The epidemiology of rotavirus diarrhea in Latin America. Anticipating rotavirus vaccines.

OBJECTIVE: To assess the disease burden and characterize the epidemiology of rotavirus diarrhea in Latin America. METHODS: We conducted a literature review of studies of children < 5 years of age who were hospitalized or seen as outpatients for diarrhea and for whom rotavirus was sought as the etiologic agent of the diarrhea. This review included inpatient and outpatient studies published since 1998 that included at least 100 children and reported surveillance activities lasting at least 12 consecutive months. RESULTS: A total of 18 inpatient and 10 outpatient studies met the criteria for inclusion in this review. Rotavirus was detected in a median of 31% of inpatients (range, 16%-52%) and 30.5% of outpatients (range, 4%-42%). The median detection rate was higher in studies that used an enzyme-linked immunosorbent assay (ELISA) (inpatients 38%, outpatients 33%) versus less sensitive methods of detection. The age distribution of rotavirus disease varied among countries, with 65%-85% of children hospitalized in the first year of life. Most countries had rotavirus admissions year round, and rotavirus generally exhibited a winter seasonal peak in both temperate and tropical climates. CONCLUSIONS: The heavy burden of disease attributable to rotavirus in Latin America suggests that vaccines currently being tested could have considerable impact in preventing hospitalizations, clinic visits, and deaths. The findings of the young age distribution of patients highlight the importance of early immunization for the success of a vaccine program. The data suggest that future surveillance for rotavirus diarrhea in Latin America should use a standardized surveillance protocol with an ELISA for detection. Data from surveillance studies will be critical to monitor the impact of the future introduction of vaccines.     

Goal setting is differentially related to change in fruit, juice, and vegetable consumption among fourth-grade children.

The impact of goal attainment in a dietary change program to increase fruit, 100% juice, and vegetable consumption was assessed among fourth-grade students. At each session, the students were given goals related to increasing fruit, juice, and vegetable consumption. Baseline consumption and postconsumption were assessed with up to 4 days of computerized dietary recalls. Analyses included regression models predicting postconsumption from the numbers of fruit-juice goals, vegetable goals, or total number of general goals attained, respectively. For students with low baseline fruit-juice preferences, attaining more fruit-juice goals resulted in increased post-fruit-juice consumption. Among those with low baseline vegetable consumption, attaining one vegetable goal was related to higher post-vegetable consumption. For boys and those with high baseline fruit, juice, and vegetable consumption, attaining three general goals was related to increased fruit, juice, and vegetable intake. The results show that goal attainment was somewhat effective in promoting dietary change among children.     

Associations among circulating sex hormones, insulin-like growth factor, lipids, and mammographic density in postmenopausal women.

OBJECTIVE: Hormone therapy use has been positively associated with mammographic density in several studies. However, few studies have examined the association between endogenous hormone levels and mammographic density. Therefore, we evaluated the relationship of endogenous sex hormones, insulin-like growth factor (IGF), and lipids with mammographic density in 88 overweight, postmenopausal women not taking hormone therapy. METHODS: Percent density and dense area were evaluated as continuous measures using a computer-assisted program. We used multiple linear regression to evaluate the associations of sex hormones, IGF, and cholesterol with mammographic density, adjusting for confounders, including adiposity. We evaluated stratification by history of hormone therapy use (former versus never) and hormone therapy latency (<5 versus > or = 5 years). RESULTS: Among former hormone therapy users, mammographic density was inversely associated with circulating levels of estrone (P = 0.01), estradiol (P = 0.003), free estradiol (P = 0.004), testosterone (P = 0.04), free testosterone (P = 0.02), androstenedione (P < 0.001), dehydroepiandrosterone (P = 0.01), and the ratio of IGF-I to its binding protein (IGF-I/IGFBP-3; P = 0.04). We found similar associations when we limited the analyses to women who had used hormone therapy within the past 5 years. We also noted positive associations of mammographic density with total cholesterol (P = 0.03) and low-density lipoprotein (P = 0.03) among former hormone therapy users. No associations were noted among women who had never used hormone therapy. CONCLUSIONS: These results suggest that there is an inverse relationship between endogenous sex hormones and mammographic density in postmenopausal women among former users of hormone therapy. This is not consistent with the hormone therapy literature and should be confirmed in larger studies.     

Movement imagery as a predictor of online control in typically developing children

The ability to mentally represent actions is suggested to play a role in the online control of movement in healthy adults. Children’s movement imagery ability and online control have been shown to develop at similar nonlinear rates. The current study investigated the relationship between movement imagery and online control in children by comparing implicit and explicit movement imagery measures with the ability to make online trajectory corrections. Imagery ability was a significant predictor of children’s online control of movement once general reaching efficiency was controlled for. These findings extend the proposed relationship between movement imagery and online control.