MRI in acute transverse myelopathy

Summary The MRI examinations of seven patients with acute transverse myelopathy (ATM) were analysed. The patients were examined 2–5 times during the course of their disease with short and long TR/TE spin-echo sequences in the sagittal projection. A previous history of autoimmune disorder and/or signs of infection at the onset of ATM were present in all cases. Cerebrospinal fluid analysis showed local synthesis of immunoglobulin in the nervous system in three cases and signs of infectious myelitis in one. During the acute phase four patients had local enlargement of the cord and all had increased signal on long TR/TE sequences. The outcome was grave in the majority of patients and there seemed to be a correlation between the degree of cord enlargement, persistence of increased signal intensity and limited recovery. Atrophy and remaining high signal intensity were noted on late MRI in patients with poor outcome. In one patient with probable anterior spinal artery occlusion, cavitation of the cord was seen.     

P185erbB-2 im Serum von Ovarialakrzinompatientinnen

Schlu?folgerung - Erh?hte Serumspiegel des p185^erbB-2 Onkoproteins k?nnen mit einem EIA bei einzelnen Ovarialkarzinompatientinnen gemessen werden. - Wegen des seltenen Vorkommens versprechen p185^erbB-2 Serumkonzentrationen keinen klinischen Nutzen bei der Identifikation oder Verlaufskontrolle von high-risk Patientinnen.     

Serum lipids and lipoproteins in patients treated with antiepileptic drugs

The concentration levels of serum lipids and lipoproteins were measured in three groups of children and adolescents treated with antiepileptic drugs: carbamazepine (14 patients), phenobarbital (20 patients), and valproic acid (20 patients). Patients treated with these drugs revealed significant changes in lipids and lipoproteins, but when the authors reevaluated the three groups of children 1 year after the end of treatment, a complete return to normal of all parameters was observed. These data demonstrate that the changes induced by these drugs are transient and reversible.     

Nutrient Intake Report: A Coordination of Patient Dietary Assessment Between Physicians and Registered Dietitians

The Nutrient Intake Report (NIR) is based on a 7-day dietary recall questionnaire used previously in research for dietary assessment and adapted for clinical use. Used to provide information and counseling as part of total patient care, the NIR acts as a cornerstone for dietary education and interaction between physician, registered dietitian, and patient. The NIR is ordered by physicians or registered dietitians, scanned and assessed by a registered dietitian, and incorporated into the laboratory section of the medical record. It documents the patient's dietary intake in the context of his or her diagnosis and general health status. The NIR also opens a dialogue between physicians and registered dietitians. Incorporation of the NIR into the medical record makes the work of the registered dietitian available to other health practitioners, which is welcome in an era when licensing and reimbursement are contingent on systematic documentation of dietary assessment and its role in patient care. J Am Diet Assoc. 1998;98:1159–1162.     

Identifying predictive variables for long-term weight change after participation in a weight loss program

Objective and design To determine if there was an association between weight change and 31 independent variables among obese persons 2 years after a weight loss program. Data were obtained from subjects' records and from questionnaires administered at enrollment and after a 2-year follow-up.Setting The 8-week weight control program was taught by registered dietitians and developed by the staff at the Sid Richardson Institute for Preventive Medicine, Houston, Tex.Subjects/samples Of the 1,460 subjects who attended at least one of eight classes, 509 subjects (123 men and 386 women) responded to the mailed follow-up questionnaire.Main outcome measures Associations between weight change and the 31 independent variables were assessed. Heights and weights were measured by the dietitians during treatment. Two-year follow-up weights were self-reported.Statistical analyses performed Analysis of variance was used for 16 of the independent variables. For the remaining variables we performed a test of the null hypothesis that the correlation coefficient was 0 based on the test of the regression coefficient between the independent and dependent variable. A stepwise regression process was used to determine the best combination of variables predictive of weight change.Results Of the 31 independent variables, 16 were significantly predictive of weight change. The adjusted R² for the entire group of 16 variables was .379. Thus, 37.9% of the variance was explained by the joint efforts of the 16 variables. Eight variables with an adjusted R² of .371 (accounting for 37.1% of the variance) were most important: feeling in control of eating habits, percentage over ideal body weight at enrollment, percentage of weight loss during the 8-week treatment, frequency of weight measurement, increase in physical activity, frequency of eating in response to emotions, number of pounds gained before subject resumed diet, and occupation.Application/conclusion The predictive variables for weight change may be useful to professionals who treat obese clients and may improve success rates of long-term weight loss.     

Influence of Using Different Sources of Carotenoid Data in Epidemiologic Studies

Objective This study compared distributions of carotenoid intake and diet-serum correlations using two sources of carotenoid data: the US Department of Agriculture-National Cancer Institute (USDA-NCI) carotenoid food composition database and values accompanying the Block-NCI Health Habits and History Questionnaire (HHHQ).

Design and subjects A 100-item food frequency questionnaire was used to collect dietary data from 2,152 adults, aged 43 to 85 years, who were participating in the Nutritional Factors in Eye Disease Study, a population-based study designed to evaluate nutritional factors associated with age-related eye disease. Blood samples were collected from a random sample of 400 nonfasting participants in the study.

Results Median carotenoid intakes using HHHQ vs USDA-NCI data were alpha carotene (229 vs 223 μg/day), beta carotene (1,321 vs 1,325 μg/day), beta cryptoxanthin (72 vs 21 μg/day), lutein + zeaxanthin (653 vs 811 μg/day), and lycopene (593 vs 1,615 μg/day). All paired differences in carotenoid intake were significantly different from zero (Wilcoxon signed-rank, P<.0001). Despite these differences, the two databases similarly ranked individuals according to carotenoid intake: Spearman correlations ranged from .71 (lycopene) to .93 (alpha carotene). Differences between diet-serum correlations (adjusted for energy, body mass index, high density lipoprotein, and total cholesterol) using HHHQ vs USDA-NCI data were minor and not significant (P>.05): alpha carotene (r=.33 vs .32), beta carotene (r=.27 vs .32), beta cryptoxanthin (r=48 vs .53), lutein + zeaxanthin (r=.28 vs .24), and lycopene (r=.29 vs .25).

Conclusions Although estimates of carotenoid intake differed significantly, only minor differences in carotenoid rankings and diet-serum correlations were observed using either data source in this population. J Am Diet Assoc. 1996; 96:1271-1275.     

Knowledge and attitudes toward breast-feeding: Differences among dietitians, nurses, and physicians working with WIC clients

We assessed the knowledge of and attitude toward breast-feeding of dietitians, nurses, and physicians who work with individuals in the Alabama Special Supplemental Food Program for Women, Infants, and Children. On a scale of 0 to 100, dietitians expressed stronger interest in lactation (78.6) and exhibited greater knowledge (79.6) of the questions asked than nurses (74.5 and 73.0, respectively). Attitude and knowledge scores of physicians (70.2 and 75.5, respectively) were not statistically different from those of dietitians or nurses. Respondents disagreed greatly about the relationship of breast-feeding to weight loss and the appropriateness of oral contraceptive during breast-feeding 6 weeks postpartum. Professionals were more knowledgeable about benefits to infants than about maternal concerns. Results of this study suggest that professional breast-feeding education programs should address maternal concerns such as weight loss, contraception, and mastitis as well as benefits to the infant.