How could complementary feeding patterns affect the susceptibility to NCD later in life?

AimsThe purpose of this paper is to provide a general framework for thinking about pathways and potential mechanisms through which complementary feeding may influence the risk of developing non-communicable diseases (NCDs).Data synthesisTo provide a context for the lack of clear and consistent evidence relating complementary feeding to NCD risk, methodological challenges faced in trying to develop an evidence base are described. Potential pathways through which complementary feeding may influence obesity-related NCD risk are described and illustrated with examples.ConclusionsNumerous aspects of complementary feeding, including diet composition as well as patterns of feeding have the potential to influence the early development of obesity, which in turn predicts later obesity and NCD risk. Specific dietary exposures during the period of complementary feeding also have the potential to program future disease risk through pathways that are independent of adiposity. These factors all require consideration when making recommendations for optimal complementary feeding practices aimed at prevention of future NCDs.     

Commentary: ethical issues in the use of computerized databases for epidemiologic and other health research

Computerization of databases has increased apprehension about loss of privacy. The intent of this paper is to facilitate health research that gives proper respect to ethical principles, thereby increasing public comfort and reducing demands for restrictive legislation concerning access to databases. We review how computerization has increased the saliency of concerns and discuss examples of the application of ethical analysis in published database research. Extreme positions notwithstanding, there is general agreement among researchers that research curiosity and the convenience of database research cannot justify the suspension of moral concerns about privacy and confidentiality. Public and professional concerns may affect policy development; therefore, the methods of ensuring privacy and protecting confidentiality must be routinely described in research proposals and published reports along with the benefits of the research. An important issue requiring further attention is that the moral responsibility to respect privacy increases with the sensitivity of information.     

Prosthetic joint infection

Total joint replacement has been one of the most remarkable successes of modern medical technology. Once John Charnley had solved the problems of implant design, choice of materials, implant fixation, and infection (initial rates of infection were approximately 10%), the way was clear for the widespread use of this valuable treatment, which is highly effective at removing pain and restoring function. Unfortunately, infection still remains an important, though less common, problem. It is associated with serious morbidity (pain, loss of function, wound breakdown, wound discharge, implant failure) and sometimes mortality. It may be impossible to eradicate or suppress infection in the long term without removal of the prosthesis, and most clinicians would consider it unwise to re-implant a new prosthesis in the presence of infection. Hence, patients with infected prosthetic joints generally require multiple additional operations and prolonged periods of antibiotic therapy. Even radical attempts at cure may fail (in 10% to 15% of cases in most series), requiring further cycles of treatment with progressively deteriorating function. Thus, the treatment of prosthetic joint infection is arduous for the patient and the health care team, with no guarantee of success.     

Escherichia coli tetracycline efflux determinants in relation to tetracycline residues in chicken

ObjectiveTo screen for Escherichia coli (E. coli) resistant to tetracycline, followed by identification of tet efflux genes by polymerase chain reaction (PCR). In addition, detection of tetracycline residues in chicken livers and kidneys were conducted using high performance liquid chromatography-tandem quadrupole mass spectrometry (HPLC-MS-MS).MethodsStrains of E. coli were isolated from samples of chicken colon and screened for tetracycline resistance. Tetracycline genes conferring resistance (Tc^r) were detected by polymerase chain reaction (PCR). Most of the isolates were resistant to tetracycline (97.9%).ResultsPCR analysis indicated that Tc^r E. coli R-plasmids contained tet(A), tet(B) and a combination of both efflux genes. None of the isolates contained other efflux tet genes tet (C, D, E and Y). High performance liquid chromatography-tandem quadrupole mass spectrometry (HPLC-MS-MS), a sensitive technique, was used to detect residues of chlortetracycline (CTC), oxytetracycline (OTC), doxycycline (DC) in chicken livers and kidneys. The samples containing tetracycline residues were at 0.13-0.65 pg/μL levels.ConclusionsTetracycline and other antibiotics are commonly used in the poultry and meat production industry for prevention of microbial infections. Multiple antibiotic resistant bacteria in Oman have increased to alarming levels, threatening public health, domestic and may have adverse effect on environment.     

Distal stent delivery with guideliner catheter: First in man experience

Failure to deliver stents is one of the commonest causes of procedural failure in contemporary PCI practice. We describe successful use of the Guideliner Catheter, the first purpose designed FDA and CE marked device delivery catheter in 13 complex cases in native coronary vessels and bypass grafts performed via the radial route to enable distal stent delivery following failure of conventional techniques. We discuss how the Guideliner catheter may be used to facilitate difficult radial cases. © 2010 Wiley‐Liss, Inc.     

Large particle hyaluronic acid for the treatment of facial lipoatrophy in HIV‐positive patients: 3‐year follow‐up study

Objectives

Facial lipoatrophy can be a stigmatizing side effect of antiretroviral (AVR) treatment for HIV‐infected patients. We sought to evaluate the long‐term efficacy and safety of a new formulation of hyaluronic acid that can be injected in larger amounts and into deeper skin layers during 3 years of follow‐up.

Methods

Twenty patients received injections of Restylane SubQ^™. Refill treatment was offered at 12 and 24 months. Treatment effects were evaluated using ultrasound, the Global Aesthetic Improvement Scale, visual analogue scale (VAS) and the Rosenberg self‐esteem scale.

Results

Seventeen patients remained at 36 months. Mean (± standard deviation) total cutaneous thickness increased from 6 ± 1 mm at baseline to 12 ± 1 mm (P<0.001) at 36 months. Response rate (total cutaneous thickness >10 mm) was 70%. Fifteen patients classified their facial appearance as very much or moderately improved. VAS increased from 39 ± 25 to 70 ± 20 (P<0.05) and higher self‐esteem scores were reported. Local swelling and tenderness after treatment was common. Persistent papules found in several patients after treatment were removed effectively with hyaluronidase injections. Three patients, treated only at baseline, still had higher total cutaneous thickness scores at 36 months.

Conclusions

Our results indicate that a large particle hyaluronic acid formulation is a durable and well‐tolerated dermal filler for treating HIV‐positive patients with facial lipoatrophy.