Body Fat Percentage of Children Varies According to Their Diet Composition

Objective To ascertain the association between diet composition and body fat percentage in 9- and 10-year-old children. Also, to examine the influence of gender, total energy intake, fitness, physical activity, and parental body mass on the relationship between diet composition and adiposity.Design Diet composition was assessed using the National Cancer Institute food frequency questionnaire, and adiposity was measured using the average of results determined using two skinfold equations. Fitness levels and physical activity were ascertained using the 1-mile run/walk test and a self-report 15-item scale, respectively.Subjects A sample of 262 children (162 boys and 100 girls, mean age=9.8±0.5 years) participated.Statistical analysis Regression analysis was used to determine the extent to which diet composition contributed to adiposity without statistical control for any potentially confounding variables. Partial correlations were calculated to assess the relationship between macronutrient intake and adiposity after potential confounders (gender, total energy intake, physical fitness, and parental body mass) were controlled statistically.Results Energy intake was positively related to adiposity. Fat intake, calculated as a percentage of total energy, was also positively related to adiposity, before and after control for potential confounding variables. Percentage of energy derived from carbohydrate was inversely related to adiposity, before and after controlling for potential confounders.Applications These findings indicate that the macronutrient intake of children, particularly dietary fat and carbohydrate intake, may play a role in adiposity, independent of the influence of total energy intake, gender, physical fitness, and parental body mass index.     

肩、肘关节外科新进展

肩关节（Shoulder） 旋转袖（Rotator Cuff） 基础研究（Basic Science） Zuckerman讨论了软骨诱导形态发生蛋白-2（cartilagederived morphogenetic protein-2，CDMP-2）的早期工作。在鼠肌腱修复中，4周时CDMP-2治疗组的修复强度高于未治疗组。Dines讨论了关于血小板衍生生长因子（platelet—derived growth factor，PDGF）和胰岛素样生长因子-1（insulin-like growth factor-1，IGF-1）最初的研究观察。     

Presentation, clinical features and outcome in different patterns of atherosclerotic renovascular disease

Atherosclerotic renovascular disease (ARD) is an increasinglyimportant cause of renal failure. However, important featuresof the clinical presentation are not fully described, and theoutcome after intervention by angioplasty remains controversial.Ninety-four patients with ARD diagnosed at angiography werereviewed. Twenty-four patients were diabetic. Thirty-nine patientshad unilateral renal artery stenosis or occlusion (group A),28 had bilateral stenosis (group B), and 27 had unilateral occlusionplus contralateral occlusion or stenosis (group C), Two yearsafter presentation, actuarial patient survival was 96%, 74.3%and 47.1% in groups A, B and C, respectively (p<0.001 forall differences); actuarial renal survival in surviving patientswas 97.3%, 82.4% and 44.7%, respectively (p<0.001 for alldifferences). Percutaneous transluminal balloon angioplasty(PCTA) was performed in 74 patients. Renal function improvedin only a minority of cases, but was stable in 73% of nondiabeticpatients 12 months after PCTA. Angioplasty was less effectivein diabetic subjects, with only 53.3% having stable renal functionat 12 months follow-up. Renal and patient survival were stronglyrelated to the initial angiographic findings. In nondiabeticsubjects, PCTA resulted in stabilization of renal function forat least one year in nearly threequarters of cases, which suggestsa benefit from intervention in this disease whose natural historyis otherwise of progression.     

Paediatric admissions to a district general hospital intensive care unit

The characteristics of all the paediatric admissions made to a district general hospital over a three-year period were analysed in this study. Paediatric admissions averaged 23 per year (10% of the total admissions to the unit over that time). The mean age was six years, median age was four years. Sixty-two per cent were medical admissions and 38% surgical. Forty-seven per cent of the surgical admissions involved head injuries. Seventy-four per cent of medical admissions were directly related to upper and lower airway problems. Mean total admission time was six days, with a median of two days. Fifty-nine per cent (40) of all cases required intubation for a mean period of five days (median = three days). All cases were PRISM scored (Pollack, Ruttimann & Getson 1988). The mean score was 8. Ninety-four percent of admissions surviving to go home. There were a total of four deaths over the three-year period. The PRISM scores of those who died had a mean of 30, which was significantly different (P < 0.05) from the survivors who had a mean PRISM score of six and a median of four. The organs of one of the nonsurvivors were transplanted. Currently there is considerable interest in the feasibility of transferring all paediatric intensive care patients to a regional centre, the consequences of such a policy must be carefully assessed if its implementation is to be a success.     

Comparative vaccination of cattle against Boophilus microplus with recombinant antigen Bm86 alone or in combination with recombinant Bm91

Cattle were vaccinated either with a single recombinant tick antigen, Bm86 or with a combination of two recombinant antigens, Bm86 and Bm91 from the tick Boophilus microplus . In three experiments, the responses of cattle to subsequent challenge with the tick were assessed. The addition of the Bm91 antigen enhanced the efficacy of the vaccination over that with Bm86 alone to a statistically significant degree. Moreover, co-vaccination with two antigens did not impair the response of cattle to the Bm86 antigen. Finally, responses of individual cattle to the two antigens were independent. All of these results may be relevant to the increase in efficacy expected from a dual antigen vaccine.     

Subgroups of smokers with different success rates after use of transdermal nicotine

To identify subgroups of smokers with different success rates, we applied "tree-structured survival analysis" (TSSA) to data from a previously published trial of transdermal nicotine. The subjects who received active treatment (14 mg patch, n 275, or the 21 mg patch, n 262) constituted the sample for this analysis. Using age, gender, the Fagerstrom Tolerance Questionnaire (FTQ), motivation to quit, number of cigarettes smoked at baseline, and body mass index (BMI) as classification variables, TSSA identified two subgroups within the 14 mg patch group and four subgroups of smokers within the 21 mg patch group. Among those receiving the 14 mg patch, individuals with a BMI greater than 26.4 kg/m relapsed sooner than did those with a BMI less than or equal to this value. Within the 21 mg patch group, the survival curve for males was significantly different from that observed in females, with males experiencing a longer time to relapse after treatment than did females. Among males, those who were less dependent relapsed significantly later than did those men who were more dependent. Among females, those with a higher motivation to quit relapsed more slowly than did those women with less motivation to quit. This information may be helpful to clinicians seeking to match specific patients to specific treatments with transdermal nicotine in order to maximize treatment outcomes.     

Aetiology of Acute Pharyngitis and Clinical Response to Empirical Therapy with Erythromycin Versus Amoxicillin

Guthrie R M, Ruoff G E, Rofman BA, Ginsberg D, Karp R R, BrownS M and Schulz GA. Aetiology of acute pharyngitis and clinicalresponse to empirical therapy with erythromycin versus amoxicillin.Family Practice 1988; 5: 29–35. One hundred and eighty-nine adults with acute pharyngitis hadculture and serological evaluation for groupA beta haemolyticstreptococci (GABHS), Mycoplasma pneumoniae, and Branhamellacatarrhalis. Sixteen patients had evidence for infection withGABHS, none for M. pneumoniae, and one for B. catarrhalis. Forthose with GABHS, there was no significant difference betweenempirical treatment by erythromycin or amoxicillin. For thosewithout GABHS, empirical treatment with erythromycin appearedto result in a statistically significant reduction in coughand a noticeable but less than significant reduction of othersymptoms when compared to empirical treatment with amoxicillin.The new formula tion of erythromycin utilized in this study(PCE) may be associated with a reduction in gastrointestinalintolerance from that reported with other erythromycin products.     

LONGEVITY AMONG ETHNIC GROUPS IN ALCOHOLIC LIVER DISEASE

As part of a multicenter V.A. Cooperative Study, 437 male veteranswith varying stages of alcoholic liver injury were followedover a 4.5 year period. Their ethnic distribution consistedof 256 Caucasians, 109 black Afro-Americans, 63 Puerto RicanHispanics, and 9 Native American Indians. Survival analysesrevealed significant differences between groups (P = 0.0002):66% of Afro-Americans were still living at 42 months; Caucasianswere intermediate with 40% survival; and only 28% of Hispanicswere alive. The number of Native American Indians enrolled wastoo small to draw conclusions but none of those enrolled survivedbeyond 24 months. Survival regression analysis of 30 clinical,laboratory, histologic and nutritional parameters, revealedthe following significant risk factors: clinical severity (P< 0.0001), histologic severity (P < 0.0001), race (P =0.001), age (P = 0.002), BUN (P = 0.01) and ALT (P = 0.02).These analyses indicated that ethnicity, independent of othervariables, is significantly associated with outcome from thedisease.     

Anti-inflammatory activity of phosphodiesterase (PDE)-IV inhibitors in acute and chronic models of inflammation

Inhibitors of cyclic nucleotide phosphodiesterases are known to suppress lipopolysaccharide (LPS)-induced tumour necrosis factor-alpha (TNF-α) production in vitro in human monocytes. The most potent of these have selectivity for type IV PDEs, suggesting that this class of PDE is the major type involved in the regulation of human TNF-α production. Using compounds of two distinct chemical structural classes, a quinazolinedione (CP-77 059) and a 4 arylpyrrolidinone (rolipram). we show here that PDE-IV-specific inhibitors are also potent in suppressing LPS-induced TNF-α production in vitro in sodium periodate-elicited murine macrophages (IC₅₀s of 1 and 33, respectively). We then report the in vivo anti-inflammatory effect of PDE-IV inhibition in five murine models of inflammation: (i) elevation of serum TNF-α induced by a subtethal LPS injection; (ii) LPS-induced endotoxic shock; (iii) LPS/galactosamine-induced endotoxic shock; (iv) carrageenan-induced paw oedema; and (v) adjuvant arthritis. Following a sublethal (5 μg/mouse) injection of LPS, serum TNF-α levels in mice peaked sharply, reaching concentrations of 3–12 ng/ ml 90 min after injection. In this sublethal LPS assay, CP-77 059 was about 30 times more potent than rolipram, with a minimum effective dose of 0.1 mg/kg versus 3 mg/kg for rolipram. This rank order is in keeping with the relative in vitro IC₅₀S for CP-77059 and rolipram, as well as their relative Ki against the human PDE-IV enzyme (46 nM and 220 nM, respectively). In LPS-induced endotoxic shock, rolipram and CP-77 059 at relatively high doses of 30 and 10 mg/kg, respectively, significantly reduced serum TNF-α levels, and also inhibited mortality 66%. In the LPS/galactosamine shock model, in which mice are rendered exquisitely sensitive to LPS by co-injection with galactosamine, only 0.1 μg of LPS/mouse Is necessary for serum TNF-α elevation and death. Both rolipram and the CP-77059 caused dose-dependent reduction of serum TNF-α and lethality. In the carrageenan-induced paw oedema model, in which there is a pronounced local TNF-α response (without a serum TNF-α elevation), rolipram significantly inhibited paw swelling as well as localized TNF-α levels in the paw. In the adjuvant arthritis model, a chronic model of inflammation also possessing localized TNF-α elevation in the inflamed paw, rolipram and CP-77059 suppressed ankle swelling and radiological evidence of joint damage. These data are consistent with a major role for PDE-IV in regulation of TNF-α production and inflammatory responses in murine systems. It suggests a potential therapeutic use for PDE-IV-specific inhibitors in inflammatory disease such as rheumatoid arthritis, septic shock and other inflammatory diseases where TNF-α has been postulated to be a contributing factor in the pathology of the disease.