The predictive validity of the Dutch Restrained Eating Scale

The present study aims to determine the predictive validity of the 10-item Dutch Restrained Eating Scale. The ultimate criterion of restrained eating is the degree to which an individual eats less than he or she actually would like to eat. Since a study on both actual food consumption and restriction of food intake is very complicated, if not impossible, the difference between actual and desired intake of energy was studied indirectly, that is, from estimates of deviations from the required energy intake. The relationships were studied between restrained eating scores and the magnitude of the deviation from energy requirement, and between restrained eating scores and intake of fat and sugar, because restriction in intake of these may also reflect dietary restraint. About 20% of the variance of scores on the Restrained Eating Scale could be explained from these measures of food intake, which suggests that the Dutch Restrained Eating Scale has moderate to good predictive validity.     

Energy expenditure at rest and during activities: A comparison between young and elderly women

Energy expenditure at rest (resting metabolic rate, RMR) and during several activities was measured in 20 young (age 19–27 years) and 19 elderly (age 65–78 years) females. Fat-free mass (FFM) was estimated by means of a four compartment model which accounted for variability in water and bone mineral in the FFM. RMR was lower (P < 0.05) in the elderly (mean ± SE 3.55 ± 0.05 kJ/min) compared to the younger females (3.92 ± 0.09 kJ/min). However, after correction for differences in FFM between the groups, RMR was 3.71 ± 0.07 kJ/min and 3.77 ± 0.06 kJ/min for the elderly and young, respectively, and the difference was not significant. Energy expenditure (EE) during several activities, standing with arm movement, bicycling at 25 Watts, and walking at 3 km/h, were not different between the two groups. However, the physical activity ratios (PAR) for the activities were higher (P < 0.05) in the elderly (1.61 ± 0.03, 3.29 ± 0.07, 4.11 ± 0.16, respectively) than in the young (1.47 ± 0.03, 2.93 ± 0.05, 3.58 ± 0.14, respectively). EE due to physical activity alone (total EE minus RMR) was significantly higher for all activities in the elderly, except for walking at fixed speed of 3 km/h. After correction for the lower relative FFM in the elderly, differences between age groups disappeared. EE for walking 500 m at an individually selected speed was higher in the elderly, although they selected a lower walking speed. Differences between young and elderly decreased when step frequency was taken into account. It is concluded that EE due to physical activity in elderly women is higher than in younger females, but that the differences in EE due to physical activity are largely attributable to differences in body composition. © 1996 Wiley-Liss, Inc.     

High-dose etoposide and cyclophosphamide without bone marrow transplantation for resistant hematologic malignancy

Seventy-five patients with resistant acute leukemia or lymphoma received high-dose cyclophosphamide and etoposide to explore the activity of this combination in resistant hematologic malignancies, and to determine the maximum doses of these drugs that can be combined without bone marrow transplantation. Etoposide was administered over 29 to 69 hours by continuous infusion corresponding to total doses of 1.8 g/m2 to 4.8 g/m2. Cyclophosphamide, 50 mg/kg/d, was administered on 3 or 4 consecutive days total 150 to 200 mg/kg ideal body weight). At all dose levels myelosuppression was severe but reversible. Mucosal toxicity was dose-limiting with the maximum tolerated dose level combining etoposide 4.2 g/m2 with cyclophosphamide 200 mg/kg. Continuous etoposide infusion produced stable plasma levels that were lower than would be achieved after administration by short intravenous infusion, and this could explain our ability to escalate etoposide above the previously reported maximum tolerated dose. There were 28 complete (35%) and 12 partial (16%) responses. Median duration of complete response (CR) was 3.5 months (range 1.1 to 20+). Seventeen of 40 patients (42%) with acute myelogenous leukemia (AML) achieved CR, including 6 of 20 (30%) with high-dose cytosine arabinoside resistance. We conclude that bone marrow transplantation is not required after maximum tolerated doses of etoposide and cyclophosphamide. This regimen is active in resistant hematologic neoplasms, and the occurrence of CR in patients with high-dose cytosine arabinoside-resistant AML indicates a lack of complete cross-resistance between these regimens.     

Perinatal outcomes in inflammatory bowel disease

Objective: To determine whether inflammatory bowel disease (IBD) is associated with increased risk for adverse perinatal outcome.

Methods: A case–control study of 116 singleton pregnancies with IBD compared to 56?398 singleton controls delivered between 1986 and 2001.

Results: Patients with IBD were slightly older (32.8 vs. 30.6 years, p <?0.001), more likely to be Caucasian or Asian than Black or Latino (92% vs. 57%, p <?0.001) and have private health insurance (33% vs. 3%, p <?0.001). IBD was associated with an increased risk for labor induction (32% vs. 24%, p?=?0.002), chorioamnionitis (7% vs. 3%, p?=?0.04) and Cesarean section (32% vs. 22%, p?=?0.007), but there were no differences in neonatal outcomes. Subgroup analysis demonstrated an increased risk for low birth weight (LBW) in the ulcerative colitis group vs. the Crohn's disease group (19% vs. 0%, p?=?0.002). Patients with prior surgery for IBD had a lower incidence of LBW (0% vs. 12%, p?=?0.03). Flares during pregnancy were associated with an increased risk for preterm delivery (27% vs. 8%, p?=?0.02) and LBW (32% vs. 3%, p?=?0.003).

Conclusion: IBD was an independent risk factor for Cesarean section but there was no increase in adverse perinatal outcome. Crohn's disease, prior IBD surgery and quiescent disease were associated with a lower risk for LBW.     

F-19 MR imaging of glucose metabolism in the rabbit

Noninvasive metabolic magnetic resonance (MR) imaging reflecting glucose metabolism in the aldose-reductase-sorbitol (ARS) pathway was performed in the rabbit head; after administration of the fluorinated glucose analogue 3-fluoro-3-deoxy-D-glucose (3FD-glucose), fluorine-19 images were generated. Images of 3FD-glucose showed significant 3FD-glucose uptake by adipose tissue, indicating its buffering effects in case of excess loads of glucose. Images of 3-fluoro-3-deoxy-D-sorbitol (3FD-sorbitol) demonstrated the spatial distribution of aldose reductase activities and significant sorbitol accumulation in the lens. Images of 3-fluoro-3-deoxy-D-fructose (3FD-fructose) showed preferential uptake of fructose by muscle tissue. The extremely low toxicity of 3FD-glucose indicates promise for its clinical application in metabolic imaging.     

Renal thorium deposition associated with transitional cell carcinoma: radiologic demonstration in two patients

Abdominal radiography, excretory urography, retrograde pyelography, and computed tomography were performed in two patients who had undergone retrograde pyelography with thorium dioxide (Thorotrast) approximately 40 years ago. Both patients developed a transitional cell carcinoma due to suburothelial thorium deposition. Typical thorium densities were demonstrated at CT in the peripelvicalyceal area as well as in retroperitoneal lymph nodes. Elderly patients in whom radiographic examination reveals retained Thorotrast in the kidney should be followed up because of the high risk of renal carcinoma.     

Meniscal injuries: detection using MR imaging

Both retrospective and blinded analyses of thin-section, high-resolution magnetic resonance (MR) images of the knee joint, produced using a solenoid surface coil, indicate that MR imaging is an effective technique for evaluating meniscal injuries. Images of 49 patients were evaluated, and the results were correlated with those of subsequent arthroscopy. A grading scale was developed to rate the index of suspicion of a meniscal tear based on the MR images. Overall, approximately 80% of menisci rated grade 4 (definite tear) or 3 (probable tear) were found to have corresponding tears at arthroscopy. In many other patients with a grade 4 or 3 meniscus in whom a corresponding tear was not found arthroscopically, meniscal tears at other sites or other abnormalities were correctly diagnosed using MR. A majority of the false-positive MR images involved the posterior horns of the menisci, the sites of most false-negative arthroscopic diagnoses. The predictive value of a negative MR image was almost 100%. Even in patients with moderate-to-large effusions, the menisci were accurately evaluated. The results imply that MR imaging is useful in the preoperative evaluation of suspected meniscal tears.