Differences in Nutrient Intake and Diet Quality among Non-Hispanic Black Adults by Place of Birth and Length of Time in the United States.

Prior research suggests that migrating to the United States (US) can negatively affect the diets and health of immigrants. There is limited information on how relocating to the US affects the diets of Black-identifying immigrants. To address this gap, this study examined differences in nutrient intake and diet quality among non-Hispanic Black adults by place of birth and length of time in the US. Cross-sectional data from the National Health and Nutrition Examination Survey (2005-2016) were analyzed. Approximately 6508 non-Hispanic Black adults were categorized into three groups: foreign-born (FB) living in the US <10 years (n = 167), FB living in the US ≥ 10 years (n = 493), and US-born (n = 5848). Multivariable-adjusted logistic and linear regression models were evaluated to identify differences in nutrient intake and diet quality (as measured by the Healthy Eating Index (HEI) of 2015) across the three groups when controlling for socio-demographics. Compared to US-born adults, both FB groups had significantly higher HEI-2015 scores and higher odds of meeting dietary recommendations for several nutrients: saturated fat, sodium, and cholesterol. There were no differences in nutrient intake between the two FB groups; however, FB (<10 years) adults had better diet quality than FB (≥10 years) ones. Place of birth and length of time in the US were associated with dietary intake among non-Hispanic Black adults. More research is needed to improve understanding of dietary acculturation among Black-identifying immigrants in the US.

Targeted exercise for African-Americans with multiple sclerosis: Project TEAAMS.

BACKGROUND: We propose a randomized controlled trial (RCT) that examines the effects of a remotely-delivered, cultrally-tailored exercise training program for immediate and sustained improvements in patient-reported outcomes (PROs) of walking dysfunction, symptoms, and health-related quality of life (HRQOL) among African-Americans with multiple sclerosis (MS). METHODS/DESIGN: The study will be conducted using a parallel group RCT design. The RCT examines the effects of a remotely-delivered, culturally-tailored exercise training program compared with an active control condition among 100 African-Americans with MS. The primary PROs focus on walking dysfunction. The secondary PROs include symptoms of fatigue, depression, anxiety, and HRQOL. The tertiary PROs include exercise behavior and mediator variables based on social cognitive theory. Participants will be randomly assigned into one of two conditions, intervention (Aerobic and Resistance Exercise Training) or active control (Stretching and Flexibility), using a random numbers sequence with concealed allocation. The conditions will be administered over four months by a trained behavioral coach who will be uninvolved in recruitment, screening, random assignment, and outcome assessment. We will monitor the outcomes of interest before and after the 4-month intervention period, and then again 4 months after intervention cessation for capturing stability of intervention effects. The data analysis will follow intent-to-treat principles with a linear mixed model. DISCUSSION: If successful, this RCT will provide initial evidence for the uptake and implementation of the program in clinics/environments providing healthcare for African-Americans with MS.

A Novel Visual Grading for Ureteral Encrusted Stent Classification to Help Decide the Endourologic Treatment.

Objective: The aim of the study is to propose a visual classification for encrusted stents (ESs) to help choose the appropriate endourologic treatment. Materials and Methods: A multicenter, retrospective, and descriptive study was performed. A total of 140 patients with encrusted Double-J stents were enrolled from 5 different institutions. The novel visual grading for ureteral encrusted stent (V-GUES) classification system ranges from A to D, increasing with severity of encrustation. Results: ESs could be removed with a single intervention in 112 patients (86.8%). Type A and B ESs could be removed in all patients (100% success). Type D stents had minor retrieval and stone-free rates (p = 0.006 and p < 0.0001, respectively). Flexible ureteroscopy had a low success rate (77.7%) for type C stents (odds ratio [OR]: 0.21). Combined access had a 100% success rate for retrieval of type C ESs and a 92.9% success rate for type D ESs (OR: 9.18). Type D stents were associated with patients requiring more than one session to retrieve the stent (OR: 0.11) and stones (OR: 0.21). Conclusions: The V-GUES system is associated with treatment success rates of ES retrieval and stone-free status. It is also associated with the complication rate and the number of sessions needed for patients to be stent and stone free. The V-GUES classification could help counsel patients about the best treatment options and their outcomes. Further prospective studies will be needed to provide external validation.

Society of Behavioral Medicine (SBM) position statement: provide funding for incentive programs to expand healthy food offerings in SNAP-authorized small food stores.

Individuals and families with limited access to healthy foods often experience increased risk for poor diet and chronic disease. Low-income communities are more likely to have a large number of small food stores (e.g., corner stores and dollar stores) compared to higher-income communities. Since many of these small food stores participate in the Supplemental Nutrition Assistance Program (SNAP), increasing healthy food offerings in these stores may expand healthy food retail in low-income communities. We recommend the provision of funding for incentive programs that encourage SNAP-authorized small food stores in low-income communities to expand their healthy food offerings. This programming should (a) provide seed grants to store owners to develop or reconfigure store infrastructure, (b) offer store owners technical assistance and educational materials on marketing strategies for promoting healthy food items to customers, and (c) give a tax break to SNAP-authorized small food stores in low-income communities that maintain a predetermined minimum stock of U.S. Department of Agriculture-recognized staple foods.

Long-Term Passive Ureteral Dilatation with Double-J Stent: Possibly an Effective Treatment for Recurrent Renal Colic Caused by Papillary Renal Necrosis.

Background: An uncommon cause of recurrent renal colic is mucous tissue passage secondary to renal papillae necrosis. Because of its low prevalence, the correct management of recurrent obstructive uropathy produced by renal papillary necrosis (RPN) is not well defined. Case Presentation: We present a case of recurrent renal colic associated with the expulsion of mucous tissue in a young woman's urine with a history of excessive consumption of nonsteroidal anti-inflammatory drugs (NSAIDs). The patient required multiple admissions to the emergency department because of recurrent episodes of renal colic. A retrograde pyelogram and histopathologic study of the expulsed tissue supported the diagnosis of RPN. The patient was managed with Double-J stents for 12 months, complete withdrawal of NSAIDs, and large volume intake of water. A satisfactory outcome was seen radiologically and endoscopically after treatment. The patient stopped experiencing new renal colic episodes because of the passive ureteral dilatation despite still presenting the mucous tissue expulsion in the urine. Conclusions: Passive ureteral dilatation with Double-J stents could possibly be an effective treatment for patients with recurrent renal colic secondary to persistent renal papillae necrosis.

Distribución de Aedes aegypti y Aedes albopictus en Guatemala 2016 / Distribution of Aedes aegypti and Aedes albopictus in Guatemala 2016

Los recientes brotes de zika y chikungunya en Guatemala, y el continuo padecimiento de dengue, hacen necesario generar preguntas respecto a la presencia de los vectores de arbovirus, Aedes aegypti y A. albopictus, en este país. Los reportes publicados previamente, señalan la presencia de estos vectores en cuatro departamentos de Guatemala. El objetivo de este estudio fue actualizar los reportes de A. aegypti y A. albopictus en Guatemala para informar con datos robustos a las agencias de salud. Se utilizaron datos del Programa de Enfermedades Transmitidas por Vectores del Ministerio de Salud Pública y Asistencia Social, que contiene principalmente información sobre la presencia de estadios larvales de los vectores. Los sitios de colecta de los mosquitos fueron validados usando herramientas de Sistemas de Información Geográfica, generando mapas de distribución de ambas especies de vectores en todo el país. Los resultados incluyen la presencia de A. aegypti en 21 departamentos y A. albopictus en 11. Aedes aegypti fue reportado en zonas bajas con tolerancias a altas temperaturas (32.3-34.8°C), mientras A. albopictus se reportó en zonas con mayor precipitación y en mayores altitudes (2,301 m). Se concluye en un notable incremento en la distribución de estas dos especies en Guatemala, basados en los informes del primer trimestre 2016 del Programa de Enfermedades Transmitidas por Vectores colectados en época seca. Se discuten la oportunidad de integrar a la academia con los programas actuales de vigilancia epidemiológica para abordar las necesidades de investigación de estos vectores a nivel nacional.

Recent outbreaks of zika and chikungunya in Guatemala, and the continued burden of dengue, make necessary to generate novel questions regarding the presence of arboviruses vectors, Aedes aegypti and A. albopictus, in this country. Reports published before this manuscript, indicated the presence of these vectors in four departments of Guatemala. The aim of this study was to update the reports of A. aegypti and A. albopictus in Guatemala to better inform health agencies. We used data from the Programa de Enfermedades Transmitidas por Vectores, which mainly contains information about the presence of larval stages of vectors. Sites of mosquito collection were validated using geographic information systems tools, generating maps of both vector species' occurrence across the country. The results include A. aegypti presence in 21 departments and A. albopictus in 11. Aedes aegypti was reported in lowlands with high temperature tolerance, while A. albopictus was reported in drier zones and in higher altitudes (2,301 m). We conclude a notable increase in the distribution of these two species in Guatemala, based on the reports of the first quarter of 2016 of the Program of Vector-borne Diseases collected during the dry season. We discuss the opportunity to integrate the academy with epidemiological surveillance programs to address theresearch needs of these vectors at the national level