Atherogenesis in white carneau pigeons. Effects of low-level cholestane-triol feeding.

Cholesterol auto-oxides have been shown to be angiotoxic in vivo and in vitro. Whether this toxicity is itself an atherogenic risk factor has not been established. In this study White Carneau pigeons were gavage-fed either 0.05% pure cholesterol or 0.05% pure cholesterol with trace levels of cholestane-triol (cholestane-3 beta,5 alpha,6 beta-triol) for 3 months. These are amounts similar to estimated U.S. dietary intake levels. Aortic lipids, aortic calcium and coronary artery histopathology were assessed. Aortic total cholesterol, cholesterol ester, and cholesterol ester/cholesterol ratio were: 1.87 vs 1.70 mg/g, 1.23 vs 1.01 mg/g, and 25 vs 26% for the cholesterol vs cholesterol + triol groups, respectively. These values are similar to published values at this duration and level of cholesterol feeding and are not statistically significantly different from each other. Aortic accumulation of calcium in the cholesterol + triol group was 1.16 +/- 0.35 mg/g, whereas in the cholesterol-fed group it was 0.82 +/- 0.27 mg/g, an increase of 42% (P greater than 0.02). Coronary artery atherosclerosis, as measured by percent mean lumenal stenosis, was 5.23% +/- 5.4, in the cholesterol + triol group as compared to 2.80% +/- 1.4 in the cholesterol group, an increase of 87% (P less than 0.01). These results suggest that dietary exposure to low levels of cholestane-triol, is atherogenic to a greater degree than exposure to pure cholesterol alone.

Cardiac sarcoplasmic reticulum. Effects of an atherogenic diet during the neonatal and juvenile period.

The effect on the cardiac sarcoplasmic reticulum of an atherogenic (1% cholesterol) diet fed during the neonatal vs the juvenile period of life was studied in Yorkshire swine. Male piglets were randomly assigned at birth to 1 of 4 groups: group I (control), group II (lactation feeding), group III (juvenile period feeding) and group IV (lactation and juvenile feeding). All animals were killed at 55 weeks of age and cardiac sarcoplasmic reticulum (SR) isolated for assay of calcium uptake, Ca2+-Mg2+ ATPase activity, and lipid analysis by thin-layer chromatography and gas chromatography. The amount of cholesterol/mg SR protein and the cholesterol/phospholipid ratio were higher in the animals fed during lactation (groups II and IV) and lower in those fed only during the juvenile period (group III). Phospholipid fatty acid patterns as measured by gas chromatography were unaltered in any group. Calcium uptake was markedly diminished in all experimental conditions: group II 47%, group III 65% and group IV 96%. Compared to the observed changes in calcium transport, the ATP hydrolytic activity was relatively less affected. Only in group IV a significant decrease (41%) was seen. Groups II and III show no change in ATP hydrolytic activity. The decrease in calcium uptake and altered cholesterol/phospholipid ratio without effect on ATP hydrolytic activity is consistent with an uncoupling of calcium transport related to the atherogenic diet in early life.

Teenagers' preferences regarding the presence of family members, peers, and chaperones during examination of genitalia.

During physical examination that include the genitalia, teenagers are typically separated from their parents and females are provided with a chaperone. To assess teenagers' attitudes regarding this practice, 140 females and 60 males awaiting treatment in a general adolescent clinic were asked their opinion about a physical examination that include the genitalia. Teenagers indicated whether they would want to be accompanied during the examination, and by whom, as a function of the hypothetical clinical situation that varied the sex and familiarity of the physician. Choices reflected teenagers' age and sex, rather than physician characteristics. Young males and females strongly preferred to be accompanied, generally by a family member. With increasing age, males preferred to be alone with the physician whereas females preferred to be accompanied. Regardless of sex and age, virtually none chose the company of peers. Despite strong development differences, however, there also were pronounced individual differences among teenagers of the same age. Our results suggest that service delivery be adapted to the particular preference expressed by individual teenagers. Needs assessment for adolescent programs may best be achieved by conducting similar surveys in local clinical settings.

Follow-up of adolescent trauma victims: a new model of care.

A comprehensive model of service delivery for the rehabilitative care of adolescents with closed head injuries is presented. Our data show that the Glasgow Coma Scale score on hospital admission correlates with the length of time required for follow-up. Adolescents with mild closed head injuries require more follow-up than adults with comparable injuries because of adolescent developmental stages that complicate the recovery process. Anticipatory guidance has helped the patient and family cope with stresses. Finally, we have identified a typical pattern of difficulties during the recovery process including: impaired judgment, reduced attention span, irritability, short-term memory loss, and ongoing memory deficits.

Adolescent nutrition.

We have briefly reviewed the nutritional requirements of adolescents and the significant difficulties in establishing nutrient requirements for this period of rapid growth. In general, although there are data for specific nutrients in adolescents on which to base recommendations for nutritional requirements, by and large, most requirements are extrapolated from data on infants or adults. There is still a large void to be filled in determining the physiological requirements for nutrients during the adolescent growth spurt. Until this is accomplished, many of our data, as presented in the report, are extrapolated. For specific recommendations for individual adolescents, the reader is again referred to the FAO/WHO publication and the National Research Council Publication.

Atherosclerosis during adolescence.

Interest in diseases of the arteries during the juvenile period is evident during the first half of this century. In the 1950s, it was clearly demonstrated that the early lesions of atherosclerosis were detectable in children and, especially, in adolescents. By the end of the 1960s, the scope of early atherosclerotic changes in the arteries of juveniles became firmly established. In the 1970s, the search for adult risk factors in juveniles began in earnest. In the 1980s, adult risk factors were identified in juveniles and correlated with pathologic changes. The therapeutic issues that involve life-long compliance in high-risk children and adolescents are unique to this age group.

A comparison of inner-city and upper-middle class youths' exposure to violence.

Exposure to violence in healthy adolescents has not been explored. We questioned 838 youths (ages 11-24 years; 620 females) from two medical clinics. The Exposure to Violence Questionnaire was completed by 403 inner-city adolescents (inner-city group), and 435 middle-to-upper class youths (resort group). Inner-city participants were more often victims, knew of victims, and witnessed more assaults, rapes, knifings, life-threatening events, and murders than their resort group counterparts. In both groups, males were more likely to have been victims, witnesses, and to have known victims personally than were females, except for sexually related crimes. In both settings, youths often did not seek medical or psychological help after victimization. Adolescents are exposed to a startling amount of violence. Violence prevention should be targeted to the inner-city male population.

Visual-motor problems of adolescents who attempt suicide.

Using the Canter Background Interference Procedure with the Bender-Gestalt Test, a group of 18 adolescent suicide attempters earned test scores indicating they had significantly more problems with visual-motor coordination than did a control group of 21 adolescents. There were also a greater number of school failures and behavior problems among these suicide attempters. The findings suggest that learning disabilities may be an unrecognized factor which increases the risk of suicide attempts by adolescents.