Periconception weight management in the Women, Infants, and Children program.

INTRODUCTION: Reproductive age women, particularly low-income and minority women, are at risk for obesity. As an integral service provider for these women, the US Department of Agriculture Special Supplemental Nutrition Program for Women, Infants, and Children is uniquely positioned to refine its focus and efforts. METHODS: Strategies for accomplishing this goal include identifying pregnant, inter-partum and post-partum women in need of targeted patient-centred services including education, counselling and support to address weight loss or appropriate gestational weight gain. RESULTS: These services may include calorie-controlled diets, behavioural strategies, alternative methods of education delivery and extending post-partum benefits. Implementation of these strategies is feasible through collaboration with related government subsidized programs and reallocation of funds, staff and other resources. CONCLUSIONS: Given the magnitude of the problem and the adverse outcomes that obesity has on health and quality of life, Women, Infants, and Children can more positively impact the lives of our most vulnerable families, which face an obesogenic environment.

Diclofenac induced in vivo nephrotoxicity may involve oxidative stress-mediated massive genomic DNA fragmentation and apoptotic cell death.

Diclofenac (DCLF) is a nonsteroidal anti-inflammatory drug that is widely used for the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute muscle pain conditions. Toxic doses of DCLF can cause nephrotoxicity in humans and experimental animals. However, whether this DCLF-induced nephrotoxicity involves apoptotic cell death in addition to necrosis is unknown. The goals of this investigation were to determine whether DCLF-induced nephrotoxicity involves oxidative stress and apoptotic type genomic DNA fragmentation, and if so, whether DCLF-induced oxidative stress and DNA fragmentation cause apoptotic cell death in mouse kidneys. Male ICR mice (CD-1; 25-45 g), fed ad libitum, were administered nephrotoxic doses of DCLF (100, 200, 300 mg/Kg, po) and sacrificed 24 h later. Blood was collected to evaluate renal injury (BUN), lipid peroxidation (MDA: malondialdehyde levels), and superoxide dismutase (SOD) activity (a marker of oxidative stress). Kidney tissues were analyzed both quantitatively and qualitatively to determine the degree and type of DNA damage, and evaluated histopathologically for the presence of apoptotic characteristics in the nucleus of diverse types of kidney cells. Results show that diclofenac is a powerful nephrotoxicant (at 100, 200, and 300 mg/kg: 4.7-, 4.9-, and 5.0-fold increases in BUN compared to the control, respectively) and a strong inducer of oxidative stress (significant increase in MDA levels). Oxidative stress induced by DCLF was also coupled with massive kidney DNA fragmentation (100, 200, and 300 mg/kg: 3-, 8-, and 10-fold increases compared to control, respectively). A dose-dependent increase in MDA levels and SOD activity was also observed, which indicated a link between oxidative stress and nephrotoxicity. Qualitative analysis of DNA fragmentation by gel electrophoresis showed a DNA ladder indicative of Ca2+-Mg2+-endonuclease activation. Histopathological examination of kidney sections revealed numerous apoptotic nuclei across proximal and distal tubular cell linings. Collectively, these data for the first time suggest that DCLF-induced nephrotoxicity may involve production of reactive oxygen species leading to oxidative stress and massive genomic DNA fragmentation, and these two free radical mediated events may ultimately translate into apoptotic cell death of kidney cells in vivo, and reveal a DNA-active role for DCLF.

Atypical antipsychotic agents: patterns of activity in a series of 3-substituted 2-pyridinyl-1-piperazine derivatives.

A series of 3-substituted 2-pyridinyl-1-piperazine derivatives have been appended to cyclic imide groups and evaluated for their potential antipsychotic activity. The dopamine receptor affinities of these target molecules, as well as their ability to block apomorphine-induced stereotypy or reverse neuroleptic-induced catalepsy, was dependent on the lipophilic and electronic characteristics of the substituent situated on the pyridine ring. Groups with + omega and - phi values were most consistent with the desired biological profile of the target molecules, the cyano moiety being the optimum choice. Evaluation of compound 12 in a monkey model of amphetamine psychosis, and the regional selectivity it expresses for the A10 dopaminergic cell bodies in electrophysiological experiments, suggest this compound would be an atypical antipsychotic agent with few side effects.

Early introduction of solid foods among urban African-American participants in WIC.

OBJECTIVE: To compare infant feeding practices among low-income, urban, African-American women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) with current recommendations for infant feeding. DESIGN: Longitudinal follow-up of women and their infants who participated in a WIC-based breast-feeding promotion project. Women enrolled prenatally at or before 24 weeks of gestation were followed up until 16 weeks postpartum. SUBJECTS/SETTING: Two hundred seventeen African-American WIC participants in an urban area. METHODS: Data related to infant feeding practices were collected by interviewers who used a structured questionnaire to determine when nonmilk liquids or solids were introduced to the infant. Reported practices were compared with current recommendations. STATISTICAL ANALYSIS PERFORMED: Contingency table analysis, including chi 2 tests, and multivariate analysis using logistic regression. RESULTS: By 7 to 10 days postpartum, approximately a third of infants were receiving some nonmilk liquids or solids; this escalated to 77% by 8 weeks and 93% by 16 weeks postpartum. Women breast-feeding exclusively (i.e., not adding nonmilk liquids or solids) were least likely, and women providing mixed feeding (breast milk and formula) were more likely, than women feeding formula exclusively to introduce nonmilk liquids and solids at each data collection time period. APPLICATIONS/CONCLUSIONS: WIC participants who receive instruction about infant feeding nutrition are no more likely than mothers who do not participate in WIC to follow infant feeding guidelines recommended by the American Academy of Pediatrics in regard to the time when solids should be introduced to infants' diet. Our findings suggest the need for WIC to implement more powerful and innovative educational and motivational strategies to help mothers delay the introduction of nonmilk liquids and solid foods until their infants are 4 to 6 months old, as recommended.

Counseling and motivational videotapes increase duration of breast-feeding in African-American WIC participants who initiate breast-feeding.

OBJECTIVE: To evaluate the relative effects introducing motivational videotapes and/or peer counseling in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics serving African-American women have on breast-feeding duration. DESIGN: Experimental intervention study. Pregnant women were enrolled at or before 24 weeks gestation and were followed up until postpartum week 16. Women were interviewed at enrollment, 7 to 10 days, 8 weeks, and 16 weeks postpartum. SUNJECTS/SETTING: One hundred fifteen African-American WIC participants who initiated breast-feeding and who had been enrolled in 1 of 4 clinics. INTERVENTION: Two-by-two factorial design, in which 4 clinics were randomly assigned to receive either no intervention, a motivational video package intervention, a peer-counseling intervention, or both interventions. MAIN OUTCOME MEASURES: Breast-feeding duration in weeks and relative risk ratios for breast-feeding cessation before 16 weeks postpartum. STATISTICAL ANALYSIS PERFORMED: Contingency table analysis, including chi2 tests and log-rank tests; multivariate analysis using Cox proportional hazards regression analysis. RESULTS: A higher proportion of women were breast-feeding at 8 and 16 weeks postpartum in the intervention clinics than in the control clinic. The proportion of women reporting breast-feeding declined at 8 and 16 weeks postpartum, but the rate of decline was slower in the 3 intervention clinics than in the control clinic. Being younger than 19 years of age or older than 25 years of age, having a male infant, and returning to work or school all negatively affected breastfeeding duration, whereas previous breast-feeding experience positively influenced breast-feeding duration. APPLICATIONS/CONCLUSIONS: WIC-based peer counselor support and motivational videos can positively affect the duration of breast-feeding among African-American women. WIC nutritionists and other health professionals in contact with this population should expand their efforts toward promoting increased duration of breast-feeding.

Young women with physical disabilities: risk factors for symptoms of eating disorders.

Women with disabilities are at risk for poor psychological adjustment and unhealthy weight-control practices. This study was conducted to determine the prevalence of symptoms of eating disorders in a clinic-based sample of women who had two disabling conditions and to identify condition-related risk factors that were linked to these symptoms. A cross-sectional survey of 71 women (mean age = 23 yr) with spina bifida or rheumatologically related illnesses was conducted to assess the symptoms of eating disorders, condition-related characteristics, and weight-control practices. Symptoms of eating disorders were measured by the Eating Disorders Inventory (EDI). Eight percent of the respondents reported a sufficient number of symptoms of eating disorders to indicate a possible clinical disorder. More than 20% of the respondents scored at or above the clinical cut-point on at least one of the eight EDI subscales. Selected condition-related characteristics (multiple conditions, condition-affected driving, and uncertainty of illness course) were associated with EDI scores after adjusting for demographic variables, family factors, and weight-control practices.

The effect of tetrathiomolybdate on the metabolism of copper by hepatocytes and fibroblasts.

Tetrathiomolybdate (TTM) has been examined for its effect on copper metabolism in mouse hepatocytes in primary culture and human fibroblasts. It decreased the amount of copper inside hepatocytes, decreased the rate of copper uptake by hepatocytes in a concentration dependent manner, and increased the copper efflux from the cells. TTM appeared to remove copper preferentially from the labile pool, but with a lower affinity than cage chelators. In fibroblasts, TTM only had a marginal effect on copper levels below a concentration of 100 microM and had no clear effect on the rate of copper uptake. TTM was not toxic to human fibroblasts, but in some preparations, a concentration of more than 50 microM was toxic to hepatocytes.

WIC-based interventions to promote breastfeeding among African-American Women in Baltimore: effects on breastfeeding initiation and continuation.

We evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7-10 days among African-American WIC participants. Of the 242 women with complete data, 48% initiated breastfeeding, but only 31% were still breastfeeding at 7-10 days. Initiation was associated with cesarean delivery, infant feeding instruction, no artificial milk discharge pack, attending the peer counselor only-intervention site, and intention to breastfeed. Continuation was influenced by infant feeding instruction, no artificial milk discharge pack, and intention to breastfeed. Overall, trends toward a positive impact of the breastfeeding promotion activities were evident but weak, and largely gone by 7-10 days postpartum.

Sources of influence on intention to breastfeed among African-American women at entry to WIC.

To examine how individuals within a woman's life influence her infant feeding intention, we interviewed 441 African-American women on the breastfeeding attitudes and experiences of their friends, relatives, mother, and the baby's father. Women were interviewed at entry into prenatal care at clinics associated with one of four Baltimore WIC clinics chosen for a breastfeeding promotion project. Qualitative data were also collected among 80 women. Friends and "other" relatives were not influential. Grandmothers' opinions and experiences were important, but their influence was reduced after considering the opinion of the baby's father. The opinion of the woman's doctor was an independent predictor of infant feeding intention. Breastfeeding promotion programs should recognize the separate influence of fathers, health providers, and grandmothers in women's infant feeding decisions.

Alteration in the tissue retention of [14C]-caffeine in pregnant mice by dimethylsulfoxide.

This study was undertaken to investigate if dimethylsulfoxide (DMSO)-induced potentiation of maternal toxicity and teratogenicity of caffeine (CA) is mediated by DMSO-induced alteration of CA levels in maternal and fetal tissues. Pregnant CD 1 mice were given single dose of [14C]-caffeine intraperitoneally (i.p.) on gestational day 12, in distilled water (DW) or 20% (v/v) solution of DMSO in DW. At 6, 12, and 24 hr following dosing, radioactivity in various maternal and fetal tissues was compared. Significantly (P < or = 0.05) higher CA-derived radioactivity was seen in maternal brain, carcass and heart as well as placenta and fetal heads and bodies 6 hr after dosing with CA in DMSO compared to CA in DW. A concomitant reduction in urinary excretion of CA-derived radioactivity in DMSO group or compared to CA in DW was observed at this time. At 12 hr following dosing, significantly (P < or = 0.05) higher CA-derived radioactivity was noted in maternal heart, brain, and carcass; placenta; and fetal bodies in mice receiving CA in DMSO compared to those receiving CA in DW. These results suggest that increased accumulation of CA in certain maternal and fetal tissues could contribute to the observed increase in maternal and fetal toxicity of CA by DMSO.

Uptake of copper by mouse hepatocytes.

This study has investigated the uptake of copper by mouse hepatocytes. The cells gave similar results whether they were used right after isolation or maintained overnight on collagen-coated dishes. Uptake from cells in suspension followed two phases: an initial rapid binding followed by a linear uptake phase. The two phases were not so easily distinguishable in cells grown in culture where uptake was linear over the first hour. The uptake showed saturation but may not have followed simple kinetics. Histidine stimulated uptake in a concentration-dependent manner, as did some other amino acids, but copper had very little effect on histidine uptake. The process was not dependent on intracellular adenosine triphosphate (ATP), since inhibitors that substantially reduced ATP levels inside the cell did not alter copper uptake. The inhibitors, however, blocked histidine uptake to varying degrees, suggesting that copper and histidine are taken up by different pathways. The uptake was reduced markedly by N-ethyl maleimide, and preincubation of the cells with "Pronase" resulted in a decrease of uptake. A model for the uptake of copper by hepatocytes that incorporates the data presented in this paper with that produced by earlier workers is suggested.

Developmental effects of fumonisin B1-containing Fusarium moniliforme culture extract in CD1 mice.

Pregnant Charles River CD1 mice were treated with a semipurified extract of Fusarium moniliforme culture containing 0, 12.5, 25, 50 or 100 mg FB1/kg each day orally (diluted in distilled water) between gestational days (GD) 7 and 15 to evaluate the developmental toxicity of FB1. Following sacrifice of dams on GD 18, litters were examined for gross abnormalities and divided equally for skeletal or visceral examination by routine techniques. Significant maternal mortality was observed at doses of 50 and 100 mg FB1/kg. Dose-dependent decreases in maternal body weight gains, number of live offsprings per litter, and mean body weight of the offspring were produced at FB1 doses of 25 mg/kg or higher. The percentage of implants resorbed increased at all doses in a dose-dependant manner. A dose-dependant increase, except at the lowest dose tested, in the incidence of ossification deficits involving digits and sternum, short and wavy ribs, and hydrocephalus of lateral and third ventricles was also evident. Cleft palate was seen only at the highest FB1 dose. Maternal intoxication manifested as a dose-dependant increase in the severity of ascites associated mainly with increased histopathologic scores reflecting hepatocellular damage at day 18. Concommittant increases in serum alanine amino transferase (ALT) on GD 12, reflecting parenchymal liver cell damage, was also observed at all doses above 12.5 mg of FB1/kg. These results suggest that FB1-containing F. moniliforme culture extract is developmentally toxic in mice, and that this toxicity may be mediated by maternal hepatotoxicity.

Effect of chelators on copper metabolism and copper pools in mouse hepatocytes.

Disorders of copper storage are usually treated by chelation therapy. It is generally thought that the chelators act by mobilizing copper from the liver, hence allowing excretion in the urine. This paper has examined the effect of chelators on copper uptake and storage in mouse hepatocytes. Penicillamine, a clinically important chelator, does not block the uptake of copper or remove copper from hepatocytes. Two other copper chelators, sar and diamsar, which form very stable and kinetically inert Cu2+ complexes by encapsulating the metal ion in an organic cage, were shown to block copper accumulation by the cells and to remove up to 80% of cell-associated copper. They also removed most (approximately 80%) of the 64Cu accumulated by the cells in 30 min, but released only a small percentage (less than 20%) of that accumulated over 18 h. The results show that copper in the hepatocyte can be divided into at least two pools, an easily accessible one, and another, not removable even after long-term incubation with any of the chelators. Most of the copper normally found in the cell appeared to be associated with the former pool.