Plasma leptin influences gestational weight gain and postpartum weight retention

BACKGROUND: Leptin, a product of the obese (ob) gene, is released from adipocytes. At the same body mass index, women have higher concentrations than men. Thus, during pregnancy, leptin may influence gestational weight gain and retention of a portion of that gain postpartum. OBJECTIVE: We examined the relation between plasma leptin at entry to prenatal care and subsequent changes in weight from entry to prenatal care (at 17 wk gestation, baseline) until 6 mo postpartum. DESIGN: This was an observational study of leptin, gestational weight gain, and postpartum weight retention (at 6 wk and 6 mo postpartum) in 103 low-income pregnant women from Camden, NJ, with a pregravid body mass index (in kg/m2) in the normal range (19.8-26). RESULTS: After potential confounding variables were controlled for, leptin at entry significantly (P < 0.05) predicted weight gain in pregnancy, including measured rate of weight gain (x +/- SEE: 0.25 +/- 0.13 kg x unit log leptin(-1) x wk(-1)), measured rate of third-trimester weight gain (0.37 +/- 0.15 kg x unit log leptin(-1) x wk(-1)), rate of weight gain from recalled pregravid weight (0.23 +/- 0.09 kg x unit log leptin(-1) x wk(-1)), and net rate of gestational weight gain (0.22 +/- 0.09 kg x unit log leptin(-1) x wk(-1)). The leptin concentration at entry also significantly predicted retained weight in the postpartum period (at 6 mo: 7.29 +/- 3.33 kg/unit log leptin at entry) and marginally predicted changes in the sum of skinfold thicknesses (at 6 mo: 14.7 +/- 7.5 mm/unit log leptin at entry). CONCLUSION: These results suggest that a high leptin concentration at entry to prenatal care may predict an increased risk of overweight and obesity in vulnerable women.     

Salivary fluoride levels in overdenture wearers after topical fluoride gel application

This study describes salivary fluoride levels after topical fluoride gel application on overdenture abutments. Fluoride levels were evaluated separately for the subjects with normal unstimulated salivary flow rate (n = 16) and for those with a low flow rate (n = 8). One drop of fluoride gel (Karigel-N, Lorvic) was placed in two abutment depressions of the duplicated overdenture, after which unstimulated whole saliva was collected for 30 minutes. Samples for fluoride analysis were taken at 5-minute intervals. Two additional samples were taken at 45 and 60 minutes. Fluoride concentration at the abutment-denture interface (remaining fluoride concentration) was measured at the end of the study. Salivary fluoride concentrations decreased gradually in both groups of subjects, but after 1 hour they remained at a higher level in subjects with low flow rates. Subjects' salivary flow rates correlated negatively with remaining fluoride concentration at the denture-tissue interface. Consequently, mean remaining fluoride concentration was significantly higher in subjects with low flow rate than in their normal counterparts.     

Why do adults with mucoviscidosis refuse a medically recommended course of intravenous antibiotic therapy?

OBJECTIVE: To better understand the needs of spouses who provide care to spinal cord injury (SCI) survivors, by comparing their self-perceptions and complaints with those of their partners with disabilities and with those of spouses who do not provide care. DESIGN: Survey, including demographics, health concerns questionnaire, and administration of the Center for Epidemiologic Studies Depression Scale (CES-D), the Perceived Stress Scale (PSS), the Life Satisfaction Index (LSI-Z), and the Quality of Life and Individual Needs Questionnaire. SETTING: Two British SCI treatment centers, serving a defined population-based catchment area. PARTICIPANTS: One hundred twenty-four spouses of a longitudinally followed sample of SCI survivors, all of whom had been injured 23 or more years when the study was conducted in 1993. OUTCOME MEASURES: Scores on the above standardized tests, and responses to survey questions. RESULTS: Spouses had more depressive affect (p < .001) than their partners with disabilities, as measured by the CES-D. On the PSS, they exhibited no significant differences. Compared with spouses who were not caregivers, the caregiving spouses reported more physical stress (p = .005), emotional stress (p = .011), burnout (p = .007), fatigue (p = .002), and anger and resentment (p = .029). On the CES-D, they had more symptoms of depressive affect (p = .004) and somatic depression (p = .005). CONCLUSIONS: Spouses of long-term SCI survivors who fulfill a caregiving role report more symptoms of stress and depression than their partners with disabilities and other spouses who are not caregivers.     

Computer simulation of the enteric neural circuits mediating an ascending reflex: roles of fast and slow excitatory outputs of sensory neurons

Recent electrophysiological studies of the properties of intestinal reflexes and the neurons that mediate them indicate that the intrinsic sensory neurons may transmit to second order neurons via either fast (30-50 ms duration) or slow (10-60 s duration) excitatory synaptic potentials or both. Which of these possible modes of transmission is involved in the initiation of motility reflexes has not been determined and it is not clear and what the consequences of the different forms of synaptic transmission would be for the properties of the reflex pathways. In the present study, this question has been addressed by the use off a suite of computer programs, Plexus, which was written to simulate the activity of the neurons of the enteric nervous system during intestinal reflexes. The programs construct a simulated enteric nerve circuit based on anatomical and physiological data about the number, functions and interconnections of neurons involved in the control of motility. The membrane potentials of neurons are calculated individually from physiological data about the reversal potentials and membrane conductances for Na+, K+ and Cl-. Synaptic potentials are simulated by changes in specific conductances based on physiological data. The results of each simulation are monitored by recording the membrane potentials of up to 16 separate defined neurons and by recording the summed activity of whole classes of neurons as a function of time and location in the stimulated network. The present series of experiments simulated the behaviour of a network consisting of 18,898 sensory neurons and 3708 ascending interneurons after 75% of the sensory neurons lying in the anal 10 mm of a 30 mm long segment of small intestine were stimulated once. The results were compared with electrophysiological data recorded from myenteric neurons during ascending reflexes evoked either by distension or mechanical stimulation of the mucosa. When transmission from sensory neurons to ascending interneurons was via fast excitatory synaptic potentials, the latencies and durations of the simulated responses were too brief to match the electrophysiologically recorded responses. When transmission from sensory neurons was via slow excitatory synaptic potentials, the latencies were very similar to those recorded physiologically, but the durations of the stimulated responses were much longer than seen in physiological experiments. The latencies and durations of simulated and physiologically recorded responses matched only when the firing of ascending interneurons was limited to the beginning of a slow excitatory synaptic (in this study by limiting the duration of the decrease in K+ conductance). The simulation provided several physiologically testable predictions, indicating that Plexus is an important tool for the investigation of the properties and behaviour of the enteric nervous system.     

Is the use of dummy or carry-cot of importance for sudden infant death?

The study was undertaken to test the significance of dummy use and carry-cots for counts of sudden infant death (SID). Based on the impression that very few SID victims have a dummy (comforter, pacifier) in their mouth at the time of death, and that a high proportion of SID babies were found dead in a carry-cot (portable crib, pram), a case-control study was performed. Questionnaires were sent to 167 parents of SID victims and to 352 parents of live-infants matched for sex and time of birth. Questionnaires were returned by 121 parents of SID victims (73%) and 307 parents of controls (87%). Only 4 SID victims (3%) were found dead with a dummy in their mouth. A quarter of the controls always used a dummy, 24% during night-time and 23% during daytime between 0 and 2 months of age, whereas this was only true for 10% in the SID group, the odds ratios being 0.27 for night-time and 0.36 for daytime. This trend was also seen until 1 year of life. Of the SID victims, 48% were found dead in a carry-cot, 79% during the cold time of the year and two thirds outdoors. Most deaths occurred during the afternoon (12 pm-5 pm). In both SID and control groups daytime use of carry-cots was equally frequent. Approximately 40% in both groups slept in such a cot between 5-7 days a week during the daytime. CONCLUSION: The use of dummy could be a favourable factor in the prevention of SID. Because of the frequent use of carry-cots during the daytime both in the SID group and the control group, the high percentage of SID in such cots does not seem to be of significance. However the high frequency of deaths in outdoor placed carry-cots during the cold period of the year may give clues to understanding the death mechanism in SID.     

Arrested rearrangement of TCR V beta genes in thymocytes from children with X-linked severe combined immunodeficiency disease

Human X-linked severe combined immunodeficiency disease (SCID) is an immunodeficiency disorder in which T cell development is arrested in the thymic cortex. B lymphocytes in children with X-linked SCID seem to differentiate normally. X-linked SCID is associated with a mutation in the gene that encodes the IL-2R gamma-chain. Because TCR-beta gene recombination is a pivotal initial event in T lymphocyte ontogeny within the thymus, we hypothesized that a failure to express normal IL-2R gamma could lead to impaired TCR-beta gene recombination in early thymic development. PCR was used to determine the status of TCR-beta gene-segment rearrangements in thymic DNA that had been obtained from children with X-linked SCID. The initial step in TCR-beta gene rearrangement, that of D beta to J beta recombination, was readily detected in all thymus samples from children with X-linked SCID; in contrast, V beta to DJ beta gene rearrangements were undetectable in the same samples. Both D beta to J beta and V beta to DJ beta TCR genes were rearranged in the thymic tissues obtained from immunologically normal children. We conclude that TCR beta-chain gene rearrangement is arrested in children with X-linked SCID. Our results suggest a causative relationship between the failure of TCR beta-chain gene rearrangements to proceed beyond DJ beta rearrangements and the production of a nonfunctional IL-2R gamma-chain.     

The possibility of using a helium-oxygen medium for preservation of isolated organs

From 1967 to 1974 vaginal and cervical smears of about 46,000 teenage girls and young women up to the age of 25 were examined. Among these were 250 doubtful and positive cases (0,54%). Of the 67 positive ones 46 cases were known to be histologically examined (69%); 8 times an invasive carcinoma and 38 times a carcinoma in situ were found. Women under the age of 25 should therefore be included in routine check-up with cervical and vaginal smears.