Engaging Intergenerational Hispanics/Latinos to Examine Factors Influencing Childhood Obesity Using the PRECEDE–PROCEED Model

Maternal and Child Health Journal - Introduction Hispanics/Latinos are disproportionately affected by obesity in the U.S. Multiple factors place Hispanic/Latino children at risk for overweight,...     

Combination therapy with pulsed methylprednisolone in rheumatoid arthritis.

Pulsed methylprednisolone (PMP) has been shown to produce clinical improvement and reduction in the ESR and acute phase protein concentrations in patients with active rheumatoid arthritis and has been advocated for use either as an alternative to slow-acting antirheumatoid drugs (SAARDs) or in conjunction with SAARDs to accelerate the response to treatment. To test these potential roles for PMP 45 patients with active RA were randomly allocated to treatment with PMP alone, PMP + sulphasalazine (SAS - at a maintenance dose of 2.0 g/day), or PMP + D-penicillamine (DPA - at a maintenance dose of 500 mg/day). In each case three 1 g intravenous infusions were given on alternate days during the first week of the trial. Patients were monitored for 24 weeks by standard clinical and laboratory measurements. All three treatment groups showed significant clinical and laboratory improvements at two weeks. With PMP + DPA and PMP + SAS these improvements were sustained and were not significantly different in these two treatment groups. However, in the 'PMP only' group ESR and CRP rose to pretreatment values by eight weeks. Twelve patients withdrew from the study owing to a relapse of the RA. No serious adverse effects were seen in the 'PMP only' group. Both combination regimens were well tolerated; adverse effects seen were attributable to either DPA or SAS. We conclude that PMP alone is insufficient for treatment of RA but can be used successfully in combination with either DPA or SAS. A comparison between these results obtained from two previous groups of 15 patients treated with DPA alone and SAS alone (using the same study design) shows that PMP accelerated the response to therapy by at least six weeks.     

Reversible oxidant-induced increases in albumin transfer across cultured endothelium: alterations in cell shape and calcium homeostasis

To determine whether reactive oxygen molecules could directly and reversibly increase the transfer of albumin across an endothelial barrier, we measured albumin transfer across monolayers of endothelium cultured on micropore filters before and after exposure to xanthine and xanthine oxidase. Xanthine and xanthine oxidase increased endothelial albumin transfer in a dose-dependent fashion. Parallel phase contrast and fluorescence microscopy demonstrated retraction of adjacent cells from one another and disruption of the actin filaments. The oxidant- induced increases in albumin transfer and changes in cell shape were reversed by removing xanthine oxidase and then incubating the monolayers for 3 1/2 hours in tissue culture media enriched with fetal bovine serum. However, incubation in tissue culture media without serum resulted in progressive injury and cell death. Hence, the brief exposure to oxidants initiated a progressive injury process that was reversed by incubation in serum. Because intracellular and extracellular calcium are important determinants of cell shape, and because some oxidized membrane lipids act as calcium ionophores, we asked whether oxidants altered endothelial calcium homeostasis. Xanthine-xanthine oxidase increased release of 45Ca++ from preloaded cells. The calcium antagonist lanthanum chloride prevented xanthine- xanthine oxidase increases in endothelial albumin transfer and prevented the changes in cell shape; chelation of extracellular calcium inhibited lysis of endothelium by xanthine-xanthine oxidase; and the calcium ionophore A23187 increased endothelial albumin transfer and mimicked the oxidant-induced changes in cell shape. Lanthanum chloride inhibited these effects of A23187. These data suggest that oxygen radicals can reversibly increase endothelial permeability to macromolecules, that this is associated with reversible changes in endothelial cell shape and actin filaments, and that the changes in cell shape are related to oxidant-induced changes in endothelial calcium homeostasis.     

Changes in brain water diffusion during the 1st year of life

PURPOSE: To evaluate the normal water diffusion changes that occur during the 1st year of life. MATERIALS AND METHODS: Diffusion-weighted imaging was performed in 40 subjects (age range, birth to 1 year) in whom both magnetic resonance imaging and neurologic assessment results were normal at the time of imaging and, where available, at follow-up. Apparent diffusion coefficient (ADC) was calculated in four areas of white matter (anterior and posterior subcortical and internal capsule) and four of gray matter (cortex, thalamus, head of the caudate nucleus, and lentiform nucleus). Linear regression was used to examine the effect of age on ADC, and analysis of variance was used to compare ADC within different brain regions. RESULTS: ADC decreased with age in all regions (P <.01). Data best fit with a logarithmic decline (r(2) = 0.20-0.63). ADC was significantly higher in white (113 x 10(-5) mm(2)/sec) than in gray matter (102 x 10(-5) mm(2)/sec; P <.001). Significant differences were seen among three white matter regions (subcortical, 188 x 10(-5) mm(2)/sec at birth; anterior limb of internal capsule, 130 x 10(-5) mm(2)/sec; posterior limb of internal capsule, 109 x 10(-5) mm(2)/sec) and three gray matter regions (cortex, 134 x 10(-5) mm(2)/sec at birth; head of caudate nucleus, 134 x 10(-5) mm(2)/sec at birth; and thalamus and lentiform nucleus, 120 x 10(-5) mm(2)/sec; P <.01). CONCLUSION: Results suggest that in neonates and infants, water diffusion is highly dependent on both subject age and brain location.