Role of gastro-oesophageal reflux in infant irritability

Gastro-oesophageal reflux (GOR) disease may cause excessive crying in infants. The role of GOR was evaluated in infant irritability and an attempt was made to define clinical predictors of pathological reflux. Seventy consecutively admitted infants with irritability and presumptive GOR were retrospectively reviewed. All had undergone prolonged oesophageal pH monitoring. Pathological GOR was defined as a fractional reflux time of > or = 10% and was significantly less common in infants under 3 months (one of 24; 4.2%) than in older infants (10 of 46; 21.7%). All infants with pathological GOR presented with frequent vomiting, and 'silent' pathological reflux did not occur. Poor weight gain, feeding refusal, backarching, and sleep disturbance were not significantly associated with pathological GOR. The results suggest that pathological GOR is an unlikely cause of infant irritability under the age of 3 months.     

Eating habits, health status, and concern about health: a study among 1641 employees in the German metal industry

BACKGROUND: Nutrition has been found to be associated with sociodemographic characteristics and concern about health. There is limited knowledge, however, of associations between blue-collar worker's diet, morbidity, and health care utilization. METHODS: We conducted a survey on eating habits, physical symptoms, health care utilization, health status, and concern about health in two German metal companies. A self-administered questionnaire was mailed to employees of whom 1641 participated in the study (response rate 54. 7%). RESULTS: Most employees were characterized by a combination of healthy and unhealthy eating elements. Using linear regression analyses adjusted for age, gender, and occupational status, healthy eating was negatively associated with stomach aches and headaches, but not with cardiovascular disease. Restricted activity days and days in hospital were associated with healthy eating, but self-assessed health status and physician consultations were not. Using stepwise multiple regression analysis, age, gender, and concern about health were strongly and morbidity was weakly related to diet. Occupational status, marital status, and number of children were not associated with nutrition. CONCLUSIONS: Health promotion programs should motivate younger and male employees to participate in and aim toward increasing concern about health.     

Ex Vivo and in Vitro Testis and Ovary Explants: Utility for Identifying Steroid Biosynthesis Inhibitors and Comparison to a Tier I Screening Battery

Testis and ovary explants have been proposed as in vitro screensfor identifying potential inhibitors of steroid biosynthesis.The goals of the current study were to optimize the conditionsof the two assays, to characterize these assays using severalcompounds with well-defined endocrine activity, and to comparethe responses from the explant assays with an in vivo male batterycurrently undergoing validation using the Crl:CD BR rat in orderto evaluate their utility as test systems for screening unknowncompounds for possible steroid biosynthesis inhibition activity.There were two components to the testis/ovary assays: ex vivoand in vitro. The ex vivo component used testes/ovaries fromanimals dosed with the test compounds in vivo, and the in vitrocomponent used testes/ovaries from control animals. For thetestis assays, decapsulated testis explants (50 mg) were placedinto glass scintillation vials, ±1.0 IU/ml hCG for 3h in a shaking water bath (34°C). Following the incubationperiod, medium was removed, centrifuged, and frozen until assayedfor hormone concentrations. A similar procedure was used forthe ovary explant assay except that each ovary was incubatedseparately. The testis explants were evaluated using the followingcompounds: ketoconazole (KETO), a testosterone biosynthesisinhibitor; aminoglutethimide (AG) (only in vitro) and anastrozole(ANA), aromatase inhibitors; finasteride (FIN), a 5-reductaseinhibitor; 17ß-estradiol (17ßE2), an estrogenreceptor agonist; flutamide (FLUT), an androgen receptor antagonist;ICI-182, 780 (ICI), an estrogen receptor antagonist; haloperidol(HALO), a D² receptor antagonist; and reserpine (RES), a dopaminedepletor. In the ovary assay, AG (only in vitro), ANA, ICI,and HALO (only in vitro) were evaluated. Addition of fetal calfserum to the medium allowed measurement of estradiol (E2) inthe testis assay, but production was not inhibited by ANA orAG. In the ovary explant assay, only AG was identified as inhibitingE2 production in vitro. Hence, both the testis and ovary explantassays appear to have limited utility for detecting aromataseinhibitors. Screening of these nine diverse endocrine-activecompounds resulted in all of them being identified as alteringthe endocrine system when assessed by ex vivo and in vitro testisexplants. Using only the in vitro assessment with the criteriaof steroid biosynthesis inhibition, four of nine compounds werecorrectly identified in the testis explant assay (17ß-E2,KETO, FLUT, and HALO). The predictability of both the in vitroand ex vivo ovary assay was 50%, suggesting a 50% false positiveor negative rate with unknown compounds. However, of the sevencompounds assessed to date (17ß-E2, ICI, ANA, KETO,FLUT, HALO, and RES), all were correctly identified using anin vivo male battery, which also has the capability to detectother endocrine activities. Therefore, the testis and ovaryexplant assay would not be necessary if one were using an invivo male battery, since this screen would identify steroidbiosynthesis inhibitors and would also identify several otherendocrine activities. Because of the difficulties in assessingcytotoxicity and the high false positive/ negative rates, theovary and testis explant assays are not useful as routine screeningprocedures for detecting steroid biosynthesis inhibitors; however,they may have utility in confirming in vivo findings.     

Tyrosine hydroxylase- and/or aromatic l-amino acid decarboxylase-containing cells in the suprachiasmatic nucleus of the Syrian hamster (Mesocricetus auratus)

Catecholamines, including dopamine (DA), affect the activity of cells in the suprachiasmatic nucleus (SCN) of the hypothalamus, the principal circadian clock in mammals. This study examined the distribution of dopaminergic cells in the SCN of the male Syrian hamster, using both single- and double-label immunocytochemistry for tyrosine hydroxylase (TH), the rate-limiting enzyme in DA synthesis and for aromatic

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-amino acid decarboxylase (AADC), the second enzyme needed to produce DA. Some neurons immunopositive for TH (TH+) were found in the SCN, but most of the TH+ cells of the region were located just outside the borders of the nucleus, as defined by pyronin Y staining. In the SCN, 91% of these cells were also immunopositive for AADC and thus, likely to be dopaminergic. Cells positive for AADC, many of which were not TH+, were found throughout the SCN, with the highest concentration seen in the ventral aspects of the nucleus. Cells containing AADC, but lacking TH may synthesize products other than DA, such as trace amines. These anatomical observations suggest that local neurons that produce DA and perhaps trace amines, may play a role in SCN function and in the neural control of circadian rhythms.     

Need adjustment of utilization of occupational health promotion for reducing back pain? Results of an employee survey of the metal industry

We analysed data of a cross-sectional survey of 974 employees in the German metal industry to determine the degree to which worksite health promotion matches the needs of employees. 27% of study participants have already taken part in individually oriented health promotion, and another 48% want to participate most readily in activities aiming at preventing and reducing musculo-skeletal complaints. Recent participation (within a fourteen-month period) in these classes was low among male blue collar workers (7%) compared to male and female white collar employees (18 and 26%). Among blue collar workers the percentage of subjects who suffered from chronic back pain and did not recently participate in the relevant classes of the company health insurance plan (unserved prevalence) was 30%, compared to 17 and 26% in male and female white collar employees. Participants were less exposed to work-related predictors of chronic back pain than non-participants. Participants were, however, more often afflicted with chronic back pain than non-participants. In addition, the intention to participate was strongly associated with this type of complaint. Shift work was the most important single explanation for the low participation rates of blue collar workers. Suggestions are advanced to neutralise the adverse effects of shift work on participation, to strengthen the primary preventive functions of individual worksite health promotion, and to integrate it with structural measures of health and safety at work.     

Ern?hrungsgewohnheiten bei Besch?ftigten in der Metallindustrie: Determinanten und Muster

Zusammenfassung Mit 1641 Beschäftigten zweier metallverarbeitender Betriebe wurde eine Studie zu Möglichkeiten und Grenzen betrieblicher Gesundheitsförderung durchgeführt, die auch Ernährungsgewohnheiten und gesundheitsbezogene Lebensstile einschloss. Nur ein kleiner Teil der Befragten ass täglich gesunde Nahrungsmittel, viele mieden aber den täglichen Verzehr ungesunder Nahrung. Der grösste Teil der Stichprobe wird durch eine Kombination gesunder und ungesunder Elemente des Essverhaltens gekennzeichnet. Die Gruppe der überwiegend gesunden Esser wird eher von Frauen als von Männern, eher von älteren als von jüngeren Menschen, eher von Verheirateten als von Alleinlebenden und eher von Angestellten als von Arbeitern gebildet. Die Schulbildung und die Kinderzahl wirkten sich nicht auf das Essverhalten aus. Gesunde Esser konsumierten weniger Alkohol und Nikotin, trieben mehr Sport und nahmen eher Kurse zur Gesundheitsförderung in Anspruch als überwiegend ungesunde Esser.

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Eating habits of emplyees in the metal industry: Determinants and patterns

Summary We conducted a survey on chances and barriers of occupational health promotion and health behaviour including diet in two South German metal companies. Only a small percentage of the 1641 participants consumed healthy food each day, but many avoided eating unhealthy food. Most employees are characterized by a combination of healthy and unhealthy elements. The group of healthy eaters consists of more women than men, more older than younger people and more non-manual than manual workers. The level of education and number of children have not been associated with eating habits. Healthy eaters consumed less alcohol and tobacco and were more engaged in sports and in health promotion programmes than unhealthy eaters.

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Habitudes alimentaires des employés de la métallurgie: Facteurs déterminants et modèles

Résumé Une enquête portant sur les attitudes envers la prévention de la santé en milieu professionnel et les modes de vie protecteurs de la santé a été réalisée sur une population de 1641 employés de deux entreprises métallurgiques. Seule une petite partie des sujets se nourissait quotidiennement d'aliments sains, une grande partie d'entre eux évitant toutefois de manger des aliments malsains. Pour la majorité des sujets on peut qualifier le comportement alimentaire de combinaison d'éléments nutritionnels sains et malsains. Le groupe des sujets ayant un comportement alimentaire essentiellement sain se recrute plutôt chez les femmes que chez les hommes, plutôt chez les personnes âgées que parmi les jeunes, plutôt chez les gens mariés que chez les personnes seules et enfin plutôt chez les employés que parmi les ouvriers. Le type de formation scolaire et le nombre d'enfants n'ont pas eu d'influence sur le comportement alimentaire. Ce sont surtout les sujets se nourissant de manière saine qui consomment de l'alcool de manière modérée, ne fument plutôt pas ou plus, font le plus de sport et suivent plutôt des cours sur les programmes de santé que les sujets ayant un comportement alimentaire plutôt malsain.

     

26-56 抗生素治疗痤疮可能增加上呼吸道感染的危险

对于一般痤疮的标准及适当的治疗方案是长期使用抗生素。常用于治疗痤疮的抗生素为局部使用红霉素和克拉霉素及口服米诺环素、多西环素和四环素。因此痤疮患者是研究长期使用抗生素疗效的独特群体。     

Mechanisms of blood pressure alterations in response to the Valsalva maneuver in postural tachycardia syndrome

The postural tachycardia syndrome (POTS) is characterized clinically by orthostatic lightheadedness and tachycardia. When these patients perform a Valsalva maneuver, there is an excessive blood pressure increment after cessation of the maneuver (phase IV) that is sometimes associated with headaches. It is not known whether excessive phase IV is due to excessive peripheral vascular tone (an -adrenergic mechanism) or is a manifestation of increased -adrenergic tone (hyperadrenergic state). The authors undertook a pharmacologic study evaluating the effect of intravenous phentolamine (-adrenergic antagonist) and propranolol (-adrenergic antagonist) on the different phases of the Valsalva maneuver in a group of patients with POTS and age-matched normal control subjects. Patients with POTS had mean phases, when compared with controls, that were characterized by more negative II-E (p=0.07), smaller II-L (p=0.04), and significantly larger phase IV (p=0.001). The effect of phentolamine was qualitatively and quantitatively different in POTS when compared with controls. Ten mg phentolamine in controls resulted in a significant accentuation of phase II-E (p=0.001), attenuation of phase II-L (p=0.002), and increase of phase IV (57.6 vs 30.7 mm Hg; p=0.025). These changes resembled those of patients with POTS at baseline. In patients with POTS, the phase II abnormalities, already present, were further accentuated (p<0.001), and phase IV became smaller (50.6 vs 73.8 mm Hg; p=0.09). Propranolol had no significant effect on phases II-E and II-L, but significantly reduced phase IV in both controls (p<0.05) and in patients with POTS (p<0.001) and improved the headache symptoms, when present, during and after phase IV. The authors conclude that phase IV is mainly under -adrenergic regulation and that the exaggerated phase IV in POTS is a result of a hyperadrenergic state.     

Intracavitary urokinase for enhancement of percutaneous abscess drainage: phase II trial

OBJECTIVE: To evaluate the effectiveness of urokinase as an abscess-cavity irrigant during percutaneous abscess drainage. SUBJECTS AND METHODS: In a prospective study, approved by the Food and Drug Administration and the review board at our institution, urokinase and saline were used as abscess-cavity irrigants. In the study group of 42 patients, half the patients were randomly placed into the urokinase group and the other half were placed into the control saline group. Doses used varied with the size of the abscess. Data collected from patient charts were evaluated with standard statistical methods. RESULTS: The results indicate definite benefits of the urokinase treatment. The length of stay (p = 0.0025) and treatment costs (p = 0.0021) were significantly less for the urokinase group. Other clinical parameters, including the febrile course, elevated WBC, and days of drainage, trended in a favorable fashion. CONCLUSION: Urokinase injected intracavitarily is an effective technique for shortening the treatment time and improves the clinical course for patients treated with percutaneous drainage techniques.     

Recent highlights in the pathophysiology of atopic eczema

Atopic eczema (AE) belongs to the group of atopic diseases that have become increasingly prevalent over the last decades. The pathophysiology of AE has long remained enigmatic, but much scientific effort has been invested in elucidating the genetic background and the immunological mechanisms underlying AE, leading to a better understanding of this complex disease and to new therapeutic strategies. This review provides an update on the scientific progress that has been achieved in clarifying the pathophysiological mechanisms of AE.