The effect of Ramadan on maternal nutrition and composition of breast milk

BACKGROUND: There are many advantages of breast milk for infants. Many factors can affect the volume and composition of breast milk. One of them is the maternal diet. The objective of this study is to determine the effect of Ramadan fasting on maternal nutrition and breast milk composition. METHODS: A total of 21 breast-feeding mothers aged between 17 and 38 years who fasted during Ramadan month and volunteered to give milk samples were surveyed. The ages of the infants were between 2 and 5 months. The study was performed during Ramadan and 2 weeks after the end of Ramadan. RESULTS: The results showed that during Ramadan, zinc, magnesium and potassium levels in breast milk decreased significantly (P<0.05). The mother's weight increased approximately 1 kg after Ramadan. Changes in body mass index of the mother were not statistically significant. A significant decrease in vitamin A intake was observed after Ramadan (P < 0.05). During Ramadan, energy and most nutrient intakes except protein and vitamins A and C were found below daily recommended dietary allowances necessary for lactating women. CONCLUSIONS: Ramadan fasting had no significant effect on the macronutrient composition of the breast milk and consequently the growth of the infants. There were significant differences in some of the micronutrients such as zinc, magnesium and potassium. The nutritional status of lactating women was affected by Ramadan fasting. All of the nutrient intakes (except vitamins A, E and C) decreased during Ramadan. For these reasons, it would seem prudent to excuse lactating women from fasting during Ramadan.     

Speech-controlled generation of radiology reports

Voice entry has been successfully employed to generate radiology reports with a word recognizer with a 1,000-word lexicon capacity. About 50% of reports were able to be dictated with a single 900-word lexicon. This was split into five sections by anatomic or subspecialty application. Each was augmented to 900 words. By switching from one lexicon to another, it was possible to dictate more than 70% of reports. With exclusive use of three lexicons in subspecialty areas (gastrointestinal radiology, neuroradiology, and mammography), and with further modification of the respective vocabulary, it has been possible to employ the system 88% of the time. Twelve percent of cases included wording that was beyond the scope of the lexicon. Computer subsets that allow different translations of some words when used in different contexts have been used. Some of these are used as triggers that will print whole lines, sentences, or even complete reports. Dictation times with voice entry take about 20% longer. Recognition reliability has been greater than 95%.     

Provisional results of the CLS cup using IDES

Summary A review was made of two series of CLS cups, fixed by expansion and anchoring in the acetabular periphery, in order to ascertain the usefulness of the International Documentation and Evaluation System. One hundred and fifty cases, from a series of 180, were documented and implanted by the same surgical team in Barcelona. The provisional results are described with a follow up of between one and 5 or more years. These were compared with 625 cases documented in the Berne Foundation with a similar follow up. The results were similar and the series studied is justified because of its documentary accuracy. The possible advantages of the CLS cup are discussed.

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Résumé Afin de vérifier l'intérêt du programme IDES (International Documentation and Evaluation System), nous avons revu deux séries comprenant 805 cotyles CLS dont le principle de fixation mécanique est l'expansion et l'ancrage dans la paroi acétabulaire. Sur une série de 180 cas, 150 sont décrits et minutieusement documentés selon l'IDES. Ces cotyles ont été mis en place à Barcelone par la même équipe chirurgicale, et leur suivi va de 1 an à plus de 5 ans. Les résultats, que l'on considère comme provisoires, sont comparés à 625 cas documentés de la Fondation de Berne. Le suivi de ces derniers cas est de la même durée et les résultats sont très semblables. Sur 150 cas de CLS, on a combiné celui-ci avec la tige de Müller autobloquante cimentée chez 80% des patients et avec la tige Spotorno non cimentée chez les autres 20%. Les indications les plus fréquentes ont été la coxarthrose (62% des cas) et la nécrose ischémique (20%). Les résultats cliniques actuels montrent une stabilité totale de l'implant et une homogénéisation radiographique, sans surcharge polaire supérieure ni résorption inférieure. Il n'y a pas de différence clinique ni radiologique à 1 an et à 5 ans. Dans un cas il a fallu changer l'implant à cause d'un descellement aseptique dû à une mauvaise technique d'implantation, et deux cas d'infection ont également nécessité une reprise. Il y a eu deux mauvaises orientations du cotyle pendant l'intervention, mais la situation de l'implant a pu être aisément corrigée.

     

Evaluation of Prediction Accuracy for Volume of Distribution in Rat and Human Using In Vitro,In Vivo,PBPK and QSAR Methods

Volume of distribution at steady state (V_ss) is an important pharmacokinetic parameter of a drug candidate. In this study, V_ss prediction accuracy was evaluated by using: (1) seven methods for rat with 56 compounds, (2) four methods for human with 1276 compounds, and (3) four in vivo methods and three Kp (partition coefficient) scalar methods from scaling of three preclinical species with 125 compounds. The results showed that the global QSAR models outperformed the PBPK methods. Tissue fraction unbound (f_u,t) method with adipose and muscle also provided high V_ss prediction accuracy. Overall, the high performing methods for human V_ss prediction are the global QSAR models, Øie-Tozer and equivalency methods from scaling of preclinical species, as well as PBPK methods with Kp scalar from preclinical species. Certain input parameter ranges rendered PBPK models inaccurate due to mass balance issues. These were addressed using appropriate theoretical limit checks. Prediction accuracy of tissue Kp were also examined. The f_u,t method predicted Kp values more accurately than the PBPK methods for adipose, heart and muscle. All the methods overpredicted brain Kp and underpredicted liver Kp due to transporter effects. Successful V_ss prediction involves strategic integration of in silico, in vitro and in vivo approaches.     

Drug‐related behaviors independently associated with syphilis infection among female sex workers in two Mexico–US border cities

Aims To identify correlates of active syphilis infection among female sex workers (FSWs) in Tijuana and Ciudad Juarez. Design Cross‐sectional analyses of baseline interview data. Correlates of active syphilis (antibody titers >1 : 8) were identified by logistic regression. Setting Tijuana and Ciudad Juarez, two Mexican cities on the US border that are situated on major drug trafficking routes and where prostitution is quasi‐legal. Participants A total of 914 FSWs aged ≥18 years without known human immunodeficiency virus (HIV) infection who had had recent unprotected sex with clients. Measurements Baseline interviews and testing for syphilis antibody using Treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR) tests. Findings Median age and duration in sex work were 32 and 4 years, respectively. Overall, 18.0% had ever injected drugs, 14.2% often or always used illegal drugs before or during sex in the past month, 31.4% had clients in the last 6 months who injected drugs, and 68.6% reported having clients from the United States. Prevalence of HIV and active syphilis were 5.9% and 10.3%, respectively. Factors independently associated with active syphilis included injecting drugs (AOR: 2.39; 95% CI: 1.40, 4.08), using illegal drugs before or during sex (AOR: 2.06; 95% CI: 1.16, 3.65) and having any US clients (AOR: 2.85; 95% CI: 1.43, 5.70). Conclusions Among female sex workers in Tijuana and Ciudad Juarez, drug‐using behaviors were associated more closely with active syphilis than were sexual behaviors, suggesting the possibility of parenteral transmission of T. pallidum. Syphilis eradication programs should consider distributing sterile syringes to drug injectors and assisting FSWs with safer‐sex negotiation in the context of drug use.     

Simultaneous total arch replacement and abdominal aortic surgery

It is common to encounter patients with coexisting aortic arch aneurysm and abdominal aortic lesions. We conducted simultaneous total arch replacement and abdominal aortic surgery in 3 patients having such lesions. Mean operative time was 511 minutes and no in-hospital mortality occurred. Postoperative respiratory failure was observed in an 80-year-old patient who recovered and all three patients were discharged in good condition. No other postoperative complication was seen. Simultaneous total arch replacement and abdominal aortic surgery may thus offer advantages to patients with such double aortic lesions if it can be conducted safely.     

Behavioural Effects of the Methanolic Root Bark Extract of Securinega Virosa in Rodents

Securinega virosa is used traditionally as sedative in children and in mental illnesses. In this study, the behavioral effects of methanolic root bark extract of S. virosa were investigated in mice. The results revealed that the extract significantly (P<0.05) and dose-dependently reduced the onset and prolonged the duration of sleep. The extract significantly (P<0.05) decreased exploratory activity and reduced the rate of apomorphine-induced stereotyped climbing at the doses tested (6.25–25mg/kg). It also produced a significant and dose-dependent motor coordination deficit in mice at the doses tested (P<0.01). The intraperitoneal median lethal dose in mice was 774.6mg/kg while the preliminary phytochemical screening revealed the presence of alkaloids, tannins, saponins and flavonoids. These results suggest that methanolic root bark extract of S. virosa contains biologically active principles that are sedative in nature and lend pharmacological credence to the ethnomedical use of the plant.     

Effects of alcohol abstinence on spontaneous feeding patterns in moderate alcohol consuming humans

It has previously been found through observational techniques that moderate alcohol consumers tend to add alcohol calories to their diets without displacing macronutrient calories. The present investigation was an active manipulation of alcohol consumption to test for causation by instructing subjects to refrain from alcohol for five days. Twenty-five moderate alcohol consumers, identified with the Michigan Alcoholism Screening Test, were asked to complete a food intake diary for ten consecutive days during which they refrained from drinking any alcoholic beverages for either the first five days or the last five days. The subjects recorded in a diary everything they either ate or drank, the time at which the meal began and ended, their subjective state before and after the meal, and the number of other people present. Subjects' overall intake of food energy during the alcohol week was significantly higher than during the no alcohol week (2205 vs. 1829 kcal) and meals eaten during the alcohol week contained significantly more food energy than did meals eaten during the no alcohol week (649 vs. 541 kcal). Alcohol added additional calories to the diets without altering any other macronutrient intake. These results could have both health and weight loss implications.