Comparative study of diets and disease prevalence in Greek Chians part II Chian immigrants to Athens and to the United States

The study examined differences in Greek and Greek‐American diets and disease patterns related to migration within the Mediterranean and from the Mediterranean to the United States. Data reported here discuss changes in food patterns and health‐related characteristics of two populations, both originating from the Greek island of Chios, residing either in Athens, Greece, or urban centers in the United States. Food consumption and medical history questionnaires were mailed to 2652 Chians residing in Athens, New York, and the San Francisco Bay region of California. A total of 381 usable responses were obtained; 79% of both the Chian Greek and the Chian Greek American sample were first generation emigrants. Food consumption data were analyzed as monthly frequencies of 49 food items and categories using factor analysis and discriminate analysis. Associations between location of residence and disease prevalence were examined using maximum‐likelihood logit analysis; results were controlled for age, Body Mass Index, physical activity, smoking habit, and socio‐economic status. After controlling for these potential confounders, as well as for presence of the conditions of elevated serum cholesterol, hypertension, and diabetes, Chian American men were identified at higher risk for cardiovascular disease (CVD) than their Athenian counterparts (p < 0.06). This difference in risk for CVD may be related to more frequent use of oils and fats other than olive oil, and less frequent use of olive oil. Among women, diabetes exhibited a positive association with Chian women residing in Athens (p < 0.09), which may be explained by a less frequent use of foods rich in complex carbohydrates by Athenian women than by their American counterparts.     

Functional Ability After Above-the-knee Amputation for Infected Total Knee Arthroplasty

Background  

Prosthetic joint infection is an uncommon but serious complication of total knee arthroplasty (TKA). Control of infection after TKA is not always possible, and the resolution of infection may require an above-knee amputation (AKA).     

Hepatitis B virus and hepatitis C virus infections in children

PURPOSE OF REVIEW: To analyse the most relevant recent information on efficacy, duration and coverage of anti-hepatitis B virus vaccination; correlates of mother-to-child hepatitis C virus transmission; the natural history and outcomes of hepatitis B and C virus infections in children; the efficacy and safety of specific therapies. RECENT FINDINGS: Insufficient hepatitis B virus vaccine coverage and incomplete or delayed vaccine cycles need improvement in many countries. Hepatitis B virus mutants may explain some fulminant hepatitis in perinatally infected infants and vaccine failures. No interventions to prevent vertical hepatitis C virus transmission have been identified. Spontaneous clearance of hepatitis B is lower in children than in adults, while the rates appear to be similar for hepatitis C. The disease progression is slower for both infections in childhood. Several studies support the efficacy and safety of interferons and lamivudine in chronic hepatitis B or of interferons and ribavirin in chronic hepatitis C in children, but the optimal therapy remains unclear. SUMMARY: There are doubts as to the long-term persistence of anti-hepatitis B immunization in low-endemicity areas. Routine hepatitis C virus testing in pregnancy is not recommended as there are no available prophylactic measures. Although hepatitis B and C virus infections are usually asymptomatic or with mild manifestations in childhood, concerns around their long-term clinical impact suggest the need for early treatment. Children should preferably be treated in the context of targeted trials for a better understanding of the efficacy and tolerance of drugs currently used in adults.     

Evaluation of antihypertensive therapy with the combination of olmesartan medoxomil and hydrochlorothiazide

BACKGROUND: Most patients with hypertension require more than one agent to control blood pressure (BP). The purpose of this study was to assess the efficacy and safety of the angiotensin II receptor blocker olmesartan medoxomil in combination with hydrochlorothiazide (HCTZ). METHODS: This was a randomized, double-blind, factorial design study. After a placebo run-in period, eligible patients (n = 502) with a baseline mean seated diastolic blood pressure (SeDBP) of 100 to 115 mm Hg were randomized to one of 12 groups: placebo, olmesartan medoxomil monotherapy (10, 20, or 40 mg/day, HCTZ monotherapy (12.5 or 25 mg/day), or one of six groups of olmesartan medoxomil/HCTZ combination therapy. The primary endpoint was the change in mean trough SeDBP from baseline at week 8. Statistical analyses were conducted to determine whether at least one combination produced a larger reduction in SeDBP at week 8 than the individual corresponding component doses, but did not compare BP reductions with different combination doses. RESULTS: Olmesartan medoxomil plus HCTZ produced greater reductions in both SeDBP and seated systolic blood pressure (SeSBP) at week 8 than did monotherapy with either component. All olmesartan medoxomil/HCTZ combinations significantly reduced SeDBP and SeSBP compared with placebo in a dose-dependent manner. Reductions from baseline in mean trough SeSBP/SeDBP were 3.3/8.2 mm Hg, 20.1/16.4 mm Hg, and 26.8/21.9 mm Hg with placebo, olmesartan medoxomil/HCTZ 20/12.5 mg, and olmesartan medoxomil/HCTZ 40/25 mg, respectively. All treatments were well tolerated. CONCLUSIONS: Olmesartan medoxomil/HCTZ combination therapy produced BP reductions of up to 26.8/21.9 mm Hg and was well tolerated.