Impact of Adopting Lower-Fat Food Choices on Energy and Nutrient Intakes of American Adults

Objective To evaluate the energy and nutrient intake of free-living men and women who choose foods consistent with different fat-reduction strategies.Design For each year of the Continuing Survey of Food Intake by Individuals from 1989 through 1991, food codes were used to sort respondents by type of milk; type of meats; and type of cheese, yogurt, salad dressing, cake, and pudding (ie, full-fat or fat-modified products) consumed.Subjects A nationally representative sample of 3,313 men and 3,763 women who completed 3-day intake records and consumed either a reduced-fat or full-fat food from at least 1 of the 3 fat-reduction strategy categories.Statistical analysis performed Analysis of variance with the Scheffé test was used to analyze differences in energy and nutrient intake between exclusive users, mixed users, and nonusers of each strategy or combined strategies.Results Regardless of fat-reduction strategy, men and women who used them reported significantly lower intakes of total fat (up to 18 g lower), saturated fat (up to 12 g lower), cholesterol (up to 75 ing lower) and energy compared with nonusers. Exclusive users of single strategies met or approached recommendations of the National Cholesterol Education Program for total fat, saturated fat, and cholesterol intake; micronutrient intake varied depending on the strategy used. Skim milk users had the most favorable micronutrient intake, whereas lean meat users reported inadequate intake of zinc (men 6396 and women 59% of the Recommended Dietary Allowances [RDAs]) and female users of fat-modified products reported inadequate intakes of vitamin E (64% of RDA) and zinc (65% of RDA). Multiple-strategy users achieved National Cholesterol Education Program goals and reported adequate micronutrient intakes and significantly lower energy intake. Mixed users of fat-modified products compared with nonusers of any fat-modified products had adequate micronutrient intake and lower intakes of total fat (32% vs 36% of energy for men and 32% vs 35% of energy for women) and saturated fat (11% vs 13% of energy for men and 11% vs 12% of energy for women). In addition, nonusers of any fat-modified strategy had the highest cholesterol and energy intake and the lowest intake of. many micrbnutrients.Applications A variety of fat-reduction strategies can be implemented to reduce energy, total fat, saturated fat, and cholesterol intake. Some of the strategies were associated with an inadequate micronutrient intake, so additional dietary guidance is needed to ensure that all nutrient requirements are met. Furthermore, people who do not use any fat-reduction strategy or those who exclusively use lean meats or fat-modified products would benefit from understanding how to balance their food choices. J Am Diet Assoc. 1999;99:177–183.     

TRANSVAGINAL URETHROLYSIS FOR URETHRAL OBSTRUCTION AFTER ANTI-INCONTINENCE SURGERY

Purpose

Urethral obstruction following a stress incontinence procedure occurs in 5 to 20% of patients. We examine the success of transvaginal urethrolysis in resolving voiding dysfunction.

Materials and Methods

A retrospective chart review was performed on 39 patients who had undergone transvaginal urethrolysis for urethral obstruction following an anti-incontinence procedure. Preoperatively, a history was taken, and pelvic examination and either video urodynamics or cystoscopy were done.

Results

All 39 patients complained of urge incontinence, 13% had urinary retention, 51% had incomplete bladder emptying and 36% voided to completion but had irritative voiding symptoms. Previous surgery included retropubic urethropexy in 41% of the cases, pubovaginal sling in 38% and bladder neck suspension in 21%. Mean length of followup after urethrolysis was 16 months. Of the 39 patients 33 (85%) had resolution of urge incontinence but 5 still required occasional intermittent catheterization. The remaining 6 patients had continued urge incontinence. An augmentation procedure was performed in 4 patients with improvement of symptoms.

Conclusions

Our data support transvaginal urethrolysis for the treatment of iatrogenic urethral obstruction. It is a rapid, effective and minimally invasive technique that should be considered if voiding dysfunction does not resolve spontaneously.     

Stimulus novelty and significance in electrodermal orienting responses: The effects of adding versus deleting stimulus components

Several aspects of a feature-matching theory formulated to account for the roles of stimulus novelty and significance in determining orienting responses (ORs) were examined. Stimulus significance and stimulus novelty were independently manipulated, and the electrodermal component of the OR was measured while sequences of compound pictorial or verbal stimuli were presented. Each sequence included a test stimulus, which was either significant or neutral, and was preceded by several standard control stimuli. Novelty was manipulated by either adding or deleting components from the standard stimuli, and significance was defined within the framework of the guilty knowledge paradigm. A change in the number of components of both verbal and pictorial test stimuli affected OR magnitude for significant but not for neutral test stimuli. Similar ORs were obtained regardless of the direction of stimulus change.     

PREVALENCE OF MATERNAL Ro (SS-A) AND La (SS-B) AUTOANTIBODIES IN RELATION TO CONGENITAL HEART BLOCK

The prevalence of autoantibodies to ribonucleoprotein antigensin cases of congenital heart block was established using immunofluorescence,counterimmunoelectrophoresis, double immunodiffusion and Westernblots. All of 35 mothers of babies with congenital heart block,none of five mothers of babies with other types of heart block,10 of 29 women with connective tissue disease but no babieswith heart block, four of 445 normal pregnant women and twoof 109 healthy nonpregnant women had either Ro (SS-A) or La(SS-B) antibodies. Of 15 babies with congenital heart block,10 of 10 who were less than 3 months old possessed antibody.Antibody titres in affected but not in normal infants were lowercompared with their mothers' titres, suggesting deposition ofantibodies in the baby's tissues. The findings indicate thatplacental transfer of anti-Ro (SS-A) or anti-La (SS-B) is essentialfor development of congenital complete heart block. KEY WORDS: Maternal autoantibodies, Anti-Ro (SS-A), Neonatal lupus, Congenital heart block.     

The Effect of Acute Versus Delayed Remote Ischemic Preconditioning on Reperfusion Induced Ventricular Arrhythmias

Remote Ischemic Preconditioning and Cardiac Arrhythmias. Introduction: The effect of remote ischemic preconditioning (RIPC) on arrhythmias in in vivo models is unknown. Our purpose was to determine effects of both acute and delayed RIPC on arrhythmias. Methods and Results: In the acute protocol anesthetized open chest rats were exposed to 5 minutes of proximal left coronary artery occlusion (CAO) and 10 minutes of reperfusion. Rats were either untreated (ischemia/reperfusion, IR group, n = 17) or received RIPC (n = 14) with 5 minutes bilateral femoral occlusions followed by 5 minutes of reperfusion times 3, started 30 minutes before CAO. At reperfusion, onset of ventricular tachycardia (VT) was delayed in RIPC group (25.7 seconds) versus IR (8.8 seconds; P = 0.04). Number of episodes of VT was 17.0 in IR versus 3.0 in the RIPC group (P = 0.01) and duration of VT was 54.1 seconds in IR versus 4.9 seconds in RIPC (P = 0.019). Number of ventricular premature complexes (VPC) was 26.0 in IR and 10.0 in RIPC rats (P = 0.04). Levels of reperfusion injury salvage kinases (RISK), that is, phospho‐Akt and phospho‐p70S6 in the risk area of IR and RIPC hearts were similarly higher compared to the nonischemic areas both at 1 and 10 minutes into reperfusion. Delayed RIPC was induced on day 1 and on day 2, myocardial IR was induced. Delayed RIPC did not affect VT or VPC. Conclusion: Acute RIPC of the lower limbs induced a powerful delay in/and reduction in IR induced ventricular arrhythmias, but without evoking the RISK pathway; a late protective phase of RIPC on arrhythmias did not occur. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1374‐1383, December 2012)     

The Role of Allergic Contact Dermatitis in Diaper Dermatitis

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, and must not exceed two pages of text including references. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.     

Single Physician Approach to Radiofrequency Catheter Ahlation in Patients with Supraventricuiar Tachycardia

The minimal requirements for safe and effective performance of catheter ablation using radio/requency current are still unclear. To determine the feasibility and safety of single physician approach to catheter ablation of supraventricuiar tachycardia substrate using radio-frequency energy, the results of the ablation procedure in 52 consecutive patients were evaluated. The procedures were performed during 1 year by the same physician and nurse. Twenty-one patients had selective atrioventricuJar (AV) nodal pathway ablation and 31 patients had accessory AV pathway ablation. Forty-eight patients (89%) had the diagnostic and the ablative procedure during the same electrophysiological test. In the 21 patients with AV nodal reentrant tachycardia, all had successful selective ablation of the fast (13) or the slow (8) pathways. Eight patients had recurrence of the clinical tachycardia and had a successful reablation. No patient developed complete AV block or other significant complications. The mean fluoroscopy time during the procedure was 16.0 ± 8.6 minutes. In the eight patients with Wolff-Parkinson-White syndrome, all concealed accessory pathways were successfully ablated with a mean fluoroscopy time of 30.0 ± 27.9 minutes. Two patients had recurrence of the conduction through the accessory pathway and had a successful reablation. Eighteen of 19 patients with a single overt accessory pathway had successful ablation, with a fluoroscopy time of 22.7 ± 20.6 minutes. Three patients had an early recurrence of the conduction through the accessory pathway, reablation was successful in two of them. Ten accessory pathways were ablated in four patients with multiple pathways during nine procedures. Only two patients developed minor peripheral vascular complications. Radiofrequency ablation of supraventricular tachycardia substrates may be performed effectively and safely by a small team just of one physician and one nurse.