Early rapid weight gain and current overweight in relation to asthma in adolescents born with very low birth weight

Early catch-up growth and subsequent overweight are suggested to be associated with later cardiovascular diseases and later type II diabetes. However, the impact of early catch-up growth and childhood overweight on the development of asthma has been less studied, particularly in children born with very low birth weight (VLBW). A birth cohort of 74 VLBW children (birth weight < or = 1500 g) was followed from birth and investigated on asthma at 12 yr of age. Early rapid weight gain was in one way defined as an increase of weight > or =1 standard deviation score (SDS) at 6 months of corrected postnatal age. Current overweight was defined by body mass index (BMI) exceeding 21.2 and 21.7 kg/m(2), respectively, for boys and girls at 12 yr of age. Current asthma was diagnosed by a pediatrician, according to asthma ever in combination with a positive response to hypertonic saline bronchial provocation test and/or wheeze at physical examination at 12 yr old. Being overweight at 12 yr of age was associated with an increased risk for current asthma in the VLBW children [crude odds ratio (OR): 5.5, 95% confidence interval (CI): 1.3-22.2]. After adjustment for early weight gain and neonatal risk, the OR of overweight increased nearly three times (adjusted OR: 15.3, 95% CI: 2.5-90.6). Early rapid weight gain seemed to be inversely associated with current asthma (adjusted OR: 0.49 for an increase of weight equal to 1 SDS, 95% CI: 0.23-1.02, p = 0.06). In addition, early rapid weight gain was inversely associated with the magnitude of bronchial responsiveness at 12 yr (coefficient -1.15, p < 0.01). There was a strong and positive association between overweight and asthma at 12 yr of age in the VLBW children. This strong association had been reduced by early rapid weight gain, possibly via the reduction of bronchial responsiveness.     

抗精神病药物治疗引起患者体质量增加及其相关因素分析

目的　探讨抗精神病药(APD)引起患者体质量增加及其相关因素。方法　对6 7例首次住院单用APD治疗的精神分裂症患者进行住院及出院后4个月的随访评估。结果　各时点体质量增加与GI评分无相关性,在出院时与BPRS、SAPS减分值有相关性,而随访期与SANS减分值有相关意义。逐步回归分析显示,在α=0 .0 5水平上,进入回归方程的因素依次为:APD品种,最大服药剂量与服药时间的积,阴性症状,病前1a最佳功能水平。结论　APD治疗中的体质量增加是与疗效无关的药物不良反应,受药物、精神症状及综合社会心理因素等方面的影响,而饮食与活动的中介作用不应低估。控制体质量增加有重要的医学及社会意义。     

Serum and red blood cell folate in depression

Serum folate concentrations were estimated in patients with major depressive disorders, lithium-treated patients, detoxified alcoholic patients and normal controls. Red blood cell (RBC) folate concentrations were also estimated in subgroups of patients with major depressive disorder and normal controls. Results showed significantly lower serum and RBC folate concentrations in patients with major depressive disorder than in normal controls. Lower serum folate concentrations were associated with greater severity of depression. There was no association between serum and RBC folate concentrations and endogenicity of depression or the presence of weight loss.     

Long-term follow-up and the role of surgery in adolescents with morbid obesity

PURPOSE: Obesity has become a health-care crisis in the United States. Adolescent obesity is now one of the most common childhood disorders, with 4.7 million American adolescents having a body mass index (BMI) greater than the 95th percentile. Most patients do not respond to diet modification or exercise programs and attention is now turning toward surgery as a source of weight loss in adolescents. Few studies have looked at the overall morbidity and mortality of weight loss surgery in this patient population. METHODS: This is a retrospective study of medical charts of 15 bariatric surgical procedures performed on 14 adolescents without known genetic syndromes associated with severe childhood obesity from 1971 to 2001 at the University of Minnesota. Procedures performed on these patients included vertical banded gastroplasty (n = 7), Roux-en-Y gastric bypass (n = 5), and jejunoileal bypass (n = 3). Jejunoileal bypass procedures were performed from 1971 to 1977, after which time this procedure was abandoned. Patient age ranged from 13 to 17 years (mean, 15.7 years). Mean follow-up time was 6 years, with 9 patients available for long-term follow-up. RESULTS: All procedures were performed using an open technique by 1 surgeon. There were no perioperative deaths; complications included 1 case of wound infection, 2 episodes of dumping syndrome that resolved without revision, 1 episode of hypoglycemia, and 1 case of short-term electrolyte imbalance in a patient who underwent jejunoileal bypass. The average BMI dropped from 58.5 +/- 13.7 to 32.1 +/- 9.7 kg/m(2) (P < .01)--a 45% reduction. CONCLUSIONS: Surgery for morbid obesity is safe and results in significant weight loss in adolescents who fail medical therapy.     

Sleeping more as a way to lose weight

Caloric consumption in a society with readily available food is likely to be approximately proportional to the number of hours of being awake. Thus, replacing 1 h of inactive wakefulness (e.g. watching TV), with sleeping is likely to result in a substantial reduction in caloric intake. Calculations are presented to illustrate the possible benefits of such a switch on weight reduction.     

187例精神疾病患者劳动能力鉴定分析

目的：探讨精神疾病患者劳动能力鉴定状况及与其相关问题。方法：分析1998至2002年共187例精神疾病患者的劳动能力鉴定资料，并进行不同年代、不同诊断、不同级别的组问比较。结果：除1998年外，其余各年度基本资料相似；诊断以精神分裂症为主，精神发育迟滞为次；前者的平均年龄最大、病期最短、累计病休时间最长、残疾级别最低，后者反之。结论：劳动能力鉴定应按有关标准执行，但目前仍存在一些有待进一步完善的问题。     

Mifepristone-induced abortion and birth weight in the first subsequent pregnancy.

OBJECTIVES: To assess the effect of a medically induced abortion (MA) on birth weight in the first subsequent pregnancy. METHODS: Pregnant women who had had a MA, a surgical abortion (SA), or primigravidas with no history of abortion (NA), were recruited for a prospective cohort study between July 1998 and February 2001. The sample for the present analysis included 12995 singleton live births at term. RESULTS: The overall incidence rate of low birth weight (LBW) was 1.0%. The rates of LBW in the MA, SA, and NA groups were 1.0%, 0.9%, and 1.2, respectively. There were no significant differences in LBW rates between the MA and SA groups, neither between the MA and NA. Logistic regression analysis was used to estimate the effects of MA on birth weight, and we found no relationship between risk of LBW and MA. CONCLUSIONS: We did not find a statistically significant relationship between a history of one medically induced abortion and LBW for the first subsequent term pregnancy.     

Super-reactivity to amphetamine toxicity induced by schedule of reinforcement

The chronic exposure of rats to a schedule of operant water reinforcement coupled with chronically restricted access to water sensitized the animals to intermittentd-amphetamine injections (0.31–2.5 mg/kg with intervals of 12–23 days between any two injections) in such a way that this drug came to produce catastrophic losses of body weight (32.4% of control levels). In the sessions whend-amphetamine was administered, the rats were also given a total of 12 brief electric shocks. Loss of body weight was unaccompanied by parallel changes in operant behavior performance, or in food or water intake. Remarkably, in other studies with the same interventions (sham schedule sessions, water deprivation, and foot shocks), with the exception that reinforcers were never delivered,d-amphetamine did not produce catastrophic falls in body weight. This super-reactivity tod-amphetamine toxicity may be mediated by a possible stressor action of the schedule of reinforcement. Its mechanism might be analogous to the known sensitization produced by classical experimental stressor stimuli to the repeated administration ofd-amphetamine.     

我国青年男子理想体重计算方法的探讨

在营养调查的基础上,以975名北方籍和921名南方籍青年为代表,以实测身高体重为依据,分别推出了理想体重计算公式。北方理想体重(kg)=[身高(cm)-150]×0.6+50;南方理想体重(kg)=[身高(cm)-150]×0.6+48。为检验样本的代表性,又另取北方籍783名青年和南方籍883名青年进行了验证,结果表明,推出的计算公式有较好的代表性。用推出的计算公式分别对1464名北方青年和2264名南方青年的身高体重进行分析,结果表明,新推出的计算公式比以往的计算公式更符合我国的情况,因而更具有实用意义。     

Outcome Following Bariatric Surgery in Super versus Morbidly Obese Patients: Does Weight Matter?

Background: Numerous investigators have attempted to identify prognostic indicators for successful outcome following bariatric surgery. The purpose of this study was to determine whether degree of obesity affects outcome in super obese [>225% ideal body weight (IBW)] versus morbidly obese patients (160-225% IBW) undergoing gastric restrictive/bypass procedures. Methods: Since 1984, 157 patients underwent either gastric bypass or vertical banded gastroplasty. Super obese (78) and morbidly obese (79) patients were followed prospectively, documenting outcome and complications. Results: Super obese patients reached maximum weight loss 3 years following bariatric surgery, exhibiting a decrease in body mass index (BMI) from 61 to 39 kg/m² and an average loss of 42% excess body weight (EBW). Morbidly obese patients had a decrease in BMI from 44 to 31 kg/m² and carried 39% EBW at 1 year. After their respective nadirs, each group began to regain the lost weight with the super obese exhibiting a current BMI of 45 kg/m² (61% EBW) versus 34 kg/m² (52% EBW) in the morbidly obese at 72 months cumulative follow-up. Currently, loss of 50% or more of EBW occurred in 53% of super obese patients versus 72% of morbidly obese (P < 0.01). Twenty-six percent of super obese patients returned to within 50% of ideal body weight (IBW) while 71% of morbidly obese were able to reach this goal (P < 0.01). Co-morbidities and complications related to surgery were similar in each group. Conclusions: Super obese patients have a greater absolute weight loss after bariatric surgery than do morbidly obese patients. Using commonly utilized measures of success based on weight, morbidly obese patients tend to have better outcomes following bariatric surgery.