Elevation of factor VII activity and mass in young adults at risk of ischemic heart disease.

The Northwick Park Heart Study found that elevation of factor VII in middle-aged subjects was an independent risk factor for subsequent ischemic heart disease. The present study was designed to determine whether factor VII elevation is present at a younger age and whether zymogen or activated factor VII is responsible for this elevation. A group of 20 asymptomatic first degree relatives (mean age 34.9 years) of patients with premature ischemic heart disease were compared with 15 age-matched normal subjects at low risk of ischemic heart disease and 15 older subjects with established ischemic heart disease (mean age 49.7 years). Factor VII procoagulant, coupled amidolytic and antigenic assays, as well as fasting serum triglyceride and cholesterol assays, were performed on all three groups. Factor VII antigen and coagulant activity was significantly elevated in first degree relatives, as was factor VII antigen in the patients with ischemic heart disease. The increased factor VII level in these subjects was caused by elevated factor VII zymogen, not activated factor VII. The results of this study, combined with those of previous studies, suggest that factor VII may be a useful additional marker of the risk for ischemic heart disease and merits further investigation.

Glucocorticoid receptor density and binding affinity in healthy horses and horses with systemic inflammatory response syndrome.

BACKGROUND: Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis occurs in horses with systemic inflammatory response syndrome (SIRS). Peripheral resistance to glucocorticoids has not been investigated in horses. OBJECTIVE: To determine if glucocorticoid receptor (GR) function in horses can be measured using flow cytometry, and to use this information to evaluate HPA axis dynamics. ANIMALS: Eleven healthy adult horses in parts 1 and 2. Ten horses with SIRS and 10 age and sex matched controls in part 3. METHODS: Flow cytometry was used to evaluate GR density and binding affinity (BA) in 3 healthy horses in part 1. In part 2, exogenous ACTH was administered to eight healthy horses. Their cortisol response and GR properties were measured. In part 3, CBC, serum biochemistry, cortisol and ACTH, and GR properties were compared between controls without SIRS (n = 10) and horses with SIRS (n = 10), and between survivors and nonsurvivors (n = 4 and n = 6 respectively). RESULTS: Flow cytometry can be used to measure GR properties in equine PBMCs. No correlation was observed between plasma cortisol concentration and GR density or BA in healthy horses (r = -0.145, P = .428 and r = 0.046, P = .802 respectively). Nonsurvivors with SIRS had significantly decreased GR BA (P = .008). Horses with triglyceride concentration > 28.5 mg/dL had increased odds of nonsurvival (OR=117; 95% CI, 1.94-7,060). GR BA <35.79% was associated with nonsurvival (OR = 30.33; 95% CI, 0.96-960.5). CONCLUSIONS AND CLINICAL IMPORTANCE: Tissue resistance to glucocorticoids contributes to HPA axis dysfunction in adult horses with SIRS. These horses might benefit from treatment with exogenous glucocorticoids.

Does the sodium level in drinking water affect blood pressure levels?

Sodium consumed in excess may make a significant contribution to the causes of many diseases, especially for those who suffer from hypertension. More than 90% of hypertension is essential hypertension. Drinking water may contribute 10% to one's total sodium intake; for patients on sodium restricted regimens, drinking water may account for 64% of total intake. At present, insufficient evidence is available to conclude whether sodium in drinking water causes elevation of blood pressure. It is possible that reducing sodium intake early in life may minimize the risk of hypertension in the later years. Dietitians play a key role in the control of hypertension. Many communities in the U.S. exceed the recommended 20 mg/L or less sodium in drinking water; this may present a hazard to some members of our population.

An eating plan and update on recommended dietary practices for the endurance athlete.

This article presents a six-group exchange food plan for the endurance athlete. The plan allows approximately 1,850, 3,460, and 3,760 kcal for a weight reduction diet, general training diet, and carbohydrate-loading intake plan, respectively. Because complex carbohydrate is the primary source of fuel, the training diet and the carbohydrate-loading diet contain 500 g and 600 g carbohydrate, respectively, whereas in the weight reduction plan more than 60% of total energy is carbohydrate. Overall nutrient adequacy of the exchanges and fluid needs for the athlete are discussed. Recommendations and protocol for current dietary practices are given. Dietitians are encouraged to assess the caloric needs of their clients and to individualize the suggested plans in accordance with the needs of each athlete.

Effects of microwave cooking/reheating on nutrients and food systems: a review of recent studies.

Microwave-oven technology has been improved by the use of low power. With the utilization of low-power techniques, studies showed equal or better retention of nutrients for microwave, as compared with conventional, reheated foods for thiamin, riboflavin, pyridoxine, folacin, and ascorbic acid. Beef roasts microwaved at "simmer" were comparable with conventionally cooked roasts in sensory quality, while vegetables cooked by an institutional (1,150 w) microwave oven were superior to those cooked in a domestic (550 w) microwave oven. Microwave-cooked bacon had lower levels of nitrosamines than conventionally cooked bacon; however, the use of a new alpha-tocopherol coating system has been found to be a safe N-nitrosamine inhibitor regardless of cooking method used.

Current and future foodservice applications of microwave cooking/reheating.

Microwave ovens are widely used in foodservice establishments; currently, they are used primarily for reheating. In comparison with conventional methods, approximately 75% less energy is required for microwave cooking or heating. In the future, it is possible that minimal microwave energy will be used to extend shelf life of foods. It is expected that "combination" convention or convection/microwave systems and conveyor microwave systems that can be electronically programmed will be widely used in the future. New food product designs and types of disposable packaging are available.

A nutrition survey of and recommendations for individuals with Prader-Willi syndrome who live in group homes.

The purpose of this study was to describe anthropometric data and identify diet-related problems of individuals with Prader-Willi syndrome (PWS) who reside in group homes. A group home is a licensed foster care facility that provides 24-hour care for the developmentally disabled. Questionnaires were sent to dietitians (or the person responsible for nutrition care) of 25 group homes; responses from 18 homes were analyzed. The mean age of residents with PWS was 25 +/- 8.4 years and the mean height was 152.4 +/- 9.7 cm. The mean weight for 19- to 22-year-old men was 75.5 +/- 26.8 kg and that for women of the same age was 74.5 +/- 20 kg. The residents consumed a mean of 1,000 to 1,500 kcal/day. Most of the group homes (n = 16) locked their kitchens at night, and in 12 of the homes stealing and hoarding of food occurred. Pica behavior (eating of nonfoods) was reported in 7 homes. One third of all residents had success in weight loss and were on a maintenance diet, but a major problem was determination of a desirable weight goal. Our key recommendations for dietitians are weigh residents weekly; use the body mass index with prescribed zones for determination of weight goals; monitor change in circumference measurements; follow the guidelines of 7 to 8 kcal/cm of height for weight loss and 10 to 14 kcal/cm of height for weight maintenance; administer 1,000 kcal/day or more and encourage daily aerobic exercise; respect food preferences while adhering to dietary prescriptions; adhere to strict food control procedures; and use nutrition education methods and an interdisciplinary approach for behavior modification.

Trends in contact lens-associated corneal ulcers.

Charts of 320 patients with corneal ulcers seen on the Cornea Service of Wills Eye Hospital from July 1, 1992, to June 30, 1995, were reviewed retrospectively. Of these cases, 96 (30%) were associated with contact lens use. Ulcers in contact lens users accounted for 36% of cases in the last 6 months of 1992 and all of 1993, 20% of cases in 1994, and 29% in the first 6 months of 1995. The contact lenses most commonly associated with ulcers were disposable extended-wear lenses. They were used in 33% of contact lens-associated ulcers in 1992, 27% in 1993, 39% in 1994, and 44% in 1995. Pseudomonas was the predominant organism prior to 1993 (1-4). From 1993 to 1995, however, the number of Pseudomonas ulcers steadily decreased. Two or three Acanthamoeba infections continue to be treated each year. There has been a significant decrease in the number of contact lens-related ulcers treated at our institution compared with previous years (p < 0.01) (3, 4).

Strategies for using university health services for cholesterol screening.

Seven hundred seventy students, parents, and employees participated in free cholesterol screenings during key promotional events at Central Michigan University between 1989 and 1992. Participants were self-selected volunteers who wanted to know their cholesterol levels. More than one third of the participants (32.4% of the students, 38.0% of the parents, and 54.3% of the employees) were found to have borderline or high cholesterol readings that put them at risk of coronary artery disease (CAD) because of hypercholesterolemia. The screening may have attracted subjects with a family history of CAD or other risk factors, and these individuals need follow-up lipid profiles and cholesterol education. The authors provide a description of the innovative approaches of their program and offer suggestions for promotional cholesterol screening programs.

Prognosis for racing with conservative management of cervical vertebral malformation in thoroughbreds: 103 cases (2002-2010).

BACKGROUND: Cervical vertebral malformation (CVM) is seen in young, rapidly growing horses, and is commonly associated with a poor prognosis for racing. HYPOTHESIS/OBJECTIVE: To examine the records of a population of Thoroughbreds with a presumptive diagnosis of CVM and to determine which radiographic findings and neurologic exam findings have an effect on these horses achieving athletic function when managed conservatively. ANIMALS: One hundred and three thoroughbreds presumptively diagnosed with CVM and treated conservatively between 2002 and 2010. METHODS: Racing records were reviewed in this retrospective study to determine which horses raced after treatment. Horses were separated into groups based on whether or not they raced. Medical records were reviewed, and results of neurologic examination, radiographic and laboratory findings, treatments, and outcome were assessed and compared between groups. RESULTS: Sixteen horses were excluded because of insufficient information. Of the remaining horses, thirty-three were euthanized after diagnosis, while the remaining seventy were discharged for treatment. Twenty-one of 70 horses treated medically (30%) went on to race. Horses that went on to race had a significantly lower neurologic grade (P = .0002), with a median of 1.0 in the thoracic limbs and 2.0 in the pelvic limbs. Euthanized horses and nonstarters were more likely to have kyphosis (P = .041) or cranial stenosis (P = .041) on standing lateral cervical radiographs. CONCLUSIONS AND CLINICAL IMPORTANCE: Some horses can race after the diagnosis of CVM. Neurologic examination and radiographic findings can be helpful in predicting racing prognosis.

Effect of an integrated support programme on the concerns and wellbeing of women with breast cancer: a national service evaluation.

PURPOSE: To carry out a national service evaluation of the integrated cancer support programme offered by The Haven using the Measure Yourself Concerns and Wellbeing (MYCaW) outcome questionnaire. METHODS: Breast cancer survivors who visited one of three Haven centres in the UK completed the MYCaW questionnaire before and after 6 one-hour complementary therapy sessions. RESULTS: Statistically significant decreases in mean baseline scores (indicating improvement) for concerns and wellbeing were observed after treatment: concern 1 (5.09 ± 1.04 vs 3.17 ± 1.60, p < 0.0001, n = 402), concern 2 (4.69 ± 1.08 vs 3.08 ± 1.56, p < 0.0001, n = 372), and wellbeing (3.30 ± 1.41 vs 2.63 ± 1.28, p < 0.0001, n = 402). The therapies most commonly used were acupuncture, nutrition, massage and aromatherapy, shiatsu, counselling and reflexology. After therapy, 91% of reported scores (n = 328) rated the concern as being a little better, much better or gone. CONCLUSIONS: These findings suggest that women with breast cancer find the Haven integrated support programme valuable for addressing their main concerns and improving their feeling of wellbeing.