Family involvement in the treatment of childhood obesity: the Copenhagen approach.

INTRODUCTION: The objective of this study was to assess the impacts of a family-based childhood obesity treatment on anthropometry and predictors of dropout and successful weight loss. MATERIALS AND METHODS: The 18-month treatment consisted of a intensive period (IP) including physical exercise, nutritional guidance, family psychotherapy, child group sessions and a 1-year follow-up (FU). RESULTS: One hundred children (10-12 years old, >140% of median weight-for-height) participated. The 81 children completing the IP decreased significantly from 2.9 to 2.6 body mass index (BMI) standard deviation score (SDS) units (p < 0.001). Furthermore, mean body fat percentage decreased significantly from 33.7 to 31.9 during IP. The 49 children completing the FU had a further decrease of 0.2 BMI SDS units (p = 0.003). Weight loss was less in children from immigrant families. Drop-out was higher if the mother had limited education and in immigrant families. CONCLUSIONS: This treatment with a psychological approach is feasible and results in significant weight loss during the programme. Future research should focus on how to improve the results of families with limited education and immigrants with non-European origin.

Pre-translational regulation of neutrophil L-selectin in glucocorticoid-challenged cattle.

L-selectin (CD62L) gene expression in neutrophils is commonly referred to as "constitutive" because circulating neutrophils require a constant supply of this adhesion molecule for continuous trafficking into peripheral tissues. Under normal circumstances, marginating blood neutrophils and neutrophils that become activated for migration into infected tissues rapidly shed surface CD62L that is ligated to the vascular endothelium. However, this does not shut down CD62L gene expression because these cells continue to express surface CD62L. In contrast, glucocorticoid challenges resulting from stress and hormone injections result in gradual and chronic down-regulation of CD62L on the surface of blood neutrophils. Rather than being associated with migration, this type of CD62L down-regulation associates with pronounced neutrophilia and increased susceptibility to infections. Nothing is currently known about glucocorticoid regulation of CD62L expression in neutrophils. In other cell systems, however, this steroid hormone binds to cytoplasmic glucocorticoid receptors (GR) that influence expression of glucocorticoid-responsive genes at multiple pre-translational levels. Thus, the hypothesis of the present study was that glucocorticoid challenge suppresses CD62L mRNA expression in blood neutrophils. Suppressed CD62L gene expression might help explain the chronic down-regulation of surface CD62L in neutrophils and accompanying neutrophilia. The main objectives of the study were to monitor neutrophil CD62L mRNA abundance before and during subtle and severe glucocorticoid challenges and to determine if CD62L mRNA expression correlates with degree of glucocorticoid challenge. Parturient dairy cows and dexamethasone-treated steers were used as models of subtle and severe (respectively) glucocorticoid challenges. Data presented from both models support the hypothesis and show for the first time that glucocorticoids regulate neutrophil CD62L at a pre-translational level. Results also showed that inhibited CD62L mRNA expression correlated precisely with down-regulated surface expression of CD62L on neutrophils and peak neutrophilia during severe glucocorticoid challenge. Therefore, results of this study indicate that bovine neutrophils are highly sensitive to the blood environment, displaying full capacity to alter CD62L gene expression and trafficking patterns in response to changing glucocorticoid levels. This may serve animals well when heightened inflammatory responses begin to lead to tissue damage, but may be detrimental to overall health if animals are exposed to opportunistic pathogens while stressed or undergoing glucocorticoid therapy. Although this study did not elucidate how glucocorticoids inhibit neutrophil CD62L mRNA expression, presented data implicate GR as possibly being involved because neutrophils from cattle in both models expressed GR mRNA. Further in vitro studies using purified populations of neutrophils will be required to determine if GR is directly involved in glucocorticoid regulation of CD62L gene expression and, if so, at what level.

An immunogenomics approach to understanding periparturient immunosuppression and mastitis susceptibility in dairy cows.

Studies comparing in vivo and in vitro functional capacities of leukocytes from non-parturient and periparturient dairy cows have provided substantial evidence that systemic and local mammary immune defenses are deficient around parturition. This evidence has lead to the reasonable hypothesis that immune deficiency underlies the heightened mastitis susceptibility of periparturient cows. Nutrition and vaccine studies substantiate this hypothesis, showing that dietary antioxidant supplementation and rigorous immunization regimes can bolster innate and humoral immunity to the point that mastitis severity and time for return to normal milk production are reduced. However, completely effective resolution of this significant production disease has not been achieved because so little is understood about its complex etiology. In particular, we possess almost no knowledge of how or why immune cells responding to parturient physiology end up with deficient functional capacities. Fluctuations in reproductive steroid hormones and chronic shifts in neuroendocrine hormones with roles in nutrient partitioning and appetite control may affect the expression of critical leukocyte genes in periparturient dairy cows. A thorough understanding of leukocyte biology during periparturition would seem a critical goal for future development of effective mastitis prevention strategies. Recently, our group has begun to use cDNA microarray technology to explore bovine leukocyte RNA for global gene expression changes occurring around parturition. We are working within the context of a hypothesis that the physiology of parturition negatively affects expression of critical genes in blood leukocytes. In the current study we initiated hypothesis testing using leukocyte RNA from a high producing Holstein cow collected at 14 days prepartum and 6 hours postpartum to interrogate a cDNA microarray spotted with > 700 cDNAs representing unique bovine leukocyte genes. This analysis revealed 18 genes with > or = 1.2-fold higher expression 14 days prepartum than 6 hours postpartum. BLASTN analysis of these genes revealed only one that can be considered a classical immune response gene. All other repressed genes were either unknown or putatively identified as encoding key proteins involved in normal growth and metabolism of cells. Given the critical roles of these repressed genes in normal cell functions, we may have identified good candidates to pursue with respect to periparturient immunosuppression and mastitis susceptibility.

[Fathers' presence at deliveries in Denmark.]. / Une étude au Danemark. La présence des pères à l'accouchement.

In a sub-study under the research program Fathers' Relation to Their Infants, an investigation was conducted on fathers and delivery in Denmark. The fathers were present in 88.1% of all deliveries (N=698). For the most of the remaining 11.9% the reasons for not participating seem related to either an Islamic background (6%), special circumstances at the delivery, or the woman being single. The fathers stated in answers to a questionnaire before delivery (N=165) that they wanted to be present for their own sake and not only to support their partners, and to another questionnaire after delivery (N=116) that they were happy to have been there (98%). 87.5% of the fathers participated in prophylactic consultations. Almost all of them found it beneficial. Two-thirds felt personally welcome but 54% did not feel directly invited and 40% did not experience that they were directly addressed to by the midwives during the consultations. The results point to the need for changes in routines in hospitals in accordance with the actual wishes in families of today.