Diet Quality Is Associated with Higher Nutrient Intake and Self-Rated Health in Mid-Aged Women

Objective: To develop a diet quality score reflecting adherence to national dietary recommendations for the Australian Longitudinal Study on Women's Health (ALSWH) and to compare this against energy standardized nutrient intakes and indices of health.

Design: Cross-sectional survey in a nationally representative sample of mid-aged women participating in a cohort study.

Subjects: Data from 9,895 women aged 50–55 who participated in the 2001 survey and had four or less missing values on their food frequency questionnaires were used to calculate the Australian Recommended Food Score (ARFS) based on adherence to Australian Dietary Guidelines.

Measure of Outcome: Correlates of ARFS were investigated including, mean nutrient intakes and indices of self-rated health and health service use. Associations were examined using ANOVA for continuous variables and Chi-squared tests for categorical variables. Area of residence and educational attainment were used as covariates in all modeling, to adjust for sampling frame and socioeconomic status.

Results: The maximum ARFS was 74, with a mean of 33.0 ± 9.0 and 21% achieving a score > 40. Higher ARFS was associated with indicators of higher socio-economic status, better self-rated health and lower health service use, p<0.0001, higher intakes of micronutrients and lower percentage of energy as total or saturated fat, p<0.0001.

Conclusions: The Australian Recommended Food Score can be used to rank mid-aged women in terms of diet quality and nutrient intake and is associated with indices of self-rated health and health service use. The ARFS can be used to measure future associations with health outcomes and mortality.     

Hereditary and environmental influences on blood pressure values of premenopausal women and their college-age daughters.

Blood pressure (BP) and environmental (dietary/lifestyle) variables were measured in 62 healthy normotensive pairs of premenopausal mothers (44.3 years) and their college-age consanguineous daughters (18.7 years) to estimate the relative contributions of genetic vs environmental factors on BP. As expected, the mothers had significantly higher systolic (SBP) and diastolic (DBP) blood pressures than the daughters (p less than 0.004 and 0.012, respectively). Among the dietary/lifestyle variables measured, mothers were found to have significantly higher mean weight and body mass index (BMI) (p less than 0.009 and 0.001, respectively), and significantly lower lean body mass (LBM) and calcium intake than their daughters (p less than 0.003 and 0.037, respectively). Significant correlations were found between mean BP of the mothers and their mean weight and BMI. No significant correlations existed for the daughters. The familial resemblances between BP of the mothers and daughters were relatively low, i.e., 0.14 for SBP and 0.19 for DBP. From these findings we conclude that the higher BP values with increased age among this healthy female population primarily result from an increase in BMI and a shift from lean to fat mass, as measured by midarm circumference. Our results suggest that environmental factors, i.e., excessive energy intake over time, accompanied by decreased physical activity, are primarily responsible for the greater indices of body fat and the higher BPs observed in this sample of healthy premenopausal women.     

Inequalities in oral health: are schoolchildren receiving the Bolsa Família more vulnerable?

OBJECTIVE

To evaluate the association between being a recipient of the Bolsa Família program and oral health conditions in Brazilian schoolchildren.

METHODS

A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Família program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval).

RESULTS

Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Família. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Família . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools.

CONCLUSIONS

Schoolchildren benefiting from the Bolsa Família program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.     

Hypothesis testing and anomaly explaining

An experimenter who tests a hypothesis and observes an anomaly that conflicts with his knowledge and views, normally reacts by suspecting some sort of mistake. When he has excluded this possibility, his second sensible reaction is to find an ad hoc interpretation to explain the anomaly. When his favorite interpretation is interesting, probable, simple, elegant and testable enough, he can experiment to verify this explanation as a new hypothesis, independently from the anomaly. This article describes how a scientific investigation walks on two legs: one leg of hypothesis testing and a second leg of anomaly explaining     

新疆地区维吾尔族和汉族溃疡性结肠炎危险因素的分析

背景:溃疡性结肠炎(UC)的发病在不同地区和民族之间存在差异,其发病率逐年增高,但发病原因至今仍不十分明确。目的:探讨新疆地区维吾尔族和汉族UC发病可能的危险因素。方法:纳入经结肠镜检查和病理活检确诊的93例初发型UC患者,其中维吾尔族患者46例,汉族患者47例,同时选择匹配的健康人作为对照。行问卷调查,对可能与UC发病相关的11个变量行单因素分析,差异有统计学意义的变量进一步行多因素条件logistic回归分析。结果:单因素分析显示:油腻饮食、阑尾切除、肠道感染、精神紧张、牛奶摄入与维吾尔族人群UC的发病相关(P<0.05);而吸烟、辛辣饮食、阑尾切除、肠道感染、精神紧张、牛奶摄入与汉族人群UC的发病相关(P<0.05)。多因素条件logistic回归分析显示:油腻饮食(OR=1.970,95%CI:1.412～2.785,P=0.000)、偶尔和经常牛奶摄入(OR=3.219,95%CI:1.190～8.567,P=0.005;OR=2.375,95%CI:1.024～6.649,P=0.004)可能是维吾尔族人群UC发病的危险因素;精神紧张(OR=1.975,95%CI:1.032～3.469,P=0.025)、经常牛奶摄入(OR=4.291,95%CI:1.418～11.913,P=0.012)可能是汉族人群UC发病的危险因素,而吸烟可能是保护因素(OR=0.076,95%CI:0.015～0.527,P=0.004)。结论:新疆地区维吾尔族和汉族UC的发病危险因素可能存在差异,对于维吾尔族人群,油腻饮食、牛奶摄入可能是UC发病的危险因素;而精神紧张、经常牛奶摄入可能是汉族人群UC发病的危险因素,吸烟可能是保护因素。     

Features of the Onset of Takayasu's Arteritis According to Gender

Background

Although there are various published epidemiological studies regarding Takayasu''s arteritis (TA), none have analyzed the influence of gender on the clinical and laboratory manifestations or vascular alterations at disease onset.

Objectives

To analyze the influence of gender on clinical and laboratory manifestations and variations in vascular imaging at TA onset.

Methods

A retrospective, unicentric cohort study that evaluated 55 consecutive TA patients between 1982 and 2012. All available clinical data and laboratory test results related to the onset of the disease were analyzed. We included only patients aged 12-35 years at diagnosis to exclude age-related factors.

Results

We analyzed 17 men and 38 women, mostly Caucasian, with a comparable mean age between genders. There was no gender difference regarding the clinical or laboratory characteristics, comorbidities, or smoking habit, except for abdominal pain, which was more common in men. Regarding vascular lesions, the presence of ascending aortic aneurysms was significantly more frequent in males. Male gender represented an independent risk factor for the occurrence of abdominal pain and ascending aortic aneurysms in TA patients.

Conclusion

Abdominal pain and ascending aortic aneurysms occurred more frequently in men with TA, suggesting a more severe disease profile in males.     

小切口开腹术中内镜治疗 Peutz-Jeghers 综合征患者小肠息肉——附7例分析

背景: Peutz-Jeghers综合征(PJS)患者的小肠多发息肉可引起出血、肠梗阻、肠套叠、息肉恶变等严重并发症,传统外科手术治疗创伤大、术后并发症多,且多次小肠切除术可致短肠综合征。目前关于小切口开腹术中内镜治疗PJS患者小肠息肉的报道较少。目的: 探讨小切口开腹术中内镜治疗PJS患者小肠多发息肉的疗效和可能优势。方法: 回顾性分析南通市第一人民医院1998年9月～2008年10月7例接受小切口开腹术中内镜治疗的PJS患者的息肉切除情况、手术相关并发症和长期随访结果。结果: 7例PJS患者术中共切除929枚小肠息肉,直径≤10mm 492枚,11～30mm 377枚,≥30mm 60枚,最大者45mm×38mm。术后2例患者分别出现肠功能障碍和少量便血,1例术后1年内腹部偶有隐痛不适,经治疗后均好转,无严重并发症和死亡病例。随访1～8年,无患者出现需考虑外科手术治疗的病情变化。结论: 小切口开腹术中内镜治疗能安全有效地切除小肠多发息肉,可反复治疗而无须切除肠段,对PJS患者具有重要临床应用价值。     

Presence of depressive symptoms during early pregnancy and the risk of preterm delivery: a prospective cohort study

BACKGROUND: The impact of prenatal depression on pregnancy outcomes is largelyunknown. METHODS: We conducted a population-based prospective cohort study amongpregnant women of the Kaiser Permanente Medical Care Programto examine the impact of prenatal depression on the risk ofpreterm delivery. We interviewed pregnant women in their earlypregnancy. Women's depressive symptoms were ascertained usingthe standard Center for Epidemiological Studies Depression Scale(CESD). The presence of significant prenatal depressive symptomsand severe depressive symptoms was determined by CESD scores16 and 22, respectively. RESULTS: Among the 791 participants who answered CESD questions and delivereda live birth, after controlling for potential confounders usingthe Cox proportional hazard regression, women with CESD scores16 had almost twice the risk of preterm delivery compared withwomen without depressive symptoms: adjusted hazard ratio (aHR)= 1.9, 95% confidence interval (CI) 1.0–3.7. The riskof preterm delivery increased with increasing severity of depression:aHR = 1.6 (CI 0.7–3.6) for CESD 16–21 and aHR =2.2 (CI 1.1–4.7) for CESD 22. The risk of preterm deliveryassociated with prenatal depression appears to be exacerbatedby low educational level, a history of fertility problems andthe presence of obesity and stressful events. The observed associationswere not confounded by the use of antidepressants, althoughsome of the associations did not reach statistical significance. CONCLUSIONS: Our findings show that pregnant women with depressive symptomsare at increased risk of preterm delivery and, in addition,provide preliminary evidence that social and reproductive riskfactors as well as obesity and stressful events may exacerbatethe effect.     

Skill training with alcoholics: A clinical extension

The present study attempted to replicate and extend a behavioral skill training package developed by Chaney, O'Leary, & Marlatt (1978) to a group of alcoholics of higher socio-economic status than the population originally studied. Subjects receiving the skill training package, which consisted of behavioral rehearsal of coping responses generated for potential relapse-precipitating events, were compared to a control group which received no additional treatment and to a discussion control group which discussed the potential relapse-precipitating events without rehearsing specific responses. All subjects received the assigned treatment as an adjunct to a standard inpatient treatment program. Unlike the results of the Chaney et al. study, which found the skill training package to be superior to both control groups, the present study found that both the skill training and discussion groups were superior to the no- treatment control group, and did not differ from each other.