APOE, APOE promoter, and Tau genotypes and risk for concussion in college athletes.

OBJECTIVE: To investigate associations of APOE, APOE promoter (G-219T), and tau protein exon 6 polymorphisms (47 and 53) and a history of self-reported concussion in college athletes. DESIGN: Multi-center cross-sectional study. SETTING: Male football and male and female soccer programs at the University of South Carolina, Jacksonville University, Benedict College, and the College of Charleston. PARTICIPANTS: Active 18- to 30-year-old (n = 195) intercollegiate male football players and male and female soccer players during 2001 and 2002. ASSESSMENT OF RISK FACTORS: Written questionnaires and blood or mouthwash samples for DNA for genotyping by RFLP/PCR. MAIN OUTCOME MEASUREMENT: Self-reported history of concussions over the previous 8 years. RESULTS: A statistically significant, nearly 3-fold increase in risk of a history of concussion for those with the APOE promoter G-219T TT genotype relative to the GG genotype (OR, 2.8; 95% CI, 1.1 to 6.9) adjusted for age, sport, school, and years in their primary sport, a finding that was stronger for Cantu grade 2 and 3 concussions. CONCLUSIONS: These results suggest that college athletes with an APOE promoter G-219T TT genotype may be at increased risk for having a history of concussions, especially more severe concussions. Although there was some support for the possibility that the tau 53 polymorphism may be associated with increased risk of prior concussion (OR, 2.1; 95% CI, 0.3 to 14.5), there was no support for an association with APOE genotypes. The results of this cross-sectional study support the need for a prospective study of genetic factors, such as APOE promoter polymorphisms, and the incidence of and sequelae from concussions in college athletes.     

Utilization of screening mammography: comparison of different physician specialties

Data obtained on 426 consecutive patients referred to a breast center by 122 physicians, including family practitioners, general surgeons, and other specialists, showed that the obstetricians-gynecologists referred the greatest average number of patients per physician, with more than 50% of these referrals for screening mammography. Internists referred fewer patients by nearly a factor of ten, with only one-third of these patients referred for screening mammography. Internists may be the weakest link in the utilization of screening mammography.     

A two-step method for understanding and fitting growth curve models

With data from a repeated measures design, analysts often overlook growth curve analysis based on the Potthoff-Roy model. The reluctance to perform a growth analysis may result partially from unfamiliarity with the technique, and partially from the lack of readily available computational programs to fit the models. Although growth curve analysis has traditionally appeared as a special technique in multivariate analysis, one can fit the models with the use of two simple ideas: transformation of variables, and weighted least squares (WLS). When presented in this manner, growth models are a natural extension of univariate repeated measures models. Growth curve analyses share with univariate analyses the common objective to limit estimation to a parsimonious set of parameters that characterize the response profiles. One can readily fit models with commonly available software. The two-step methodology also allows the fit of more general growth models that are appropriate when groups have different shape profiles. Two examples illustrate this approach to growth curve analysis.     

Spontaneous rupture of the stomach

A case of spontaneous rupture of the stomach associated with perforation of the diaphragm is reported. Spontaneous rupture of the stomach is a rare but fatal condition. The pathophysiologic features, clinical manifestations, and treatment are discussed.     

Laminar Necrosis of Placental Membranes: A Histologic Sign of Uteroplacental Hypoxia

Laminar necrosis of placental membranes (LN), a band of coagulative necrosis at the choriodecidual interphase, is a histologic lesion of unclear pathogenesis that has been reported in placentas from preeclampsia, preterm premature rupture of membranes, and preterm abruption. To better explore other possible correlations of LN, we performed a retrospective case-control study in which data on pregnancy risks and outcomes, neonate conditions, and placental gross, routine microscopic, and selected immunohistochemistry examinations in 52 consecutive cases of LN were compared with 52 gestational age-matched control cases without LN. Maternal hypertensive disorders and combinations of 2 or more maternal, fetal, neonatal, or placental conditions known to be potentially associated with uteroplacental hypoxia were more prevalent in patients with LN than in control patients. By immunohistochemistry, LN areas were positive for complement 9 (marker of necrosis) and negative for active caspase 3 (marker of irreversible apoptosis), nitrotyrosine residues (marker of oxidative stress), and Ki-67 (proliferation marker), thus confirming their necrotic rather than apoptotic nature. However, LN areas were flanked by caspase 3 positivity, and the positivity for nitrotyrosine residues was more pronounced in the decidua and mesenchyme in the same membrane rolls as LN, which indicates a probable role of apoptosis and oxidative stress in the development of LN. Based on these immunohistochemical results and clinicopathologic correlations, we believe LN should be recognized and reported as a hypoxic placental lesion.Presented at the 9th Meeting of the International Federation of Placenta Associations; Mainz, Germany; September 24 to 27, 2003     

A guide to interpreting soil ingestion studies : II. Qualitative and quantitative evidence of soil ingestion

Four major studies have attempted to qualitatively and quantitatively assess the extent of soil ingestion in children using the soil tracer methodology. The validity of the estimates of soil ingestion in each study was reevaluated in light of the inherent strengths and limitations of study design and/or execution, as well as via a novel methodology for estimating the soil recovery variance for each tracer, which then led to the estimation of soil ingestion detection limits for each tracer for studies performing mass-balance analyses. Based on these analyses it is concluded that the Binder et al. (1986, Arch. Environ. Health 41, 341-345) and Van Wijnen et al. (1990, Environ. Res. 51, 147-162) studies provide no convincing evidence to support qualitative and quantitative estimates of soil ingestion due to inherent limitations in their respective study designs. The Davis et al. (1990, Arch. Environ. Health 45, 112-122) and Calabrese et al. (1989, Regul. Toxicol. Pharmacol. 10, 123) studies displayed convincing qualitative evidence of soil ingestion. However, the results indicate that the median soil ingestion estimates of Davis et al. were less reliable than those of Calabrese et al. The range of detection limits vary according to the tracer and the assumption of acceptable precision in recovery estimation. The minimum detection level of soil ingestion in children in the Calabrese et al. study, with a variance in recovery of 100% +/- 20%, was 21 mg/day based on Zr.(ABSTRACT TRUNCATED AT 250 WORDS)     

A nutrition education workshop for managers of nutrition centers for the elderly utilizing videotaped simulations for assessment

As funds become increasingly scarce, an effective nutrition education method which reaches large numbers of elderly individuals is appropriate. A nutrition workshop was provided for 30 managers of government-sponsored nutrition centers for the elderly in a 5-county area. The workshop curriculum, determined after interests of both center managers and participants at the nutrition centers were assessed, was presented in a packet of materials to each workshop attendee and supplemented with explanations and demonstrations. A pre- and post-test evaluation instrument, which included videotaped simulations of typical nutritional situations encountered with elderly persons at the centers, was used to measure attitudes and knowledge before and after the workshop. As a result of the workshop, knowledge increased significantly as measured by the test instrument and 75% of the managers reported use of materials and ideas during the 5 months following the workshop.