Dietary calcium, saturated fat, fiber and vitamin C as predictors of forearm cortical and trabecular bone mineral density in healthy children and adolescents

Diet, weight–bearing physical activity (WPA) and daylight hours spent outdoors (DE) were related to bone mineral density in the distal (BMDd) and ultradistal (BMDud) forearm of 495 healthy children (8–11 years) and adolescents (11–17 years). BMD was assessed by single photon absorptiometry. Using multiple regression, BMDd was predicted by saturated fat and BMDud by fiber in children. In adolescents, BMDd was predicted by saturated fat and vitamin C, and BMDud by calcium and vitamin C. WPA and DE were not related to BMD. In conclusion, our results showed that current intake of calcium, saturated fat, fiber and vitamin C were positively associated with forearm BMD in children and adolescents. These associations depended on age and bone type. If our findings are verified, dietary recommendations, especially when aimed at young people, may have to be reconsidered.     

DC cardioversion during continuous veno-venous haemofiltration

Sir, Recently, we delayed starting continuous veno-venous haemofiltration(CVVH) treatment because we were reluctant to perform directcurrent (DC) cardioversion during CVVH. In the end, it provedto be no problem. Case. A 15-year-old,     

Behavioural states: concomitants, clinical implications and the assessment of the condition of the nervous system

Behavioural states do exist in the human fetus. These states have been called 1F to 4F and resemble states 1 to 4 in the neonate. States 1F and 2F are similar to 'non-REM sleep' or 'quiet sleep' and 'REM-sleep' or 'active sleep', respectively. The fetus spends most of the time in these two states. Each state can be characterized by a particular combination of 3 variables: presence or absence of fetal eye movements and body movements, and fetal heart rate patterns A, B, C and D. From about 36 wk these combinations can be recognized during longer periods without interruptions, and with clear state-transitions. At 32 wk a certain linkage between the three variables is already present but a step-wise increase can be seen between 36 and 38 wk. Fetal breathing, mouthing movements and fetal voiding are state concomitants. Breathing movements are much more regular during state 1F than during state 2F, while the incidence is increased in 2F. It is demonstrated that knowledge of fetal behavioural states is necessary for an adequate interpretation of the fetal heart rate patterns. The concept of behavioural states may be useful for the early detection of disturbances of the developing fetal nervous system. It is therefore concluded that further studies on fetal behaviour have to be 'standardized' for behavioural states.     

A logistic regression model including DNA status and morphology of spermatozoa for prediction of fertilization in vitro

To determine predictive values of routine semen analysis, sperm morphology evaluation using strict criteria and DNA status for in-vitro fertilization (IVF), 66 consecutive couples undergoing IVF in a university hospital IVF programme were prospectively investigated. Semen samples from 66 men were evaluated by routine semen analysis, morphology evaluation using strict criteria and acridine orange staining for determination of DNA status. A new technique is described for acridine orange scoring which consisted of evaluation of two smears per case, with and without heat treatment. Resistance to heat-provoked denaturation was determined by the difference between two evaluations. A logistic regression model was built and receiver operating characteristic curves were constructed to determine the threshold values and to compare diagnostic properties. Morphology evaluation using strict criteria and concentration of progressively motile spermatozoa were found to be the principal parameters determining the sperm fertilizing capacity in vitro. The logistic regression model composed of morphology evaluation using strict criteria and acridine orange score had a powerful diagnostic capability for prediction of fertilization in vitro.      

ECG-synchronized cardiac MR imaging: method and evaluation

An electrocardiographic (ECG) sensing and gating device compatible with a 0.35-tesla (T) magnetic resonance (MR) imager has been developed and used to produce 802 MR images of the heart in 30 patients. The instrument consists of an isolated acquisition module, an electrically floating preamplifier, and a monitor gating module. Two spin-echo images were acquired for each of five, 0.7-cm thick, transaxial sections from the base to the apex of the heart during each ECG-synchronized imaging run. Image quality was assessed in a blind study by two investigators, on a scale from 0 to 3, as diagnostic [2-3] or nondiagnostic [0-1]. There was agreement in 91.4% of their assessments of diagnostic images (68.1% of the images studied). Resolution of heart anatomy on the MR images was adversely affected by prolonged spin-echo time delay, imaging in late diastole, image acquisition at the cardiac apex, irregular triggering, and artifacts. The synchronization of gradient pulses to the ECG at 0.35 T appears safe for patients, permits diagnostic resolution of images, allows image acquisition at distinct points during the cardiac cycle, and enables monitoring of patients during imaging.