An Observational Study of the Association between Adenovirus 36 Antibody Status and Weight Loss among Youth

ObjectiveAlthough the human adenovirus 36 (Ad-36) is associated with obesity and relative hypolipidemia, its role in pediatric weight loss treatment response is uncertain. Therefore, the primary study objective was to determine whether Ad-36 antibody (AB) status was associated with response to a pediatric weight loss program. The secondary objective was to assess the association between Ad-36 AB status and baseline lipid values.MethodsParticipants included 73 youth aged 10-17 years in a residential camp-based weight loss program. The study examined differences in baseline lipid values between Ad-36 AB+ and AB− youth as well as differences in response to treatment, including indices of body size and fitness.ResultsAt baseline, results showed that Ad-36 AB+ youth evidenced significantly lower levels of total cholesterol and triglycerides than Ad-36 AB− youth (all p < 0.05). After 4 weeks of treatment, the Ad-36 AB+ youth showed a smaller reduction in BMI percentile than the Ad-36 AB− youth (p < 0.05), a difference of about 0.48 kg.ConclusionAd-36 AB status showed a weak association with treatment response, but was associated with a better lipid profile. Ad-36 AB status should be assessed in studies of pediatric obesity treatment and prevention.Key Words: Adenoviruses, Ad-36, Lipids, Obesity, Pediatrics, Physical fitness, Weight loss     

Computed tomography-guided percutaneous core needle biopsy in pancreatic tumor diagnosis

AIM: To evaluate the techniques, results, and complications related to computed tomography(CT)-guided percutaneous core needle biopsies of solid pancreatic lesions.METHODS: CT-guided percutaneous biopsies of solid pancreatic lesions performed at a cancer reference center between January 2012 and September 2013 were retrospectively analyzed. Biopsy material was collected with a 16-20 G Tru-Core needle(10-15 cm; Angiotech, Vancouver, CA) using a coaxial system and automatic biopsy gun. When direct access to the lesion was not possible, indirect(transgastric or transhepatic) access or hydrodissection and/or pneumodissection maneuvers were used. Characteristics of the patients, lesions, procedures, and histologic results were recorded using a standardized form. RESULTS: A total of 103 procedures included in the study were performed on patients with a mean age of 64.8 year(range: 39-94 year). The mean size of the pancreatic lesions was 45.5 mm(range: 15-195 mm). Most(75/103, 72.8%) procedures were performed via direct access, though hydrodissection and/or pneumodissection were used in 22.2%(23/103) of cases and indirect transhepatic or transgastric access was used in 4.8%(5/103) of cases. Histologic analysis was performed on all biopsies, and diagnoses were conclusive in 98.1%(101/103) of cases, confirming3.9%(4/103) of tumors were benign and 94.2%(97/103) were malignant; results were atypical in 1.9%(2/103) of cases, requiring a repeat biopsy to diagnose a neuroendocrine tumor, and surgical resection to confirm a primary adenocarcinoma. Only mild/moderate complications were observed in 9/103 patients(8.7%),and they were more commonly associated with biopsies of lesions located in the head/uncinate process(n =8), than of those located in the body/tail(n = 1) of the pancreas, but this difference was not significant.CONCLUSION: CT-guided biopsy of a pancreatic lesion is a safe procedure with a high success rate, and is an excellent option for minimally invasive diagnosis.     

Pseudo failure of sensing in patients with universal pacemakers and junctional rhythms

Ventricular fibrillation has been only rarely observed as a complication of cardiac pacing after the advent of demand pacemakers. Automatic AV sequential pacing (DDD) may provide the setting for ventricular fibrillation in patients with junctional rhythms. In this report we present two patients with implanted DDD pacemakers in whom ventricular pacemaker spikes were seen occurring on top of the T wave during episodes of junctional rhythm. This apparent lack of sensing of QRS complexes does not represent pacemaker malfunction, but rather, is the result of physiologic lack of sensing (blanking) which occurs 56 to 100 msec. following the output of the atrial and ventricular channels. During junctional rhythm when the atrial spike occurs at the beginning of a QRS complex the ventricular channel is blanked and does not sense the intrinsic ventricular activity and thus, ventricular output occurs during repolarization. Increasing the maximum pacemaker rate and decreasing the AV delay will reduce the chance occurrence of this phenomenon.     

Pseudo second degree atrioventricular block with bradycardia. Successful treatment with quinidine.

Pseudo second degree atrioventricular block resulting from blocked His premature beats was successfully treated with quinidine. The diagnosis was proved by His bundle electrogam which showed both blocked and conducted His premature beats. The blocked His prematures produced second degree atrioventricular block by making the atrioventricular junction refractory. Quinidine abolished both conducted and blocked His extrasystoles. There has been no recurrence of arrhythmia during a one-year follow-up.     

No association between consumption of eggs with energy or macronutrient intake: Objective evidence from the remote food photography method

Background and aimsGreater egg consumption is associated with poor glycemic control. However, greater egg intake could simply be a marker for other dietary indiscretions such as greater intake of energy or saturated fat, which may influence glycemic control. We examined the association between egg consumption and total energy intake and saturated fat intake, measured using the remote food photography method.MethodsAn observational study was conducted with 48 healthy adults consuming ≥1 eggs/week. Photographs of all meals consumed for seven days were captured via a smartphone application called SmartIntake® and analyzed for nutrient intake. Fasting blood samples were collected. Linear correlations between egg consumption and nutrient intake or measures of glycemic control were determined.ResultsDaily egg intake was significantly associated with cholesterol intake, but not with the daily energy and saturated fat intake or measures of glycemic control.ConclusionsHigher consumption of eggs in free-living conditions was not associated with undesirable profiles of macronutrient intake, total EI, or an impaired glycemic profile in this study population. Thus, the assertion that eggs are linked with impaired glycemic control because of the accompanying intake of greater energy and saturated fat, does not appear valid.Trial registrationNCT 03404700.     

Aortocoronary bypass: early results of operations in community hospitals of greater New Orleans.

All 588 aortocoronary bypass operations performed in the community hospitals of greater New Orleans before 1974 are reported. Hospital mortality averaged 8.7% (4.3% for one bypass; 6.4% for two; 10.3% for three or more; 26% when bypass was combined with another cardiac procedure). Mortality ranged from 5% to 31% among ten surgical groups and from 0 to 20% among seven community hospitals. Men over 60 had excessive mortality (25%). The incidence of major nonfatal complications (myocardial infarction in 12.8% of patients, intraventricular conduction defects in 9.6%, significant arrhythmias in 10.7%, and complications requiring reoperation in 9.5%) also varied with the surgical group, the complexity of the procedure, the patient's age, and the hospital. As determined by these four factors, results of bypass operations in the community hospitals of greater New Orleans ranged from excellent to poor.