Longitudinal assessment of cardiac diastolic function in HIV-infected patients.

Asymptomatic isolated diastolic dysfunction (DD), with normal left ventricular systolic function, may be the first indication of underlying cardiac disease in HIV-negative populations. We previously reported a high prevalence (37%) of DD among asymptomatic HIV-infected patients at low risk for AIDS and cardiovascular disease (CVD). We performed a longitudinal assessment of interval echocardiographic changes in this cohort over a four-year period. Repeat transthoracic echocardiograms (TTEs) utilized standard techniques. Sixty (of the original 91) HIV-infected patients, predominately men, underwent repeat TTE (median follow-up 3.7 years, interquartile range [IQR] 3.5, 4.0). Cohort characteristics (median; IQR) include age 42.0 (36.5, 46.0) years, HIV duration 16.4 years (8.1, 18.9), current CD4 count 572.0 cells/mm(3) (436.5, 839.0), antiretroviral therapy (ART) duration 8.1 years (4.8, 13.4) and Framingham risk score 1.0 (0.0, 2.0). DD was observed in 28/60 patients on re-evaluation (47%, 95% confidence interval [CI] 34%, 60%); 31% (11/36) of patients had new onset DD for an overall incidence of 8.2/100 person-years. On follow-up, subjects with DD were older, had a trend towards higher body mass index, hypertension and longer duration of HIV infection compared with subjects without DD. We confirmed a high prevalence of DD (47%) in asymptomatic HIV-infected patients at low risk for AIDS and CVD.

Consumer misperceptions of diet quality.

OBJECTIVE: This study compares consumers' self-perceived diet quality with calculated diet quality to assess the degree of consumer misperception regarding one's own diet quality and to identify factors associated with such misperception. DESIGN: The perceived diet quality was measured by consumers' self-perception of the overall healthfulness of their diet. The calculated diet quality was measured by the Healthy Eating Index, a 10-component indicator of overall diet quality developed from 3 consecutive days of 1-day 24-hour dietary recall and 2-day diet record. SUBJECTS/SETTINGS: Measures of perceived and calculated diet quality were obtained for a sample of 2862 household meal planners/preparers from the 1989-90 Continuing Survey of Food Intake by Individuals and the Diet and Health Knowledge Survey. OUTCOME: Dietary misperception was assessed by classifying respondents based on categories of perceived and calculated diet quality into three groups: optimists, realists, and pessimists. STATISTICAL ANALYSES: Bivariate statistical tests and multivariate logistic regression were used for comparing the characteristics of optimists with the other two groups. RESULTS: An estimated 40% of the population of household meal planner/preparers were optimists who perceived the quality of their diets to be better than their calculated diet quality. In multivariate analysis, household size, gender, education, smoking status, perceived health status, importance of nutrition in grocery shopping, and belief about the need for dietary change were found to be significant predictors of being optimistic about diet quality. Nutritionists and health professionals need to be aware of this misperception and alert dietary optimists about their false perceptions of diet quality.

Modelling nutrition knowledge, attitudes, and diet-disease awareness: the case of dietary fibre.

Understanding how nutrition knowledge and attitudes vary across different population groups is critical for designing and evaluating nutrition education programmes and monitoring the nation's progress toward dietary goals. In this paper we use the Diet and Health Knowledge component of the USDA Continuing Survey of Food Intakes by Individuals to examine consumer knowledge of dietary fibre, fibre consumption attitudes and the awareness of fibre-related health problems. We use a latent variable probit model to estimate the relationships between an individuals's socio-demographic characteristics and his or her fibre knowledge, attitude and disease-awareness. The results suggest that the demographic profile of persons least knowledgeable about the fibre content of foods is low income, male, Black, Hispanic, smoker and low education levels. Add to this list younger individuals and one has a good description of those who lack information on the importance of eating plenty of grain products as well as those who lack awareness of fibre/disease links. The research suggests that messages about increasing fibre intake may have greatest success when targeted to individuals with some or all of these characteristics.

Rotatory nystagmus in infantile esotropia.

We reviewed the charts of 119 children with infantile esotropia followed for 27 months to 16 years (average 82.5 months). Of the 119, 14 (12%) had fine (high frequency, low amplitude) rotatory nystagmus. The presence of the nystagmus may account for a decline in visual acuity of up to two lines under binocular viewing conditions.

Determinants of pannus formation in long-surviving artificial heart calves, and its prevention.

In a group of 76 calves maintained with Jarvik-5 and Jarvik-7 artificial hearts, pannus formation in the atrial location was evaluated retrospectively using a grading system based on measurement of the pannus tissue. Pannus was present in 87% of the calves surviving one to 7 mos with an old-style inflow quick-connect design utilizing polyester felt surfaces. This design had a suboptimal hemodynamic flow path. Using a new design of quick-connect with an improved hemodynamic flow path and a Biomer blood-contacting surface, pannus occurred only in 17% of calves surviving one to 9 mos. Furthermore, the pannus formation with the new design was mild in the 2 cases where it occurred, whereas the pannus formation in animals with the old cuffs was frequently severe. One calf survived 9 mos with no pannus formation utilizing our new quick-connect system, and we conclude that pannus is no longer a problem in our experiments. We also reviewed the relation of pannus to anticoagulant regimens and found that Persantine, Coumadin, and aspirin were not effective in preventing pannus when the inflow cuff design was conducive to its development.