Evaluating the ability to measure pork fat quality for the production of commercial bacon.

This study was conducted to evaluate three fat quality measures to characterize the suitability of pork bellies for commercial bacon production. Bellies from six sources (A to F) and two weight ranges (4.5/5.5 kg and 5.5/6.4 kg) were sampled by randomly selecting 50 belly sets from commercial combos of pork bellies from each source. The fat on these 50 individual bellies was assessed for quality using three methods: an FTNIR spectrophotometer to predict iodine (IV) value, a Durometer to assess fat firmness, and a subjective fat quality score (FQS) to assess integrated values of fat color, firmness, oiliness, and wetness. Data show that the fat quality measures differed (P<0.05) by pork belly source and weight class with significant interactions between the two. Bellies were subsequently manufactured into bacon and bacon slicing yield index varied significantly (P<0.05) by belly source, weight class, and their interaction. Durometer and FQS results were significantly (P<0.05) correlated with bacon slice yield. The 50 belly subsamples obtained from each source/weight class also allowed the prediction of frequency distribution-based values based on fat quality measures (proportion IV>74, proportion Durometer value <50, and proportion FQS>3. These were also correlated with slice yield. The data lead to a new paradigm model that is useful to describe both the uncertainty in fat quality measures and the relationships observed from pork bellies from different sources.

Reducing unnecessary coagulation testing in hypertensive disorders of pregnancy.

OBJECTIVE: To estimate the magnitude of laboratory testing for hypertension in pregnancy and determine whether abnormalities in prothrombin time (PT), activated partial thromboplastin time (aPTT), and fibrinogen can be predicted by results of common, less expensive tests. MATERIALS AND METHODS: Laboratory records were searched and charts were reviewed to identify gravidas tested for hypertension and to exclude conditions producing coagulopathy. Contingency tables were constructed to assess the ability of the platelet count, lactate dehydrogenase, and transaminases to predict coagulation test results. RESULTS: Preliminary data on 73 gravidas found that a platelet count plus a lactate dehydrogenase test best predicted coagulation abnormalities. Results on another 732 gravidas indicated that coagulation tests were obtained in about 30%. No patient had a PT greater than 18 seconds, two had an aPTT greater than 40 seconds, and three had fibrinogen levels less than 200 mg/dL. The combination of a normal platelet count plus a normal lactate dehydrogenase had a negative predictive value of 100% for clinically significant abnormalities of PT and aPTT, and 99% for significant abnormalities of fibrinogen. CONCLUSIONS: Substantial coagulation testing was done on gravidas evaluated for a hypertensive disorder even though the prevalence of clinically significant abnormalities was low. Laboratory evaluation of patients suspected of having preeclampsia need not include a PT, aPTT, or fibrinogen test when there is no evidence of bleeding or of a condition that could produce coagulopathy and when the platelet count and lactate dehydrogenase level are both normal.

Experimental deposition of environmental tobacco smoke submicrometer particulate matter in the human respiratory tract.

Measurements of 15 nonsmokers and 3 smokers breathing environmental tobacco smoke (ETS), were conducted to study particle deposition within the human respiratory tract. The subjects inhaled ETS of count median diameter (CMD) of about 0.2 micron and geometric standard deviation (GSD) of 1.7 The particle size distribution in the submicrometer range in the inhaled and exhaled air from the subjects was measured using a scanning mobility particle sizer (SMPS). A deposition of 56.0 +/- 15.9% was observed for nonsmokers while breathing ETS through the nose and 48.7 +/- 11.6% while breathing ETS through the mouth. One individual tested four times gave an average deposition of 57.4 +/- 11.5%, providing an indication of intraindividual variation. Such a variation is expected since the breathing rate was not controlled in order that an indication of the deposition experienced on a day-to-day basis could be obtained. For nonsmokers the deposition while breathing through the mouth was lower than through the nose and the variability within the measurements was also lower for mouth breathing. The latter could be due to the variation in individual size and shape of the nasal passage. Smokers had, on average, a higher rate of deposition but also a higher interindividual variability making it difficult to draw conclusions with respect to the affect of smoking on ETS particle deposition. The average deposition of the three smokers was 65.3 +/- 24.1% for nasal breathing and 66.1 +/- 17.6% for mouth breathing.

Effect of food on the absorption of frusemide and bumetanide in man.

1. The influence of food on the absorption of frusemide and bumetanide was compared in two separate randomized crossover studies. 2. On three separate occasions frusemide 40 mg was administered to eight healthy male volunteers intravenously, orally in the fasting state and orally after a standard breakfast. Blood and urine were collected at intervals over 8 h and urine alone for a further 16 h. The study was then repeated in nine healthy volunteers using intravenous and oral bumetanide 2 mg. 3. Breakfast significantly reduced the peak plasma concentration of frusemide from 2.35 +/- 0.49 to 0.51 +/- 0.19 mg l-1 (95% confidence intervals (95% CI) = 1.39 to 2.28 mg l-1) and delayed the time to peak concentration from 0.69 +/- 0.21 to 1.91 +/- 0.93 h (95% CI = 0.41 to 2.03 h). The oral bioavailability of frusemide was significantly reduced by approximately 30% (75.6 +/- 10.6 to 43.2 +/- 16.8%; 95% CI = 13.5 to 51.4%). 4. With bumetanide, the meal also significantly reduced the peak concentration from 0.097 +/- 0.015 to 0.036 +/- 0.012 mg l-1 (95% CI = 0.048 to 0.073 mg l-1) and delayed the time to peak from 0.53 +/- 0.08 to 1.36 +/- 0.72 h (95% CI = 0.23 to 1.44 h). However, food had no statistically significant effect on the bioavailability and urinary recovery of bumetanide. 5. In this study, the absorption of bumetanide was affected less than frusemide by food.

Continuous intrathecal baclofen infusion for symptomatic generalized dystonia.

Five patients with generalized dystonia who were refractory to oral medications were treated by continuous intrathecal baclofen infusion. Dystonia was related to cerebral palsy in three patients and to Hallervorden-Spatz disease in two. Responsiveness to intrathecally administered baclofen was evaluated after bolus injections in one patient and during continuous infusions via an external micropump in four. Patients who responded to trial injections were subsequently implanted with a programmable pump for continuous infusion of baclofen. Dystonia in the three patients were cerebral palsy was substantially improved by continuous intrathecal baclofen infusion in doses of 500 to 800 micrograms/d. Benefit has persisted for > 19 months of continuous infusion. Dystonia in the two patients with Hallervorden-Spatz disease was not improved, although the screening trial was limited by side effects in one patient and by meningitis in the other. We conclude that continuous intrathecal baclofen infusion is beneficial therapy for some patients with generalized dystonia and that additional investigations are indicated.

Effect of oral protein loading on renal hemodynamics in human pregnancy.

Glomerular filtration rate (GFR) and ERPF increase approximately 50% in human pregnancy. To determine if pregnant women have additional "renal reserve," inulin and p-aminohippurate clearances (Cin, CPAH) were measured in maximally hydrated women before and after a 300-g steak meal, once during late gestation, and again > or = 3 mo postpartum. Protein loading increased Cin [106 +/- 5 (SE) to 119 +/- 4 ml/min, P < 0.003], but not CPAH (587 +/- 35 to 624 +/- 32 ml/min, NS) in the nonpregnant state, but neither clearance was altered during gestation (Cin: 156 +/- 7 to 160 +/- 9.6 ml/min, NS; CPAH: 831 +/- 36 to 899 +/- 37 ml/min, NS). A natriuresis occurred only postpartum (+142 mu eq/min, P < 0.02), which could be explained by the increased GFR alone, since indexes of filtrate delivery and reabsorption (V/GFR, CH2O/GFR, CH2O/V) and fractional sodium excretion changed little. Dopamine excretion, uninfluenced by protein, did not correlate with increments in GFR. A carbohydrate meal (time controls) had no effect on the above described parameters. We make the following conclusions. If protein and pregnancy achieve hyperfiltration by similar mechanisms, these pathways appear "exhausted" in gestation. Also, oral protein loading does not measure maximal renal reserve, since basal GFR in late gestation was substantially greater than that measured after protein feeding in nonpregnant subjects.

The use of in vitro DNA adduct formation to estimate the genotoxicity of residues at contaminated sites.

Genotoxic carcinogens such as polycyclic aromatic hydrocarbons (PAHs) covalently bind to the bases in DNA to form adducts. The formation of DNA adducts is significant with respect to chemical carcinogenesis. Many contaminated sites contain quantities of carcinogens such as PAHs, and the evaluation of the genotoxicity of these soils has important implications for human risk assessment. DNA adducts can be formed using an in vitro system incorporating extracts from contaminated soils. The 32P-postlabelling assay is a sensitive technique for the detection of DNA adducts from complex mixtures of environmental carcinogens. These techniques have been used to form and detect DNA adducts using soils from a number of coal gasworks sites. The results show that the extent of adduct formation depends partially on the petroleum hydrocarbon content of samples, but also on other undetermined factors related to composition. While environmental weathering has been shown to effect the PAH composition of samples, this is not an important factor in controlling the genotoxicity of samples as estimated by DNA adduct formation.

Effect of autonomic blockade on pressor responses to vasopressin in pregnant rats.

OBJECTIVE: We tested the hypothesis that gestational changes in reflex neural control of the heart and vasculature contribute to altered cardiovascular responses to vasopressin during pregnancy. STUDY DESIGN: Changes in mean arterial pressure, cardiac output, total peripheral resistance, and heart rate were measured in response to constant infusion of arginine vasopressin (0.15 to 2.5 mU/kg/min) in conscious pregnant and virgin rats (n = 9) with total autonomic blockade plus restoration of baseline hemodynamics by norepinephrine infusion. RESULTS: Resting cardiac output was 40% higher and total peripheral resistance 30% lower in pregnant animals (p < 0.01). Constant infusion of arginine vasopressin evoked equivalent changes in mean arterial pressure in both groups, but the respective contributions of cardiac output and total peripheral resistance to mean arterial pressure differed between groups. Cardiac output was unchanged and the increase in total peripheral resistance was significantly blunted in pregnant vs virgin rats during arginine vasopressin infusion. Control data in nonblocked revealed similar pressor responses to arginine vasopressin in gravid compared with virgin rats but no differences in the contributions of cardiac output and total peripheral resistance to the change in mean arterial pressure. CONCLUSION: These findings suggest that neural modulation of arginine vasopressin-induced hypertension is altered during pregnancy and are consistent with a reduction in intrinsic vascular sensitivity to arginine vasopressin during gestation.

Prior feeding alters the response to the 50-g glucose challenge test in pregnancy. The Staub-Traugott effect revisited.

OBJECTIVE: To examine the effect of prior meal ingestion on the glucose, insulin, and C-peptide response to a 50-g glucose challenge test in the third trimester of pregnancy. RESEARCH DESIGN AND METHODS: Ten pregnant women with gestational diabetes mellitus and 12 nondiabetic pregnant control subjects matched for age and weight underwent a 50-g glucose challenge test on three occasions within a 2-wk period, in random order. On one occasion the test was administered in the fasting state (fasting glucose challenge test), on a second occasion the test was administered 1 h after ingestion of a standard mixed meal (1-h postprandial study), and on a third occasion the test was administered 2 h after ingestion of a standard mixed meal (2-h postprandial study). RESULTS: In the control subjects, the plasma glucose level 1 h after ingestion of 50 g of glucose was higher in the fasting study (7.8 +/- 0.4 mM, 7 of 12 subjects with glucose > or = 7.8 mM) than in the 1-h postprandial study (6.7 +/- 0.3 mM, 3 of 12 subjects with glucose > or = 7.8 mM) and the 2-h postprandial study of (6.3 +/- 0.4 mM, 3 of 12 with glucose > or = 7.8 mM) (P < 0.01). In the postprandial studies of control subjects, insulin and C-peptide levels were higher at the time of ingestion of the 50 g of glucose, but the early (1 h) insulin secretory response was less than in the fasting study. In the diabetic patients, glucose levels 1 h after 50-g glucose ingestion were similar in the fasting study (10.5 +/- 0.4 mM, no subjects with glucose value < 7.8 mM) and the 1-h postprandial study (11.0 +/- 0.6 mM, 1 subject with glucose < 7.8 mM), but was lower in the 2-h postprandial study (9.3 +/- 0.3 mM, 1 subject with glucose < 7.8 mM) (P < 0.03). In contrast to the control subjects, the insulin secretory response to 50 g of oral glucose was greater in the two postprandial studies than in the fasting study. CONCLUSIONS: We have reached the following conclusions. 1) In nondiabetic gravidas, plasma glucose concentrations 1 h after ingestion of a 50-g oral glucose load are higher if administered in the fasting state compared with the postprandial state. 2) During normal pregnancy the Staub-Traugott Effect, i.e., improved glucose disposal after successive glucose load administrations, occurs and appears to be caused by mechanisms other than enhanced insulin secretion with successive glucose loads. 3) The effect of the prandial state on plasma glucose response to the 50-g glucose challenge test used to screen for gestational diabetes mellitus may be of sufficient magnitude to significantly alter the operating characteristics, i.e., sensitivity and specificity, of this test.

Total autonomic blockade eliminates the attenuated pressor response to angiotensin II in pregnant rats.

Pressor responses to angiotensin II (ANG II) are markedly attenuated in reflex-intact pregnant animals, a phenomenon widely attributed to intrinsic changes in vascular reactivity. To test the hypothesis that gestational augmentation of neural reflex activity contributes importantly to this phenomenon, changes in mean arterial pressure (MAP), cardiac output (CO), and total peripheral resistance (TPR) were compared during constant infusion (25-400 ng.kg-1.min-1) of ANG II in conscious virgin and pregnant rats, using a model of total autonomic blockade (chlorisondamine chloride and methscopolamine bromide), with restoration of baseline hemodynamics by infusion of norepinephrine. Basal CO was higher and TPR lower in pregnant (CO 121.8 +/- 3.8 ml/min; TPR 0.78 +/- 0.04 mmHg.ml-1.min) compared with virgin (CO 95.9 +/- 3.9 ml/min; TPR 1.05 +/- 0.08 mmHg.ml-1.min) rats (P < 0.005). Pressor responses to ANG II were similar in both groups of reflex-blocked animals due to comparable changes in TPR and CO (not significant by repeated-measures analysis of variance). Other experiments demonstrated that changes in MAP after bolus administration of ANG II did not differ in areflexic virgin and gravid rats. Thus in the absence of autonomic control ANG II has similar effects on systemic resistance in pregnant and nonpregnant rats, suggesting that reflex neural mechanisms contribute significantly to gestational changes in pressor responsiveness. These data further suggest that pregnancy is not accompanied by a generalized decrease in vascular reactivity to all pressor agents.

Continuous intrathecal baclofen infusion for spasticity of cerebral origin.

OBJECTIVE: To determine if continuous intrathecal baclofen infusion (CIBI) would provide continuous relief of spasticity in patients with spasticity of cerebral origin, especially children with cerebral palsy. DESIGN: Prospective, unblinded trial, before and after CIBI. SETTING: Children's Hospital of Pittsburgh (Pa). PATIENTS: Thirty-seven patients, 5 to 27 years of age, with spasticity of cerebral origin. INTERVENTION: Continuous intrathecal baclofen infusion for 3 to 48 months. MAIN OUTCOME MEASURES: Muscle tone, range of motion, upper extremity timed tasks, activities of daily living (ADLs). RESULTS: Six and 12 months after CIBI, muscle tone was significantly decreased in the upper (P = .04) and lower (P = .001) extremities. There was a significant relationship between baclofen dosage and muscle tone in the upper (P = .02) and lower (P = .001) extremities. Hamstring motion, upper extremity function, and ADLs were significantly improved in 25 patients who were capable of self-care. CONCLUSION: Spasticity of cerebral origin can be effectively treated with CIBI. Because baclofen dosages can be titrated for the desired clinical response, CIBI is particularly useful for patients who need some spasticity to stand and ambulate.

Metabolic clearance of vasopressin and an analogue resistant to vasopressinase in human pregnancy.

The metabolic clearance rate (MCR) of arginine vasopressin (AVP) increases fourfold during human pregnancy. To explore whether circulating vasopressinase may play a role in this change, six women underwent a three-tier infusion clearance study, twice, in random order, to determine the MCRs of either AVP or 1-deamino-8-D-AVP (dDAVP, an analogue resistant to degradation by vasopressinase). Volunteers were tested in late pregnancy (LP), 24-48 h postdelivery (PD), and 5-6 (PP1) and 10-12 (PP2) wk postpartum, thus examining MCRs when vasopressinase levels were high, before and after removal of the placenta (LP and PD), and when plasma enzyme activity was becoming (PP1) and became (PP2) undetectable. Manipulation of infusate permitted comparison of MCRs at three plasma levels whose range was similar at each test period. PAVP and PdDAVP (2.2 and 10 pg/ml, respectively, during the initial infusion) increased to 8 and 31 pg/ml, stepwise increments that had no influence on respective MCRs (AVP: 3.4, 2.2, 0.77, and 0.67 l/min during LP, PD, PP1, and PP2 compared with 0.18, 0.21, 0.17, and 0.15 l/min for dDAVP). Comparison of similar and submaximal urinary osmolality revealed PdDAVP values three- to fourfold greater than PAVP. Von Willebrand factor (VWF) and factor VIIIc levels increased almost fourfold in response to dDAVP during pregnancy, but only doubled in the nonpregnant state; these differences did not reach significance. We conclude that although AVP disposal rates increase fourfold in pregnancy, those of dDAVP change little, suggesting a role of vasopressinase in the increased MCR of AVP in gestation (as well as in the genesis of certain polyuric disorders of pregnancy).(ABSTRACT TRUNCATED AT 250 WORDS)

The syndrome of preeclampsia.

Preeclampsia has traditionally been viewed as one of several forms of hypertension complicating pregnancy. More recently, the multisystem nature of this unique gestational disorder has been emphasized. Pathophysiologic events, including abnormal placentation and heightened vascular reactivity, may occur weeks or months prior to clinical recognition of the disease. Although most frequently presenting as hypertension and proteinuria, hepatic (abdominal pain and elevation of transaminases) and hematologic (intravascular hemolysis and thrombocytopenia) involvement may be important features of the disease. Current theories suggest that multiorgan dysfunction may be caused by widespread vascular endothelial dysfunction, vasospasm, and variable activation of coagulation mechanisms. Pending delivery, which is the only definitive therapy for preeclampsia, maternal complications of intracerebral hemorrhage and eclampsia may be prevented with judicious use of antihypertensive medication (e.g., hydralazine) and magnesium sulfate, respectively. Finally, data from a number of small trials suggest that low-dose aspirin (60-100 mg/d) may reduce the incidence of preeclampsia in patients at high risk without adversely affecting the fetus or newborn; however, it is recommended that aspirin not be used as a routine prophylactic intervention until publication of results of several ongoing large multicenter trials, which will help to more fully clarify the benefits and risks of this approach.

Indirect blood pressure measurement in pregnancy: Korotkoff phase 4 versus phase 5.

Controversy exists regarding which Korotkoff phase should be used to estimate diastolic blood pressure during pregnancy, some authorities recommending phase 5 (disappearance of sounds) and others suggesting phase 4 (muffling). Available data indicate that Korotkoff phase 5 more closely approximates true intraarterial diastolic pressure in pregnant women. Nonetheless, it has been suggested that phase 5 is unmeasurable in a significant number of gravid women, making this end point less desirable. However, studies examining this issue indicate that Korotkoff phase 5 is determinable in more than 90% of gravid women and that the incidence of an indeterminable phase 4 is at least as great as that for phase 5. Moreover, there appears to be greater observer variability in the measurement of phase 4 compared with phase 5. We conclude that available evidence supports recommendations for the use of Korotkoff phase 5 as the preferred end point to estimate diastolic blood pressure during pregnancy. In those few patients having very low or indeterminate phase 5 determinations, both phase 4 and phase 5 should be recorded and the former used to guide patient management. An alternative strategy is to record both phases in all gravid women beginning at the first prenatal visit so that baseline phase 4 values are available in the event that phase 5 becomes indeterminate.

Effect of sinoaortic denervation on pressor responses in pregnant rats.

We tested the hypothesis that augmented arterial baroreflex activity contributes to attenuation of pressor responses in intact pregnant animals by comparing changes in blood pressure and heart rate during infusions of angiotensin II, phenylephrine, and vasopressin in chronically instrumented pregnant and virgin rats approximately 5 wk after sinoaortic denervation (SAD) or sham surgery. Baseline mean arterial pressure was significantly lower in pregnant animals in both the sham-operated (pregnant 91.7 +/- 1.7 mmHg, virgin 103.7 +/- 2.5 mmHg) and SAD states (pregnant 107.3 +/- 4.0 mmHg, virgin 114.1 +/- 4.0 mmHg). Pressor responses to all three agents were significantly blunted in pregnant animals compared with similarly treated virgins, with the magnitude of attenuation similar in both sham and SAD states. Heart rate decreased similarly in reflex-intact pregnant and virgin animals during pressor infusions. These findings suggest that attenuated pressor responses in the pregnant rat are due primarily to mechanisms other than augmentation of arterial baroreflex activity and are consistent with a generalized reduction in vascular sensitivity during gestation.