Different associations between body composition and alcohol when assessed by exposure frequency or by quantitative estimates of consumption.

BACKGROUND: Alcohol intake is widely assumed to contribute to excess body fatness, especially among young men; however, the evidence is inconsistent. We have addressed this research question by investigating associations between reported alcohol consumption and body composition from large representative national surveys in a high alcohol-consuming country with a high obesity prevalence. METHODS: The present study comprised a secondary analysis of combined cross-sectional nationally representative Scottish Health Surveys (1995-2010). Reported alcohol-drinking frequency was divided into five groups: from 'nonfrequent drinking' (reference) to daily/'almost every day' among 35 837 representative adults [mean (SD) age: 42.7 (12.7) years (range 18-64 years)]. Quantitative alcohol consumption was categorised into seven groups: from '1-7 to ≥50 10 g units per week'. Regression models against measured body mass index (BMI) and waist circumference (WC) were adjusted for age, physical activity, income, smoking, deprivation category and economic status. RESULTS: Among alcohol-consuming men, heavier drinking (21-28 units per week) was associated with a higher BMI by +1.4 kg m-2 [95% confidence interval (CI) = 1.38-1.43] and higher WC by +3.4 cm (95% CI = 3.2-3.6) than drinking 1-7 units per week. However, those who reported daily drinking frequency were associated with a lower BMI by -2.45 kg m-2 (95% CI = -2.4 to -2.5) and lower WC by -3.7 cm (95% CI = -3.3 to -4.0) than those who reported less-frequent drinking. Similar associations were found for women. Most of these associations were restricted to subjects aged >30 years. Unexplained variances in BMI and WC are large. CONCLUSIONS: Quantitative alcohol consumption and frequency of consumption were positively and inversely associated, respectively, with both BMI and WC among alcohol-consuming adults. Surveys are needed that evaluate both the quantity and frequency of consumption. The lowest BMI and WC were associated with a 'Mediterranean' drinking style (i.e. relatively little, but more frequently).

Hepatic fat and abdominal adiposity in early pregnancy together predict impaired glucose homeostasis in mid-pregnancy.

Hepatic fat and abdominal adiposity individually reflect insulin resistance, but their combined effect on glucose homeostasis in mid-pregnancy is unknown. A cohort of 476 pregnant women prospectively underwent sonographic assessment of hepatic fat and visceral (VAT) and total (TAT) adipose tissue at 11-14 weeks' gestation. Logistic regression was used to assess the relation between the presence of maternal hepatic fat and/or the upper quartile (Q) of either VAT or TAT and the odds of developing the composite outcome of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or gestational diabetes mellitus at 24-28 weeks' gestation, based on a 75 g OGTT. Upon adjusting for maternal age, ethnicity, family history of DM and body mass index (BMI), the co-presence of hepatic fat and quartile 4 (Q4) of VAT (adjusted odds ratio (aOR) 6.5, 95% CI: 2.3-18.5) or hepatic fat and Q4 of TAT (aOR 7.8 95% CI 2.8-21.7) were each associated with the composite outcome, relative to women with neither sonographic feature. First-trimester sonographic evidence of maternal hepatic fat and abdominal adiposity may independently predict the development of impaired glucose homeostasis and GDM in mid-pregnancy.

An observational cohort study of the management and outcomes of vascular trauma.

OBJECTIVES: To evaluate aetiology, presentation, management and mortality following iatrogenic and non-iatrogenic vascular trauma in a regional vascular centre. METHODS: Retrospective observational cohort study of patients presenting with vascular trauma during a seven year period between January 2000 and December 2006. RESULTS: 182 cases of vascular trauma were identified (averaging 26 cases p.a.). The majority (n=132, 73%) were iatrogenic and tended to occur in patients aged >45 years, while 50 (27%) were penetrating/blunt, non-iatrogenic and predominantly occurred in younger males. The majority of iatrogenic vascular injuries (80/132) (61%) followed a cardiac intervention (angiography n=56, angioplasty n=23, pacemaker insertion n=1) and are now increasingly treated by non-operative therapies (thrombin, coils and covered stents). Overall, non-iatrogenic vascular trauma was associated with 4% mortality, compared with 7% following iatrogenic injury. However, while iatrogenic trauma of cardiological origin was associated with a mortality of only 1.3% (1/80), iatrogenic trauma of non-cardiological origin incurred a mortality of 17% (9/52). CONCLUSIONS: The commonest cause of vascular trauma (and with the lowest mortality rate) was cardiological related iatrogenic injury. However, while non-cardiological iatrogenic injury occurred with the same incidence as penetrating/blunt trauma, it was associated with a fourfold excess mortality.

Recurrent rectal tumour: localization using CT-guided percutaneous 'breast coil' placement prior to surgery.

A 58-year-old man presented with rectal tumour recurrence 5 years following abdomino-perineal resection for rectal cancer. As the recurrent lesion was small and surrounded by fibrotic tissue, it was felt necessary to localize the lesion prior to surgery. We describe the use of percutaneous CT-guided breast localization coil placement using a transgluteal approach for the pre-operative localization of such lesions in order to facilitate surgical removal.

Factors affecting patency of subintimal infrainguinal angioplasty in patients with critical lower limb ischemia.

BACKGROUND: Because subintimal angioplasty (SA) is a technique that can achieve recanalization of long arterial occlusions, it is considered an alternative to lower limb bypass operations. The aim of this prospective study was to identify the risk factors that affect patency of SA in patients suffering from critical limb ischemia (CLI). METHODS AND RESULTS: 51 consecutive infrainguinal SA were done in 46 patients suffered from CLI. The patients were followed-up with regular duplex scans up to 12 months post-intervention. Sex, atherosclerosis risk factors, and some technical details of the procedure (number of patent run-off vessels after the procedure, length and re-entry point of angioplasty) were examined as potential risk factors of patency, using survival analysis statistical techniques. The overall patency rate at 12 months post-intervention was 50%. According to Cox-regression analysis, the factors that affect patency were the number of run-off vessels and the length of occlusion. Patients with two or three run-off vessels had a hazard of occlusion of 0.30 (P = .027) compared to those who had one run-off vessel. The 12-months patency in patients with more than one run-off vessels was 81% vs. 25% in patients with one run-off vessel. Regarding the length of angioplasty, the hazard of reocclusion was 1.02 for every centimeter of occlusion (P = .049). CONCLUSIONS: The number of patent run-off crural vessels after the angioplasty and the length of occlusion are significant risk factors for reocclusion of infrainguinal SA in patients with CLI. Trying to recanalize more than one run-off vessels could raise the SA patency.

The potential of pesticides to contaminate the groundwater resources of the Axios river basin in Macedonia, Northern Greece. Part I. Monitoring study in the north part of the basin.

The Axios river basin is an area of high agricultural importance for Macedonia, Northern Greece. High priced crops such as cotton, corn, sugarbeets, vegetables and rice are rotated with cereals and alfalfa and thus a great variety of pesticides are used annually for the control of pests and diseases. Moreover, the groundwater resources of the specific area constitute the main source of potable water for the surrounding cities and villages. Therefore, a study was initiated to investigate the probable risks of groundwater contamination with pesticides. The leaching of pesticides from agricultural soils was monitored in the phreatic horizon as well as in soil water samples collected with suction lysimeters. In parallel studies, the presence of pesticides in the irrigation water and the water of Axios river was also monitored. Pesticides like carbofuran, atrazine, alachlor and prometryne, which were regularly applied in the northern part of the basin during 1992-1994 were detected at concentrations occasionally exceeding 1 microg/l in soil water from the deeper soil layers and in the phreatic horizon. Residues of pesticides others than the ones applied in the studied area like propanil, terbufos and paraoxon-methyl were also detected at the deeper soil layers and in the phreatic horizon. The latter pesticides were also detected at significant concentrations in the irrigation water which mainly consisted of riverine water. The lack of an independent soil draining system and the use of riverine water for irrigation purposes resulted in the redistribution of residual amounts of these pesticides in the phreatic horizon beneath the agricultural area.

The potential of pesticides to contaminate the groundwater resources of the Axios river basin. Part II. Monitoring study in the south part of the basin.

A monitoring study was conducted during 1992-1994 in the south part of the Axios river basin, which constitutes one of the main rice-cultivated basins of Greece. The potential of pesticides to contaminate groundwater resources was assessed under realistic agricultural conditions using suction lysimeters. Pesticide residues were also measured in local drainage canals, the phreatic horizon and Axios river. Carbofuran, atrazine, alachlor, prometryne and propanil were regularly detected at concentrations exceeding 1 microg/l in the soil water of deeper soil layers and in the phreatic horizon of the fields. Residues of those pesticides were measured in the soil water and the phreatic horizon of all the studied fields even though they had only been applied in certain fields. This almost uniform distribution of pesticide residues across the whole of the studied area was attributed to rice cultivation. Soil water and its pesticidal content was horizontally transported from saturated soil conditions beneath rice paddies to adjacent corn or cotton-cultivated fields with lower soil moisture contents. The presence of high pesticide concentrations in the water of the Axios river, which was used for the irrigation of the studied area, had probably contributed to the generalized pesticide contamination of the soil water in the studied area. These results suggest that there is a high risk for groundwater contamination in the basin.