OBJECTIVES: Kahnawake Schools Diabetes Prevention Project is a 3-year community-based, primary prevention program for non-insulin-dependent diabetes mellitus in a Mohawk community near Montreal, Canada. Objectives are to improve healthy eating and encourage more physical activity among elementary school children. METHODS: Intervention incorporates behavior change theory, Native learning styles, the Ottawa Charter for Health Promotion, and a health promotion planning model. Evaluation uses a mixed longitudinal and cross-sectional design to measure obesity, fitness, eating habits, and physical activity of elementary school children in the experimental and comparison communities. Intermediate variables are self-efficacy and perceived parental support. Process evaluation provides feedback to the intervention. RESULTS: During 3 years, 63 distinct interventions that included a Health Education Program reinforced by school events, a new Community Advisory Board, a recreation path, and community-based activities promoting healthy lifestyles were implemented. Baseline consent rates were 87 and 71% in the experimental and comparison schools. As expected, anthropometric data increase with age. Between 9 and 10 years there are increased weight, height, BMI, and skinfold thicknesses; decreased fitness; and increased television watching. CONCLUSIONS: Implementing a Native community-based diabetes prevention program is feasible through participatory research that incorporates Native culture and local expertise.

Child↗

PubMedDate not supplied

Fatal hydrofluoric acid cutaneous exposure with refractory ventricular fibrillation.

A patient with hydrofluoric acid burns involving only 8% of his body surface area died from intractable cardiac arrhythmia secondary to the depletion of ionized calcium by fluoride ion. For burns of this type, immediate subcutaneous injection of 10% calcium gluconate into the burn wound is recommended and the dose given should be titrated to the relief of local pain. Immediate debridgement of the burn wound also can decrease the treacherous aspect of the circulating fluoride ion, which binds to calcium to form an insoluble salt, effectively removing the calcium ion from any physiologic interaction.

Burns, Chemical↗

PubMedDate not supplied

Mucinous adenocarcinoma of the parotid gland. Report of a case with fine needle aspiration findings and histologic correlation.

BACKGROUND: Mucinous adenocarcinoma rarely arises as a primary tumor within the parotid gland, and only the histologic features of this tumor have been described. CASE: A 4-cm, firm mass arose in the right parotid gland of a 72-year-old male over a six-week period. Cystic on computed tomography, the mass, on fine needle aspiration biopsy, yielded monomorphic, moderately atypical cells, both single and clustered, associated with abundant mucoid material and focal necrosis. Tumor cells had eccentric nuclei, prominent nucleoli and occasional cytoplasmic vacuolization. A few binucleated and multinucleated tumor cells were present. Histologic sections of the resected gland showed mucinous adenocarcinoma. A metastatic workup was negative. The differential diagnoses on cytology included other primary tumors of the parotid gland producing mucin or a mucoid matrix and metastatic mucinous adenocarcinomas. CONCLUSION: To our knowledge, this is the first cytologic description of mucinous adenocarcinoma, primary in the parotid gland.

Adenocarcinoma, Mucinous↗

PubMedDate not supplied

Coping and confidence among parents of children with diabetes.

Sixty-two mothers and 45 fathers of children with diabetes completed questionnaires to assess their confidence to manage the disease and treatment. Implications of parental confidence for attitudes to (1) child-rearing, (2) coping and (3) perceived restrictions of the disease were considered. Mothers and fathers differed in reported child-rearing behaviours and strategies for coping. More confident fathers reported that information was helpful in coping with the disease, while more confident mothers reported that support from the family was more helpful. Predictors of children's locus of control scores differed between mothers and fathers. However, children expressed more external locus of control beliefs where parents believed their children to be more restricted.

Adaptation, Psychological↗

PubMedDate not supplied

Diazepam metabolism in cultured hepatocytes from rat, rabbit, dog, guinea pig, and man.

Diazepam metabolism has been investigated in cultured hepatocytes from rat, rabbit, dog, guinea pig, and man. The metabolite profile obtained by HPLC analysis of the culture medium indicated that substantial differences exist corresponding to known species differences in the metabolite profile of diazepam in vivo. These differences were attributed to a combination of the rate at which a metabolite was formed and the rate at which it is removed from the medium by further metabolism. The intrinsic clearance of nordiazepam in hepatocytes from each of the species exhibited the most marked species variation (rat much greater than guinea pig greater than rabbit greater than human greater than dog). Species that exhibited a high intrinsic clearance for nordiazepam were also those species that exhibited significant hydroxylation at the 4'-site of the molecule. The disappearance of diazepam was rapid in rat, dog, and guinea pig hepatocytes, but slow in human hepatocytes. Moreover, rat and human hepatocytes exhibited different saturability of diazepam clearance with respect to diazepam concentration accounting, at least in part, for the different rates of diazepam metabolism in the different species. These results support the value of hepatocytes in drug metabolism studies and especially in studies of species differences in metabolism.

Adult↗

PubMedDate not supplied

Continuous-flow ventilation as an alternative to assisted or controlled ventilation in infants.

Explore the source record for details and available documents.

Blood Pressure↗

PubMedDate not supplied

Characteristics of infants who undergo neonatal autopsy.

To identify factors associated with the performance of a neonatal autopsy, we surveyed autopsy practice patterns in a tertiary care neonatal intensive care unit for 1 year. After 56 neonatal deaths, 33 (59%) autopsies were performed. We used multivariable analysis to compare the clinical and demographic characteristics of infants who had an autopsy with those who did not. We found two variables to be negatively correlated with having an autopsy performed: birth asphyxia (p < 0.05) and Medicaid coverage (p < 0.05). Early neonatal death (< or = 2 days of age) was not correlated with lack of an autopsy. Pulmonary hypoplasia occurred more often in the group having autopsy. However, only birth asphyxia was significantly correlated with lack of an autopsy after adjusting for other variables in the analysis. The primary cause of death was not associated with performance of an autopsy. We found no significant association between consent for autopsy and the characteristics of the physician requesting it. These data suggest that the infant's socioeconomic status and diagnosis may influence parental consent for autopsy. There may be other characteristics of physicians who request it, parents who consent, or other socioeconomic factors influencing consent for the neonatal autopsy.

Adult↗