Reboxetine add on therapy to haloperidol in the treatment of schizophrenia: a preliminary double-blind randomized placebo-controlled study

The negative symptoms of schizophrenia remain a major clinical challenge. Reboxetine is an antidepressant whose major mechanism of action is as a noradrenergic reuptake inhibitor. This study was a 6-week randomized placebo-controlled trial of reboxetine or placebo add on to haloperidol 5 mg in the treatment of 30 patients with DSM-IV schizophrenia. The trial failed to demonstrate any significant difference between the placebo and reboxetine groups on any of the outcome measures. This trial does not suggest that increased noradreneregic drive mediated by reuptake inhibition in patients taking dopamine antagonists is of therapeutic value in schizophrenia.     

Improvement of walking speed prediction by accelerometry and altimetry, validated by satellite positioning

Activity monitors based on accelerometry are used to predict the speed and energy cost of walking at 0% slope, but not at other inclinations. Parallel measurements of body accelerations and altitude variation were studied to determine whether walking speed prediction could be improved. Fourteen subjects walked twice along a 1.3km circuit with substantial slope variations (−17% to +17%). The parameters recorded were body acceleration using a uni-axial accelerometer, altitude variation using differential barometry, and walking speed using satellite positioning (DGPS). Linear regressions were calculated between acceleration and walking speed, and between acceleration/altitude and walking speed. These predictive models, calculated using the data from the first circuit run, were used to predict speed during the second circuit. Finally the predicted velocity was compared with the measured one. The result was that acceleration alone failed to predict speed (meanr=0.4). Adding altitude variation improved the prediction (meanr=0.7). With regard to the altitude/acceleration-speed relationship, substantial inter-individual variation was found. It is concluded that accelerometry, combined with altitude measurement, can assess position variations of humans provided inter-individual variation is taken into account. It is also confirmed that DGPS can be used for outdoor walking speed measurements, opening up new perspectives in the field of biomechanics.     

Clival chordoma presenting with acute brain stem hemorrhage.

The authors present a case of a 29-year-old man who developed rapidly progressive cranial nerve palsies and a right hemiparesis secondary to a pontine hemorrhage. The rare but correct diagnosis of a clival chordoma which had invaded the brain stem and subsequently hemorrhaged was based on computed tomography and magnetic resonance imaging. The diagnosis was confirmed at surgery when the patient underwent a successful operative decompression of tumor and clot from the pons via a sub-occipital craniotomy. This represents the first case of a clival chordoma to hemorrhage into the brain stem, which was diagnosed preoperatively and the patient survived.     

High phenotypic correlations among siblings with autism and pervasive developmental disorders

The objective of this study was to examine familial factors influencing clinical variation in sibships that contained at least 2 children affected with autism or another form of pervasive developmental disorder (PDD). The sample included a total of 60 families, 23 with multiple cases of PDD and 37 with a single affected child. Measurements of IQ, adaptive behaviors in socialization and communication, and autistic symptoms were taken on all affected children. A high intraclass correlation, especially on IQ and an index of social behaviors, was observed between affected children from the same family. In contrast, low correlations were observed on measurements of IQ and adaptive behavior between affected and unaffected children from the same family. These data indicate that variation in severity of PDD is influenced by familial, and probably genetic, mechanisms. The results are discussed in relation to current theories on the genetics of autism and the heritable mechanisms underlying variations in clinical severity. © 1996 Wiley-Liss, Inc.     

Whole-body protein turnover and resting energy expenditure in obese, prepubertal children

BACKGROUND: Obesity is becoming more frequent in children; understanding the extent to which this condition affects not only carbohydrate and lipid metabolism but also protein metabolism is of paramount importance. OBJECTIVE: We evaluated the kinetics of protein metabolism in obese, prepubertal children in the static phase of obesity. DESIGN: In this cross-sectional study, 9 obese children (x +/- SE: 44+/-4 kg, 30.9+/-1.5% body fat) were compared with 8 lean (28+/-2 kg ,16.8+/-1.2% body fat), age-matched (8.5+/-0.2 y) control children. Whole-body nitrogen flux, protein synthesis, and protein breakdown were calculated postprandially over 9 h from 15N abundance in urinary ammonia by using a single oral dose of [15N]glycine; resting energy expenditure (REE) was assessed by indirect calorimetry (canopy) and body composition by multiple skinfold-thickness measurements. RESULTS: Absolute rates of protein synthesis and breakdown were significantly greater in obese children than in control children (x +/- SE: 208+/-24 compared with 137+/-14 g/d, P < 0.05, and 149+/-20 compared with 89+/-13 g/d, P < 0.05, respectively). When these variables were adjusted for fat-free mass by analysis of covariance, however, the differences between groups disappeared. There was a significant relation between protein synthesis and fat-free mass (r = 0.83, P < 0.001) as well as between protein synthesis and REE (r = 0.79, P < 0.005). CONCLUSIONS: Obesity in prepubertal children is associated with an absolute increase in whole-body protein turnover that is consistent with an absolute increase in fat-free mass, both of which contribute to explaining the greater absolute REE in obese children than in control children.     

History of food acceptance research in the US Army

The history of food acceptance research by the US Army in Chicago and Natick is reviewed. The review covers the staff of the two research centers, the research programs, and the significant accomplishments of the Army laboratories from the 1940s to the present. Accomplishments begin with the development of the nine-point hedonic scale, and the development of the first Food Acceptance Laboratory. Further accomplishments include studies of sensory psychophysics, food preferences, food choice and food intake. The laboratories designed methods and conducted research on the role of consumer variables in the acceptance of food products and food service systems. Recent work has focused on new scaling approaches, the role of contextual factors and the importance of product expectations. Throughout the period of the review, the Army research has examined the relationship of laboratory acceptance to field acceptance, and the relationship of acceptance to intake.     

Stimulation of thermogenesis in men after combined glucose-long-chain triglyceride infusion

The effect of combined long-chain triglyceride infusion (Intralipid 20%) with graded doses of insulin/glucose on energy expenditure was examined in 17 healthy young male volunteers by using the euglycemic insulin clamp technique in combination with indirect calorimetry. Intralipid was infused for 90 min at a constant rate of 0.23 g/min; plasma free fatty acids increased from base-line values of 380 +/- 8 mumol/l to steady state levels of 650 +/- 12 mumol/l. After 90 min the Intralipid was continued and insulin was infused at three rates (0.5, 2, and 4 mU/kg . min) to achieve steady state hyperinsulinemic plateaus of 63 +/- 4, 167 +/- 10, and 410 +/- 15 microU/ml. Plasma glucose concentration was maintained constant at basal euglycemic levels (insulin clamp technique) by infusing glucose at 0.24, 0.48, and 0.59 g/min, respectively. Glucose storage during the insulin clamp (ie, glucose uptake minus glucose oxidation) was 0.13, 0.33, and 0.40 g/min for each group and exogenous lipid storage was 0.17, 0.18, and 0.19 g/min, respectively. The net increment in energy expenditure was 0.15, 0.24, and 0.26 kcal/min, respectively, which represents 8.5% of the energy content of the total amount of glucose and lipid stored. The experimentally determined value (approximately 9%) for the cost of storing both glucose and lipid was found to be significantly greater than predicted by stoichiometric calculations. However, the experimental value for the combined infusion was less than that observed for glucose storage alone (12%). This finding provides support for the use of combined glucose/fat infusions in parenteral nutrition as it is used more economically than when glucose is infused alone.     

A new procedure to assess the energy requirements of lactation in Gambian women

The combined 24-h energy expenditure (24-h EE) of mother and child was measured with a respiratory chamber (indirect calorimeter) in a group of 16 lactating Gambian women and was compared with that of a control group of 16 nonpregnant, nonlactating (NPNL) Gambian women. Breast-milk production (738 +/- 47 g/d: mean +/- SE) was adequate to allow a normal rate of growth of their 2-mo-old babies (28.0 +/- 2.4 g/d). The combined 24-h EE (mother and child) was higher (8381 +/- 180 kJ/d. P less than 0.001) than that of NPNL women (6092 +/- 121 kJ/d). Two-thirds of this differences could be attributed to the child's EE and one-third to a greater spontaneous physical activity of lactating women. The energy retained by the child for growth in conjunction with the calorimetric measurements allowed the calculation of the extra energy requirements for lactation, which were found to be 2100 kJ/d. These results confirm the values of the current dietary recommendations for lactation, based on the energy cost of milk production.     

Assessment of physical activity with a pedometer and its relationship with VO2max among adolescents in Switzerland

Summary Objectives: In the absence of a gold standard, the assessment of physical activity in children remains difficult. To record physical activity with a pedometer and to examine to what extent it is correlated with VO₂max.Methods: Survey on physical activity and fitness; 233 Swiss adolescents aged 11 to 15 carried a pedometer (Pedoboy^®) during seven consecutive days. VO₂max was estimated through an endurance shuttle run test.Results: The physical activity recorded by the pedometer did not vary from one day to the other (p>0.05). The physical activity was higher among boys than among girls (p<0.001) and higher among younger adolescents (6^th versus 8^th grade; p<0.001). The correlation between physical activity and estimated VO₂max was 0.30 (p<0.01).Conclusions: The use of a pedometer to assess physical activity over one entire week is feasible among adolescents. The record provided by the pedometer gives an objective measure of the usual physical activity and, as such, is relatively well correlated with aerobic capacity.

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Zusammenfassung Fragestellung: Mangels einer allgemein akzeptierten Wertskala verbleibt die Schätzung der physischen Aktivität der Kinder schwierig. Physische Aktivität mittels eines Pedometers zu messen und feststellen, in welchem Ausmass diese Aktivität mit VO₂max in Zusammenhang steht.Methoden: Untersuchung über physische Aktivität und körperliche Verfassung; 233 schweizerische Jugendliche im Alter von 11 bis 15 Jahren trugen einen Pedometer (Pedoboy^®) während sieben aufeinanderfolgenden Tagen. VO₂max wurde durch einen Dauerlauftest bewertet.Resultate: Die vom Pedometer registrierte physische Aktivität änderte sich nicht von einem Tag zum anderen (p>0.05). Die physische Aktivität war bei den jungen Männern höher als bei den jungen Frauen (p<0.001) und höher je jünger die Jugendlichen waren (6. Klassenstufe versus 8. Klassenstufe; p<0.01). Der Zusammenhang zwischen physischer Aktivität und geschätzte VO₂max war 0.30 (p<0.01).Schlussfolgerungen: Der Gebrauch eines Pedometers, um während einer ganzen Woche die physische Aktivität Jugendlicher zu schätzen, ist durchaus möglich. Die vom Pedometer registrierten Daten geben einen objektiven Anhaltspunkt für die normale physische Aktivität und stimmen mit der Aerobic-Kapazität einigermassen überein.

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Résumé Objectifs: En l'absence d'une méthode de référence acceptée par tous, l'évaluation de l'activité physique chez les enfants est difficile. Evaluer l'activité physique à l'aide d'un pédomètre et analyser la corrélation entre activité physique et VO₂max.Méthodes: Enquête sur l'activité et la condition physique; 233 adolescents suisses de 11 à 15 ans ont porté un pédomètre (Pedoboy^®) pendant sept jours consécutifs. La VO₂max a été calculée grâce au test d'endurance de course navette.Résultats: L'activité physique enregistrée par le pédomètre ne varie pas d'un jour à l'autre (p>0.05). Le niveau d'activité physique est plus élevé chez les garçons que chez les filles (p<0.001) et parmi les adolescents les plus jeunes (comparaison entre la 6ème année et la 8ème année; p<0.001). Le coefficient de corrélation entre l'activité physique mesurée par le pédomètre et la VO₂max est de 0.30 (p<0.01).Conclusions: Il est possible d'utiliser le pédomètre chez les adolescents pour évaluer l'activité physique sur une durée d'une semaine entière. Les données enregistrées par le pédomètre donnent une mesure objective du niveau d'activité et sont relativement bien corrélées avec la capacité aérobie.