Referrals for pediatric weight management: the importance of proximity.

BACKGROUND: Limited access to weight management care can have a negative impact on the health and well-being of obese children and youth. Our objectives were to describe the characteristics of clients referred to a pediatric weight management centre and explore potential differences according to proximity. METHODS: All demographic and anthropometric data were abstracted from standardized, one-page referral forms, which were received by a pediatric weight management centre in Edmonton, AB (Canada) between April, 2005 and April, 2009. RESULTS: Referrals (n = 555; 52% male; age [mean +/- standard deviation]: 12.4 +/- 2.6 y; BMI: 32.3 +/- 6.8 kg/m2; BMI percentile: 98.4 +/- 1.7; BMI z-score: 2.3 +/- 0.4) were received from 311 physicians. Approximately 95% of referrals were for boys and girls classified as obese or very obese. Based on postal code data, individuals were dichotomized as either living within (local; n = 455) or beyond (distant; n = 100) the Edmonton Census Metropolitan Area. Numerous families resided several hundred kilometres away from our centre. Overall, distant clients were taller, weighed more, and were more overweight than their local counterparts. For distant clients, the degree of overweight was higher in youth versus children. CONCLUSION: Pediatric weight management services must be designed to optimize access to health services, especially for distant clients who may be at increased obesity-related health risk.

Migration inhibition of endothelial cells by lymphokine-containing supernatants.

Many of the reactions of cellular immunity are mediated by soluble lymphocyte-derived factors (lymphokines). One important category of lymphokine action involves effects on cell motility. These effects have been described mainly with respect to inflammatory cells. In this report, we describe the ability of a lymphocyte product to inhibit the migration of endothelial cells in a system in vitro. The responsible factor is distinct from a previously described mediator that inhibits the migration of tumor cells. The ability of lymphocytes to influence the migration properties of endothelial cells is consistent with data of others showing a relation between the immune system and processes involving neovascularization.

The surfactant system of human fetal lung organotypic cultures: ultrastructural preservation by a lipid-carbohydrate retention method.

Human fetal lung organotypic cultures consisted of epithelial elements (congruent to 40- 100 micrometer in diameter) formed by the reaggregation of single cells from a monodisperse suspension of enzymatically dissociated fetal lung. These elements, termed alveolar-like structures, were composed primarily of type II alveolar epithelial cells whose apical surfaces bordered the central lumen of the alveolar-like structure. Pulmonary surfactant secreted by the type II cells was retained within the lumen and accumulated in close association with the epithelium. These characteristics made this culture system an advantageous model for the morphological study of human pulmonary surfactant in vitro. A lipid-carbohydrate retention procedure which reduced the extraction of tissue components and thus provided improved preservation of multilamellar bodies and tubular myelin surfactant was used in an ultrastructural study of organotypically cultured surfactant. Human surfactant was observed for the first time with most of its structural components intact. In vitro human surfactant was found to be similar to in vivo rodent and non-human primate surfactant, but with certain differences. Long surfactant tubules were not observed. There were more transformed multilamellar bodies present with more foci undergoing transformation. Each focus contained fewer layers of tubular myelin surfactant than occurs in rodent surfactant. No epiphase-hypophase areas were observed, only tubular myelin surfactant. In addition, a previously unreported intrasurfactant matrix material was observed.

Acceleration of fetal lung maturation by aminophyllin in pregnant rabbits.

To test the hypothesis that fetal lung maturation can be accelerated by one of the xanthine derivatives, aminophyllin was given to 40 pregnant rabbits beginning on the 20th gestational day for a period of 7-10 days. The fetuses were delivered by cesarean section and fetal lung maturity was assessed by determining the biochemical, functional, and ultrastructural characteristics of aminophyllin-treated vs. control animals. The phospholipid content of the lung tissue homogenate from the aminophyllin-treated group was significantly higher than in the control subjects (saline injected) at 28 days of gestation (421 +/- 9 vs. 368 +/- 12 mug/mg wet wt, mean +/- SEM) and at 29 days of gestation (531 +/- 10 vs. 475 +/- 20). The alveolar wash phospholipid content of the aminophyllin-treated group was higher at 30 days (167 +/- 9 mug/mg dry wt, mean +/- SEM vs. 117 +/- 17). The lung compliance derived from pressure volume curves was also significantly higher in the aminophyllin-treated group when compared with controls at 27 days of gestation (0.023 +/- 0.0005 ml/cm H2O, mean +/- SEM vs 0.010 +/- 0.0002) and at 28 days of gestation (0.048 +/- 0.0003 vs 0.035 +/- 0.0006). There was no significant difference in the number of lamellar bodies in the type II cells between the aminophyllin-treated and the control groups. The data show that aminophyllin has accelerating effects on fetal lung maturation in rabbits when the drug is given to pregnant rabbits during the last 7-10 days of gestation.