Serum zinc and copper concentrations in low birth weight infants during first three months of life: correlation to birth weight and different feedings

Serum zinc (Zn) and copper (Cu) concentrations were measured in infants weighing 740 g to 2,500 g at birth. They were divided into three groups depending on their birth weight; Group I ranged from 740 to 1,500 g (N = 35), Group II from 1,501 to 2,000 g (N = 26), and Group III from 2,001 to 2,500 g (N = 19). They were fed breast milk (N = 24), commercially available non-supplemented formula with low Zn and low Cu content (N = 42), or Zn- and Cu-supplemented formula (N = 14). Serum Zn levels of breast fed infants were apparently higher than those of the other two different formula fed infants, the difference being significant at 1 month of age in Group I. After the decline of serum Zn level during the first month of life, the level in Groups II and III remained unchanged, whereas the level in Group I further declined progressively until 3 months of age. An incidence of hypozincemia (0.65 micrograms/ml) was highest in Group I, medium in Group II, and lowest in Group III. The serum Cu level was elevated progressively after birth in all groups, but the mean level was consistently highest in Group III, medium in Group II and lowest in Group I. No difference in serum Cu level was found among the infants with different feedings.     

Systematic review of the cost-effectiveness of sample size maintenance programs in studies involving postal questionnaires reveals insufficient economic information

ObjectivesTo identify and assess the existing cost-effectiveness evidence for sample size maintenance programs.Study Design and SettingArticles were identified by searching Cochrane Central Register of Controlled Trials Embase, CINAHL, PubMed, and Web of Science from 1966 to July 2011. Randomized controlled trials in which investigators evaluated program cost-effectiveness in postal questionnaires were eligible for inclusion.ResultsFourteen studies from 13 articles, with 11,165 participants met the inclusion criteria. Thirty-one distinct programs were identified; each incorporated at least one strategy (reminders, incentives, modified questionnaires, or types of postage) aimed at minimizing attrition. Reminders, in the form of replacement questionnaires and cards, were the most commonly used strategies, with 15 and 11 studies reporting their usage, respectively. All strategies improved response, with financial incentives being the most costly. Heterogeneity between studies was too great to allow for meta-analysis of the results.ConclusionsThe implementation of strategies such as no-obligation incentives, modified questionnaires, and personalized reply paid postage improved program cost-effectiveness. Analyses of attrition minimization programs need to consider both cost and effect in their evaluation.     

Endothelium-dependent flow-mediated vasodilation in the postprandial state in type 2 diabetes mellitus

This study examined the effects of fat- plus sucrose-rich meals on endothelium-dependent flow-mediated vasodilation in diabetic patients. Flow-mediated vasodilation in the postprandial state decreased significantly, and the decrease correlated inversely with the magnitude of postprandial hyperglycemia, suggesting that endothelial function in diabetic patients becomes impaired postprandially.     

Predictive factors in the response to interferon therapy in chronic hepatitis C

Factors predicting the efficacy of interferon therapy were statistically analyzed on 111 patients with chronic hepatitis C. Of the treated patients (total doses of interferon; 96–468 MU), 35 (31.5%) had a long-term remission. On multivariate analysis, hepatitis C virus genotype (p<0.0001), histological diagnosis (p<0.05), fibrosis score of histological activity index (p<0.01) and source of infection (p<0.05) were found useful for predicting the response to interferon therapy. Our findings suggest that the outcome of interferon therapy can be predicted to some degree from pretreatment data, and that a new therapeutic strategy is necessary for the group of patients who are predicted to be nonresponders.     

Response of the left anterior descending coronary artery to acetylcholine in patients with chest pain and angiographically normal coronary arteries

Because atherosclerotic plaque burden affects the likelihood of plaque rupture, it is important to determine the presence and extent of atherosclerotic plaque. We hypothesized that endothelial dysfunction becomes more prominent with development of atherosclerotic plaque; therefore, we examined the relation between coronary endothelial dysfunction and the presence of atherosclerotic plaque. In 36 patients with normal coronary arteries, acetylcholine (ACh; 3 and 30 μg/min) and nitroglycerin were infused into the left coronary ostium, and the diameter of the left anterior descending (LAD) coronary artery was quantitatively measured in response to each drug. The plaque burden was measured in the same segment using intravascular ultrasonography. The plaque burden was 31.2 ± 2.1% and correlated inversely with changes in coronary diameter induced by 3 μg/min of ACh (r = −0.754, p <0.0001), 30 μg/min of ACh (r = −0.552, P = 0.0005), and nitroglycerin (r = −0.531, P = 0.0009). Multivariate regression analysis showed that the change in coronary diameter induced by 3 μg/min of ACh was associated with plaque burden, independent of the effects of nitroglycerin-induced dilation. Receiver-operating characteristics analysis demonstrated that a cut-off value for the change in coronary diameter induced by 3 μg/min of ACh for predicting a plaque burden of>30% was 0%, with a sensitivity of 0.82 and a specificity of 0.95. These findings suggest that coronary endothelial dysfunction is correlated with atherosclerotic plaque burden, indicating that atherosclerotic plaque may be detected based on coronary endothelial function as assessed by low-dose ACh infusion.