C4EE) n = 10; WT for 4 weeks with sequential EE (WT4EE) n = 12. EE was performed 3 days a week using five weight lifting exercises. Loss in body weight did not differ between groups. Expressed as a ratio of fat-free mass (FFM) to weight loss WT4EE showed a 8.1%, 9.7%, and 11.4% difference compared to EE, C4EE, and C, respectively (P < 0.05). WT4EE also showed significant increases from baseline of 8.2% in aerobic capacity (L/min) and 12.5% in the strength index (SI/kg FFM). WT4EE showed the smallest decrease of all groups in resting metabolic rate of 6.1% of the baseline value; however, this decrease was significant. Although WT4EE showed some favorable changes from baseline, the magnitude of the changes between groups was small. There were no significant differences found between C4EE and the other study groups. Thus, the delay or sequential use of exercise during VLCD provided only small differences for WT4EE compared to the other groups and any clinical significance for the individual is presently unknown.

Does the amount of endurance exercise in combination with weight training and a very-low-energy diet affect resting metabolic rate and body composition?

Effects of large (LA; 400 min/wk) and moderate (MA; 200 min/wk) amounts of endurance exercise in combination with weight training (3 d/wk) were compared with the effects of no exercise (C) in 23 obese females after a 12-wk, 3360-kJ/d very-low-energy diet (VLED). The LA group lost 6.5 kg more weight, mainly as fat (6.4 kg), than the C group (P < 0.05). No measurable differences were found among groups for decreases in resting metabolic rate (-729 to -1233 kJ/d; NS) or fat-free mass (-2.9 to -3.9 kg; NS). No improvements in aerobic capacity were achieved with the addition of exercise to a VLED (-0.079 to -0.037 L/min; NS). Strength indexes were improved (+16 to +5 kg; P < 0.05) or maintained with exercise (-3 kg; NS) whereas a loss (-9.3 kg; P < 0.05) or maintenance (+4.5 kg; NS) was found for VLED alone. Large amounts of endurance exercise in combination with weight training added to a VLED appear to improve weight and fat loss compared with a VLED alone.

What is vestibular papillomatosis? A study of its prevalence, aetiology and natural history.

OBJECTIVES: To clarify the prevalence, aetiology, symptoms and natural history of vestibular papillomatosis. DESIGN: Study in two parts: 1. prevalence assessed by colposcopic examination of the vulva of unselected patients by one doctor (J.M.W.); 2. patients selected by clinical appearance as having vestibular papillomatosis (by J.M.W. and other doctors) assessed in a research clinic. SETTING: Outpatient genitourinary medicine clinic in South London. SUBJECTS: Part 1 study: 295 female clinic attenders; part 2 study: 18 women with clinical vestibular papillomatosis. MAIN OUTCOME MEASURES: Part 1 study: number of unselected patients found to have vestibular papillomatosis. Part 2 study: associated symptoms, histology, DNA hybridisation and polymerase chain reaction on vulval biopsies. Clinical regression of lesions. Cervical cytology and colposcopy. RESULTS: Part 1 study: Vestibular papillomatosis was identified by colposcopic examination of the vulva in 3/295 (1%) of women. Part 2 study: 9/18 (50%) women with vestibular papillomatosis were asymptomatic; the other nine had intermittent mild symptoms. Thirteen (72%) had a history of genital warts. Vulval biopsies had features suggestive of wart virus infection on histology in 17/18 (94%) and HPV16 was found by DNA hybridisation studies or polymerase chain reaction in 7/18 (39%). On follow up (mean duration 9 months) the vulval lesions had regressed in 9/12 patients. Ten patients had cervical wart virus infection or intraepithelial neoplasia (CIN), or both, and five needed laser treatment for this. CONCLUSIONS: In this study vestibular papillomatosis was associated with human papillomavirus (HPV) infection. This study suggests that vestibular papillomatosis need not be treated, but patients with it may be at increased risk for CIN.

Muscle hypertrophy with large-scale weight loss and resistance training.

The combined effects of exercise and energy restriction on changes in body fat and fat-free mass (FFM) are controversial. This study was conducted to determine whether muscle hypertrophy is possible during weight loss. Fourteen obese females received a 3360-kJ/d liquid diet for 90 d. Seven subjects received a weight training (WT) regimen and seven subjects remained sedentary (C). Biopsy samples were obtained from the vastus lateralis muscle at baseline and after 90 d of treatment. The average weight loss over the 90-d period was 16 kg with approximately 24% of the weight loss from FFM and 76% from fat. The amount and composition of the weight loss did not differ between WT and C groups. The cross-sectional area of slow twitch and fast twitch fibers was unchanged by treatment in C subjects but significantly increased in WT subjects. It appears that weight training can produce hypertrophy in skeletal muscle during severe energy restriction and large-scale weight loss.

Continuing education needs of hospital-based nurses in Alabama.

Staff nurses (n = 403) and nurse executives (n = 82) were surveyed to determine the continuing education (CE) needs of hospital-based nurses in Alabama. Nurse executives preferred on-site, live offerings on Wednesday. Staff nurses preferred on-site, live offerings on Monday or Tuesday. Findings indicated that there was a difference in: (a) nurse executives' and staff nurses' perception of reimbursement policies, (b) nurse executives' and staff nurses' choice for days of week preferred, and (c) reimbursement policies and practices for RNs and LPNs.

Estimation of peak oxygen consumption from a sub-maximal half mile walk in obese females.

This study compared peak oxygen consumption estimated from a half mile sub-maximal walk test with oxygen consumption determined from a maximal treadmill test with 96 obese females. A half mile walk was completed as quickly as possible without running. Retests on 71 subjects were completed to determine the reliability of the half mile walk. Hearts rates were obtained for 15 s immediately upon completion of the walks. Stepwise regression to estimate peak VO2 was used with the following variables: walk time (TM), body weight, height, BMI, age, and heart rate (HR). The best equation was peak VO2 (ml/kg/min) = 53.23 - (1.98 x TM) - (0.32 x BMI) - (0.08 x age), r = 0.76, s.e.e. = 2.89 ml/kg/min. The mean difference between determined and estimated peak VO2 in a cross-validation group of subjects who were not included in the validation group was 0.15 ml/kg/min (n.s.), r = 0.77, s.e.e. = 3.01 ml/kg/min, E = 3.09. Reliability for time to complete the half mile walk was r = 0.87 with 0.1 min difference (n.s.). This study indicated the half mile walk to provide an accurate, reliable estimate of peak VO2 which should be useful in the clinical setting.

Azithromycin vs doxycycline in the treatment of non-gonococcal urethritis.

Azithromycin is a novel azalide macrolide active against Chlamydia trachomatis and Ureaplasma urealyticum. High persistent tissue concentrations allow short courses or even single doses to be considered. Sixty-two patients were studied, 19 received azithromycin 1 g in a single dose, 22 received azithromycin 500 mg in a single dose on day 1 followed by 250 mg once daily for 2 days and 21 received doxycycline 200 mg in a loading dose followed by 100 mg every 12 h for 7 days. Efficacy of these 3 regimens was compared in the treatment of non-gonococcal urethritis (NGU). Clearance of C. trachomatis from post-treatment cultures was satisfactory with all regimens. Response defined as the absence of symptoms and reduction in polymorphonuclear leucocytes in a Gram stained smear of urethral secretion to less than 5 cells per hpf (x 100 objective) was statistically better for the 3 day regimen of azithromycin than for the other 2 regimens. All treatments were well tolerated. Three days or single doses of azithromycin compared to 7 days of tetracycline (or 10-14 days as is often prescribed) have obvious advantages for patient compliance.

Episodic acyclovir therapy to abort recurrent attacks of genital herpes simplex infection.

Frequent recurrence of genital herpes simplex infection can be a distressing condition. Continuous suppressive oral acyclovir is effective but expensive. Hitherto episodic therapy has given disappointing results. An open comparative study of patient initiated therapy is reported here. Acyclovir 200 mg five times daily for five days aborted 44% of recurrences and shortened 38% by greater than or equal to 50%, giving useful response in 82% of 34 recurrences. Acyclovir 400 mg twice daily for five days aborted 60% and shortened 17% giving useful benefit in 77% of 20 recurrences. Acyclovir 200 mg twice a day for five days gave unsatisfactory results. Patients were selected for frequent recurrences and a recognized prodrome, and care was taken to help to identify early prodromal symptoms. In these patients acyclovir in dosages of 200 mg five times daily for five days and 400 mg bd for five days proved convenient and cost effective.

Effects of health locus of control and social network on adolescent risk taking.

The purpose of this study was to determine if health locus of control and social network are predictors of adolescent risk-taking. Findings demonstrated that 12% of the variance in risk-taking could be explained by 2 of the 3 dimensions of health locus of control (internal and powerful other health locus of control subscales), and social network.