Surgical revision of biliopancreatic diversion

Biliopancreatic diversion is a very effective method for weight reduction. In some instances it is too effective and needs to be revised.     

Body size, fatness, and leanness of Mexican American children in Brownsville, Texas: changes between 1972 and 1983.

Changes in the height, weight, body mass index, triceps skinfold, and arm and estimated midarm muscle circumferences in lower socioeconomic Mexican American children, 6 through 17 years of age, from Brownsville, Texas, were documented on the basis of surveys done in 1972 and 1983. With the exception of height in youths ages 14-17, all parameters show gains at most ages, and in particular an increase in fatness. Brownsville Mexican American youth are similar in height, weight, and the body mass index to Mexican American youth in other areas of Texas. These trends confirm the large proportion of relatively short but heavy children among Mexican Americans.     

Teaching behavioral medicine using individual coronary heart disease risk factors

Two hundred twenty-one first-year medical students participated in a voluntary coronary heart disease risk factor self-change project designed to teach the principles of behavioral change. Blood pressure, serum lipids, percentage body fat, cardiovascular fitness, and smoking status were measured prior to the project. Students designed their own programs of behavior modification and, after 8 weeks, repeat measurements were obtained in students whose projects related to coronary heart disease risk (56% of entire group). Despite generally low initial coronary heart disease risk factors, most risk factor groups successfully altered the targeted risk factors. The subgroup attempting to lower serum cholesterol (n = 49) reduced total cholesterol 15 +/- 24 mg/dl (mean +/- SD) and low-density lipoprotein cholesterol 11 +/- 20 mg/dl (P less than 0.001 for both). The blood pressure group (n = 9) decreased systolic blood pressure 8 +/- 10 mm Hg (P less than 0.05), and the weight-loss group (n = 33) lost 3.0 +/- 2.9 kg (P less than 0.001), reducing estimated percentage body fat 1.7 +/- 1.8 (P less than 0.001). The self-change project was well received by the students and appears to be a useful technique for introducing the principles of behavioral medicine to first-year medical students.     

The Busselton children's survey, 1983. Body size from five to 16 years of age

In 1983, 1623 primary and secondary schoolchildren took part in a health survey which was organized by the Busselton Population Studies Group. Age, sex, weight, height and country of birth were recorded for each child. Where possible, the country of birth of parents and the occupation of the father were extracted from previous Busselton surveys of adults. Compared with Perth schoolchildren, the difference in the attained weight and height of Busselton children at any age was small. This was so even though the two communities differ in location (rural compared with metropolitan), in ethnic origin (mainly British compared with diverse origins) and, probably, in social-rank distribution. Data from the two communities showed that a similar small secular increase in height had occurred since 1970/1971. This increase averaged at 1.2 cm for children at each year of age in Busselton and 1.5 cm to 1.6 cm for children in Perth.     

Plasma and erythrocyte essential fatty acids during total parenteral nutrition in infants: effects of a cutaneous supply

In order to prevent essential fatty acid (EFA) deficiency induced by fat-free total parenteral nutrition (TPN), 10 infants on TPN were rubbed three times daily for 20 days using oenethera oil (80% EFA). Total EFA amount provided cutaneously was 1900 mg/kg/d. Plasma and red blood cells phospholipids were determined on days 1 and 20 in these 10 treated and six untreated infants on TPN and compared with those of normal control infants. On day 1, plasma nonessential FA including 20:3 n-9(p less than 0.01) were increased in both TPN groups while 18:2 n-6 and 18:3 n-3 (p less than 0.001 and p less than 0.01) were decreased. On the 20th day, EFA deficiency had worsened with a decrease in plasma level of 20:4 n-6 (p less than 0.02) and a higher than normal triene/tetraene ratio : 3.4 +/- 1.1 and 2.3 +/- 0.6 vs 0.1 +/- 0.1 (p less than 0.02). As for red blood cells phospholipids, 16:0 was increased and 18:2 n-6 and 20:3 n-6 were decreased (p less than 0.05) on day 1. On day 20, these FA were more abnormal while 20:3 n-9 became significantly increased (p less than 0.05). No difference was observed between the TPN groups at any time. These results show that cutaneous application of large amounts of EFA-rich oil is unable to prevent or cure TPN induced EFA deficiency.     

Identification of single dissimilar odors is achieved by humans with a single sniff

The duration that a single odor needs to be sniffed for identification was determined for 18 humans. A hot wire anemometer and an oscilloscope were used to monitor the duration, volume and inhalation rate of sniffs. In Experiment 1 subjects used 1, 3 or 5 natural sniffs, or an unlimited number of natural sniffs to sample seven dissimilar single odors of moderate perceived intensity, and demonstrated that each odor could be identified with a single sniff. In Experiment 2 subjects demonstrated that each of the odors could be identified with the shortest sniff (0.42 sec) they could physically achieve. In Experiment 3 tests with two of the odorants at several concentrations showed that sniff duration influences identification over a narrow range of concentrations that is just above the recognition threshold. These results together with earlier data that described the optimum conditions for the detection of an odor and the perception of odor intensity, provide information that is necessary for the development of a standard olfactometer and standard methods for human olfactory measurements.     

The simultaneous determination of cerebrospinal fluid and plasma adenosine deaminase activity as a diagnostic aid in tuberculous meningitis

The simultaneous determination of cerebrospinal fluid (CSF) and plasma adenosine deaminase (ADA) activity was evaluated as a diagnostic aid in tuberculous meningitis (TBM). CSF and plasma ADA activity were determined in four groups of patients: (i) a 'no meningitis' group of 174 children investigated for possible meningitis, but found to be uninfected; (ii) an aseptic meningitis group of 40 children; (iii) a bacterial meningitis group of 31 children; and (iv) a TBM group of 27 patients (24 children and 3 adults). CSF ADA alone was determined in a further 23 children with aseptic meningitis, 19 with bacterial meningitis and 13 children and 7 adults with TBM. Both the CSF/plasma ADA ratio and the absolute CSF ADA activity were raised in TBM (mean values 0,24 and 12,61 U/I respectively) and bacterial meningitis (mean values 0,59 and 15,43 U/I respectively), but not in the aseptic meningitis group (mean values 0,06 and 2,00 U/I) or the 'no meningitis' group (mean values 0,04 and 1,51 U/I). Both values will distinguish TBM from aseptic meningitis, but do not appear to hold any marked advantages over conventional CSF criteria in the diagnosis of TBM.