Fatty acid composition of the milk lipids of Nepalese women: correlation between fatty acid composition of serum phospholipids and melting point.

Milk was collected from 36 Nepalese women, 15 to 32 years of age, in order to investigate relationships between the proportions of intermediate chain-length (C10-C14) fatty acids and critical n-3 and n-6 polyunsaturated fatty acids in the milk lipids they were producing. Serum was also obtained from these lactating women and the fatty acid composition of their serum phospholipid fraction was determined and compared with that of the corresponding milk lipid fraction. Compared to women in technologically advanced parts of the world, the serum phospholipids of the Nepalese women contained nutritionally adequate proportions of linoleic acid (LA) (16.8%), alpha-linolenic acid (ALA) (0.53%), arachidonic acid (AA) (5.69%), and docosahexaenoic acid (DHA) (1.42%). However, although the milk lipids contained adequate proportions of ALA (1.81%), AA (0.43%), and DHA (0.23%), the lipids contained low to moderate percentages of LA (mean, 9.05%). Positive correlations were observed between the proportions of AA (P=0.001, r=0.50) and ALA (P=0.03, r=0.36) in the serum phospholipids and milk lipids of the women. As the proportion of C10-Cl4 fatty acids in the milk lipids increased from 10% to 40%, there was preferential retention of three critical n-3 and n-6 fatty acids (ALA, AA, and DHA) at the expense of two relatively abundant nonessential fatty acids, namely stearic acid and oleic acid. In addition, using fatty acid melting point data and the mol fraction of the 9 most abundant fatty acids in the milk, we estimated the mean melting point (MMP) of the milk lipids of the Nepalese women. The MMPs ranged from 29.3 to 40.5 degrees C (median, 35.5 degrees C). These results indicate that: 1) the levels of AA and ALA in the blood of lactating mothers influence the levels of these fatty acids in the milk they produce; 2) when the mammary gland produces a milk that is rich in C10-Cl4 fatty acids, it somehow regulates triglyceride synthesis in such a way as to ensure that the milk will provide the exclusively breast-fed infant with the amounts of the critical n-3 and n-6 fatty acids it requires for normal growth and development; and 3) the melting point of the milk lipid fraction is determined mainly by the mol % of the intermediate chain-length (C10-C14) fatty acids, oleic acid, linoleic acid, and alpha-linolenic acid.

Bile salt-stimulated lipase in the milk of Fulani and Kanuri women in Nigeria and native Nepalese women.

Human milk provides newborns with several physiologically important proteins not found in cow's milk, including bile salt-stimulated lipase (BSSL) that compensates for the reduced lipolytic capability of the newborn intestine. We analyzed the milk of two ethnically distinct groups of women in northern Nigeria and Nepal. The milk of the Nepalese women (n = 36) contained slightly more BSSL activity (mean, 38.8 units/mL) than that of Fulani (n = 48; mean, 30.3 units/mL) and Kanuri (n = 90; mean 27.6 units/mL) women in Nigeria. There was also a weak positive correlation between the BSSL content of the milk and the body mass index (BMI) of the lactating women. The BSSL activity declined with the length of lactation for both well-nourished and undernourished women. The presence of a heat-stable inhibitor of BSSL in cow's milk was also demonstrated. This finding, along with the decrease in BSSL activity postgestation, could be of significance to populations such as the Fulani of the western Sahel who supplement the diets of their infants with unpasteurized cow's milk.

Characteristics of depressed and non-depressed children and their parents.

A sample of 186 outpatient children considered by both clinicians and parents as depressed or non-depressed were compared in terms of child and parent variables. Parents of depressed children appeared to be more overinvolved with their children, more overprotective, more likely to have communication difficulties in the family and more apt to undermine the child's learning. More girls were depressed than boys and depressed children exhibited more somatic complaints and coexisting phobic or anxiety disorders. The results of the present study need to be replicated with a broader group of depressed and non-depressed children and their families from other regions of the country. Further research in this area is indicated in order to provide clinicians who work with depressed children with a better understanding of their symptoms and parental characteristics.

Legionnaires' disease: new clinical perspective from a prospective pneumonia study.

In an attempt to ascertain the incidence of Legionnaires' disease at our hospital, a prospective case-control pneumonia study was conducted for 11 months. Specialized diagnostic tests for Legionella pneumophila, including serologic study, direct immunofluorescent examination, and selective culture, were made routinely available in our hospital. To our surprise, L. pneumophila was the most common cause of pneumonia (22.5 percent) attributable to a single pathogen, followed by Streptococcus pneumoniae (10.6 percent). In 68.8 percent of the cases, Legionnaires' pneumonia was hospital-acquired. In contrast to other investigators, we found that abdominal pain, diarrhea, neurologic signs, abnormal liver function results, hypophosphatemia, and hematuria did not occur significantly more frequently in pneumonia caused by L. pneumophila than in that caused by other microorganisms. However, hyponatremia within five days of onset of pneumonia occurred significantly more frequently in Legionnaires' disease (p less than 0.0001). Since the clinical presentation is nonspecific, specialized laboratory tests are necessary to make the diagnosis. As a result of our experience, we suggest an approach using serologic tests as a screen to determine whether more specialized tests for Legionnaires' disease should be introduced into a hospital without previously recognized cases of Legionnaires' disease.

Isolation of Pittsburgh pneumonia agent from a hospital shower.

Tatlockia (Legionella) micdadei, the Pittsburgh pneumonia agent, was isolated from a hospital shower. Although it was not possible, at the current time, to establish an epidemiological link to disease acquisition, this information may be significant because it provides further evidence that a water-associated reservoir of this organism exists within the hospital.

Pharmacokinetics and distribution of the new antihypertensive agent pinacidil in rat, dog and man.

1. The antihypertensive agent pinacidil was rapidly, and almost completely, absorbed following oral administration of 0.5 mg/kg of the [14C]pinacidil monohydrate to rats and dogs. The half-life was about 1 and 2 h in the two species, respectively. A bioavailability of 80% of unchanged pinacidil in the rat suggests a first-pass effect in this species. 2. After oral and intravenous administration of [14C]pinacidil about 85% of the radioactivity was recovered in the urine and 15% in the faeces in rats and dogs; 80-90% was excreted during the first 24 h. Autoradiographic studies in the rat showed similar distributions after oral and intravenous administration. 3. An oral dose of 5 or 10 mg pinacidil monohydrate was rapidly absorbed in healthy volunteers and had a pharmacokinetic profile very similar to that found in rats and dogs. Concomitant food ingestion did not change the bioavailability of the drug.

Metabolism of the new antihypertensive agent pinacidil in rat, dog and man.

1. The antihypertensive agent pinacidil is eliminated from the body mainly by biotransformation in the liver, followed principally by renal excretion of the metabolites. 2. The metabolism and elimination of pinacidil is similar in rat, dog and man, and is independent of the route of administration. 3. After an oral dose, the 24 h urinary excretion of unchanged pinacidil is 13, 4, and 5% in rat, dog and man, respectively. Faecal excretion in the rat and dog is 2 and 4%. 4. In rat, dog and man the main biotransformation product is the pyridine-N-oxide of pinacidil. Following oral administration of pinacidil, 40, 54 and 54%, respectively, is excreted in the urine as the N-oxide during the first 24 h, and less than 1% in the faeces in rat and dog. 5. Three unidentified minor metabolites were found in plasma, urine and faeces in rat and dog. 6. The major metabolite, the pyridine-N-oxide of pinacidil, has an anti-hypertensive potency about a quarter of that of pinacidil. In animals and human volunteers with normal kidney function, however, the plasma concn. of the N-oxide are always lower than those of the parent compound, so that the metabolite contributes little to the antihypertensive effect of pinacidil.

Isolation of Legionella pneumophila from hospital shower heads.

Legionella pneumophila serogroup 6 was isolated from nine of 16 shower heads in a Chicago hospital ward where three patients had contracted Legionnaires' disease caused by serogroup 6 L. pneumophila. Each patient had showered there 2 to 10 days before the onset of disease symptoms. We also isolated the bacteria in two other hospitals, and found the same serogroups as had been causing Legionnaires' disease in those hospitals: serogroup 1 in Pittsburgh and serogroups 1 and 4 in Los Angeles. However, showers from hospital wards where no patients had contracted Legionnaires' disease also yielded L. pneumophila. Shower heads at the Chicago hospital were sterilized with ethylene oxide but rapidly became recontaminated, suggesting that the potable water at these hospitals may have contained the organism. The question of whether aerosols of shower water or other exposures to potable water containing L. pneumophila may cause nosocomial Legionnaires' disease has not been resolved but deserves further study.

The effects on urinary kinin excretion of oral salt and water loads in dogs.

Ten dogs received 1 l of 37 degrees C tap water by stomach tube. Urine flow rate increased from 17 +/- 6 ml in the control hour to 285 +/- 25 ml in the second hour following the water intake. The diuresis was paralleled by increased urine kinin excretion from 23 +/- 9 ng/h to 94 +/- 17 ng/h. Urine kallikrein and urine sodium excretions remained unmodified. In seven dogs urine sodium excretion was increased from 0.87 +/- 0.22 mmol/h to 14.9 +/- 1.9 mmol/h by intragastric administration of 2% NaCl. Urine flow moderately increased from 15.1 +/- 2.5 ml/h to 64.3 +/- 15.0 ml/h. Urine kinin excretion was unchanged. The results suggest a relationship between high rates of urine flow and urinary kinin excretion.

Prostaglandins, a link between renal hydro- and hemodynamic in dogs.

An increase of the intrarenal pressure to 40 mmHg induced by ureteral constriction or by kidney compression is shown to be followed by increased renal blood flow in anesthetized dogs. This hyperemia is probably the result of enhanced intrarenal prostaglandin activity since it is followed by increased urinary prostaglandin E excretion and is abolished by indomethacin pretreatment. The increase of renal blood flow seems to be due to dilation of the afferent arteriole in order to maintain the filtration pressure. The glomerular filtration rate is thus severely depressed in indomethacin pretreated dogs. Urine and electrolyte excretion is comparably redcued during elevated intrarenal pressure in non-pretreated and in indomethacin pretreated dogs, which suggests that factors other than glomerular filtration rate are involved. Urine osmolarity is positively correlated with renal blood flow, and urine osmolarity increases during elevated intrarenal pressure in non pretreated dogs, whilst urine osmolarity remains unchanged in dogs pretreated with indomethacin.