Sleep Problems in Two-Year-Olds

The parents of children aged between 18 and 32 months attendinga south-west London general practice were asked to completea questionnaire and diary about their child's sleep behaviour.Of the 142 parents approached, 116 (82%) responded and 99 completedboth the sleep diary and questionnaire. One-quarter of the respondentswere found to be troubled by their child's sleeping patterns.Analysis showed that the children of these parents had moredisturbed sleeping-waking rhythms, and slept less time bothduring the day and night compared with the children of parentswho had no complaints about the child's sleeping pattern. Nodemographic or social factors were found to be associated withdisturbed sleep patterns. However, children with sleep problemswere less often given an attachment object at bedtime, lessoften cuddled on waking at night and more often taken into theirparents' bed than other children. These findings raise the possibilitythat modification of the way parents handle the child with sleepproblems might effect an improvement in the child's sleep.     

Molecular Genetic Basis of Hypertrophic Cardiomyopathy:

Genetics of SCD in HCM. Hypertrophic cardiomyopathy (HCM) is an autosomal dominant disease caused by mutations in sarcomeric proteins. The disease is characterized by left ventricular hypertrophy in the absence of an increased external load, and myofibrillar disarray. A large number of mutations in genes coding for the β-myosin heavy chain (β-MyHC), cardiac troponin T (cTnT), cardiac troponin I, α-tropomyosin, myosin binding protein C (MyBP-C), and myosin light chain 1 and 2 in patients with HCM have been identified. Genotype-phenotype correlation studies have shown that mutations carry prognostic significance. The Gly²⁵⁶Glu, Val⁶⁰⁶Met, and Leu⁹⁰⁸Val mutations in the μ-MyHC are associated with a benign prognosis. In contrast, Arg⁴⁰³Gln, Arg⁷¹⁹Trp, and Arg⁴⁵³Cys mutations are associated with a high incidence of sudden cardiac death (SCD). Mutations in cTnT are associated with a mild degree of hypertrophy, but a high incidence of SCD. Mutations in MyBP-C are associated with mild hypertrophy and a benign prognosis. However, it has become evident that factors other than the underlying mutations, such as genetic background and possibly environmental factors, also modulate phenotypic expression of HCM.     

Increase in Plasma Atrial Natriuretic Peptides during Acute Volume Expansion in Hypertensive Man

ABSTRACT. A new hormonal system originating from cardiac atria has recently been discovered. These peptide hormones have important functions in the regulation of blood volume and fluid homeostasis. We have measured plasma concentrations of atrial natriuretic peptides (ANP) in two patients during acute volume expansion. ANP concentrations increased in relation to an increase in right atrial pressure, and significant diuresis/natriuresis was observed. We conclude that hormonal as well as neuronal mechanisms are activated by acute volume loading in man.     

Olestra Postmarketing Surveillance Study: Design and Baseline Results from the Sentinel Site

Objective To describe the design of the Olestra Postmarketing Surveillance Study (OPMSS) and to present baseline results from the sentinel site. The purpose of the OPMSS is to monitor consumption patterns of olestra-containing snacks and to determine whether consumption affects nutritional status.Design The OPMSS combines repeated cross-section, random-digit dial telephone surveys before and after the market release of olestra-containing foods as well as intensive dietary and clinical assessments on a subsample of survey participants.Subjects Data are from baseline telephone (n=1,962) and clinical (n=1,069) assessment of participants (aged 18 to 74 years) in the Marion County, Indiana, sentinel site. Mean age of participants in the telephone survey was 43.2 years; 19% of respondents were black and 29% had completed college.Statistical analysis Analyses examined associations among savory snack use, fruit and vegetable consumption, and demographic and health-related characteristics. Data from the telephone survey were adjusted to be representative of the Marion County population.Results Almost 96% of the population surveyed had eaten savory snacks in the month before the survey: 74% had eaten regular-fat, 26% fat-reduced, and 78% nonfat types. Total snack consumption did not differ by gender, education, or race. Residents younger than 35 years ate snacks 16 times a month compared with 12 times a month among older residents. Types of snacks consumed differed markedly by demographic characteristics. Male, younger, and less educated residents ate more regular-fat snacks; female, white, and college-educated residents ate more nonfat snacks. In general, residents practicing healthful behaviors, including not smoking, eating fruits and vegetables, and exercising, also ate fewer regular-fat and more nonfat snacks. Fat intake was also related linearly to use of snack foods, ranging from 33.2% of energy among those consuming 1 serving per month or less to 36.8% among those consuming 20 or more servings per month.Applications/conclusions Procedures for recruitment and nutrition assessment appear adequate for evaluating the impact of olestra consumption on nutritional status. Nutritionists should be aware that there is potential for relatively high olestra consumption, given that almost 35% of Marion County residents eat snack foods at least 20 times a month. Consumers eating at least 20 servings of snacks per month derived more than 12% of their total energy and fat from snack foods, which suggests that substituting olestra snacks could substantially reduce intakes of fat and energy. J Am Diet Assoc. 1998;98:1290–1296.     

The effect of maximal exertion on the levels of plasma peptides in cyclists with different physical working capacities

Abstract. The studies were carried out on thirty-one sportsmen, cyclists aged 21–28 years, after the termination of a training course just before the start of their season. They exercised on a bicycle ergometer according to the following schedule: 30 N at 60 rev/min for 6 min, 40 N at 70 rev/min for 5 min, 50 N at 80 rev/min for 5 min and 50 N at 90 rev/min until exhaustion. According to the level of training the subjects were divided into three groups. In the three groups of cyclists were determined the concentrations of total plasma peptides and their individual fractions obtained by gel-filtration on Sephadex G-10.
It was found that the total plasma peptide concentration varied with the level of fitness. The lowest plasma peptide concentration was observed in cyclists with the lowest level of fitness and it differed from those observed in cyclists with intermediary and high levels of fitness. After exercise the biggest increase in plasma peptide concentration was found in the cyclists with the low level of fitness, and the lowest one in those with the high level of fitness.
Individual plasma peptide fractions also revealed differences before and after exercise depending on the level of fitness.     

The effect of maximal exertion on the levels of plasma peptides in cyclists with different physical working capacities

Abstract The studies were carried out on thirty-one sportsmen, cyclists aged 21–28 years, after the termination of a training course just before the start of their season. They exercised on a bicycle ergometer according to the following schedule: 30 N at 60 rev/min for 6 min, 40 N at 70 rev/min for 5 min, 50 N at 80 rev/min for 5 min and 50 N at 90 rev/min until exhaustion. According to the level of training the subjects were divided into three groups. In the three groups of cyclists were determined the concentrations of total plasma peptides and their individual fractions obtained by gel-filtration on Sephadex G-10.
It was found that the total plasma peptide concentration varied with the level of fitness. The lowest plasma peptide concentration was observed in cyclists with the lowest level of fitness and it differed from those observed in cyclists with intermediary and high levels of fitness. After exercise the biggest increase in plasma peptide concentration was found in the cyclists with the low level of fitness, and the lowest one in those with the high level of fitness.
Individual plasma peptide fractions also revealed differences before and after exercise depending on the level of fitness.     

The safety of atropine premedication in children with Down''s syndrome

Forty-five operative procedures were performed in 32 patients with Down's syndrome at the Royal Alexandra Hospital for Children, Sydney in a single year recently. Atropine premedication was administered to 25 patients with Down's syndrome on 38 occasions. Three dosage regimes of atropine were used: 20 micrograms/kg, 12 micrograms/kg, both intramuscularly, and 10 micrograms/kg intravenously. There was no statistically significant difference in the alteration of heart rate for the three dosage groups of atropine used when children with Down's syndrome were compared with weight-matched control children having similar operative procedures performed.     

Specificity of anti-HLA-B27 cytotoxic T lymphocytes

Sub-types of HLA-B27 were detected by cytotoxic T lymphocytes (CTL) generated between HLA-A, -B- and -C-identical B27-positive individuals. We now report the specificity of six independent CTL's generated by mixed lymphocyte culture (MLC) of HLA-A, -B and -C serologically identical B27-positive responder and stimulator cells. Three CTL's recognize one sub-type, and three the other. The combined reactivity of all CTL's allows unequivocal "typing" of B27-positive cells for the two different sub-types B27K and B27W. The specificity of two CTL's was analysed by cold-target inhibition. The results indicate that (1) no further sub-types of HLA-B27 can be detected by the CTL's raised in these combinations; (2) the majority of the CTL's is directed against the B27 antigens; and (3) "extra reactions" on B27-negative cells are caused by a subset(s) of CTL's recognizing unknown antigens shared between stimulator and target cells. CTL's raised by stimulation of HLA-B27-negative responder cells with B27-positive cells of either sub-type lysed all B27-positive target cells indiscriminately. In cold-target inhibition, however, B27-positive cells, carrying the sub-type of B27 different from that of the stimulator, could not inhibit the lysis of cells bearing the stimulator sub-type of B27. This indicates the activation, in B27-negative responders, of at least two different groups of CTL clones, one directed against shared determinants of HLA-B27, and one against the HLA-B27 sub-type. Heterogeneity of the HLA-B27 antigen may have implications for studies on the well-known association between this antigen and various diseases.