Endocrine obesity: bioelectric profiles (biotypes) detected in the body composition

136 patients were selected (16 men and 120 women with non-specific menstrual disturbances) with a BMI (Body Mass Index) between 25 and 45 kg/m2, which were diagnosed with "disendocrinia" (GH deficit, hyperadrenocorticism, hypothyroidsm, hyperandrogenism, menstrual cycle disorders). The proposed approach, based on the visualization of the value distribution of the electric measures in different graphics, is able to immediately explain the bioelectric state of the individual's lean-mass. Subjects with hypothyroidism present, along with their overweight, less bio-conducting mass, with an altered fluid intra/extra-cellular distribution. Patients with hyperadrenocorticism show instead an hyperhydratation of the body mass, especially in the extracellular level. Patients with menstrual disorders (amenorrea, polycystic ovary syndrome, anovulatory cycle etc...) present a lean mass reduction (elevated Rs) and an increase of the intra-cellular compartment (elevated-Xc). Patients with hyper-androgenism (and hirsutism) show a characteristic bioelectric "pattern", with low Rs levels and high Xc levels. Subjects with GH deficit (men and women), has a trend of documenting bioelectric measures with lower lean mass and higher fat-mass. Different electric biotypes seem to characterize the body composition in the several endocrine disorders.     

Survey on learning needs and preferred sources of information to meet these needs in Italian oncology patients receiving chemotherapy

Cancer patient education can be especially important in topics like side effects of chemotherapy. Information needs of oncology patients are scarcely investigated in Italy. This study aimed to identify the learning needs, the amount of information desired and the preferred methods of information delivery of Italian cancer patients receiving chemotherapy. A total of 111 cancer patients completed a questionnaire developed for this study, which was assessed for validity and reliability. Respondents ranked the following priority information: illness, recovery, treatments, chemotherapy side effects and trajectory of illness. The great majority wanted to receive as much information as possible about all these topics. Most patients showed their wish to be informed along with their relatives, but only a few wanted relatives to be informed before them. The preferred method for receiving information about side effects of chemotherapy was oral conversation, followed by written information. Patients preferred receiving information from the oncologist, followed by the oncology nurse and the general practitioner. Most respondents preferred to be informed before receiving the first cycle of chemotherapy. Results are consistent with the existing literature with regard to information priorities, quantity of information desired and preferred methods of information. In contrast with a non-disclosure dominant culture, Italian cancer patients manifest their wish to be informed a great deal and personally about their condition. In order to meet cancer patients' information needs, health professionals' education and practice should be improved.     

USPSTF recommendations for STI screening

Since 2000, the U.S. Preventive Services Task Force (USPSTF) has issued eight clinical recommendation statements on screening for sexually transmitted infections. This article, written on behalf of the USPSTF, is an overview of these recommendations. The USPSTF recommends that women at increased risk of infection be screened for chlamydia, gonorrhea, human immunodeficiency virus, and syphilis. Men at increased risk should be screened for human immunodeficiency virus and syphilis. All pregnant women should be screened for hepatitis B, human immunodeficiency virus, and syphilis; pregnant women at increased risk also should be screened for chlamydia and gonorrhea. Nonpregnant women and men not at increased risk do not require routine screening for sexually transmitted infections. Engaging in high-risk sexual behavior places persons at increased risk of sexually transmitted infections. The USPSTF recommends that all sexually active women younger than 25 years be considered at increased risk of chlamydia and gonorrhea. Because not all communities present equal risk of sexually transmitted infections, the USPSTF encourages physicians to consider expanding or limiting the routine sexually transmitted infection screening they provide based on the community and populations they serve.     

Increased frequency and enhanced perception of reflux in non-erosive reflux disease patients non-responders to proton pump inhibitors

BackgroundThe unsatisfactory response to medical treatment in non-erosive patients is becoming a real challenge for gastroenterologists. Non-responder patients, evaluated under treatment, present symptoms which are related to non-acidic, mixed and proximal reflux episodes.MethodsTo elucidate the reflux pattern and mechanisms related to persistence of symptoms despite treatment, oesophageal pH-impedance was performed in 55 non-erosive responder and 24 non-responder patients, studied off therapy. Ten responder and 10 non-responder patients underwent a repeated study during proton pump inhibitor treatment.ResultsNon-responders were characterised by a higher overall number and larger proportion of symptomatic reflux episodes. Non-responders were also characterised by an enhanced sensitivity to acidic, mixed and proximal refluxes. Weakly acidic reflux accounted for 29% of symptomatic refluxes in non-responders and 34% in responders. Proportions of acidic and weakly acidic reflux episodes were comparable both in responders and non-responders when analysed off and on treatment.ConclusionsAn increased overall number of reflux episodes and enhanced sensitivity to reflux are strongly associated with treatment failure. Treatment strategies aimed at decreasing transient lower oesophageal sphincter relaxations, pain modulators or anti-reflux surgery should be considered in non-responders in whom a significant relationship between symptoms and reflux has been confirmed.     

Pregnancy among the Hmong: birthweight, age, and parity.

OBJECTIVES. The influx of Southeast Asians into the United States allows for the study of this special population and contributes to a broader understanding of reproductive health. METHODS. We used information on birth certificates to identify 1937 Hmong children born 1985 through 1988 in California, and we compared birthweight and reproductive factors as related to these children with the same factors as related to 3776 White, non-Hispanic children born in the same period. RESULTS. Mean birthweight among Hmong children (3311 g) was significantly lower (P less than .05) than among White children (3452 g), but the proportion of births under 1500 g was higher for Whites. Hmong women were of much higher parity and were more likely to deliver at both a young (less than 18 years) and an old (greater than 40 years) maternal age. At every age and every parity, however, Hmong women had cesarean sections at one-half to one-tenth the rate of White women. CONCLUSIONS. Despite a high proportion of births at high parity and advanced maternal age, Hmong women gave birth to very low-birthweight babies at essentially the same rates as White women. Their lower cesarean section rates, however, deserve further attention.     

Laparoscopic resection of an incidental appendiceal mucocele: is it correct. Case report

Mucocele of the appendix is an uncommon disorder, characterized by a cystic dilatation of the lumen; it's mainly due to mucinous cystadenoma. Definite diagnosis is difficult preoperatively. It can be discovered incidentally at laparotomy or laparoscopy performed for other reason. Treatment consist in complete resection avoiding rupture of the cyst in the peritoneal cavity. Indeed, rupture of the lesion either spontaneous or accidental, during surgery may result in the clinical condition of pseudomyxoma peritonei. Therefore, open approach is recommended for the surgical treatment of these lesions. The role of laparoscopic surgery in the management of appendiceal mucocele remains controversial. We report a case of mucous cystadenoma of the appendix, successfully removed during a laparoscopy for perforated peptic ulcer, which was well at a 12-month follow-up. Laparoscopic appendectomy is not contraindicated in mucocele of appendix, if appropriate precautions can be taken intraoperatively.     

Reproductive outcomes in relation to malathion spraying in the San Francisco Bay Area, 1981-1982.

We studied reproductive outcomes in a cohort of 7,450 pregnancies identified through three Kaiser-Permanente facilities in the San Francisco Bay Area, in relation to exposure to the pesticide malathion, applied aerially to control an infestation by the Mediterranean fruit fly. We included in the cohort all women over age 17 who were registered at these facilities and who were confirmed as pregnant during the spraying period. Residence histories throughout the pregnancy were obtained by mailed questionnaire or telephone interview from 933 women with adverse outcomes and a sample of 1,000 women with normal outcomes, and were converted to geographical coordinates. We linked the coordinates for malathion spraying corridors with the residence coordinates to create individual exposure indices for each week of pregnancy. The statistical analysis compared each of the adverse pregnancy outcome groups against an appropriate control group using logistic regression or survival time regression approaches. After adjustment for various confounders, no important association was found between malathion exposure and spontaneous abortion, intrauterine growth retardation, stillbirth, or most categories of congenital anomalies. Gastrointestinal anomalies were related to second trimester exposure (odds ratio = 2.6), based on 13 cases and not specific to any particular International Classification of Diseases code.     

The leukocyte count: associations with intensity of smoking and persistence of effect after quitting

Information from examinations of 62,541 adults enrolled in a study of smoking from 1979 through 1982 in Oakland, California, was used to explore the associations of various measures of intensity of smoking with the leukocyte count and to try to determine whether there was a persistent effect of smoking cigarettes on the leukocyte count. In current, regular cigarette smokers, leukocyte counts were higher in smokers of a large number of cigarettes and were associated with smoking cigarettes with a high tar and nicotine yield, deep inhalation of the cigarette smoke, and a longer duration of smoking. There was an association of past smoking with a high leukocyte count independent of age, sex, and race. In past smokers of cigarettes who used no other form of tobacco, the leukocyte count was related to time since quitting, smokers who had quit more recently having higher leukocyte counts. The study shows that a high leukocyte count is associated consistently with various measures of intensity of cigarette smoking. Moreover, it appears that smoking has an effect on the leukocyte count that persists after quitting. Delineation of the physiologic basis for the acute and chronic effects of cigarette smoking on the leukocyte count might lead eventually to a better understanding of the mechanisms for regulation of granulopoiesis and the release and destruction of leukocytes.