Change in obesity‐related metabolic abnormalities associated with body mass index improvement through life‐style intervention: A meta‐regression

The reduction in body mass index standard deviation score (BMI‐SDS) associated with improvement in biomarkers relating to metabolic health in obese children is unknown. We aimed to establish the change in BMI‐SDS associated with improved inflammation, liver function, and insulin resistance to inform clinical guidelines for pediatric weight management interventions and to assess the efficacy of future trials. A large‐scale systematic review was conducted to identify relevant studies. Studies of children with a diagnosis of obesity according to defined BMI thresholds, participating in lifestyle interventions to reduce obesity, were included. Studies must have reported baseline (pre‐) and postintervention (or change of) BMI‐SDS and either fasting glucose, homeostatic model of insulin resistance (HOMA‐IR), alanine aminotransferase (ALT), C‐reactive protein (CRP), or interleukin‐6 (IL‐6). A series of meta‐regressions were conducted to establish links between BMI‐SDS change scores and change in metabolic markers of health. Sixty‐eight articles were identified. From the meta‐regression analyses, across all study subsets, greater mean falls in all four parameters, (HOMA‐IR, Glucose, ALT, and CRP) were observed with greater mean loss of BMI‐SDS, but the trends were only statistically significant for HOMA‐IR and CRP (P = .003; P = .021). However, we could not find minimum changes in BMI‐SDS that would ensure a fall in these outcomes. At this time, we are unable to recommend a definitive value of BMI‐SDS reduction needed to improve the markers of metabolic health. Future trials should aim to report additional indices of derived BMI values, which may better reflect changes in actual adiposity.     

Reliability and validity of the Spanish Language Wechsler Adult Intelligence Scale (3rd Edition) in a sample of American, urban, Spanish-speaking Hispanics

The utility of the Spanish WAIS-III was investigated by examining its reliability and validity among 100 Spanish-speaking participants. Results indicated that the internal consistency of the subtests was satisfactory, but inadequate for Letter Number Sequencing. Criterion validity was adequate. Convergent and discriminant validity results were generally similar to the North American normative sample. Paired sample t-tests suggested that the WAIS-III may underestimate ability when compared to the criterion measures that were utilized to assess validity. This study provides support for the use of the Spanish WAIS-III in urban Hispanic populations, but also suggests that caution be used when administering specific subtests, due to the nature of the Latin America alphabet and potential test bias.     

Safety of human MRI at static fields above the FDA 8 T guideline: sodium imaging at 9.4 T does not affect vital signs or cognitive ability

PURPOSE: To assess whether exposure to a 9.4 T static magnetic field during sodium imaging at 105.92 MHz affects human vital signs and cognitive function. MATERIALS AND METHODS: Measurements of human vital signs and cognitive ability made before and after exposure to a 9.4 T MR scanner and a mock scanner with no magnetic field are compared using a protocol approved by the U.S. Food and Drug Administration (FDA). RESULTS: Exposure to a 9.4 T static magnetic field during sodium imaging did not result in a statistically significant change in the vital signs or cognitive ability of healthy normal volunteers. CONCLUSION: Vital sign and cognitive ability measurements made before and after sodium imaging at 9.4 T suggest that performing human MRI at 105.92 MHz in a 9.4 T static magnetic field does not pose a health risk.     

Abnormalities in surfactant in sudden infant death syndrome as a postmortem marker and possible test of risk

To determine whether physical abnormalities in lung surfactant, particularly inversion of the hysteresis between surface tension and surface area, are an effective postmortem marker for sudden infant death syndrome (SIDS).

Methodology:

Bronchoalveolar lavage (BAL) was employed to obtain lung rinsings from 55 infants under 24 months of age at autopsy, comprising 34 index cases and 21 controls. Folch reagent was used to extract the lipoid content which was then applied at two surface concentrations, fixed and BAL-determined (BALD), to the pool of a Langmuir trough in which surface tension (γ) was measured continuously by the Wilhelmy method as surface area ( A ) was cycled.

Results:

The γ: A loops from SIDS samples were inverted relative to controls (i.e. they were hysteresis reversed, this inversion being quantified by an empirical surface tension:area reversal (STAR) score). There was a wide scatter of STAR scores, but a critical value was found which offered a significant ( P = 0.017) separation of SIDS cases from controls for a fixed surface concentration and a highly significant separation ( P = 1.0 × 10^-4) for BALD surface concentrations. Differences in the yields of phospholipid and proteolipid, or their correlation to STAR scores, did not reach statistical significance.

Conclusions:

Inversion of the γ: A loops (i.e. hysteresis inversion) would appear to offer a better postmortem marker of SIDS than any reported previously, the procedure having potential for development as a prospective test indicating the risk of this disease.     

Low binding capacity of murine tetramers mutated at residue 227 does not preclude the ability to efficiently activate CD8+ T lymphocytes

MHC tetramers are used to directly enumerate and visualize the antigen-specific T lymphocyte population of interest by flow cytometry, regardless of the T lymphocyte's functional capacity. Assay sensitivity can be hindered by non-specific binding activity, which is due to the inherent interactions of CD8 and MHC. Point mutations within the alpha3 loop of the HLA MHC class I heavy chain have been shown to reduce or abrogate MHC/CD8 interactions and also alleviate non-specific binding. This report compares the effects of two well-described mutations on the binding capacity and functional capacity of MHC tetramers in the H-2 MHC murine system. Tetramers folded with MHC mutated at either residue 227 or 245 of the class I heavy chain were compared to wild-type tetramer in binding studies using various antigen-specific, TCR-positive lymphocytes and cell lines. These experiments showed that the binding of wild-type and residue 245-mutated tetramer were comparable on CTL cultures, OT-1 splenocytes, and hybridomas. Both wild-type and 245-mutated tetramers' binding capacity was observed to be equally dependent on CD8 expression. Residue 227-mutated tetramer consistently bound antigen-specific CTL less efficiently, but in the absence of CD8 all three tetramers had similar binding capacity. In functional studies, 227-mutated tetramer had the greatest capacity to stimulate cytokine production in the absence of exogenous antigen addition. These experiments demonstrate that reduction of a tetramer's high avidity interaction with CD8 will not necessarily decrease the ability to stimulate the effector functions of activated T cells.     

Sexual abuse of female children and adolescents--detection, examination and primary care

Epidemiological studies show a prevalence of sexual abuse experience among girls from 14-33%. Although indicators of abuse are unspecific, the combination of several findings may be indicative: Somatic signs may be sexually transmitted diseases, vulvovaginal complaints. Psychosocial nonsexual indicators are abrupt behavioural changes, running away from home, eating disorders. Psychosexual signs are hypersexualisation of the language and behaviour, disturbed body image and gender identity. Indirect evidence of abuse is given not only in cases of old vaginal and anal lesions but also in situations, where deep tears of the hymen in the typical localization at the posterior part can be found. The workup and care for children in whom there is suspicion of abuse but no clear evidence asks for highly competent professionals in a multidisciplinary cooperation including pediatric gynecologists, child psychiatrists, children-protection groups and other specialists to avoid on one hand unjustified destabilisation or even destruction of familial structures but to assure on the other hand, that the child victims are treated and followed after in a short and long term comprehensive medical and psychosocial care.