Relationships between the development of biological risk factors for coronary heart disease and lifestyle parameters during adolescence: The Northern Ireland Young Hearts Project

The purpose of this study was to examine relationships between the longitudinal development of biological risk factors for coronary heart disease (CHD) (namely, serum lipids, body fatness, blood pressure and cardiorespiratory fitness) and the development of lifestyles considered to be atherogenic. The study was conducted in a representative sample of adolescents from Northern Ireland, a region of high coronary mortality, and atherogenic aspects of lifestyle such as cigarette smoking, physical inactivity and selected aspects of diet were examined. Repeated measurements were made at 12 and 15 y of age on 229 boys and 230 girls. Longitudinal relations were analysed with generalised estimating equations, and the following longitudinal relations were found: for boys diastolic blood pressure was positively associated with vitamin C intake (P = 0.014), and inversely with energy intake (P = 0.006), and smoking (P = 0.048). Systolic blood pressure was inversely related to physical activity (P = 0.012), and smoking (P = 0.000). Body fatness was also inversely related to smoking (P = 0.006). Total cholesterol (TC) was positively related to physical activity (P = 0.044) and the TC:HDL cholesterol ratio positively to vitamin C intake (P = 0.008). Cardiorespiratory fitness was positively related to physical activity (P = 0.000) and inversely to smoking (P = 0.031). For girls, systolic blood pressure was positively related to vitamin C intake (P = 0.042); HDL cholesterol inversely to carbohydrate intake (P = 0.014), fat intake (P = 0.031), cholesterol intake (P = 0.042) and smoking (P = 0.035) and positively to energy intake (P = 0.035). The TC:HDL cholesterol ratio was inversely related to energy intake (P = 0.038) and finally, cardiorespiratory fitness positively to physical activity (P = 0.001). These results offer additional evidence that changes in lifestyle are associated with changes in biological risk factors in adolescents. Education and intervention at this stage, particularly in relation to cigarette smoking, physical activity and certain aspects of diet appear justified as part of a preventative strategy for CHD.     

Technetium phosphate bone scan in the diagnosis of septic arthritis in childhood

The technetium phosphate bone scans of 106 children with suspected septic arthritis were reviewed to determine whether the bone scan can accurately differentiate septic from nonseptic arthropathy. Only 13% of children with proved septic arthritis had correct "blind" scan interpretation. The clinically adjusted interpretation did not identify septic arthritis in 30%. Septic arthritis was incorrectly identified in 32% of children with no evidence of septic arthritis. No statistically significant differences were noted between the scan findings in the septic and nonseptic groups and no scan findings correlated specifically with the presence or absence of joint sepsis.     

Flexor tendon repair using a “six strand” method of repair and early active mobilisation

A "six strand" method of tendon repair has been used to treat 36 fingers with flexor tendon lacerations. Following surgery, active mobilisation in a protective splint was begun immediately. 63% of lacerations were in zone 2 and 27% in zone 1. 69% and 100% respectively achieved an excellent or good result using Buck-Gramcko's assessment method. 81% of all the fingers were rated excellent or good.     

Atypical distribution of Pneumocystis carinii infiltrates during radiation therapy

Bilateral peripheral pulmonary infiltrates caused by Pneumocystis carinii developed in a patient undergoing mediastinal irradiation after chemotherapy for Hodgkin disease. The paramediastinal part of the lung included within the treatment port remained clear during the 2 1/2 weeks of radiation therapy. The distribution of the pneumocystis infiltrates was altered by the radiation, producing a pattern that is the "radiographic negative" of typical post-radiation therapy paramediastinal fibrosis.     

Patterns of Gestational Weight Gain and Infants Born Large-for-Gestational Age Across Consecutive Pregnancies

Introduction

Factors that occur between consecutive pregnancies may influence repeated excessive gestational weight gain (GWG) and infants born large-for-gestational age (LGA). We examined interpregnancy interval, weight retention, and GWG in women's first pregnancy as predictors of excessive GWG and LGA in women's second pregnancy.