A Randomized Pilot Study of Behavioral Treatment to Increase Calorie Intake in Toddlers With Cystic Fibrosis

This pilot study examined a behavioral treatment to increase calorie intake in toddlers with cystic fibrosis. Eight toddlers were randomly assigned to behavioral plus nutrition (BEH) or nutrition intervention (NTR) conditions. Calorie intake and weight were measured at pre- and posttreatment. The BEH group showed a trend for changes in calorie intake pre- to posttreatment (p = .07; 40% increase). Results for the BEH and NTR groups did not differ significantly. Most participants achieved weight gains consistent with normal growth. Seventy-five percent had not shown this pattern during the year prior to intervention. These results support the feasibility and potential for behavioral interventions in this age group.     

Orthopedic office management. The need for planning and goals

The purpose of this article is to provide physicians in private practice with a methodology for shaping their own destinies and to ensure they will be able to cope successfully with the current changes, as well as those yet to come, that will impact on their practices. It attempts to highlight those core techniques employed in long-term and strategic planning, enabling them to understand what the planning process is all about.     

Comparison of chemical, histomorphometric, and absorptiometric analyses of bones of growing rats subjected to dietary calcium stress

Absorptiometric, histomorphometric, and chemical analyses of bones from growing rats fed diets with low (0.2%, w/w), marginal (0.4%, w/w), or adequate (0.8%, w/w) calcium (Ca) content with or without phytate were compared. Phytate was added to each diet in a molar ratio of 19:1 to calcium. Male weanling Sprague-Dawley rats were fed one of the six diets for 8 weeks. At the end of 8 weeks, rats were killed, and mandibles, femurs, and tibias were removed. Bone density profiles were determined on the mandibles and femurs using single photon absorptiometry. Femurs were also used for calcium and phosphorus analyses. Tibias were used for histomorphometric analyses. Bone density of the femurs and mandibles increased as dietary Ca increased. The only effect of phytate addition measured was in the 0.8% calcium diet, where density was lower in rats fed the phytate-containing 0.8% calcium diet. Femur calcium concentration also increased as dietary Ca increased and was unaffected by addition of phytate. Femur phosphorus concentration was unaffected by dietary Ca levels but was increased by 10% when phytate was added to the diet. Bone density values were highly correlated with bone calcium and phosphorus levels (r = 0.94). Rats fed the 0.2% calcium diets had 20% lower mineralized bone area and 20% larger medullary cavity area than rats fed the other diets. Bone densitometry appears to be useful for determining changes in bone occurring in growing rats fed low, marginal, and adequate levels of dietary Ca. Bone density values also correlated well with chemically determined calcium and phosphorus concentrations and with histomorphometric data.     

Measurement of oxygen uptake in the non-steady-state

The purpose of these experiments was to develop and validate an open-circuit technique for measurement of gas exchange during the transition from rest to constant load steady-state exercise. The design of the open-circuit system employed to measure gas exchange in these experiments used a mixing chamber to collect the subject's expired ventilation where fractions of O2 and CO2 were determined via electronic gas analyzers. A gasometer was used to measure inspired ventilation and the analog signals from the two gas analyzers and the gasometer were sent to a microcomputer for computation of VO2. In calculating VO2, the mixed expired gas concentrations were matched with ventilatory volume using a previously determined time delay. To determine the validity of the open-circuit system, four subjects performed a series of 16 rest-to-work transitions on a cycle ergometer. In eight of the experiments, serial measurements of VO2 were obtained every 20 s for 3 min using the open-circuit mixing chamber system while the additional eight experiments used the Douglas bag technique. No significant difference (p greater than 0.05) existed between VO2 values calculated by the two techniques. Mean differences in VO2 between the two techniques during the first three 20-s measurement periods were 6, 53, and 63 ml, respectively. Using the Douglas bag technique as the standard, this represents a relative measurement error of 0.1%, 4.5%, and 3.6%, respectively, at the above time intervals. These data demonstrate that an open-circuit system employing a mixing chamber and the appropriate time delay to match expired gas fractions and ventilation is a sensitive means of measurement of VO2 in the non-steady-state.     

Blinded clinical evaluation of positron emission tomography for diagnosis of probable Alzheimer's disease.

We evaluated the sensitivity and specificity of positron emission tomography for diagnosis of probable Alzheimer's disease under conditions similar to those encountered in the routine clinical practice of nuclear medicine. We obtained tomographic images of regional cerebral blood flow from three groups of subjects: (1) 13 subjects, ages 69 to 84, who had probable Alzheimer's disease diagnosed by validated clinical criteria; (2) 15 subjects, ages 57 to 77, who had Parkinson's disease without dementia; and (3) 11 subjects, ages 65 to 83, who were normal. Three blinded reviewers, who had not previously seen the images, categorized them as normal, bilateral temporoparietal flow defects typical of Alzheimer's disease, or other abnormality. Consensus interpretation demonstrated sensitivity of 0.38 (5/13) and specificity of 0.88 (23/26) for identifying patients with probable Alzheimer's disease. Thus, the criterion of bilateral temporoparietal reduction in cerebral blood flow used in this study did not have sufficient sensitivity to be of clinical value. While other criteria may be developed to improve diagnostic accuracy, clinical utility can be established only by testing for validity in patients with a full spectrum of complicating neurologic and psychiatric conditions for whom diagnosis is uncertain and who are then followed longitudinally to determine clinical outcome or pathologic findings.     

DL-2-amino-4-phosphonobutyric acid does not eliminate "ON" responses in the visual system of goldfish.

DL-2-Amino-4-phosphonobutyric acid (APB) suppresses activity in retinal ON pathways. It is generally assumed that loss of the ON pathway would result in loss of ON responses in the visual system. We tested this assumption by recording activity from the optic nerves of intact goldfish (Carassius auratus) before and after intraocular injection of APB. Whole-nerve responses to increments and decrements of light were compared to electroretinogram responses and to tectal evoked potentials. APB severely reduced the amplitude of the electroretinogram b-wave but left ON and OFF responses from the optic nerve and tectum intact, although decreased in sensitivity. We conclude that APB does not completely eliminate ON responses in the visual system, at least in goldfish. The selectivity and effectiveness of APB must be evaluated in other species before this agent can be relied upon as a useful tool in understanding the roles of ON and OFF pathways in visual function.     

Contraceptive use and sterilization among Puerto Rican women.

A comparison of contraceptive use in the early to mid-1980s among married Puerto Rican women aged 15-49 in the New York City area reveals that island-born Puerto Rican women living in New York rely on female sterilization to nearly the same extent as do women living in Puerto Rico (45% and 41%, respectively) and that mainland-born Puerto Rican women use sterilization as much as do all women in the United States (19% for both groups). Puerto Rican women in New York use reversible methods to a greater extent than do women in Puerto Rico (22% v. 16%), but to a lesser extent than do all women in the United States (37%). Although mainland-born Puerto Rican women in New York use reversible methods more than do island-born women in New York (42% v. 23%), they tend not to adopt these methods to the same extent as do all U.S. women during the early reproductive years, when education and employment are critical to socioeconomic attainment.