Impact of parental weight status on a school-based weight management programme designed for Mexican-American children.

BACKGROUND: While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. OBJECTIVES: This study was a secondary data analysis of a randomized controlled trial and investigated the impact of having zero, one or two obese parents on children's success in a school-based weight management programme. METHODS: Sixty-one Mexican-American children participated in a 24-week school-based weight management intervention which took place in 2005-2006. Children's heights and weights were measured at baseline, 3, 6 and 12 months. Parental weight status was assessed at baseline. Repeated measures anova and ancova were conducted to compare changes in children's weight within and between groups, respectively. RESULTS: Within-group comparisons revealed that the intervention led to significant decreases in standardized body mass index (zBMI) for children with zero (F = 23.16, P < .001) or one obese (F = 4.99, P < .05) parent. Between-group comparisons indicated that children with zero and one obese parents demonstrated greater decreases in zBMI compared to children with two obese parents at every time point. CONCLUSIONS: The school-based weight management programme appears to be most efficacious for children with one or no obese parents compared to children with two obese parents. These results demonstrate the need to consider parental weight status when engaging in childhood weight management efforts.

Obesity status transitions across the elementary years: use of Markov chain modelling.

OBJECTIVE: The objective of this study was to assess overweight and obesity status transition probabilities using first-order Markov transition models applied to elementary school children. METHOD: Complete longitudinal data across 11 assessments were available from 1494 elementary school children (from 7599 students in 41 out of 45 schools in a Southeast Texas school district) from kindergarten to the beginning of the fifth grade. Heights and weights were measured by trained school nurses using standard procedures at the beginning and end of each school year for the 11 consecutive assessments. To estimate the transition probabilities, first-order three-state (healthy weight, overweight and obese) Markov transition models were fit to the longitudinal weight status data of all assessment periods. RESULTS: While there was a gradual shift to more children in the overweight or obese category over 5 years, children were most likely to stay in the same weight category as the previous assessment. A consistent seasonal difference in the probability of changing weight status category was seen, with a greater probability of becoming overweight and obese during the summer compared with the school year. The transition probabilities to obesity were higher among boys, Hispanic and non-Hispanic Black, and lower socioeconomic status children. CONCLUSIONS: This study provides the first application of a Markov transition model to child weight status data. The transitions into the overweight and obese categories were small, but persistent, with smaller percentages transitioning out of overweight or obese. Early monitoring and summer intervention strategies are needed to prevent the slow, but relentless, transition into the overweight and obese categories.

Impact of human leukocyte antigen molecules E, F, and G on the outcome of transplantation.

BACKGROUND: HLA class I molecules are divided into classic (Ia) and nonclassic (Ib). Nonclassic HLA molecules (E, F, and G) have acquired relevance owing to their immunomodulatory properties and possible repercussions for induction of tolerance in organ transplantation. The objective of this study was to identify the impact of these molecules on transplant success or failure. METHODS: A systematic review of literature was performed with the use of MeSH terms in Pubmed. Clinical trials, randomized clinical trials, case-control studies, and reviews from the past 15 years were included. RESULTS: HLA-E*0103/E*0103 genotype is associated with lower risk of graft-versus-host disease, decreased mortality, and greater disease-free survival after bone marrow transplantation. There were no significant associations between HLA-F and clinical outcomes in any of the studies. Elevated serum levels of HLA-G were associated with a lower incidence of rejection in hepatic and renal transplantation during the 1st year and lower T-cell response after bone marrow, liver, and kidney transplantation. Detection of mRNA of HLA-G1 was also associated with less graft rejection. CONCLUSIONS: Current literature suggests that nonclassic HLA Ib molecules play an important role in immunotolerance in organ transplantation; however, more studies are required to predict outcomes related to specific genotypes.

Efficacy of high doses of botulinum toxin A for treating provoked vestibulodynia.

BACKGROUND: Provoked vestibulodynia is difficult to treat. The beneficial effects of botulinum toxin A are being considered because of the muscular anomalies observed in this pathology. OBJECTIVE: To evaluate the efficacy of botulinum toxin A in the treatment of provoked vestibulodynia. METHODS: Patients aged between 18 and 60 years presenting with provoked vestibulodynia (according to the 2003 International Society for the Study of Vulvar Disease classification) received 50 U of botulinum toxin A bilaterally in the bulbospongiosus muscle under electromyographic monitoring. Pain was evaluated by a visual analogue scale (VAS), quality of life was evaluated by the Dermatology Life Quality Index and sexual function by the Female Sexual Function Index. RESULTS: Twenty patients received the injections. Sixteen patients presented with a muscular hyperactivity on electromyography. After 3 months, 80% of the patients improved in terms of pain. Mean ± SD VAS values significantly decreased from 8·37 ± 1·22 (range 4·5-10) to 2·57 ± 2·67 (0-9; P < 0·0001) at month 3 and to 3·90 ± 2·92 (0-9; P < 0·001) at month 6. Quality of life and sexual function improved significantly during the first 6 months (P < 0·0001). After 3 months, 13 patients (out of 18 for whom intercourse was not possible before the injections; 72%) were able to have sexual intercourse. CONCLUSION: Botulinum toxin A seems to be an effective and safe treatment for provoked vestibulodynia; 100 U botulinum toxin A significantly reduced pain 3 and 6 months after injections without side-effects. The treatment also improved quality of life and sexual function of patients. Botulinum toxin A appears to be a promising option for managing sexual pain disorder.

Celulitis facial en paciente anciano. A propósito de un caso / Facial cellulitis in the elderly subject. A case report

La celulitis es una infección de la piel con algún grado de extensión al tejido celular subcutáneo. La puerta de entrada fundamental suele ser una solución de continuidad en la piel de pacientes ancianos, diabéticos, inmunodeprimidos, individuos con estasis linfático y niños. El interés del caso radica en la necesidad de una rápida orientación diagnóstica, así como el tratamiento precoz del proceso desde la atención primaria, ya que este tipo de infección puede evolucionar rápidamente con complicaciones locales y sistémicas que pueden llegar a comprometer la vida del paciente en las primeras horas (AU)

Cellulitis is a skin infection with some degree of extension into the subcutaneous cellular tissue. It is usually caused by a cut on the skin of elderly, diabetic patients, with immunological disease, patients with lymph stasis and children. This case is of interest because of the need for a rapid diagnostic orientation as well as early treatment of the condition in primary health care. This is because this type of infection can evolve quickly with local and systemic complications that may become life-threatening to the patient in the first hours (AU)

External radiation assessment in a wet phosphoric acid production plant.

The factories dedicated to the production of phosphoric acid by the so-called wet acid method are usually considered typical NORM industries, because the phosphate rock used as raw material usually contains high concentrations of (238)U-series radionuclides. The magnitude and behaviour of the radionuclides involved in the production process revealed the need to determine its dosimetric impact on workers. This work aims to partially compensate this lack of knowledge through the determination of external effective dose rates at different zones in the process at a typical plant located in the southwest of Spain. To this end, two dosimetric sampling campaigns have been carried out at this phosphoric acid production plant. The first sampling was carried out when phosphate rocks originating in Morocco were processed, and the second one when phosphate rock processed came from the Kola Peninsula (Russia Federation). This differentiation was necessary because the activity concentrations are almost one order of magnitude higher in Moroccan phosphate rock than in Kola phosphate rock. The results obtained have reflected external dose rate enhancements as high as 1.4microSvh(-1) (i.e., up to thirty times the external exposition due to radionuclides in unperturbed soils) at several points in the facility, particularly where the digested rock (pulp) is filtered. However, the most problematic points are characterised by a small occupation factor. That means that the increment in the annual effective external gamma dose received by the most-exposed worker is clearly below 1mSv (European Commission limit for the general population) under normal production. Nevertheless, special care in the design and schedule of cleaning and maintaining work in the areas with high doses should be taken in order to avoid any possibility of exceeding the previously mentioned general population limit. In addition, the results of the dosimetric campaign showed no clear correlation between (226,228)Ra activity concentrations in the material fluxing during the process (the most important radionuclides from the dosimetric point of view) and the external dose rates. Furthermore, any general dependence of the origin of the rock (i.e., on their radioactive contents) on the external effective dose rate measured has not been observed. These latter findings could be a consequence of three effects: (1) a variable radiation shielding at the different points along the process, (2) a changing geometry of irradiation (from a rock pile up to a thin-layered pulp passing through a solid mass inside pipes and deposits), and (3) the existence of a "memory effect", or background contamination in the installation equipment due to the presence of radionuclide-enriched scales and sludges in pipes and deposits.

Behaviour and fluxes of natural radionuclides in the production process of a phosphoric acid plant.

In recent years there has been an increasing awareness of the occupational and public hazards of the radiological impact of non-nuclear industries which process materials containing naturally occurring radionuclides. These include the industries devoted to the production of phosphoric acid by treating sedimentary phosphate rocks enriched in radionuclides from the uranium series. With the aim of evaluating the radiological impact of a phosphoric acid factory located in the south-western Spain, the distribution and levels of radionuclides in the materials involved in its production process have been analysed. In this way, it is possible to asses the flows of radionuclides at each step and to locate those points where a possible radionuclide accumulation could be produced. A set of samples collected along the whole production process were analysed to determine their radionuclide content by both alpha-particle and gamma spectrometry techniques. The radionuclide fractionation steps and enrichment sources have been located, allowing the establishment of their mass (activity) balances per year.

Reduction of pegaptanib loss during intravitreal delivery using an oblique injection technique.

PURPOSE: To develop an injection technique that reduces drug loss occurring due to reflux and consequent subconjunctival bleb formation after standard intravitreal pegaptanib injection. METHODS: Prospective interventional case series report. The 27-gauge needle is inserted obliquely via pars plana to create a valved wound. The rate of subconjunctival bleb formation is evaluated performing ultrasound biomicroscopy, (1/2)h after intravitreal drug delivery comparing standard (straight)with this new described injection technique (oblique) using Fisher's exact test. RESULTS: Eyes on which oblique injection technique was performed developed significantly less subconjunctival bleb than those treated with the standard technique. The rate of injection-related complications (retinal detachment, vitreous haemorrhage, traumatic cataract, and endophthalmitis) in our small series was similar between both groups. CONCLUSIONS: The use of this technique can result in reduced drug loss after intravitreal pegaptanib injection. Larger studies are needed to determine if the rate of complications associated with intravitreal injections, especially endophthalmitis, is lowered with this technique.

An assay on the effect of preliminary restoration tasks applied to a large TENORM wastes disposal in the south-west of Spain.

A large industrial wastes disposal site, where two phosphate rock processing plants release their wastes, located close to Huelva town (SW of Spain), has been partially submitted to restoration as a preliminary step in a possible decomissioning process. Due to the high natural radioactivity contents of these wastes, this repository is considered as a radiological anomaly, being actually considered as TENORM (technically enhanced naturally occurring radioactive materials). The efficiency of this restoration from the radiological point of view according to the new European regulatory framework was evaluated in this work. The results allow to conclude that, as a consequence of the partial restoration works, the external dose rate has been drastically reduced above the repository system. Nevertheless, special attention must be paid on the occupational factor to be applied to workers on the unrestored system. The application of a dosimetric model allows the prediction of the negative effects of using certain industrial wastes as a cover system in this restoration/mitigation task.

A semi-empirical approach for determination of low-energy gamma-emmiters in sediment samples with coaxial Ge-detectors.

A simple method for the determination in sediment samples of low-energy gamma-emitters with coaxial Ge detectors and using a cylindrical sample geometry is outlined. This method allows an easy estimation of self-absorption effects by knowing the apparent densities and the composition of the investigated samples. As calibration matrixes solid samples enriched in known amounts of natural radionuclides emitting low-energy gamma rays were used. In this way, the difficult homogenisation steps needed when liquid spikes are added to a solid blank for manufacturing the calibration sample are avoided. The method has been carefully checked and validated by applying it to sediment samples with known activities of some low-energy gamma-ray emitters. Additionally, these sediment measurements have allowed to evaluate the magnitude and importance of the self-absorption corrections.

Validation of isotope signatures in sediments affected by anthropogenic inputs from uranium series radionuclides.

This paper aims to show the usefulness of 226Ra/228Ra activity ratios and confirm the possibility of using 230Th/232Th activity ratios as chronological markers in sediment cores from an estuarine system strongly contaminated by discharges from non-nuclear industries (fertiliser plants). The validation was carried out using an independent, well-established dating technique based on the analysis of the 137Cs fallout profile, which comprises the same time interval as that covered by both isotope ratios. The advantage of using the 226Ra/228Ra activity ratio profile instead of the Th-isotope profile is that determination can be accomplished with a non-destructive, simpler and less time-consuming technique, because both Ra isotopes can be determined by gamma-ray spectrometry.

[Persistence of the cognitive effects of early stimulation assessed with an animal model]. / Persistencia de los efectos cognitivos de la estimulación temprana evaluados a través de un modelo animal.

Human and animal studies have clearly demonstrated the advantageous effects of sensorially enriched rearing environments. Nevertheless, little work has been done concerning the long-lasting persistence of all these behavioral modifications. To undertake this question, a very early enrichment animal model was used. From days 10 to 24 after birth, 28 male albino rats were exposed to a multisensory stimulated environment, while other 28 littermates constituted the control group. At 3 and 6 months old two cognitive abilities were analyzed; the spatial working memory (short term memory) and the latent learning capacity (long term memory). The results evidenced an improved working memory in both 3 and 6 months old rats exposed to the early enriched environment. Moreover, the adult early stimulated group performed as well as younger subjects both on error scores and speed to solve this test. Only in the adult group of rats a superior latent learning capacity of stimulated subjects was evidenced. To conclude, the early enriched environment induced: a) persistent cognitive benefits in the adult rat and b) a more relevant influence on the subsequent behavior of older rather than younger subjects.

Enhancer dependence of polyomavirus persistence in mouse kidneys.

We previously showed that alterations in the enhancer sequence of polyomavirus DNA can alter both the level and the organ specificity of viral DNA replication during the acute phase of infection of newborn mice (R. Rochford, B. A. Campbell, and L. P. Villarreal, J. Virol. 64:476-485, 1990). In this study, we examined whether these enhancer sequence alterations can also affect polyomavirus replication during the persistent phase of infection in vivo. After infection of newborn mice with a mixture of three enhancer variants, the individual organs could select for enhancer-specific viral DNA replication during both the acute and the persistent phases of infection. Contrary to expectations, the ability of some variants to establish a high-level acute infection in some organs (e.g., the pancreas) did not necessarily lead to a persistent infection in those organs. Thus, enhancers can affect acute and persistent infections differently. In addition, some enhancer variants tended to establish a high-level persistent infection in the kidneys immediately following an acute infection; however, in all cases considerable histopathology was associated with these elevated long-term infections, and these mice were always runty. A persistent infection in the kidneys thus appears able to exist in two distinguishable states, a high-level pathological state and a low-level nonpathological state, which can be affected by the viral enhancer sequence.

Analysis of cellular DNA synthesis during polyoma virus infection of mice: acute infection fails to induce cellular DNA synthesis.

It is widely believed that infection with various DNA viruses stimulates quiescent host cells to divide in preparation for virus replication. To examine this issue, the effects of acute polyoma virus infection on cellular DNA synthesis are observed in newborn mice. Using [3H]thymidine incorporation and fluorography of whole mouse sagittal sections, we observed clear, high-resolution images of organ-specific patterns of cellular DNA synthesis in newborn animals. No alteration in these patterns was observed during acute polyoma virus infection. Other methods, including measurements of [3H]thymidine-labeled DNA-specific activities in various tissues and in situ autoradiography, also failed to detect virus-induced alterations in cellular DNA synthesis. These results indicate that newborn animals have high endogenous levels of DNA synthesis and imply that acute polyoma virus infection may not be associated with further induced levels of cellular DNA synthesis.

The new Spanish curriculum: reasons for change.

To summarize it can be stated that: The dependence of dental science on medicine in Spain has not been in any way advantageous to the profession, the practice of dentistry or the oral health of the population. Today's teaching must change if Spain is to face up to the enormous challenges of the future, including new trends in demand, the right to health and the decrease of the professional's standard of living. In future it will be necessary to include new curricular parameters, such as the organization of work, prevention and behavioural sciences, etc., with the objective of being able to provide the population with improved and more accessible services. It is necessary to reflect upon the position as regards technology, so as to be able to optimize its utilization at each appropriate level and avoid excessive dependence on industry. The new curriculum has been based on an increased amount of teaching of the basic and medical sciences, an earlier integration of the students into the clinic, a closer relationship with the community, and finally, a more integrated approach to, and methodology in, all clinical work. In Spain, both the State and the universities have made an enormous effort to bring the teaching of dental science up to date by seeking its equivalence and harmony with that of the EEC. This effort, owing to the special circumstances within Spain, has made the acceptance and extension of a profound philosophical, academic and professional change necessary.

Comparative study of bezafibrate and probucol in hyperlipidaemia.

Sixty out-patients diagnosed as having hyperlipidaemia, with a cholesterol level of greater than 200 mg/dl and/or a triglycerides level of greater than 200 mg/dl, took part in the trial. Patients were divided at random into two groups to receive pharmacological treatment plus diet; one group was given 500 mg probucol twice a day and the other group 200 mg bezafibrate twice or 3-times a day for an average treatment period of 60 days. The percentage changes in serum lipids, i.e. total cholesterol, triglycerides, HDL-cholesterol, and LDL-cholesterol, were evaluated by comparing the values before and at the end of treatment, and tolerability of the drug in use was evaluated from the appearance of adverse reactions and the ECG and blood pressure parameters. Whereas total cholesterol and LDL-cholesterol levels were reduced to a similar extent in both groups (cholesterol - 42% bezafibrate, 38.3% probucol; LDL-cholesterol - 30.8% bezafibrate, 26.5% probucol), triglycerides were reduced to a significantly greater extent (p less than 0.05) in the benzafibrate group (55.5%) than in the probucol group (24.0%). The most significant percentage change (p less than 0.005) was found with HDL-cholesterol; in the bezafibrate group, levels increased by 19.0% compared with a 11.8% reduction in the probucol group. Four (13.3%) patients on bezafibrate and 5 (16.7%) on probucol reported mild to moderately severe side-effects, mainly gastro-intestinal, but in no case was treatment interrupted, although benzafibrate dosage was temporarily reduced. ECG changes (prolongation of QTc) were recorded in 3 patients on probucol and these reverted to normal after the end of the trial.

Isolation of serotype hardjo and other leptospirae from armadillos in Argentina.

A serologic, bacteriologic, and histopathologic examination for leptospires was carried out on 89 armadillos (Chaetophractus villosus) from Argentina. Forty-seven per cent of the serum samples yielded positive results when tested by microscopic-agglutination. Predominant agglutination reactions were to the Hebdomadis and Bataviae serogroups. A total of 15 Leptospira isolations (from 16.8 per cent of the animals tested) were obtained from kidney tisse. Nine of the isolates were identified as belonging to the Bataviae group serotypes argentiniensis, paidjan, or bataviae; three other isolates proved to be the Canicola group serotype canicola; two others were Leptospira biflexa strains; and the last isolate was found to be serotype hardjo of the Hebdomadis group. The latter finding represents the first isolation of serotype hardjo from this animal species. Histopathologic examination of kidneys from 11 of the animals yielding pathogenic leptospires permitted a diagnosis of interstitial nephritis. This intersitial nephritis, presenting the characteristic picture of lymphoid infiltration, appeared intense in two animals, moderate in five others, and only slight in the remaining four. These histopathologic findings of chronic nephritis, combined with the high positive serologic and cultural isolation rates, suggest that the armadillo is an important natural reservoir-host for pathogenic leptospirae.