Changing prevalences of overweight and obesity in primary school children--a glimmer of hope?

BACKGROUND: The current epidemic of childhood obesity is a growing public health concern. Estimates of the prevalence of obesity are necessary so that secular trends can be monitored and the need for preventative measures assessed. AIMS: To establish the prevalences of overweight and obesity in Aberdeen primary schoolchildren and to investigate how children have been changing with respect to body fatness during their primary school years. METHODS: Retrospective study of two cohorts of school entrants, using height and weight data from school nurse records. RESULTS: Data were collected on 1018 children. The prevalence of overweight among children in primary year 1 decreased from 28.7% in 1997/98 to 21.5% in 2001/02 (P<0.01). The mean BMI SD score also significantly decreased in boys from 0.51 in 1997/98 to 0.32 in 2001/02. For the 1997/98 school entrants, the prevalences of overweight and obesity did not change between school entry and the end of primary school. The mean BMI SD score decreased significantly during primary school in boys but not in girls. CONCLUSION: Although childhood overweight and obesity remain major public health concerns, we report a slight improvement in measures of obesity over time, particularly in boys.

Coronary flow distribution and dynamics during continuous and pulsatile extracorporeal circulation in the pig.

Four extracorporeal perfusion conditions (continuous beating, continuous fibrillating, pulsatile beating, and pulsatile fibrillating) were tested for 15 minutes each in pigs. Coronary flow, endocardial-epicardial flow ratio, phasic coronary flow, myocardial oxygen consumption, and myocardial lactate extraction were measured. No significant differences in any of these variables were found between pulsatile and continuous flow states in either fibrillating or beating hearts (p greater than 0.05). In both fibrillating conditions, significant elevations of myocardial oxygen consumption and decreases in endocardial-epicardial flow ratios were found (p less than 0.05). Lactate extraction occurred in all conditions, and phasic coronary flows were similar in both beating conditions. These data suggest caution in the expectation that pulsatile perfusion will reverse the coronary flow and myocardial oxygen consumption changes seen with fibrillation.

Biomonitoring of possible human exposure to environmental genotoxic chemicals: lessons from a study following the wreck of the oil tanker Braer.

In January 1993 the oil tanker Braer ran aground in the Shetland Islands, Scotland. Approximately 80,000 tons of crude oil were released. Exceptionally high winds caused extensive pollution and exposure of the local population to crude oil. We describe the study which was immediately set in place to examine the exposed population for evidence of genotoxic exposure. Blood samples were taken and primary DNA damage was measured in the mononuclear cell fraction by the butanol modification of the 32P-postlabelling method. Mutation was measured at the hprt locus in T lymphocytes. No evidence of genotoxicity was obtained for either end point, but nevertheless, we believe that useful lessons were learnt, which should be incorporated into the design of future studies: (1) A rapid response is essential, and even if sufficient funds are not immediately available, it is still worth attempting to obtain samples quickly and use cryopreservation, also to attempt to estimate exposure. (2) Adequate numbers of volunteers must be sought, together with enough controls, not just to allow meaningful analysis but to overcome loss of samples and failure of things to go according to plan. (3) Points concerning laboratory practice include: (i) samples should be coded, (ii) clearly defined and proven protocols should be used, (iii) irreplaceable samples should not be used for method development, (iv) should a problem become apparent during the study, work on such samples should cease immediately until the problem is solved, (v) all critical experimental components should be pretested against a laboratory standard. (4) The study design should include replicate experiments to monitor experimental variability and reproducibility, as well as internal standards and cryopreserved "in house" samples. Care must be taken that samples from any one exposure group are spread between a number of independent experiments and that each experiment includes samples from a number of exposure groups. (5) A computerised data base should be maintained with full details of experimental variables, donor attributes, and raw data so that any contribution of experimental artefacts to "outlier" results can be monitored. (6) Because of the nature of the statistical variation for many environmental genotoxicity end points, only a large-scale study is likely to be capable of yielding useful information.

Sero-epidemiological survey of Rickettsia tsutsugamushi infection in a rural Thai village.

A sero-epidemiological survey of a rural Thai village demonstrated a 77% prevalence of antibody against Rickettsia tsutsugamushi in adults. Acquisition of antibody occurred very early in life, especially in females, but the prevalence of antibody in the adult population showed no statistically significant sexual distinction. Antibody against all three prototype strains was present in Thailand but antibody titres did not vary by strain type or the age of the individual.

Reduced level of non-esterified fatty acids in sera from patients with infectious respiratory disease.

Sera from 103 fasting individuals 3 to 76 years of age and free of clinical infectious disease and sera from 183 patients with infectious disease were assayed for serum total non-esterfied fatty acids (tNEFA) and compared. Data were also separated into five groups according to age of donor: 3--7, 8--19, 20--35, 36--60, and 61--76 years. The mean group serum levels of tNEFA increased with age. Among patients with infectious diseases sixty-five were diagnosed as having hepatitis, 41 with infectious mononucleosis, 18 with cellulitis, 12 with pulmonary tuberculosis, 11 with non-pneumococcal pneumonia, 9 with pneumococcal pneumonia, 8 with pharyngitis, 6 with pyelonephritis, 6 with aseptic meningitis, 4 with Gram-negative sepsis, and 3 with encephalitis. The sera from 23 non-fasting patients with gonorrhea were also tested. The serum tNEFA levels were found to be altered, in fact depressed from normal group values, only in patients with pneumonia or tuberculosis. This depression may be related to aberrant pulmonary metabolism during pneumonia.

Clinical illness in a wild turkey with Laminosioptes cysticola infestation of the viscera and peripheral nerves.

Laminosioptes cysticola, the fowl cyst mite, was found in peripheral nerves and thoracic and abdominal viscera of an emaciated eastern wild turkey (Meleagris gallopavo) exhibiting severe torticollis, circling, loss of balance, and wing droop. Mites, sometimes accompanied by granulomatous inflammation, were abundant in brachial plexus and sciatic nerves. Mild lymphoplasmacytic perivascular cuffing was present in the cerebellum, but no direct evidence of mites or other infectious agents was found in the central nervous system. This is the first report of L. cysticola infestation in a wild turkey and of the invasion of nervous tissue by this mite.

Transmission of Sarcocystis leporum from a cottontail rabbit to domestic cats.

Muscle tissue containing grossly visible cysts of Sarcocystis leporum from a cottontail rabbit (Sylvilagus floridanus) was fed to laboratory cats. Sporocysts averaging 13.2 x 9.7 micron were detected in the feces 14 days post-infection and were found until 69 days post-infection.

Prevalence and distribution of Sarcocystis spp. among white-tailed deer of the southeastern United States.

Sarcocysts were found by light microscopic examination of muscle in 199 (51%) of 390 white-tailed deer (Odocoileus virginianus) from the southeastern United States. Sarcocystis infections were detected more frequently in histologic sections of tongue (45%) than of heart (9%). Sarcocysts were significantly more prevalent in adult deer (54%) than fawns (26%) (P less than .01). Statistically significant differences in prevalence were not found in deer from different physiographic provinces or between sexes. Artificial digestion was more sensitive in detecting Sarcocystis infections than examination of histologic sections when both techniques were used to examine tongues of 35 deer. Three different size sporocysts, possibly representing at least two species of Sarcocystis, were recovered during feeding trials. Seven dogs (Canis familiaris) shed sporocysts 9 to 12 days after eating infected venison. Sporocysts measured 13.4-16.8 x 9.0-12.3 micrometers with an average measurement of 15.2 x 10.9 micrometers (N = 195). One of three cats (Felis catus) and one of two red foxes (Vulpes vulpes) first shed sporocysts of Sarcocystis 10 days after eating infected venison. Sporocysts from the cat measured 11.2-13.4 x 6.72-8.96 micrometers (avg 12.0 x 8.7 micrometers, N = 18), and those from the fox measured 11.2-15.7 x 9.0-11.2 micrometers (avg 13.6 x 10.2 micrometers, N = 7).

Sarcocystis spp. in white-tailed deer. I. Definitive and intermediate host spectrum with a description of Sarcocystis odocoileocanis n. sp.

Sporocysts containing four sporozoites and measuring (avg.) 15.2 micrometers X 10.7 micrometers (N = 195) were shed in the feces of dogs (Canis familiaris) 8 to 16 days (avg. 11.6 days) after the first feeding of venison infected with Sarcocystis sp. Sporocysts containing four sporozoites and measuring (avg.) 11.5 micrometers X 8.1 micrometers (N = 35) were shed by a cat (Felis catus) 14 days after ingesting Sarcocystis-infected venison. Statistical (pooled t-test) comparison of the mean measurements of the sporocysts passed by the dog and cat demonstrated a significant difference (P less than .01). The raccoon (Procyon lotor) and opossum (Didelphis virginiana) could not be infected with Sarcocystis from white-tailed deer (Odocoileus virginianus). The name, Sarcocystis odocoileocanis, is proposed for the species transmitted from white-tailed deer to dogs. Sarcocystis odocoileocanis is differentiated from S. hemionilatrantis Hudkins and Kistner, 1977 of mule deer (Odocoileus hemionus), S. ovicanis Heydorn, Gestrich, Mehlhorn and Rommel, 1975 of sheep (Ovis aries) and S. cruzi Hasselmann, 1926 (=S. bovicanis Heydorn, Gestrich, Mehlhorn and Rommel, 1975) of cattle (Bos taurus) because S. odocoileocanis has (1) low infectivity for calves and sheep and (2) apparent insignificant pathogenicity for its intermediate host.

Studies on endoparasites of the black bear (Ursus americanus) in the southeastern United States.

Examination of 53 black bears (Ursus americanus) from six states in the southeastern United States revealed at least 17 species of endoparasites, including Sarcocystis sp., Spirometra mansonoides (spargana), Macracanthorhynchus ingens, Ancylostoma caninum, Arthrocephalus lotoris, Baylisascaris transfuga, Capillaria aerophila, Capillaria putorii, Crenosoma sp., Cyathospirura sp., Dirofilaria immitis, Gnathostoma sp., Gongylonema pulchrum, microfilariae, Molineus barbatus, Physaloptera sp. and Strongyloides sp. Twelve of these represent new host records for black bear, and two are considered to be new species. Data are presented on prevalence, intensity and geographic distribution of each species. Pathologic effects were associated with infections of spargana of S. mansonoides and adults of C. aerophilia.

Parasites, diseases, and health status of sympatric populations of fallow deer and white-tailed deer in Kentucky.

In August 1983, a study on parasites, diseases, and health status was conducted on sympatric populations of fallow deer (Dama dama) and white-tailed deer (Odocoileus virginianus) from Land Between The Lakes, Lyon and Trigg counties, Kentucky. Five adult deer of each species were studied. White-tailed deer had antibodies to epizootic hemorrhagic disease (EHD) virus and Leptospira interogans serovariety icterohemorrhagiae, and fallow deer had antibodies to bluetongue and EHD viruses. Serologic tests for bovine virus diarrhea virus, infectious bovine rhinotracheitis virus, parainfluenza3 virus, and Brucella spp. were negative. One white-tailed deer had an infectious cutaneous fibroma, and one fallow deer had pulmonary mucormycosis. White-tailed deer harbored 16 species of parasites, all of which are considered typical of the parasite fauna of this host in the southeastern United States. Fallow deer harbored nine species of parasites, including eight species known to occur in white-tailed deer on the area and one species (Spiculopteragia assymmetrica) that is not. All fallow deer had inflammatory lesions in the spinal cord and/or brain that were attributed to prior infection with meningeal worm (Parelaphostrongylus tenuis), indicating that P. tenuis infections are not always fatal for this species. The apparent high rate of exposure of Land Between The Lakes fallow deer to P. tenuis without a resultant high rate of clinical cerebrospinal parelaphostrongylosis is hypothesized to be due to a low prevalence and intensity of P. tenuis, partial innate resistance of fallow deer, and acquired immunity.

Maternal carrier rates of potentially pathogenic organisms in Bangkok, Thailand.

One hundred and four healthy women delivering infants at the Royal Thai Army Hospital, Bangkok, were sampled by rectal swab for the laboratory isolation and identification of enteric bacteria of medical importance. Seventeen percent of these women had significant isolates as Salmonella, Shigella and Vibrio species. Serotypically enteropathogenic Escherichia coli were also identified in 31% of the mothers.

Initial effects of the grounding of the tanker Braer on health in Shetland. The Shetland Health Study Group.

OBJECTIVE: To determine if the oil spillage from the tanker Braer had any immediate health effects on the exposed resident population. DESIGN: Cohort study with a comparison against controls, exposure status being assigned on the basis of geographical location. SETTING: Rural Shetland. SUBJECTS: All those resident on or after 5 January 1993 (day 0) within 4.5 km of the site of tanker's grounding. Controls matched for sex and age were drawn from a general practice list 95 km distant. OUTCOME MEASURES: Demographic details; smoking and alcohol consumption; perception of health and reported presence or absence of specific symptoms; peak expiratory flow; results of haematology, liver and renal function tests, and blood and urine toxicology. RESULTS: Of subjects contacted, 420 (66%) exposed people and 92 (68%) controls were studied; 56 non-attenders were surveyed. Principal health effects arose on days 1 and 2 and were headache, throat irritation, and itchy eyes. No significant differences between those exposed and controls were found for any of the biological markers. Toxicological studies did not show any exposures that are known to affect human health. CONCLUSIONS: The study confirmed the anecdotal reports of certain acute symptoms. No evidence of pulmonary, haematological, renal, or hepatic damage was detected at the population level. Toxicological samples from exposed people did not find levels known to affect human health. Further studies are required to ascertain whether there have been any long term effects on the population.

The effect of metacarpal shortening on digital flexion force.

Metacarpal shaft fractures are common injuries that frequently unite with some shortening of the metacarpal. The aim of this study was to determine the effect of metacarpal shortening on digital flexion force. The index metacarpal of six cadaveric upper limbs was incrementally shortened. The flexion force produced at the end of the finger was recorded using a small load cell. At full extension, there was no significant change in flexion force produced regardless of the amount of shortening. However, at 50% aggregate flexion the loss of force became statistically significant at a shortening of 7.5 mm or more. At full digital flexion, the loss of force became statistically significant at shortening of 5 mm or more. At increasing amounts of finger flexion, progressive metacarpal shortening produces proportionally greater loss of fingertip flexion force. From this study it appears that metacarpal shortening of up to 5 mm should give minimal loss of finger flexion force.

PP142. Independent effects of pregnancy induced hypertension on childhood development: A retrospective cohort study.

INTRODUCTION: The effect of maternal pre-eclampsia on neurological and cognitive development of children is not well known. A literature search of Ovid MEDLINE, EMBASE and CINAHL revealed differing opinions in the current literature. It would appear that there is uncertainty regarding the independent effects of preterm birth, birth weight and pre-eclampsia on early childhood development, complicated by the fact that most pre-eclamptic mothers are delivered preterm, and many such babies are growth restricted. OBJECTIVES: To assess whether maternal hypertension in pregnancy was independently associated with additional support needs in children STUDY DESIGN: Retrospective cohort study Setting: Grampian region of Scotland Main outcome measure: The primary outcome of interest was whether a child had developed a record in the Support Needs System (Grampian). Secondary outcomes included the development of a particular disorder or deficiency for example, autism. METHODS: Linkage of birth records of all singleton deliveries occurring in primigravidae between 1995 and 2008 in Aberdeen Maternity and Neonatal Databank with the Support Needs System (SNS) dataset in Grampian. The database from which the study population is derived - the Aberdeen Maternity and Neonatal Databank (AMND) has been in existence since 1950 The Support Needs System (SNS) is part of a Scottish-wide database recording information about children who have additional support needs for more than six months and has been utilised in Grampian since 1998. The first exposed cohort comprised children whose mothers had pre-eclampsia or eclampsia and the second, those whose mothers had gestational hypertension. Children with normotensive mothers formed the unexposed cohort. Hypertensive status in pregnancy was based on Davey and MacGillivray's classification of hypertensive disorders of pregnancy. Crude and adjusted odds ratios with 95% confidence Intervals of having a record in SNS in the presence of maternal pregnancy induced hypertension were calculated using logistic regression taking account of confounders such as preterm birth and low birth weight. RESULTS: After adjusting for confounding factors, neither pre-eclampsia {Adj OR 0.80 (95% CI 0.60,1.07)} nor gestational hypertension {Adj OR 1.16 (95% CI 0.99,1.36)} showed statistically significant associations with additional support needs. An association of pre-eclampsia with cerebral palsy seen on univariate analysis also disappeared on adjusting for confounders {Adj OR 1.26 (95% CI 0.43, 3.68)}. Birth before 32 weeks gestation and birthweight below 1500g were independently associated with additional support needs in children. CONCLUSION: While maternal hypertension was not found to be independently associated with special needs in children, very preterm birth and very low birthweight showed an association.