Traditional and nontraditional supplement use by collegiate female varsity athletes

This study examined the traditional (single and multivitamin/mineral supplements) and nontraditional supplement (herbals, botanicals, and other biologic and nutrient supplements) use by female athletes. Frequency, reasons for use, and sources of supplement information were assessed with a self-report questionnaire. Participants were 162 collegiate female varsity athletes. More than half of all athletes used some type of supplement at least once a month (65.4%). Thirty-six percent (n = 58) of the sample used a multivitamin and mineral with iron. Twelve percent (n = 19) reported amino acid/protein supplement use and 17% (n = 29) used an herbal/botanical supplement. The most frequently cited reason for supplement use was "good health" (60.1%). A major source of information on supplements reported was family (53%). With the general rise in supplement use, nutrition education on the use of traditional and non-traditional supplements is warranted.     

Primary versus secondary ovarian malignancy: imaging findings of adnexal masses in the Radiology Diagnostic Oncology Group Study

PURPOSE: To analyze ultrasonographic (US), computed tomographic (CT), and magnetic resonance (MR) imaging features of primary and secondary ovarian malignant neoplasms to determine if there is any significant difference in their appearance. MATERIALS AND METHODS: Analysis of the multi-institutional Radiology Diagnostic Oncology Group data revealed 86 patients with primary ovarian carcinoma and 24 patients with a secondary ovarian neoplasm. Numerous imaging features that had been recorded for the adnexal masses with each imaging modality were reviewed and compared between primary and secondary malignant ovarian neoplasms. RESULTS: Of the imaging features assessed with all three modalities, multilocularity as determined at US (P =.02) or MR imaging (P: =.01) was the only significant feature. At US, 30 (37%) of 81 primary ovarian cancers were multilocular, whereas only three (12%) of 24 metastatic neoplasms were multilocular. At MR imaging, 40 (74%) of 54 primary ovarian cancers were multilocular, whereas only five (36%) of 14 metastatic neoplasms were multilocular. Neither a predominately solid appearance nor bilaterality was significantly different between primary and secondary neoplasms. CONCLUSION: For malignant ovarian masses, multilocularity at MR imaging or US favors the diagnosis of primary ovarian malignancy rather than secondary neoplasm, but it is difficult to accurately distinguish between primary and secondary ovarian malignancies.     

Petrous apicitis: evaluation by bone SPECT and magnetic resonance imaging

A case of petrous apicitis, an unusual inflammation of the petrous apex air cells, is reported. SPECT revealed the focal bony involvement, and these findings correlated well with the anatomical abnormalities seen on MRI.     

Family member knowledge and expectations for functional recovery after stroke

OBJECTIVE: To assess the stroke knowledge and expectations for recovery among the family members of stroke patients in an acute rehabilitation hospital. DESIGN: Survey study of 50 family members of stroke patients undergoing inpatient rehabilitation at a single urban rehabilitation hospital. RESULTS: Sixty percent of participants were able to identify whether their family member had sustained a cerebral hemorrhage or infarct; 48% were able to identify at least one treatment provided to their family member for his or her stroke. The average length of stay predicted by participants closely matched the average patient length of stay. Participants tended to overestimate the functional abilities of their family member with a stroke, both on initial assessment and discharge. This overestimation was more substantial for discharge functional ability than for initial assessment. Participants were able to predict discharge location with substantial accuracy (82% agreement, kappa = 0.41). CONCLUSIONS: The knowledge of stroke etiology and functional outcome of family members of individuals undergoing rehabilitation after stroke shows significant limitations. Participants' ability to predict functional outcome on discharge was worse than their knowledge of current functional status. Participant predictions of length of stay and discharge disposition were areas of relative strength. Further efforts are needed to enhance the knowledge level of family members of patients undergoing rehabilitation after stroke.     

First trimester findings in pregnancies after in vitro fertilization.

We assessed the frequency of abnormal sonographic findings and their significance with respect to outcome in pregnancies resulting from in vitro fertilization (IVF). We retrospectively reviewed first trimester sonograms of 53 consecutive IVF patients who had a positive pregnancy test and first trimester ultrasonography at least 4 weeks after embryo transfer, and we correlated the sonographic findings with pregnancy outcome. For controls, we compared the frequency of sonographic abnormalities in these study patients to that in a group of patients who became pregnant after ovulation induction only. In the 53 IVF patients, the numbers of gestational sacs identified on the initial sonogram were as follows: 34 singletons, 11 twins, two triplets, one quadruplets and one quintuplets; no sac was seen in four patients. In 32 patients, the first sonogram was normal, with a visualized yolk sac, or heartbeat, or both. In 10 patients the gestational sac appeared abnormal but sac contents were normal. In seven patients an abnormality of sac contents was identified, including four with an embryo but no heartbeat and three anembryonic sacs. Overall, 40% of IVF patients had sonographic abnormalities, in comparison to 7% in the control group of patients (P less than 0.05, Fisher's exact test). Of the 32 patients with normal sonograms, 26 (81%) delivered at least one live infant. Of the 10 patients whose gestation sacs appeared abnormal, nine (90%) gave birth to live infants. Of the seven patients with abnormal sac contents, two (29%) delivered at least one live infant. We conclude that abnormal findings are frequently present on the initial sonogram of pregnant patients after IVF.(ABSTRACT TRUNCATED AT 250 WORDS)     

Placental surface cysts detected on sonography: histologic and clinical correlation.

OBJECTIVE: To evaluate the clinical outcome and histologic findings of pregnancies in which placental surface cysts were detected on prenatal sonography. METHODS: A computerized search of our obstetric sonographic database from 1988 through 2000 identified 34 cases. Results of pathologic examinations, when performed, were obtained. Sonographic features were correlated with histologic findings and clinical parameters. RESULTS: On review of available microscopic slides, in all cases in which the cyst was seen at pathologic examination, there was subchorionic fibrin with central cyst formation. All pregnancies resulted in live births, although intrauterine growth restriction occurred in 4 (12%) of 34. Three (11%) of 28 cases with placental pathologic findings had maternal floor infarction. Only 2 significant associations between sonographic features and postnatal findings were found. In all cases of intrauterine growth restriction, average cyst size was larger than 4.5 cm. Of 12 cysts larger than 4.5 cm, 4 (33%) had intrauterine growth restriction. Of 22 cysts smaller than 4.5 cm, there were no instances of intrauterine growth restriction (P = .01). Of 32 cases with 3 or fewer cysts, only 2 had intrauterine growth restriction, whereas in 2 cases with more than 3 cysts, both had intrauterine growth restriction (P = .01). CONDUSIONS: Most placental surface cysts are associated with a normal pregnancy outcome. Most such cysts are related to cystic change in an area of subchorionic fibrin. Cysts larger than 4.5 cm or more than 3 in number are more frequently associated with intrauterine growth restriction.     

Determinants of children's participation in California's Medicaid and SCHIP programs

OBJECTIVE: To develop a comprehensive predictive model of eligible children's enrollment in California's Medicaid (Medi-Cal [MC]) and State Children's Health Insurance Program (SCHIP; Healthy Families [HF]) programs. DATA SOURCES/STUDY SETTING: 2001 California Health Interview Survey data, data on outstationed eligibility workers (OEWs), and administrative data from state agencies and local health insurance expansion programs for fiscal year 2000-2001. STUDY DESIGN: The study examined the effects of multiple family-level factors and contextual county-level factors on children's enrollment in Medicaid and SCHIP. DATA COLLECTION/EXTRACTION METHODS: Simple logistical regression analyses were conducted with sampling weights. Hierarchical logistic regressions were run to control for clustering. PRINCIPAL FINDINGS: Participation in MC and HF programs is determined by a combination of family-level predisposing, perceived need, and enabling/disabling factors, and county-level enabling/disabling factors. The strongest predictors of MC enrollment were family-level immigration status, ethnicity, and income, and the presence of a county-level "expansion program"; and the county-level ratio of OEWs to eligible children. Important HF enrollment predictors included family-level ethnicity, age, number of hours a parent worked, and urban residence; and county-level population size and outreach and media expenditure. CONCLUSIONS: MC and HF outreach/enrollment efforts should target poorer and immigrant families (especially Latinos), older children, and children living in larger and urban counties. To reach uninsured eligible children, it is important to further simplify the application process and fund selected outreach efforts. Local health insurance expansion programs increase children's enrollment in MC.     

Home negative pressure ventilation: report of 20 years of experience in patients with neuromuscular disease

Twenty years of experience using negative pressure devices (NPD) at home to ventilate 40 patients with neuromuscular disease is presented. The purpose of the study was to determine the costs, complications, and clinical outcome of this form of respiratory support, and to ascertain the reasons for failure to institute effective negative pressure ventilation (NPV) in nine patients. Emerson tank respirators, used mainly to rest respiratory muscles at night, and intermittent positive pressure breathing machines were used by 98% of patients at an average equipment cost of +2,700 annually. Patients in whom NPV was initiated on an elective rather than emergent basis saved an average of +12,000 during their initial hospitalization. Life table analysis shows a five-year survival of 76%, and a 10-year survival of 61%. Complications were minor and occurred at an average rate of less than one per year per patient at home on NPV. Failure to achieve satisfactory NPV in nine patients was associated with age (six patients were younger than 3 years of age), or severe thoracocervical scoliosis, which prevented proper fitting of the NPD. For reasons of safety, economy, and quality of life, NPV at home is the preferred treatment for patients having neuromuscular disease who need respiratory assistance.