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1.
Clin Exp Dermatol ; 47(5): 882-888, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34855996

RESUMO

BACKGROUND: Ulceration is a recognized risk factor for surgical site infection (SSI); however, the proportion of patients developing SSI after excision of an ulcerated skin cancer is unknown. AIM: To determine the proportion of participants with SSI after surgical excision of an ulcerated skin cancer. A secondary aim was to assess feasibility outcomes to inform the design of a randomized controlled trial to investigate the benefits and harms of perioperative antibiotics following excision of ulcerated tumours. METHODS: This was a multicentre, prospective, observational study of patients undergoing excision of an ulcerated skin cancer between March 2019 and March 2020. Prior to surgical excision, surface swabs of the ulcerated tumours of participants recruited from one centre were undertaken to determine organism growth. At 4 weeks after surgery, all participants were e-mailed or posted the Wound Healing Questionnaire (WHQ) to determine whether they had developed SSI. RESULTS: In total, 148 participants were recruited 105 (70.9%) males; mean ± SD age 77.1 ± 12.3 years. Primary outcome data were available for 116 (78.4%) participants, of whom 35 (30.2%) were identified as having an SSI using the WHQ with a cutoff score of 8, and 47 (40.5%) were identified with a cutoff score of 6. Using the modified WHQ in participants with wounds left to heal by secondary intention, 33 (28.4%) and 43 (37.1%) were identified to have SSI respectively. CONCLUSION: This prospective evaluation of SSI identified with the WHQ following excision of ulcerated skin cancers demonstrated a high proportion with SSI. The WHQ was acceptable to patients; however, further evaluation is required to ensure validity in assessing skin wounds.


Assuntos
Neoplasias Cutâneas , Infecção da Ferida Cirúrgica , Idoso , Idoso de 80 Anos ou mais , Antibacterianos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/cirurgia , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Cicatrização
2.
Eur J Clin Microbiol Infect Dis ; 34(10): 2111-9, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26245946

RESUMO

Currently available point-of-care (POC) diagnostic tests for managing urinary tract infections (UTIs) in general practice are limited by poor performance characteristics, and laboratory culture generally provides results only after a few days. This laboratory evaluation compared the analytic performance of the POC UK Flexicult(™) (Statens Serum Institut) (SSI) urinary kit for quantification, identification and antibiotic susceptibility testing and routine UK National Health Service (NHS) urine processing to an advanced urine culture method. Two hundred urine samples routinely submitted to the Public Health Wales Microbiology Laboratory were divided and: (1) analysed by routine NHS microbiological tests as per local laboratory standard operating procedures, (2) inoculated onto the UK Flexicult(™) SSI urinary kit and (3) spiral plated onto Colorex Orientation UTI medium (E&O Laboratories Ltd). The results were evaluated between the NHS and Flexicult(™ )methods, and discordant results were compared to the spiral plating method. The UK Flexicult(™) SSI urinary kit was compared to routine NHS culture for identification of a pure or predominant uropathogen at ≥ 10(5) cfu/mL, with a positive discordancy rate of 13.5% and a negative discordancy rate of 3%. The sensitivity and specificity were 86.7% [95% confidence interval (CI) 73.8-93.7] and 82.6% (95% CI 75.8-87.7), respectively. The UK Flexicult(™) SSI urinary kit was comparable to routine NHS urine processing in identifying microbiologically positive UTIs in this laboratory evaluation. However, the number of false-positive samples could lead to over-prescribing of antibiotics in clinical practice. The Flexicult(™) SSI kit could be useful as a POC test for UTIs in primary care but further pragmatic evaluations are necessary.


Assuntos
Antibacterianos/uso terapêutico , Antibacterianos/urina , Técnicas de Diagnóstico Urológico , Testes Imediatos , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , Urina/microbiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Reino Unido , País de Gales , Adulto Jovem
3.
Eur J Clin Microbiol Infect Dis ; 33(7): 1169-72, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24474246

RESUMO

PURPOSE: Cycloserine has been used previously in some areas of the world for the treatment of urinary tract infections. The emergence of multi-resistant strains of Enterobacteriaceae and the lack of new agents in the development pipeline has prompted a need to review the activity of older agents. Susceptibility testing of cycloserine has traditionally been problematic owing to testing in standard media, containing competitive alanine, thus presenting falsely elevated minimum inhibitory concentrations (MICs). This study tests urinary coliforms against cycloserine in both standard and minimal media. METHODS: Susceptibilities were performed on 500 "wild type" UTI coliforms using Mueller-Hinton broth in the range 0.008-128 µg/ml in accordance with ISO guidelines. Cycloserine was also tested in Minimal Salts medium + 2 % 1 M glucose + 0.2 % 1 M magnesium sulphate. MICs were recorded after 18 h of incubation at 35 °C and interpreted with EUCAST breakpoints (where available). RESULTS: Cycloserine MIC50 for the "wild type" coliforms was 32 µg/ml in Mueller-Hinton broth compared with 2 µg/ml in Minimal Salts. Eighty-seven per cent of "wild type" UTI coliforms show cycloserine MICs < = 8 µg/ml in Minimal Salts. The epidemiological cut-off values for cycloserine for E. coli in this study were 64 µg/ml using Mueller-Hinton broth and 8 µg/ml using Minimal Salts medium. Ninety-four per cent of trimethoprim-resistant and 82 % of third generation cephalosporin-resistant E. coli had MICs in Minimal Salts ≤ 8 µg/ml. CONCLUSION: Cycloserine is still licensed in some countries for the treatment of urinary infections and the data presented here suggest that it may play a role in the management of infections resistant to trimethoprim and third generation cephalosporins.


Assuntos
Antibacterianos/farmacologia , Ciclosserina/farmacologia , Infecções por Enterobacteriaceae/microbiologia , Enterobacteriaceae/efeitos dos fármacos , Infecções Urinárias/microbiologia , Meios de Cultura/química , Enterobacteriaceae/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana
4.
J Antimicrob Chemother ; 67(7): 1639-44, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22514265

RESUMO

OBJECTIVES: To detect and characterize Escherichia coli strains and pCT-like plasmids implicated in the dissemination of the CTX-M-14 gene in animals and humans, in England and Wales. METHODS: UK CTX-M-14-producing E. coli (n=70) from cattle (n=33), turkeys (n=9), sheep (n=2) and humans (n=26) were screened using multiplex PCR for the detection of a previously characterized plasmid, pCT. Isolates found to be carrying two or more pCT genetic markers were further analysed using PFGE. Their antimicrobial-resistance genes and virulence genes were also determined. These plasmids were transferred to Salmonella enterica serotype Typhimurium 26R and further examined for incompatibility type, genetic environment of the bla(CTX-M-14) gene, size, restriction fragment length polymorphism (RFLP) and nikB sequence. RESULTS: The 25 E. coli isolates carrying pCT genetic markers generated 19 different PFGE profiles, and 23 isolates had different virulence and antimicrobial-resistance gene patterns. One isolate from cattle was a verotoxigenic E. coli ('VTEC'); the rest were commensal or extra-intestinal pathogenic E. coli. pCT-like plasmids with similar molecular characteristics (size, replicon type, RFLP pattern, pCT markers and genetic environment of the bla(CTX-M-14) gene) were detected in 21/25 of the field isolates, which comprised those from cattle (n=9), turkeys (n=8) and humans (n=4). All pCT-like plasmids were conjugative, and most were IncK (n=21) and had the same local genetic environment flanking the bla(CTX-M-14) gene (n=23). RFLP analysis demonstrated ≥ 75% similarity among most plasmids (n=22). CONCLUSIONS: pCT-like plasmids were common vectors for horizontal dissemination of 30% of the bla(CTX-M-14) genes to different E. coli isolates from humans, cattle and turkeys.


Assuntos
Doenças dos Bovinos/microbiologia , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/veterinária , Escherichia coli/genética , Plasmídeos , Doenças das Aves Domésticas/microbiologia , beta-Lactamases/genética , Animais , Bovinos , Impressões Digitais de DNA , DNA Bacteriano/genética , Eletroforese em Gel de Campo Pulsado , Inglaterra , Escherichia coli/classificação , Escherichia coli/isolamento & purificação , Humanos , Reação em Cadeia da Polimerase , Perus , Reino Unido , Fatores de Virulência/genética , País de Gales
5.
J Hosp Infect ; 110: 148-155, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33485969

RESUMO

BACKGROUND: The emergence of multi-drug-resistant (MDR) micro-organisms prompted new interest in older antibiotics, such as colistin, that had been abandoned previously due to limited efficacy or high toxicity. Over the years, several chromosomal-encoded colistin resistance mechanisms have been described; more recently, 10 plasmid-mediated mobile colistin resistance (mcr) genes have been identified. Spread of these genes among MDR Gram-negative bacteria is a matter of serious concern; therefore, reliable and timely mcr detection is paramount. AIM: To design and validate a multiplex real-time polymerase chain reaction (PCR) assay for detection and differentiation of mcr genes. METHODS: All available mcr alleles were downloaded from the National Center for Biotechnology Information Reference Gene Catalogue, aligned with Clustal Omega and primers designed using Primer-BLAST. Real-time PCR monoplexes were optimized and validated using a panel of 120 characterized Gram-negative strains carrying a wide range of resistance genes, often in combination. Melt-curve analysis was used to confirm positive results. FINDINGS: In-silico analysis enabled the design of a 'screening' assay for detection of mcr-1/2/6, mcr-3, mcr-4, mcr-5, mcr-7, mcr-8 and mcr-9/10, paired with an internal control assay to discount inhibition. A 'supplementary' assay was subsequently designed to differentiate mcr-1, mcr-2, mcr-6, mcr-9 and mcr-10. Expected results were obtained for all strains (100% sensitivity and specificity). Melt-curve analysis showed consistent melting temperature results. Inhibition was not observed. CONCLUSIONS: The assay is rapid and easy to perform, enabling unequivocal mcr detection and differentiation even when more than one variant is present. Adoption by clinical and veterinary microbiology laboratories would aid the surveillance of mcr genes amongst Gram-negative bacteria.


Assuntos
Antibacterianos , Colistina , Farmacorresistência Bacteriana Múltipla/genética , Genes Bacterianos , Bactérias Gram-Negativas/genética , Antibacterianos/farmacologia , Colistina/farmacologia , Bactérias Gram-Negativas/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Plasmídeos , Reação em Cadeia da Polimerase em Tempo Real
6.
J Hosp Infect ; 105(4): 741-746, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32553894

RESUMO

BACKGROUND: Carbapenemase-producing Acinetobacter species, especially A. baumannii, are frequently associated with treatment failures and hospital outbreaks; thus, rapid and reliable detection of specific resistance markers is paramount. The most common carbapenemases found in A. baumannii, namely OXA-23-like, OXA-24-like, and OXA-58-like, belong to the oxacillinase group (class D ß-lactamases) which is notoriously difficult to identify phenotypically due to the lack of specific inhibitors. AIM: To design and validate a multiplex real-time polymerase chain reaction (PCR) assay to detect and differentiate the above three oxacillinases. METHODS: All available variants of the above three oxacillinase subfamilies were downloaded (as of November 2019) from the Beta-Lactamase DataBase (http://bldb.eu/) aligned with Clustal Omega and oligonucleotides designed using Primer-BLAST. A multiplex real-time PCR assay that included an internal control to discount inhibition was optimized on the Rotor-Gene Q (Qiagen) using the Rotor-Gene Multiplex PCR Kit (Qiagen) and validated using a panel of 122 previously characterized strains carrying a wide range of ß-lactamases, often in combination. FINDINGS: The in-silico approach enabled the design of oligonucleotides in conserved regions of the OXA-24-like and OXA-58-like alignments. Among the 42 described OXA-23-like variants, a single nucleotide polymorphism (SNP) was present in one of the oligonucleotide binding sites of OXA-27, OXA-166, OXA-811, OXA-812, and OXA-816. The assay was 100% sensitive and highly specific. Inhibition was not observed. CONCLUSION: The assay is easy to perform with results available in about 70 min. It enables unequivocal detection and differentiation of OXA-23-like, OXA-24-like, and OXA-58-like carbapenemases even when more than one is simultaneously present.


Assuntos
Acinetobacter baumannii/enzimologia , Acinetobacter baumannii/genética , beta-Lactamases/genética , Humanos , Testes de Sensibilidade Microbiana , Reação em Cadeia da Polimerase Multiplex , Polimorfismo de Nucleotídeo Único , Sensibilidade e Especificidade
7.
Clin Microbiol Infect ; 26(10): 1347-1354, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32220636

RESUMO

OBJECTIVES: Bloodstream infection has a high mortality rate. It is not clear whether laboratory-based rapid identification of the organisms involved would improve outcome. METHODS: The RAPIDO trial was an open parallel-group multicentre randomized controlled trial. We tested all positive blood cultures from hospitalized adults by conventional methods of microbial identification and those from patients randomized (1:1) to rapid diagnosis in addition to matrix-assisted desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) performed directly on positive blood cultures. The only primary outcome was 28-day mortality. Clinical advice on patient management was provided to members of both groups by infection specialists. RESULTS: First positive blood culture samples from 8628 patients were randomized, 4312 into rapid diagnosis and 4136 into conventional diagnosis. After prespecified postrandomization exclusions, 2740 in the rapid diagnosis arm and 2810 in the conventional arm were included in the mortality analysis. There was no significant difference in 28-day survival (81.5% 2233/2740 rapid vs. 82.3% 2313/2810 conventional; hazard ratio 1.05, 95% confidence interval 0.93-1.19, p 0.42). Microbial identification was quicker in the rapid diagnosis group (median (interquartile range) 38.5 (26.7-50.3) hours after blood sampling vs. 50.3 (47.1-72.9) hours after blood sampling, p < 0.01), but times to effective antimicrobial therapy were no shorter (respectively median (interquartile range) 24 (2-78) hours vs. 13 (2-69) hours). There were no significant differences in 7-day mortality or total antibiotic consumption; times to resolution of fever, discharge from hospital or de-escalation of broad-spectrum therapy or 28-day Clostridioides difficile incidence. CONCLUSIONS: Rapid identification of bloodstream pathogens by MALDI-TOF MS in this trial did not reduce patient mortality despite delivering laboratory data to clinicians sooner.


Assuntos
Bacteriemia/diagnóstico , Bacteriemia/mortalidade , Bactérias/classificação , Técnicas de Tipagem Bacteriana/métodos , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Bactérias/isolamento & purificação , Hemocultura , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Fatores de Tempo , Resultado do Tratamento
8.
Emerg Med J ; 26(10): 728-31, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19773494

RESUMO

BACKGROUND: There has been an unprecedented surge in the popularity of trampolines in the UK and in the number of children attending emergency departments with associated injuries. AIM: To record the incidence, injury type and risk factors for children attending the emergency department of a busy suburban hospital with trampolining injuries. METHODS: Between May and September 2008, all eligible patients had a proforma completed recording mechanism, time and type of injury, the number of children trampolining at the time of the injury and whether a supervising adult or safety net was present. Analgesia requirements, treatment and follow-up were recorded. RESULTS: 131 children presented with trampolining injuries (1.5% of paediatric attendances). The average age was 8.8 years (range 1-16). 77 (59%) had no net present and 87 (66%) no supervising adult. 89 (68%) sustained injuries without actually falling from the trampoline and, on average, 2.6 people (range 1-7) were on the trampoline at the time of the injury. 81 (62%) required a radiograph and 40 (31%) were diagnosed with fractures. 18 (14%) required surgery and 28 (21%) were discharged with clinic follow-up. 18 (14%) sustained lacerations that required closure in the department. CONCLUSION: The enormous increase in trampoline sales has brought with it a significant increase in the injuries presenting to UK emergency departments. Safety information is given by manufacturers, retailers and local government authorities, but many parents fail to heed this advice. A combination of inadequate adult supervision, several people using a trampoline simultaneously and insufficient safety equipment seems inextricably linked with injury. Greater parental and public awareness is required regarding the potential dangers of what is perhaps unwittingly considered a light-hearted pastime.


Assuntos
Serviços de Saúde da Criança , Serviço Hospitalar de Emergência , Jogos e Brinquedos/lesões , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Humanos , Incidência , Lactente , Lacerações/terapia , Masculino , Fatores de Risco , Reino Unido/epidemiologia
9.
Biochim Biophys Acta ; 1726(3): 326-7, 2005 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-16213099

RESUMO

Two genes recently associated with glycopeptide intermediate resistance in Staphylococcus aureus (GISA) are mprF and tcaA, with inactivation causing shifts in vancomycin resistance. This study reveals that expression levels of both genes are similar in groups of clinical GISA, heteroGISA and glycopeptide susceptible strains, suggesting no association with clinical isolates.


Assuntos
Proteínas de Bactérias/metabolismo , Staphylococcus aureus/efeitos dos fármacos , Resistência a Vancomicina , Aminoaciltransferases , Proteínas de Bactérias/genética , Expressão Gênica , Staphylococcus aureus/isolamento & purificação , Staphylococcus aureus/metabolismo
10.
Vet Microbiol ; 186: 37-43, 2016 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-27016755

RESUMO

CTX-M genes are the most prevalent ESBL globally, infiltrating nosocomial, community and environmental settings. Wild and domesticated animals may act as effective vectors for the dissemination of CTX-producing Enterobacteriaceae. This study aimed to contextualise blaCTX-M-14-positive, cephalosporin-resistant Enterobacteriaceae human infections and compared resistance and pathogenicity markers with veterinary isolates. Epidemiologically related human (n=18) and veterinary (n=4) blaCTX-M-14-positive E. coli were fully characterised. All were typed by XbaI pulsed field gel electrophoresis and ST. Chromosomal/plasmidic locations of blaCTX-M-14 were deduced by S1-nuclease digestion, and association with ISEcp1 was investigated by sequencing. Conjugation experiments assessed transmissibility of plasmids carrying blaCTX-M-14. Presence of virulence determinants was screened by PCR assay and pathogenicity potential was determined by in vitro Galleria mellonella infection models. 84% of clinical E. coli originated from community patients. blaCTX-M-14 was found ubiquitously downstream of ISEcp1 upon conjugative plasmids (25-150 kb). blaCTX-M-14 was also found upon the chromosome of eight E. coli isolates. CTX-M-14-producing E. coli were found at multiple hospital sites. Clonal commonality between patient, hospitals and livestock microbial populations was found. In vivo model survival rates from clinical isolates (30%) and veterinary isolates (0%) were significantly different (p<0.05). Co-transfer of blaCTX-M-14 and virulence determinants was demonstrated. There is evidence of clonal spread of blaCTX-M-14-positive E. coli involving community patients and farm livestock. blaCTX-M-14 positive human clinical isolates carry a lower intrinsic pathogenic potential than veterinary E. coli highlighting the need for greater veterinary practices in preventing dissemination of MDR E. coli among livestock.


Assuntos
Infecção Hospitalar/microbiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/genética , Escherichia coli/patogenicidade , Virulência/genética , Animais , Conjugação Genética , Farmacorresistência Bacteriana/genética , Escherichia coli/classificação , Humanos , Plasmídeos/genética
11.
Clin Microbiol Infect ; 11(3): 243-4, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15715726

RESUMO

Increased use of colistin therapy for infections caused by Pseudomonas aeruginosa has indicated a need for a more robust microbiological assay technique. This report describes a quick and simple microbiological assay for quantifying levels of colistin sulphomethate in serum and urine samples from cystic fibrosis patients. The technique uses no specialised or costly equipment and is suitable for use in all routine diagnostic microbiology laboratories.


Assuntos
Bioensaio/métodos , Colistina/sangue , Colistina/urina , Meios de Cultura , Fibrose Cística , Estabilidade de Medicamentos , Escherichia coli/efeitos dos fármacos , Humanos , Sensibilidade e Especificidade , Temperatura
12.
J Infect ; 50(3): 252-7, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15780422

RESUMO

A 67-year male presented with relapse 14 days after treatment with vancomycin for a MRSA ventriculitis. CSF samples taken at the time of relapse grew MRSA with a MIC for vancomycin of 4 mg/L by E-test and therapy with linezolid (600 mg bd) and intraventricular vancomycin (20 mg od) was initiated. Using the macrodilution E-test, the isolate was found to have sub-populations with a MIC for vancomycin of 8 mg/L and teicoplanin of 12 mg/L and a population analysis profile almost identical to the hVISA strain MU3, indicative of a hVISA strain. Concentrations of vancomycin in the CSF over the period of therapy ranged from 25.6-192.5 mg/L after intraventricular administration and those of linezolid ranged from 3.4-6.7 mg/L after intravenous administration, exceeding the MICs for this isolate. The patient made a successful recovery, with no further episodes of ventriculitis at 1-year follow-up. We report the first case of ventriculitis due to hVISA. It was successfully treated with intrathecal vancomycin and intravenous linezolid. We also believe this to be the first documented case of clinical infection due to hVISA in South Africa.


Assuntos
Acetamidas/uso terapêutico , Ventrículos Cerebrais/microbiologia , Quimioterapia Combinada/uso terapêutico , Encefalite/tratamento farmacológico , Oxazolidinonas/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Vancomicina/uso terapêutico , Acetamidas/administração & dosagem , Idoso , Farmacorresistência Bacteriana , Encefalite/microbiologia , Humanos , Linezolida , Masculino , Oxazolidinonas/administração & dosagem , África do Sul , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/isolamento & purificação , Vancomicina/administração & dosagem , Vancomicina/farmacologia
13.
Environ Health Perspect ; 67: 147-52, 1986 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-3757951

RESUMO

Studies were undertaken with individuals fed fried bacon meals to determine whether fruit or vegetables, ingested along with bacon, modified uptake and subsequent excretion of bacon mutagen(s). Urinary mutagenic activity was significant in those who had consumed bacon or mixed bacon/vegetable or bacon/fruit meals within the previous 2 to 3 hr period. Although urine activity varied by a factor of 4 among 15 subjects who consumed different meals, there was no evidence from this investigation that fruit or vegetables contributed to the inherent variability in total urinary mutagenic activity. However, some differences in excretion kinetics may be attributable to vegetable or fruit supplements in mixed meals.


Assuntos
Contaminação de Alimentos , Mutagênicos/metabolismo , Animais , Creatinina/urina , Dieta/efeitos adversos , Feminino , Frutas , Temperatura Alta , Humanos , Masculino , Carne/efeitos adversos , Suínos , Verduras
14.
J Psychosom Res ; 35(1): 49-58, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-2023142

RESUMO

Fifty-six women classified according to their restraint and disinhibition scores, using Stunkard and Messick's (1985) Eating Questionnaire, participated in an experiment in which the proportion of carbohydrate in a prepared meal and the knowledge provided to them about its contents were varied. Measures were taken of their desire for food and their willingness to eat, as well as the total intake and the amount of carbohydrate and of protein they ate at an ad libitum test meal 4 hr later. While the results do not support the argument that laboratory-induced counter-regulatory eating can be attributed to disinhibition, they emphasize the usefulness of our experimental model which allows the interaction of dietary, cognitive and personality factors to be examined concurrently in investigations of appetite control.


Assuntos
Apetite , Dieta Redutora/psicologia , Adulto , Bulimia/psicologia , Carboidratos da Dieta/administração & dosagem , Ingestão de Energia , Feminino , Humanos
15.
Hawaii Med J ; 37(4): 105-13, 1978 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-649374

RESUMO

PIP: Computer printouts of cross tabulations of selected data from the vital records for live births, infant and fetal deaths, marriages, and divorces which took place in Hawaii during 1968, 1969, 1970, 1971 and 1972 were studied in order to describe the characteristics of young parenthood in Hawaii from 1968-1972; identify special at-risk populations during preconception, interconception, pregnancy and parenting; identify children of at-risk mothers; identify trends which may affect the planning, delivery, and evaluation of needed programs and services; and determine the need for and nature of specific, modified, and innovative services to teens and preteens. Findings reported by school districts showed marked differences in pregnancy rates, premature births, and infant deaths. The 3 schools with the highest fetal death and induced abortion ratios had the lowest live birth and pregnancy rates. The 6 with lowest fetal death ratios had the highest live birth and pregnancy rates. The findings enable planning of specific health care delivery and school health programs for school districts with the highest pregnancy, premature birth, and infant death rates. Included among the recommendations are the following: 1) the data presented should be used as a bseline for program and service evaluation; 2) family life education efforts in those schools showing the greatest need should be increased; 3) prenatal care should be made more readily available and acceptable to young mothers in the high priority school district; and 4) support services for single-parent families should be planned to meet the increasing need for such services.^ieng


Assuntos
Adolescente , Serviços de Planejamento Familiar , Fertilidade , Adulto , Coeficiente de Natalidade , Criança , Feminino , Havaí , Humanos , Recém-Nascido , Idade Materna , Gravidez , Gravidez não Desejada
18.
Hawaii Med J ; 37(2): 44-50, 1978 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-640828
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