Sugar-sweetened carbonated beverage consumption correlates with BMI,waist circumference,and poor dietary choices in school children

Background  

The prevalence of obesity and overweight is increasing globally. Frequently coexisting with under-nutrition in developing countries, obesity is a major contributor to chronic disease, and will become a serious healthcare burden especially in countries with a larger percentage of youthful population. 35% of the population of Saudi Arabia are under the age of 16, and adult dietary preferences are often established during early childhood years. Our objective was to examine the dietary habits in relation to body-mass-index (BMI) and waist circumference (W_C), together with exercise and sleep patterns in a cohort of male and female Saudi school children, in order to ascertain whether dietary patterns are associated with obesity phenotypes in this population.     

Sexual rights and gender roles in a religious context

A common feature of the five faiths discussed in this article is change over time. This allowed diversity within the religions, and generally led to a degree of liberalization, but in some faiths or their sects, resulted in a narrow or rigid interpretation. For example, the golden Vedic Period of Hinduism in India when “women were worshipped” gradually faded, ushering in the social evils of female feticide, child marriage, and “sati.” The advent of Islam in the seventh century banned female infanticide, but has been unable to abolish many tribal pre-Islamic customs such as female genital mutilation in Africa and “honor killings” in parts of Asia. On the other hand, in China, the inferior status of women accorded by Confucianism has been rectified to a large extent by legislation; this has, however, been offset by a restrictive population policy allowing only one child or two children per couple in some areas of the country (with no limit in Tibet), which has led millions of women to resort to prenatal sex diagnosis and abortion if the fetus is female. In the West, the debate over the use of biomedical technology continues, with various rabbinic rulings permitting the use of assisted reproductive technologies by Jews to fulfill the obligation to procreate, and the Vatican reinforcing its opposition to these and to genetic testing on embryos and embryonic stem cell research.     

Patho-epidemiology of Cancer Corpus Uteri in Karachi South '1995-1997'.

Aim: To provide demographics and pathology of cancer of the uterine corpus in Karachi. Methodology: Data for 66 incident cases of cancer corpus uteri, ICD-10 category C54-5 registered at the Karachi Cancer Registry, for Karachi South, during a 3 year period, 1st January, 1995 to 31st December 1997 were reviewed. Results: Cancer uterine corpus (1995-97) was the sixth most common malignancy, following breast, oral cavity, ovary, esophagus and cervix. The age standardized incidence rate (ASR) world and crude incidence rate (CIR) per 100,000 were 6.4 (4.73 to 8.01) and 2.9 (2.18 to 3.57). The mean age was 53.7 years (SD 15.6; range 6-90 years). Fifty eight cases were endometrial carcinoma with ASR world and CIR per 100,000 of 5.77 (4.20 to 7.33) and 2.53 (1.88 to 3.18) respectively. Sarcomas comprised 6% of the cases. Approximately a third of the females (28.8%) were below 50 years of age. The age-specific curves showed a gradual increase from the fourth till the seventh decade, followed by an actual apparent decrease in risk after 70 years. Peak incidence was observed in the 65-69 year age group. Presenting symptoms were post-menopausal bleeding (86.4%) and purulent discharge (4%). Associated pathologies included adenomyosis, adenomatous hyperplasia (12% each) or leiomyoma (8%). Associated clinical conditions were diabetes mellitus and hypertension (4% each). The majority of the cases presented as well differentiated (39.4%), localized (59.1%) lesions. Conclusion: The incidence of cancer corpus uteri in Karachi South reflects a moderate risk population, predominantly middle aged with a higher socio-economic status. On the average the malignancy is observed a decade earlier then reported elsewhere. This calls for in-depth investigation of risk factors and identification of underlying etiology.     

Motion energy versus position tracking: spatial, temporal, and chromatic parameters

The fundamental question in motion perception is whether motion is an interpretation imposed on an object or feature perceived at separate positions at sequential instants, or whether it is the response of direction-sensitive detectors that can extract the motion-energy in the stimulus, i.e. the orientation of spatio-temporal energy. To answer this question we constructed stimuli whose position changed in one direction while the motion energy contained in the same spatial frequency moved in the same or the opposite direction (by superimposing moving sinusoidal gratings on stationary gratings of the same spatial frequency and orientation). In every case tested (0.25-25 Hz temporal frequency; 0.25-1.0 cyc/deg spatial frequency; achromatic and equiluminant contrast), the perceived direction of motion was in the direction of motion energy, indicating the existence of neurons which compute motion direction without explicitly computing spatial position. The measurements also confirmed that motion-energy computations can be modeled as separable in spatial and temporal frequency.     

IgM-enriched intravenous immunoglobulin therapy in neonatal sepsis

Despite the development of newer generation of antibiotics, mortality from neonatal sepsis remains high. In a prospective, randomized study, we investigated the use of IgM-enriched immunoglobulin therapy in neonatal sepsis. Two groups of 30 infants each (matched for gestational age, sex, weight, and other variables) were randomly allocated to receive either antibiotics alone (control group) or antibiotics plus 5 mL/kg/d for four days of IgM-enriched immunoglobulin intravenously (immunotherapy group). Mortality from sepsis in the control group was 20% (6/30), while in the immunotherapy group it was 3.3% (1/30). We conclude that IgM-enriched immunoglobulin therapy in conjunction with antibiotic therapy significantly reduces mortality from neonatal sepsis.     

Environmental contributions to the allergic asthma epidemic

Current data overwhelmingly document the existence of a worldwide asthma epidemic, although individual studies remain controversial. The epidemic is thought to involve primarily persons with allergic asthma, and many diverse theories, based on an immunopathologic understanding of disease, have recently emerged to explain this involvement. In the context of recent insights into the immune basis of experimental asthma, we discuss in this review the leading asthma epidemic theories, including a new theory based on inhaled environmental proteases. Although no single theory may yet be fully embraced, there exists substantial hope that a unifying mechanism for the epidemic will be revealed through additional research.     

Patient and referring provider satisfaction with teledermatology

BACKGROUND: Teledermatology has become more widely used, but its impact has not been clearly elucidated. We developed a teledermatology program in response to clinical need, based on the store-and-forward approach. OBJECTIVE AND METHODS: Our purpose was to evaluate the satisfaction of patient and referring physician by using telephone interview. RESULTS: Both patients and providers considered this a useful program and would recommend it to a friend or colleague. The patients were split in their overall rating of the program and its ability to treat their skin conditions. Their greatest concern was their lack of direct contact with their dermatologist. Other common concerns were waiting time and follow-up. Privacy concerns were not commonly mentioned. Providers expressed greater satisfaction than their patients. Their greatest concerns involved the inability of the program to handle the demand. CONCLUSION: The program provided a service that was valued by both patients and providers. The most common concern was the impact on the physician-patient relationship.     

Forty years of calcitonin--where are we now? A tribute to the work of Iain Macintyre, FRS

Calcitonin was discovered as a hypocalcemic principal that was initially thought to originate from the parathyroid gland. This view was corrected subsequently, and an origin from the thyroid C cells was documented. The purification and sequencing of various calcitonins soon followed. Calcitonin is a 32-amino-acid-long peptide with an N-terminal disulfide bridge and a C-terminal prolineamide residue. The peptide was shown to potently inhibit bone resorption; however, a direct osteoclastic action of the peptide was confirmed only in the early 1980s. Several osteoclast calcitonin receptors have subsequently been cloned and sequenced. Specific regions of the receptor necessary for ligand binding and intracellular signaling through cyclic AMP and calcium have been identified through systematic deletion mutagenesis and chimeric receptor studies. Calcitonin's potent antiresorptive effect has led to its use in treating Paget's disease of bone, osteoporosis, and hypercalcemia. This review retraces key aspects of the synthesis and structure of calcitonin, its cellular and molecular actions, and its therapeutic uses as they have emerged over the 40 years since its discovery. The review also examines the implications of these findings for future clinical applications as a tribute to early workers to whom credit must be given for creation of an important and expanding field. Notable are the new approaches currently being used to enhance calcitonin action, including novel allosteric activators of the calcitonin receptor, modulation of the release of endogenous calcitonin by calcimimetic agents, as well as the development of oral calcitonins.     

HIV associated thrombotic microangiopathy

Thrombotic microangiopathy (TMA) is a known complication of HIV infection. Endothelial cell injury appears to be the primary event causing platelet activation and deposition in the microvasculature. Direct cytopathic roles of HIV as well as other factors such as malignancy, drugs, and infectious agents have been implicated in the pathogenesis of HIV-TMA. Although the the majority of patients present in a more advanced stage of HIV disease, TMA can be the initial presenting symptom of HIV infection. Clinical features are those of idiopathic TMA, and the diagnosis should be suspected in any patient with new onset thrombocytopenia and microangiopathic haemolytic anaemia. Therapy with plasma exchange or infusion appears to be efficacious. A rapid diagnosis and institution of plasmapheresis is crucial for a favourable outcome. The long term prognosis of HIV-TMA is unfavourable and may depend on the stage of HIV infection. The recent data after the use of highly active retroviral treatment, however, are unavailable and current prognosis is therefore uncertain.     

Inadequate therapy and antibiotic resistance. Risk factors for mortality in the intensive care unit

BACKGROUND: The impact of nosocomial infections and multidrug resistance on mortality is a topic of considerable controversy. METHODS: A prospective, nested case control study was conducted in four intensive care units (ICUs) in Mexico to measure the impact of antibiotic resistance on and identify the main risk factors for mortality in critically ill patients with nosocomial infections. RESULTS: One hundred thirteen patients developed 119 nosocomial infections. Multivariate analysis identified two variables that were significantly and independently associated with mortality: ventilator-associated pneumonia (p = 0.0041, odds ratio [OR] = 7.7) and inadequate antibiotic treatment (p <0.0001, OR = 70.5). Although antibiotic resistance in Gram-negative rods was not an independent risk factor for mortality, there was a strong association between antibiotic resistance and inadequate treatment (chi2 for linear trend = 29.3, p <0.00001). For patients with ventilator-associated pneumonia, predicted mortality calculated by APACHE II score was 23% compared to an observed mortality of 71%. CONCLUSIONS: In this study the major risk factors for mortality were inadequate antibiotic treatment and development of ventilator-associated pneumonia. Multidrug resistance significantly increased the probability of receiving inadequate antibiotic treatment. The striking differences between observed and predicted mortality in these four ICUs indicate the need for further research and a reassessment of the current programs for prevention and control of nosocomial infections in Mexico.