Perceived weight status, overweight diagnosis, and weight control among US adults: the NHANES 2003-2008 Study.

OBJECTIVES: To examine the association between perceived overweight status and weight control, discrepancies between perceived and measured weight status, and opportunities for health care professionals (HCPs) to correct weight perception among US adults. DESIGN: Population-based cross-sectional study. SUBJECTS: In all, 16,720 non-pregnant adults from the 2003 to 2008 National Health and Nutrition Examination Survey. RESULTS: Overall, 64% (73% women, 55% men) reported a desire to weigh less and 48% (57% women, 40% men) reported pursuing weight control. Weight control was positively associated with overweight perception (odds ratio (OR) women 3.74; 95% confidence interval (CI) 2.96, 4.73; OR men 2.82; 95% CI 2.11, 3.76) and an HCP diagnosis of overweight/obesity (OR women 2.22; 95% CI 1.69, 2.91; OR men 2.14; 95% CI 1.58, 2.91), independent of measured weight status. A large proportion of overweight individuals (23% women, 48% men) perceived themselves as having the right weight. Also, 74% of overweight and 29% of obese individuals never had an HCP diagnosis of overweight/obesity. Although the majority of overweight/obese individuals (74% women, 60% men) pursued at least one weight management strategy, fewer (39% women, 32% men) pursued both dietary change and physical activity. Among overweight/obese adults, those with an HCP diagnosis of overweight/obesity were more likely to diet (74 versus 52%), exercise (44 versus 34%), or pursue both (41 versus 30%, all P<0.01) than those who remained undiagnosed. CONCLUSION: HCPs have unused opportunities to motivate their patients to control and possibly lose weight by correcting weight perceptions and offering counseling on healthy weight loss strategies.

Growth rate of human fingernails and toenails in healthy American young adults.

BACKGROUND: Human nail clippings are increasingly used in epidemiological studies as biomarkers for assessing diet and environmental exposure to trace elements or other chemical compounds. However, little is known about the growth rate of human nails. OBJECTIVE: To estimate the average growth rate of fingernails and toenails and examine factors that may influence nail growth rate. METHODS: Twenty-two healthy American young adults marked their nails close to the proximal nail fold with a provided nail file following a standardized protocol, and recorded the date and the distance from the proximal nail fold to the mark. One to three months later, participants recorded the date and distance from the proximal nail fold to the mark again. Nail growth rate was calculated based on recorded distance and time between the two measurements. RESULTS: Average fingernail growth rate was faster than that of toenails (3.47 vs. 1.62 mm/month, P < 0.01). There was no significant difference between right and left fingernail/toenail growth rates. The little fingernail grew slower than other fingernails (P < 0.01); the great toenail grew faster than other toenails (P < 0.01). Younger age, male gender, and onychophagia were associated with faster nail growth rate; however, the differences were not statistically significant. CONCLUSION: Nail growth rates have increased compared with previous estimates conducted decades ago. Toenail clippings may reflect a long exposure time frame given the relatively slow growth rate.

Successful Treatment of Disseminated Nocardiosis Caused by Nocardia veterana in a Dog.

A 5-year-old male castrated Lhasa Apso cross was evaluated for a 1-month history of inappetence, lethargy, gagging, and progressive right thoracic limb lameness. Synovial fluid analysis revealed nonseptic suppurative inflammation, and a diagnosis of immune-mediated polyarthritis (IMPA) was made. After 3 months of treatment with prednisone and later cyclosporine, the dog developed multiple firm cutaneous and subcutaneous masses and a focal mass within the jejunum. Cultures of blood, urine, skin lesions, and the jejunal mass identified Nocardia veterana by matrix-absorption laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) and allowed for earlier identification of the organism compared to more traditional secA1 gene sequencing. Immunosuppressive drug treatment was discontinued, and the dog was treated for 3 months by administration of trimethoprim-sulfamethoxazole (TMS). No recurrence of clinical signs was reported 1 year later. This case report highlights the clinical utility of MALDI-TOF MS, particularly for the rapid identification of slow-growing, fastidious organisms.

Fish consumption and risk of stroke and its subtypes: accumulative evidence from a meta-analysis of prospective cohort studies.

BACKGROUND/OBJECTIVES: To provide a reliable assessment of the hypothesized association of fish consumption with stroke risk accumulatively, an updated meta-analysis of published prospective cohort studies was conducted. SUBJECTS/METHODS: Prospective cohort studies through April 2012 in peer-reviewed journals indexed in MEDLINE and EMBASE were selected. Additional information was retrieved through Google or a search of the reference list in relevant articles. The main outcome measure was the weighted hazards ratio (HR) and corresponding 95% confidence interval (CI) for incident stroke according to fish consumption using a random-effects model. RESULTS: A database was derived from 16 eligible studies (19 cohorts), including 402,127 individuals (10,568 incident cases) with an average 12.8 years of follow-up. Compared with those who never consumed fish or ate fish <1/month, the pooled adjusted HRs of total stroke risk were 0.97 (95% CI, 0.87-1.08), 0.86 (0.80-0.93), 0.91 (0.85-0.98) and 0.87 (0.79-0.96) for those who consumed fish 1-3/month, 1/week, 2-4/week and ~5/week, respectively (P(linear trend) = 0.09; P(nonlinear trend) = 0.02). Study location was a modifier. An inverse association between fish intake and stroke incidence was only found by studies conducted in North America. The modest inverse associations were more pronounced with ischemic stroke and were attenuated with hemorrhagic stroke. CONCLUSIONS: Accumulated evidence generated from this meta-analysis suggests that fish intake may have a protective effect against the risk of stroke, particularly ischemic stroke.