Bidirectional Relationships Between Weight Change and Sleep Apnea in a Behavioral Weight Loss Intervention

Objective

To examine the bidirectional relationship between weight change and obstructive sleep apnea (OSA) in the context of a behavioral weight loss intervention.

Comprehensive approach toward improving oral hygiene at a state residential facility for people with mental retardation

Poor oral hygiene is a problem for many people with mental retardation who live in state residential facilities. An integrated treatment approach to improve oral hygiene was designed and implemented. The program focused on increasing cooperation with daily oral care. We examined whether individualized oral care plans were more effective in improving the oral hygiene of people living in this facility than generalized staff training in oral care procedures. Oral hygiene ratings of 80 individuals were tracked over a one-year period and analyzed. A modest improvement was found for all people studied, with a greater improvement for those with individualized oral care plans. The need for follow-up data and procedures to ensure follow through of recommendations is emphasized.     

Childhood chiasmal gliomas: update on the fate of patients in the 1969 San Francisco Study.

We review the current status of 28 patients with chiasmal glioma who were originally reported on by Hoyt and Baghdassarian in 1969. The median period of follow-up was 20 years. Sixteen patients are now dead, five from chiasmal glioma and the rest from other causes. Four of the five deaths from chiasmal glioma occurred before 1969. The mortality rate in patients with neurofibromatosis and those without neurofibromatosis was essentially the same. Nine of 16 patients with neurofibromatosis are dead, two from chiasmal glioma, one from aspiration, and six from another tumour. Seven of 12 patients without neurofibromatosis are dead, three from chiasmal glioma, two from an operation on their tumour, and two from a medical illness. In general the quality of life of the surviving patients is good; none reported having a noticeable decrease in vision since 1969.     

Effect of Ensure, a defined formula diet, in patients with Crohn's disease

A prospective controlled 6-month study was undertaken to compare the effect of Ensure, a defined formula dietary supplement, and diet counselling in 122 outpatients with Crohn's disease. The compliance to Ensure was poor due to a high incidence of side effects. Taking any amount of Ensure reduced the need for surgery and the amount of hospitalization. There was a trend for patients receiving Ensure to experience a decline in the value of their Crohn's disease activity index (p less than 0.10). No consistent effects of Ensure were seen on the amount of work missed due to Crohn's disease, in laboratory measurements, in the need for prednisone or Salazopyrin. The vitamin B12 intake was improved, but otherwise nutrient intake declined due to a decreased food intake. Thus, certain beneficial clinical trends were associated with taking Ensure, but larger numbers of compliant patients will need to be studied to better assess the long-term role of defined formula diets in the management of outpatients with Crohn's disease.     

Quantification of in vitro and in vivo angiogenesis stimulated by ovine forestomach matrix biomaterial

Ovine forestomach matrix (OFM) biomaterial acts as a biomimetic of native extracellular matrix (ECM) by providing structural and functional cues to orchestrate cell activity during tissue regeneration. The ordered collagen matrix of the biomaterial is supplemented with secondary ECM-associated macromolecules that function in cell adhesion, migration and communication. As angiogenesis and vasculogenesis are critical processes during tissue regeneration we sought to quantify the angiogenic properties of the OFM biomaterial. In vitro studies demonstrated that soluble OFM components stimulated human umbilical vein endothelial cell (HUVEC) migration and increased vascular sprouting from an aorta. Blood vessel density and branch points increased in response to OFM in an ex ovo chicken chorioallantoic membrane (CAM) assay. The OFM biomaterial was shown to undergo remodeling in a porcine full-thickness excisional model and gave rise to significantly more blood vessels than wounds treated with small intestinal submucosa decellularized ECM or untreated wounds.