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.     

Protection from Shigella sonnei infection by immunisation of rabbits with Plesiomonas shigelloides (SVC 01).

Plesiomonas shigelloides, an organism commonly found in water, is only rarely associated with diarrhoea in man. P. shigelloides serotype O:17 (SVC O1), which is antigenically similar to Shigella sonnei, was found to be neither virulent nor toxic for rabbits. Rabbits immunised by feeding with P. shigelloides (SVC O1) were completely protected against an oral challenge with 10(10) cells of S. sonnei but non-immunised rabbits were not. P. shigelloides (SVC O1) may be a useful vaccine strain for shigellosis.     

Acute Cellular Rejection Predominated by Monocytes Is a Severe Form of Rejection in Human Renal Recipients With or Without Campath-1H (Alemtuzumab) Induction Therapy

Campath-1H has been used successfully for induction and has resulted in a low rate of acute cellular rejection (ACR) in renal transplantation in combination with various postoperative immunosuppression regimens. This study was undertaken to investigate the extent of monocyte involvement in ACR, with or without Campath-1H induction. We found that monocytes represented the majority of inflammatory cells in grades Ib or higher ACR, but not with Ia type of ACR, regardless of the status of Campath-1H induction. Cases of ACR, following Campath-1H induction, appear to demonstrate a 'pure form' of monocytic ACR, whereas monocytes were mixed with many other types of inflammatory cells in the cases of ACR in the absence of Campath-1H induction. In addition with Campath-1H induction, the cases of monocyte-predominant ACR were found to uniformly exhibit a good response to corticosteroid treatment. We conclude that monocyte-predominate ACR may represent a severe form of rejection, with or without Campath-1H treatment.     

Structural,Magnetic, and Electrical Properties of CoFe2O4 Nanostructures Synthesized Using Microwave-Assisted Hydrothermal Method

Magnetic nanostructures of CoFe₂O₄ were synthesized via a microwave-assisted hydrothermal route. The prepared nanostructures were investigated using X-ray diffraction (XRD), field emission electron microscopy (FE-SEM), energy dispersive X-ray (EDX) spectroscopy, high-resolution transmission electron microscopy (HR-TEM), selective area electron diffraction (SAED) pattern, DC magnetization, and dielectric spectroscopy measurements. The crystal structure studied using HR-TEM, SAED, and XRD patterns revealed that the synthesized nanostructures had a single-phase nature and ruled out the possibility of any secondary phase. The lattice parameters and unit cell volume determined from the XRD data were found to be 8.4821 Å and 583.88 ų. The average crystallite size (~7.0 nm) was determined using Scherrer’s equation. The FE-SEM and TEM micrographs revealed that the prepared nanostructures had a spherical shape morphology. The EDX results showed that the major elements present in the samples were Co, Fe, and O. The magnetization (M) versus temperature (T) measurements specified that the CoFe₂O₄ nanostructures showed ferromagnetic ordering at room temperature. The blocking temperature (T_B) determined using the M-T curve was found to be 315 K. The magnetic hysteresis (M-H) loop of the CoFe₂O₄ nanostructures recorded at different temperatures showed the ferromagnetic behavior of the CoFe₂O₄ nanostructures at temperatures of 200 K and 300 K, and a superparamagnetic behavior at 350 K. The dielectric spectroscopy studies revealed a dielectric constant (ε′) and loss tangent (tanδ) decrease with the increase in the frequency, as well as demonstrating a normal dispersion behavior, which is due to the Maxwell–Wagner type of interfacial polarization. The values of ε′ and tanδ were observed to increase with the increase in the temperature.     

Investigation of Bamboo Fibrous Tensile Strength Using Modified Weibull Distribution

Ethiopia has a large coverage of bamboo plants that are used for furniture making and house building. So far, researchers have not studied the strength of Ethiopian bamboo fibers, which are utilized for composite applications. The current study measured the strength of bamboo fibers based on various testing lengths and calculated the predictive tensile strength using a modified Weibull distribution. Moreover, the quality of the extraction machine is evaluated based on shape and sensitivity parameters. This research paper incorporates the coefficient of variation of the fiber diameters, considering the defects distribution through the length for measuring the predictive strength of the fibers. The fiber diameters were calculated using the area weight methods, which had its density measured using a Pycnometer. It has been examined that as the testing gauge length and coefficient variation of fiber diameter simultaneously increased, the tensile strength of the bamboo fibers decreased. The shape parameter, sensitivity parameter, and characteristic strength of Injibara bamboo (Y. alpina) are 6.02–7.83, 0.63, and 459–642 MPa, whereas Kombolcha bamboo (B. oldhamii) are 5.87–10.21, 0.33, and 408–638 MPa, as well as Mekaneselam bamboo (Y. alpina) are 5.86–9.63, 0.33 and 488–597 MPa, respectively.     

Chemometric Evaluation of Near Infrared,Fourier Transform Infrared,and Raman Spectroscopic Models for the Prediction of Nimodipine Polymorphs

The objective of this study was to assess the performance of the chemometric model to predict the proportion of the recrystallized polymorphs of nimodipine from the cosolvent formulations. Ranging from 100% to 0% (w/w) of polymorph I, the two polymorphs mixtures were prepared and characterized spectroscopically using Fourier transformed infrared spectroscopy (FTIR), near-infrared spectroscopy (NIR), and Raman spectroscopy. Instrumental responses were treated to construct multivariate calibration model using principal component regression (PCR) and partial least square regression approaches. Treated data showed better model fitting than without treatment, which demonstrated higher correlation coefficient (R²) and lower root mean square of standard error (RMSE) and standard error (SE). Multiple scattering correction and standard normal variate exhibited higher R² and lower RMSE and SE values than second derivative. Goodness of fit for FTIR and NIR (R² ~ 0.99) data was better than Raman (R² ~ 0.95). Furthermore, the models were applied on the recrystallized polymorphs obtained by storing nimodipine-cosolvent formulations at selected stability conditions. The relative composition of the polymorphs differed with storage conditions. NIR-chemical imaging on recrystallized sample of nimodipine at 15°C qualitatively corroborated the model-based prediction of the two polymorphs. Therefore, these studies strongly suggest the importance of the potential utility of the chemometric model in predicting nimodipine polymorphs.     

Perspectives on anticipated quality-of-life and recommendations for neonatal intensive care: a survey of neonatal providers

Objective: Explore associations between neonatal providers’ perspectives on survival, quality of life (QOL) and treatment recommendations.

Methods: Providers attending a workshop on neonatal viability were surveyed about survival, perceived QOL and treatment recommendations for marginally viable infants. We assessed associations between estimated survival and perceived QOL and treatment recommendations.

Results: In the 44 included surveys, estimates of survival and QOL varied widely. Maximum care was recommended 80% of the time when anticipated QOL was high, versus 20% when anticipated QOL was low (p?<?0.001). Adjusted for confounders, odds of recommending maximum intervention were 4.4 times higher when anticipated QOL was high (95% CI 1.9 – 10.2, p?=?0.001).

Conclusions: The perspectives of practitioners who provide care to critically ill neonates regarding potential survival and QOL vary dramatically and are associated with the treatments those practitioners recommend. Practitioners should take care to avoid basing treatment recommendations on their own perspectives if they are not well aligned with those of the parents.     

Marker Based In-vitro Antioxidant Potential,Microscopy and Validated High Performance Thin Layer Chromatographic Method for Saffron

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - In vitro antioxidant potential of methanolic extract of saffron and crocetin was assessed along with...