Mothers born and raised in third-world countries compared to women born in the United States are on average of shorter size, have less weight, have narrower pelvic dimensions, and give birth to smaller infants without much difficulty. This may be due to a low-protein diet and inadequate prenatal care. Those mothers who were born and raised outside the United States (therefore with narrow pelvic dimensions), but who eat a high-protein diet and receive adequate prenatal care after migrating as adults to the United States, give birth to relatively large infants. This results in a marked cephalopelvic disproportion and severe dystocia, which frequently leads to cesarean birth. It appears that nutritional factors during pregnancy and infancy play a role as important as genetic factors in the etiology of cephalopelvic disproportion.

Adult↗

PubMedDate not supplied

Pedicle fat grafts for the prevention of scar formation after laminectomy. An experimental study in dogs.

The formation of scar tissue always follows lumbar disc surgery and usually causes no difficulty. Reoperation may be necessary because of disc reherniation or because of the scar tissue itself. Reoperation is tedious and dangerous because of the presence of scar formation. Beginning in February 1975, the authors performed laminotomies in 107 dogs in an attempt to study the possibility of prevention of scar tissue formation about the dural sac and nerve roots. Gelfoam and Gelfilm were found to increase scar formation. Micropore tape and plastics such as polyethylene, mylar, and woven and smooth silastic were tried without complete success. Free fat grafts gave better protection than other substances, but it was found that pedicle grafts of fat gave more complete prevention of scar. The living pedicle fat grafts also prevented the usual closure of the laminotomy. The technique of pedicle fat grafts has also been used with success in 36 human patients to date.

Adipose Tissue↗

PubMedDate not supplied

Cement coating of osteoarticular allografts in rats to prevent the immune response.

Recently, more attention is being paid to the treatment of the articular surface defect in the young, active individual. Resurfacing or "shell" allografts are being considered as one of the alternatives for treatment. The immune response by the host may be the chief obstacle to the successful use of fresh osteoarticular allografts. Since proteins on the surfaces of allograft bone cells are considered to be the principal antigens eliciting the immune response, we hypothesized that mechanical masking of these cells by a biodegradeable blocking agent might prevent the immune response. Osteoarticular allografts of the distal femur were performed in rats and the cut surfaces of the graft were coated with cement before implantation. In a preliminary experiment, six biodegradeable cement materials were tried (bone wax, zinc polycarboxylate, collodion, fibrin adhesive, zinc oxide, and isobutyl-cyanoacrylate). Of these, the zinc oxide cement and isobutyl-cyanoacrylate were effective in inhibiting the immune response observed in control rat distal femur allografts. A second experiment was performed using nine rats with zinc oxide and nine rats with isobutyl-cyanoacrylate cements. These were compared with 20 control rats that had allografts without cement coating. Eighteen of the control rats (90%) developed an immune response, while only 22% (2/9) of the rats with zinc oxide coating and 33% (3/9) of the rats with isobutylcyanoacrylate developed an immune response. In a third experiment distal femur allografts were performed in 13 rats using only the liquid component of the zinc oxide cement.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMedDate not supplied

Preliminary findings of high-dose thiamine in dementia of Alzheimer's type.

Thiamine is important not only in the metabolism of acetylcholine but also in its release from the presynaptic neuron. Pathologic, clinical, and biochemical data suggest that thiamine deficiency is detrimental to the cholinergic system and that thiamine-dependent enzymes may be altered in Alzheimer's disease. Two previous studies reported contradictory results in patients with dementia of Alzheimer's type treated with 3 g/day of thiamine. In the present study, we examined the effects of 3 to 8 g/day thiamine administered orally. Our results suggest that thiamine at these pharmacologic dosages may have a mild beneficial effect in dementia of Alzheimer's type. The mechanism of the observed effect is unknown, but the findings warrant further investigation, not only for their therapeutic implications but for their possible etiologic clues. In addition, the results suggest long-term carry-over effects that should be considered in the design of future studies.

Aged↗

PubMedDate not supplied

Health promotion and African-Americans: from personal empowerment to community action.

PURPOSE: Self-help among African-Americans is that tradition of individual and group efforts aimed toward racial progress and defending against a hostile society. The purpose of this paper is to encourage African-Americans, regardless of income, to take personal responsibility for their health. This review discusses each side of the individual versus societal responsibility issue and provides a rationale for integrating these two perspectives. It argues that the tradition of community-based self-help among African-Americans is a mechanism for personal empowerment that can lead to collective action; it therefore has important implications for the improvement of African-American health. SEARCH METHODS: The search made use of a computer-based inquiry with self-help, community health empowerment, and African-American or blacks used as descriptors. We also used a computerized search by the last names of key authors writing in the area of minority health. The review was limited to references between 1964 and 1994. The review also relied on our own professional libraries. Finally, 15 knowledgeable individuals employed at universities around the country were queried about their work, focusing on this subject. They were asked about their perceptions of the issues pertinent to the role of personal and societal responsibility in modifying health behaviors of African-Americans. SUMMARY OF IMPORTANT POINTS: Effective health behavior change strategies with black populations will require an integration of personal responsibility and advocacy for social systems change. The formation of effective self-help community-based coalition partnerships is viable strategy for forging systemic changes to address the health disparity problem. MAJOR CONCLUSIONS: The discussion concludes that blacks should hold themselves more personally responsible for solving their own problems while rejecting debilitating forms of extreme self-blame. Affiliation with self-help organizations and community coalitions for health empowerment is offered as a strategy for community infrastructure development with potential for improving quality of life.

Black or African American↗