Maternal conjugated linoleic acid supplementation reverses high-fat diet-induced skeletal muscle atrophy and inflammation in adult male rat offspring.

A high-saturated-fat diet (HFD) during pregnancy and lactation leads to metabolic disorders in offspring concomitant with increased adiposity and a proinflammatory phenotype in later life. During the fetal period, the impact of maternal diet on skeletal muscle development is poorly described, despite this tissue exerting a major influence on life-long metabolic health. This study investigated the effect of a maternal HFD on skeletal muscle anabolic, catabolic, and inflammatory signaling in adult rat offspring. Furthermore, the actions of maternal-supplemented conjugated linoleic acid (CLA) on these measures of muscle phenotype were investigated. A purified control diet (CD; 10% kcal fat), a CD supplemented with CLA (CLA; 10% kcal fat, 1% total fat as CLA), a high-fat (HFD; 45% kcal fat from lard), or a HFD supplemented with CLA (HFCLA; 45% kcal fat from lard, 1% total fat as CLA) was fed ad libitum to female Sprague-Dawley rats for 10 days before mating and throughout gestation and lactation. Male offspring received a standard chow diet from weaning, and the gastrocnemius was collected for analysis at day 150. Offspring from HF and HFCLA mothers displayed lower muscular protein content accompanied by elevated monocyte chemotactic protein-1, IL-6, and IL-1ß concentrations. Phosphorylation of NF-κBp65 (Ser(536)) and expression of the catabolic E3 ligase muscle ring finger 1 (MuRF1) were increased in HF offspring, an effect reversed by maternal CLA supplementation. The present study demonstrates the importance of early life interventions to ameliorate the negative effects of poor maternal diet on offspring skeletal muscle development.

Older Adults Have Delayed Amino Acid Absorption after a High Protein Mixed Breakfast Meal.

OBJECTIVES: To measure the postprandial plasma amino acid appearance in younger and older adults following a high protein mixed meal. DESIGN: Cross-sectional study. SETTING: Clinical research setting. PARTICIPANTS: Healthy men and women aged 60-75 (n=15) years, and young controls aged 20-25 years (n=15) matched for body mass index and insulin sensitivity based on the homeostatic model assessment of insulin resistance. INTERVENTION: High protein mixed meal of complete food products. MEASUREMENTS: Circulating amino acid concentrations were determined hourly before and for 5 hours after meal ingestion. RESULTS: There was no difference between cohorts in postprandial appearance of non-essential amino acids, or area under the curve of any individual amino acid or amino acid class. However, older adults had higher baseline concentrations of aspartic acid, glutamic acid, glycine, ornithine, threonine and tyrosine and lower baseline concentrations of hydroxyproline, isoleucine, leucine, methionine and valine compared to younger adults. Younger adults showed peak essential (EAA) and branched-chain amino acid (BCAA) concentrations at 1 hour post meal while older adults' peak EAA and BCAA concentration was at 3 hours. Similarly, peak total amino acid concentrations were at 3 hours in older adults. CONCLUSION: Older adults digested and absorbed the protein within a mixed meal more slowly than younger adults. Delayed absorption of AA following a mixed meal of complete food products may suppress or delay protein synthesis in senescent muscle.

Attendance at a hospital emergency department by drivers involved in automobile accidents in Italy.

OBJECTIVE: This study investigated the profile of drivers involved in automobile accidents attending a hospital emergency department (ED) in Catanzaro (Italy). METHODS: Car drivers involved in automobile accidents who were registered for emergency care between May 2003 and February 2004 were included in the study. Demographics and details of the accident were collected immediately after admittance, before examination by the medical staff. For each patient, the medical staff completed a form including diagnostic investigations and medical/surgical examination in the ED. RESULTS: Of a total of 424 drivers included in the study 27.4% had conditions that were definitely non-urgent problems. Multiple logistic regression analysis indicated that the use of the ED as a source of non-urgent care was significantly higher among patients who were driving at a lower speed when the accident occurred, among those who presented to the ED before the implementation of the new Italian traffic code, and among those who underwent fewer diagnostic investigations and medical/surgical examinations in the ED. Most of the automobile related lesions occurred in the neck (43.9%) followed by multiple body regions (12.5%) and the upper extremities (10.4%). According to the nature of the injury a third were contusions (34%), followed by pain without physical signs and symptoms (28.8%), and dislocation, sprains, and strains (22.9%). CONCLUSIONS: Development of health promotion and education campaigns is required to prevent the use of the ED as a source of non-urgent care by those involved in automobile accidents.

Inappropriate hospital use by patients needing urgent medical attention in Italy.

The purpose of this study was to determine the extent of inappropriate admissions and days of stay in acute beds of patients who were admitted to hospital after attending the emergency department for urgent medical attention in Italy. The medical records of all adult patients (aged 16 years and over) on one randomly preselected day during the period January-December 2001 were reviewed. The retrospective application was made using the Appropriateness Evaluation Protocol list of criteria. Overall, 28.4 and 75.7% of hospital admissions and days of stay, respectively, were judged to be inappropriate. Results of the multiple logistic regression analysis indicated that inappropriate admission was significantly more likely in patients who lived closer to hospital, in younger patients, in patients from lower socio-economic classes, and in patients who did not receive diagnostic procedures in the emergency department. The proportion of patients whose admission was considered inappropriate was significantly lower in medical specialties wards. The number of inappropriate hospitalisation days was significantly higher in younger patients, in those admitted inappropriately, and in patients sampled close to discharge (during the final-third of his/her stay). The number of inappropriate hospitalisation days was significantly lower in patients admitted to surgical and traumatology/orthopaedics and medical specialties wards. Our findings indicate the need for specific interventions to reduce the prevalence of inappropriate hospital use and to modify physicians' attitudes and behaviours.

Non-urgent visits to a hospital emergency department in Italy.

The purpose of this study was to determine the extent of non-urgent visits and the effect of different characteristics on such visits to one public hospital emergency department located in Catanzaro, Italy. Of 581 patients aged 15 years and older who were registered for care in the emergency department, 40 were excluded from the study as they were too ill or distressed. The survey questionnaire included questions about the patients' demographic and socio-economic characteristics, distance from home to hospital, usual health status and health status at the time of presentation to the emergency department. Of the 541 patients who agreed to participate, 19.6% of patients, according to the judgement of two observers, had non-urgent conditions. The results of the multiple logistic regression analysis showed that among all variables tested, age and sex were significant predisposing factors for utilization of the emergency department for non-urgent visits. Indeed, the odds of presenting for non-urgent care were significantly higher if patients were younger and female. Moreover, the odds of requiring non-urgent care were significantly higher in patients who present to the emergency department without medical referral and in patients who present with problems of longer duration. The most frequent reason given by patients for their visit to the emergency department was that they felt their problem was an emergency. Further investigations are necessary to evaluate the use of primary care since closer co-operation within the healthcare organization system may provide a more responsive service.

Estimation of norms from a controlled sample survey. II. Influence of body habitus, oral contraceptives, and other factors on values for the normal range derived from the SMA 12-60 screening group of tests.

PIP: The Westenberg-Mood 2-sample percentile test was used to determine if ranges of normal values for subgroups varied for variables measured on the SMA 12/60 ("AutoAnalyzer 12/60", analyzes serum). Data on 12 frequently determined serum constituents was collected from people age 20-49. Subjects were clinically normal men (423) and women (557). Individuals were subgrouped according to 1) sex, 2) geographical region of the U.S., 3) body habitus (weight), 4) season of the year when serum was drawn, 5) time of day, and 6) medications, if any, being used. Some of the more striking observations were 1) obese persons had higher concentrations of uric acid, 2) albumin and inorganic phosphate concentrations were decreased in women using oral contraceptives, and 3) lactate dehydrogenase activities were lower in the winter months. A laboratory test has increased usefulness when the normal range is narrowed; analysis of serum constituent levels in subgroups achieves this purpose.^ieng