Weight, skinfolds and circumference characteristics of poor elderly people in Mumbai, India.

This paper describes the anthropometric characteristics of 1,335 (males 545, females 790) people of low socio-economic classes aged 50-97 years (mean age 60 years) living in slums and tenement blocks around a major teaching hospital in central Mumbai (Bombay). Descriptive statistics for weight, mid-upper arm and calf circumferences, and biceps, triceps, subscapular and suprailiac skinfolds are presented. Subjects were much lighter, thinner and had smaller circumferences than their age- and sex- matched American counterparts but were similar to nationally representative Indian slum groups, as well as other Asian groups. Men were significantly heavier than women and had larger circumferences whereas women had significantly fatter skinfoldss. Age was significantly but non-linearly related to all variables in women but only to mid-upper arm and calf circumferences in men : there was a marked step effect with the age cut-off 70 years. Reliability for all measurements was high (R > 0.95), with technical errors of measurement highest for skinfolds, especially the suprailiac. The overall prevalence of oedema was 2.8%. In the whole sample, men were significantly older than women, probably because men are more likely to be out working than women, especially below 65 years old. A good participation rate was achieved (78%), with women more likely to participate than men. Almost half of the non-participancy can be attributed to work-related activity, particularly in men. Discussion focuses on practical issues of taking anthropometric measurements in elderly people living in the community, reliability, and non-participant bias.

Gastric bacterial overgrowth accompanies profound acid suppression.

BACKGROUND: Suppression of gastric acid may lead to gastric colonization by aerobic and anaerobic bacteria, and consequent clinical manifestations. The risk is likely to be higher with poor environmental hygiene. AIMS: To study the effect of short-term acid suppression with omeprazole on gastric bacterial flora. METHODS: Twenty-five ambulatory patients with acid-peptic diseases underwent clinical assessment and gastric juice collection (for pH and culture) prior to start of therapy with 20 mg omeprazole daily, on days 7 and 14 of therapy, and 7 days after omission of therapy (day 21). RESULTS: Eighteen patients completed the study. The median gastric pH was 1.8, 7.5, 7.5 and 3.4 on days 0, 7, 14 and 21 respectively. Positive gastric cultures were obtained in 13 of 25, 17 of 21, 18 of 18 and 14 of 18 patients on respective study days, with median colony counts of 1.5 x 10(4), 7.5 x 10(5), 8.7 x 10(7) and 7.3 x 10(4) cfu/mL respectively. Three patients developed self-limiting diarrhea during therapy and two more immediately after discontinuing therapy. CONCLUSIONS: Gastric colonization is common with short-term profound acid-suppression, and may cause diarrhea. Acid suppressive therapy should be used with caution especially in patients with poor environmental hygiene.

Portal venous pressure and the serum-ascites albumin concentration gradient.

CLINICAL ISSUE: Other investigators have found the serum-ascites albumin concentration gradient to be 1.1 g/dL or greater in the presence of portal hypertension and less than that in its absence. OBJECTIVE: To determine if any correlation exists between the serum-ascites albumin concentration gradient (which reflects the net serum oncotic pressure) and the portal venous pressure. METHODS: The study group comprised 15 patients who had alcoholic cirrhosis. The portal venous pressure was calculated as the difference between the measured hepatic venous wedge and inferior vena cava pressures and was expressed as the hepatic venous pressure gradient. SUMMARY: All patients had portal hypertension; the mean hepatic venous pressure gradient was 14.81 +/- 6.91 (SD) mm Hg. Fourteen of the 15 patients had a serum-ascites albumin concentration gradient of at least 1.1 g/dL; the mean value was 2.168 +/- .709 g/dL. No correlation was found between these variables (r = .0459, P > .05). CONCLUSIONS: Although the serum-ascites albumin concentration gradient is a sensitive indicator of portal hypertension in patients with alcoholic cirrhosis, it does not reflect the portal venous pressure.

Involvement of prostaglandins in chilli-induced early gastric vascular damage in adult Wistar rat.

OBJECTIVE: To explore the role of prostaglandins in protecting against chilli-induced early gastric vascular damage. METHODS: Early gastric vascular damage was induced in rats by oral administration of 8 mg/Kg chilli extract. The damage was assessed by estimating spectrophotometrically the amount of Evan's blue leaking into gastric tissue and luminal contents 10 min after exposure to chilli. Further groups of rats were pretreated with misoprostol (10, 25 or 50 micrograms/Kg) or dazmegrel (1, 5 or 25 mg) to evaluate their protective effects. RESULTS: Both misoprostol and dazmegrel were able to reduce gastric vascular damage induced by chilli in a dose-dependent fashion. CONCLUSION: Prostaglandins may play a role in protecting against chilli-induced early gastric vascular damage.

Polymorphonuclear and monocyte functions in measles.

The depression of immune responses during measles infection has been recognized since the early 20th century. Acute bacterial infections are the most common cause of morbidity and mortality in measles. This study investigated the phagocytic and bactericidal or fungicidal capacities of polymorphonuclear cells (PMN) and monocytes during measles infections. When 14 children with measles were compared with 25 healthy controls, a significant depression in PMN and monocyte function was found. Of these 14 children, seven developed acute bacterial infections. These seven children were compared with 11 children who had acute bacterial infections without measles. It was found that PMN in patients with measles did not achieve an activated state, as expected with acute infections. Serum immunoglobulins were not altered in these patients. These results confirm previous reports of depressed phagocytic and bactericial capacities of PMN in measles, and further document that peripheral blood monocyte functions are also depressed in measles.

Plasma rifampicin levels during oral contraception.

PIP: Researchers conducted a study on the effect of oral contraceptives (OCs) on rifampicin plasma levels in 6 healthy women between 19-38 years old. These women's weight ranged between 40-60 kg an their height between 150-160 cms. All hemoglobin levels were 10 g. They had not used OCs for 3 months before the research began. As a control, the volunteers 1st did not receive an OC and had a menstrual cycle. Blood samples were collected between days 15-28 of the menstrual cycle. They took a daily low dose OC containing 1 mg norethisterone acetate and 30 mcg ethinyl estradiol in the next cycle. Before and after the 2nd OC cycle, they took 450 mg of rifampicin while the stomach was void and laboratory personnel estimated plasma levels of rifampicin by microbiological assay at 0, 1, 2, 4, 6 and 8 hours. When the women were taking no OC, peak plasma levels of rifampicin ranged between 8.2-36 mcg/ml, while they varied between 11.25-29 mcg/dl during the 2nd OC cycle. Further, the time of peak concentration of rifampicin when the women did not use an OC occurred between 2-4 hours in 5 women and at 6 hours for the other woman. During OC administration, all the women's peak concentration was 2 or 4 hours. The area under curve (AUC) of rifampicin while no OC was used extended from 29.85-176 + or - 22.1 mcg/ml/hour and 61.9-157.7 + or - 14.9 mcg/ml/hour while the women took the OC. No significant difference existed between before and during OC use plasma levels of rifampicin and AUC. Even though studies show that rifampicin treatment reduces plasma levels of OCs, these results demonstrate that a low dose OC does not change rifampicin levels.^ieng