Anthropometric status of Kazakh children in the 1990s.

The 1990s were a period of considerable economic and social instability in Kazakhstan. The current study documents information on the growth performance of children living in Kazalinsk district in the far west of Kazakhstan over this turbulent period. Using anthropometric data of children, from random samples collected in 1992, 1994 and 2000, we investigate changes in body size of 4.0-4.9-year-old children over the 8-year-study period. Between 1992 and 2000, there was no statistically significant change in body size of 4.0-4.9-year-old boys, but 4.0-4.9-year-old girls became significantly smaller. This may have resulted from the prolonged period of economic instability in Kazakhstan. Furthermore, using detailed dietary intake data collected in 1994, evidence is presented to support a suggestion that the different responses to economic hardship, evidenced in the achieved body size of boys and girls, may have been influenced by gender-discrimination in household food allocation.

Height, weight and haemoglobin status of 6 to 59-month-old Kazakh children living in Kzyl-Orda region, Kazakhstan.

OBJECTIVE: To estimate the prevalence of stunting, wasting and anaemia among children aged 6-59 months in the Kzyl-Orda region of Kazakhstan, and to determine the association between childhood height and haemoglobin concentration and a range of environmental and biological factors. DESIGN: A cross-sectional study using a randomly selected sample. The mothers of children were interviewed, and finger-prick blood samples and anthropometric measurements were collected on both mothers and their children. Associations between haemoglobin (Hb) concentration, anthropometric measurements and questionnaire data were evaluated by multivariate analysis. SETTING: Health centres in Kazalinsk, Djalagash and Zhanakorgan districts of Kzyl-Orda region, Kazakhstan. SUBJECTS: Two-thousand and twenty-four children aged between 6 and 59 months born to 1501 mothers who were randomly selected from health centre records. RESULTS: The overall prevalence of stunting (<-2.0 Z-scores height for age), wasting (<-2.0 Z-scores weight for height) and anaemia (Hb<11.0 g/dl) in the study children was found to be 15.8, 0.8 and 50.1%, respectively. However, analysis demonstrated considerable variation by age, with the second year of life showing the highest prevalence of both stunting and anaemia. Both childhood height and haemoglobin concentration were found to be significantly associated with a range of environmental and maternal variables. CONCLUSIONS: This study demonstrates that the prevalence of both stunting and anaemia among Kazakh children in the Kzyl-Orda region is considerable, and similar to that of other Central Asian children. These findings highlight Central Asia as a region with levels of childhood nutritional status that are of concern. SPONSORSHIP: Funding was provided by the United States Agency for International Development, Office of Nutrition, the United Kingdom Department for International Development, and the Polden-Puckham Trust.

Haemoglobin status of adult non-pregnant Kazakh women living in Kzyl-Orda region, Kazakhstan.

OBJECTIVE: To estimate the prevalence of anaemia among adult non-pregnant women in the Kzyl-Orda region of Kazakhstan, and to determine the association between haemoglobin concentration and anthropometric, socioeconomic, reproductive and dietary factors. DESIGN: A cross-sectional study using a randomly selected sample. Subjects were interviewed, and finger-prick blood samples and anthropometric measurements were collected. Associations between haemoglobin concentration and anthropometric and questionnaire data were evaluated by sequential linear regression analysis. SETTING: Health centres in Kazalinsk, Djalagash and Zhanakorgan districts of Kzyl-Orda region, Kazakhstan. SUBJECTS: Three-thousand six-hundred and twenty-five non-pregnant women aged 18-45 y randomly selected from health centre records. RESULTS: Iron deficiency anaemia, as reflected by low haemoglobin levels (Hb<12 g/dl), was detected in 40.2% of the total sample. There was a significant curvilinear relationship between haemoglobin concentration and age, with the nadir of the curve in the 30-40 y age-group. Haemoglobin concentration was found to be positively associated with body mass index (BMI) and socioeconomic factors. Significant negative associations were found between haemoglobin concentration and duration of menses, use of the intra-uterine contraceptive device and the consumption of tea. CONCLUSIONS: This study demonstrates that iron deficiency anaemia is present at considerable levels among adult women living in Kzyl-Orda region, Kazakhstan, and provides important baseline information for future research and public health interventions. SPONSORSHIP: Funding was provided by the United States Agency for International Development, Office of Nutrition, the United Kingdom Department for International Development, and the Polden-Puckham Trust.

Exfoliated ductal epithelial cells in human breast milk: a source of target tissue DNA for molecular epidemiologic studies of breast cancer.

Studies of biomarkers of putative breast carcinogens, such as DNA adducts, have been limited by the difficulty in obtaining representative ductal epithelial cells (DECs) from breast tissue. In this feasibility study, we sought to ascertain if exfoliated DECs in breast milk could be a source of DNA for biomarker studies. Specimens (n = 38) were collected over 24 h from nursing women, and a questionnaire was administered. Cell pellets were isolated by repeated centrifugation and washing. Pellets were resuspended and incubated for 2 h, with glass adherence used to remove monocytes, resulting in an enrichment of DECs of >80%. Nonadherent cells were removed, washed, and homogenized for DNA isolation. Accurate DNA quantification was performed by 32P-postlabeling of normal nucleotides under conditions of excess ATP. Although there was wide variability in the amounts of DNA recovered, DNA yield was significantly associated with the number of weeks postpartum (P < 0.01), with optimal yield between 6 and 8 weeks after birth. There were no significant associations (P < 0.05) between the number of cells recovered and milk volume, method of collection, or the number of samples in a 24-h period per individual. This study demonstrates that breast milk can be used as a source of DECs for biomarker studies of gene-environment interaction and that sufficient DNA can be recovered to evaluate carcinogen-DNA adducts and to perform genotyping assays. Using this approach, exfoliated DECs may serve as a source of representative cells for studies of breast carcinogenesis and biomarkers of exposure, susceptibility, and effect.

A field evaluation of baits for delivering oral rabies vaccines to raccoons (Procyon lotor).

Eight field trials were conducted in 1989 and 1990 in Georgia (USA) and Maryland (USA) to evaluate baits and baiting strategies for delivering oral rabies vaccines to raccoons (Procyon lotor). Bait packets consisting of corn meal and egg batter-based baits enclosed in plastic bags were placed at 1.0-m diameter, raked tracking stations and checked daily. Packets were well accepted by raccoons; they visited 31 to 44% of the tracking stations where they removed 69 to 90% of the packets within 4 to 5 days. All or nearly all baits were removed from plastic bags and less than 1% of the baits were found only partially eaten. No rejection of water-filled paraffin ampules in baits was observed. The use of an odor attractant on bait packets did not appear to enhance bait discovery when packets were placed on raccoon travel routes. An attractant did enhance discovery when baits were placed off-road in a simulated aerial baiting test. Nontarget species comprised 31 to 53% of all visits to the stations; they took 28 to 55% of the baits but did not appear to adversely affect bait availability for raccoons. A total of 2,300 baits, each containing a wax ampule holding 10 mg of a physiological marker (iophenoxic acid), were distributed at a rate of 82 baits/km2 on 2,800 ha of Sapelo Island, Georgia. Thirty-five (65%) of 54 raccoons collected following bait placement had eaten one or more baits as indicated by elevated levels of iodine in the blood serum.

Open wounds of the scalp: an account of methods of repair.

Scalp wounds attended by loss of substance are commonly managed either by direct skin grafting or a large transposition flap of adjacent scalp and skin grafting of the donor site defect. Either of these methods has all of the inherent disadvantages of the results of skin grafting: insensate, glabrous surface devoid of hair, recurrent ulceration after minor trauma, and, finally, abnormal appearance. In the past 5 years 23 patients at Emory Affiliated Hospitals have undergone a procedure whereby all existing scalp has been mobilized by fashioning arterialized flaps and the scalp reconstructed with normal hairbearing skin. Multiple relaxing incisions in the galea are requisite to the success of the method. An underlying defect in the bony calvaria can be reconstructed at a second stage by multiple split rib grafts.

Gastric, intestinal, and gallbladder varices: hemodynamic and therapeutic considerations.

Atypically located varices are frequently overlooked in the differential diagnosis of gastrointestinal bleeding in patients with portal hypertension. The circulatory changes associated with these lesions are described and their relation to diagnosis and treatment emphasized.

Repairs in the lower abdomen, groin, or perineum with myocutaneous or omental flaps.

Our experiences with omental and myocutaneous flaps for the closure of the lower abdomen, groin, and perineum are outlined. The relative advantages and disadvantages of the various flaps are discussed.

The transverse lumbosacral back flap.

The transverse lumbosacral back flap is presented as a good one to use for coverage of sacral defects. Its reliability appears to be due to an axial pattern of its proximal portion, and to an uninterrupted subdermal vascular plexus across the midline of the back (supplying the terminal portion). A retrospective analysis of its use in 20 patients, over the last 3 years, suggests that when it is designed properly it can be most useful in the management of sacral pressure sores.

The tensor fascia lata musculocutaneous flap.

The tensor fascia lata (TFL) muscle, together with the overlying skin of the anterolateral thigh, makes a reliable musculocutaneous unit. It can be lengthened safely by taking the fascia lata and the skin of the anterolateral mid and lower thigh to within 8 cm of the knee. The skin of the longer flap is supplied by large perforating musculocutaneous arteries, the terminal branches of the vascular pedicle of the muscle. The shorter flap can easily be transposed over the trochanteric area, while the larger flap will cover not only the trochanter but also the ischial and sacral areas. The flap serves equally well as a transposition, island, or free flap. The anatomical and vascular basis of the flap is presented, together with its application in 21 patients. Possible further applications of the flap, including anterior rotation, are discussed.

The tensor fascia lata myocutaneous free flap.

The tensor fascia lata muscle and its overlying skin provide a reliable myocutaneous unit containing a large amount of soft tissue for a free flap transfer. Its anatomy is outlined, and the operative technique for transfer is detailed in a case of chronic stasis ulcer of the lower leg.

The variability of some motor components of social play and agonistic behaviour in infant eastern coyotes, Canis latrans var.

The duration and stereotypy (in terms of duration) of three actions, stand-overs (SO), generalbites (GB), And scruff-bites (SB), were measured during social play and agonistic interactions in infant eastern coyotes (Canis latrans). The rate of biting was also calculated. We found: (1) SO's and GB's lasted a significantly shorter time during play; (2) when performed during playful interactions, all three acts showed more stereotypy; (3) there was no significant difference between the rates of occurrence of biting during the two situations. A discussion of the 'exaggerated' nature of play behaviour is presented, particularly concerning the form of motor actions that are used during this activity.