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[Activity of superoxide dismutase in erythrocytes and leukocytes and levels of zinc and copper in blood of patients with diabetes. Effect of diabetic treatment on examined parameters].

UNLABELLED: The purpose of the present work was to assess the relationship of leukocyte and erythrocyte superoxide dismutase activity to its cofactors concentrations i.e. zinc and copper in plasma and erythrocyte in diabetic patients and treatment variability. 104 patients were included in the study. 23 persons were in the control group. All patients were divided into 2 groups (NIDDM and IDDM). Patients with NIDDM were divided into 3 subgroups depending on treatment (insulin, gliclazide, dietary treated). In all groups, there were assessed following parameters: the leucocyte and erythrocyte SOD activity according to the method of Misra and Fridovich, and zinc and copper concentrations in plasma and erythrocyte, which were measured by flame absorption spectrophotometry. Statistical analysis was performed using the CRISP program. CONCLUSION: 1. The leukocyte and erythrocyte superoxide dismutase activity is significantly lowered in diabetes mellitus. 2. In diabetic patients both in type I and type II as in the healthy people, there is a close correlation between SOD activity and its cofactors i.e. zinc and copper erythrocyte concentrations. 3. Insulin and gliclazide treatment increases SOD activity and delays late diabetic complications.

Adolescent↗

[Plasma amino acids profile of healthy pregnant adolescents in Maracaibo, Venezuela].

One hundred female adolescents (13-18 y) were clinical and anthropometrically studied to select only those with adequate nutrition. Most adolescents belonged to IV socio-economic stratum families (worker class). Height, weight, age, body mass index and medial arm circumference were used as anthropometric parameters. After screening, only 41 non pregnant girls (control) and 42 pregnant girls with adequate nutrition were selected to analyze plasma amino acids. Fasting peripheral venous blood was drawn, and plasma amino acids were analyzed by HPLC. Amino acid concentrations were expressed as umol/L +/- SE. SAS/STAT program was used for statistical analysis. Amino acid values of control adolescent group were found in ranges reported by other investigators, with slight variations, mostly in diminution, presumably due to nutritional, metabolic or genetic conditions of people living in tropical regions. In pregnant healthy adolescents, distributed according to gestational age: < 32 weeks (n = 30) and > 32 weeks (n = 12), a diminution of total molar plasma amino acids was found, by comparing with control values. Ten amino acids (Pro, Gly, Gln, Arg, Ser, Orn, Tau, Leu, Thr and Val) appeared significantively diminished throughout gestation, being Gly. Gln and Arg most affected since earlier weeks. During the 2nd period. Thr and Val increased their grade of affectation; whereas some amino acids values (Orn, Pro and Tau) tended to recuperate. Several of affected amino acids are gluconegoenic, thus, they could be utilized to supply the energy required by the pregnant adolescent against her double stress: the fetus development and her own development. The plasma amino acid values reported in both, healthy non pregnant and pregnant adolescents, could be taken as regional referential profile of plasma amino acids in this poblational group for further research on adolescent and fetal--maternal malnutrition.

Adolescent↗

Youth knowledge of physical activity health benefits: a Brazilian case study.

This study presents the findings of a questionnaire-based investigation of knowledge about the relationship of physical activity to health among adolescent participants of a community-based physical activity intervention program in São Paulo, Brazil. Qualitative (inductive content analysis) and quantitative methods were applied to examine the participants' responses to two open-ended questions concerning the health benefits of physical activity and the educational goals of the intervention. More than 75% of all participants stated that health benefits (of some type) are attained through participation in physical activity. More than 50% of participants reported that the goal of the intervention was to educate people about the importance of a healthy, active lifestyle. Adolescents understand the relationship of physical activity to health as reflected in their knowledge assessments; their lifestyle choices support these beliefs. These findings offer encouragement for the development and implementation of educationally oriented interventions aimed at providing physical activity information and programming.

Adolescent↗

Community reentry: perceptions of people with substance use problems returning home from New York City jails.

Each year about 100,000 people return to New York City communities from municipal jails. Although about four-fifths report drug or alcohol problems, few have received any formal drug treatment while in jail. Researchers and practitioners have identified a number of policies related to corrections, income, housing, and drug treatment that may be harmful to the successful reintegration of people leaving jail. In order to explore the challenges to successful community reentry, six focus groups and one in-depth interview were conducted with 37 men and women who had been released from jail or prison in the last 12 months. Participants were asked to describe their experiences prior to and immediately following release from jail. Findings suggest that many people leaving jail are not prepared for release and, upon release, face a myriad of obstacles to becoming healthy, productive members of their communities. We discuss the implications of these findings for programs and policies that promote community reintegration of individuals returning from correctional facilities.

Deinstitutionalization↗

Periodontal status and treatment needs in the Chiangmai/Lamphun provinces of Thailand.

As part of an oral health survey concerned with the evaluation of a collaborative primary oral health care program, the CPITN system was used to determine the periodontal status and treatment needs of 2009 Thai people aged 12-44 yr. Calculus dominated the CPITN scores. The percentage of persons with healthy periodontal tissues was small, ranging from 0.7% at age 35-44 to 4.1% at age 12. Ranges for other highest scores were bleeding-0.4% at age 35-44 yr to 6.1% at age 12 yr; calculus-62% at age 35-44 yr to 92.6% at age 17-18 yr. Pocketing did not occur to any significant extent until age 35-44 where 23.9% had 3-5 mm pockets and 12.8% had pockets 6 mm or deeper. 15-18-yr-olds who had received prior care from a Village Scaler had a significantly higher number and proportion of healthy sextants than those who had not received such care. No such effect was demonstrated in 35-44-yr-olds. The need for caution in the interpretation of this result is stressed. Attention is drawn to the desirability of differentiating between supra- and sub-gingival calculus in the CPITN scoring system and to the excessive treatment requirements that arise from classifying everyone with calculus as requiring prophylaxis and scaling. A great deal of improvement will need to be affected if the Thai national and global goals for periodontal health are to be achieved in the districts covered by this survey.

Adolescent↗

Breastfeeding success among infants with congenital heart disease.

It is a widespread misconception that infants with congenital heart disease (CHD) are not able to breastfeed. The purpose of this study was to describe breastfeeding duration and outcomes among a high-risk group of infants with CHD. Mothers of 68 infants at least 6 months of age, who had experienced cardiac surgery during the neonatal period, were surveyed regarding breastfeeding and milk expression habits. Results for this sample of infants were compared to a benchmark study conducted in 1993 at the same institution that described breastfeeding outcomes for 45 infants with CHD. Improved outcomes for the 1998-2000 sample are attributed to an active lactation consultation program instituted in 1998. These findings suggest that given support and education necessary to initiate and maintain lactation, mothers can successfully breastfeed their infants with CHD for durations recommended by the Healthy People 2010 initiative.

Adolescent↗

Health status of Indian population--current scenario.

OBJECTIVE: We aimed at establishing reference intervals for the various biochemical and hematological analytes in healthy population. We also tried to find the percentage of people with coronary artery disease (CAD) and the associated risk factors in 39,940 subjects who had attended the health check up program at our hospital from the years 1996 to 2001. METHODS: The medical record folders of all the subjects were screened manually. Reference values were established using SPSS-8.0 package and the percentiles calculated and with it the corresponding 90% confidence interval (CI). RESULTS: The prevalence of hypertension, diabetes mellitus, and coronary artery disease was found to be 22.5%, 14.2%, and 3.9% respectively. In addition only 41.1% of the population was found to be normolipemic. Most of the analytes showed reference intervals which were in agreement with our reporting values. There was no influence of diet on the reference intervals. Also, there were some analytes like lipids where it was felt that changing the reference values would assign the subjects at greater risk for CAD. CONCLUSION: Implementation of reference intervals in case of lipids poses a dilemma. Lifestyle and diet modifications would have to be implemented to reduce the burden of CAD in this population.

Adult↗

Health for all: a public health vision.

The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals.

Forecasting↗

Factors affecting energy and macronutrient requirements in elderly people.

OBJECTIVES: (i) to describe energy and macronutrient requirements in healthy and diseased elderly patients from knowledge acquired about the age-related changes in energy balance (ii) to describe changes in body composition and the consequences of physical activity and exercise programs. RESULTS: Aging in individuals considered healthy is associated with a reduction in muscle mass and strength (with consequences on autonomy), and an increase in fat mass mainly in the central area, the latter might increase the risk of cardiovascular disease. Body composition changes can be seen as a positive energy (fat) balance. The reduced fat-free mass is responsible for a low resting metabolic rate. Therefore, energy requirements are reduced all the more since physical activity is decreased. A simple means for calculating individuals' energy requirements from estimated resting metabolic rate and physical activity is not yet available in a validated form and is much required. Protein requirements are still debated. Exercise programs can be implemented for increasing muscle mass and strength (resistance training) or for improving aerobic fitness and reducing fat mass (endurance exercise). It is not yet clear whether structured exercise programs or spontaneous physical activity have similar advantages. It is not known in which cases resistance, endurance, or a combination of both exercises should be recommended. The consequences of physical activity and exercise programs on energy and macronutrient requirements is not clear. Diseased elderly persons are prone to malnutrition which impairs clinical and functional outcome. Malnutrition is the result of an energy intake inadequate to match energy requirements. Literature is very short of data on energy requirements in diseased elderly persons, who are under the complex influences of stress (increasing resting energy requirements), reduced body mass and physical activity (reducing energy requirements), plus potential effects of drugs. Almost nothing is known about macronutrient requirements. CONCLUSIONS: Further studies are required to enable calculations of energy and macronutrient requirements of individuals, especially diseased. More work has to be done to understand the energy imbalance in the elderly (healthy and diseased). Careful evaluations of physical activity and exercise programs are necessary.

Aged↗

Cancer screening of older women : a primary care issue.

PURPOSE: The purpose of this retrospective chart review was to examine whether family practice physicians and residents were screening older women for breast, gynecologic, and colorectal cancers as recommended by the American Cancer Society, the Guide to Clinical Preventive Services, and Healthy People 2000. METHODS: A retrospective chart review of women 60 years and older who were seen at least twice between July 1, 1992, and June 30, 1993, in a midwestern family practice residency program was completed. From the original sample of 660 potential subjects, a systematic random selection of every third chart was identified for review, resulting in a sample of 201. Analysis of the data was performed by descriptive statistics and chi-square tests. A series of multiple regression models using age, number of visits, type and gender of provider, and personal or family history of cancer as predictor variables was performed. RESULTS: Breast cancer screening was offered to approximately 70% of the sample, with only about one third of the older women receiving mammography or clinical breast examination. Recommendations for gynecologic cancer screening were given to 63% of the sample, with less than one third receiving Papanicolaou smears. Recommendations for digital rectal examination, fecal occult blood test, and flexible sigmoidoscopy were 58%, 59%, and 30%, respectively. The percentages of patients who actually received these tests were considerably lower. CLINICAL IMPLICATIONS: Barriers for appropriate cancer screening for older women exist for both the provider and the patient; however, many of these obstacles can be overcome. Improving the resident's exposure to the current recommendations, increasing geriatric content in the training program, and initiating a reminder system may reduce some of the provider barriers. The use of midlevel providers may increase the preventive services offered to older women as well as educate and empower these women to become responsible for their own healthcare. Together, physicians and midlevel providers can become patient advocates through political activism, encouraging legislation that guarantees payment for cancer screening tests. Finally, primary care providers can become actively engaged in research that explores the healthcare concerns of older women.

Aged↗

[A dietary intervention study on the hypertensive high risk population in a northern rural area of Beijing].

To investigate the relationship between optimal living mode, healthy dietary pattern and the incidence of primary hypertension, a dietary intervention study on hte hypertensive high risk population was carried out in Fangshan district of Beijing during 1997-1999. The subjects were divided into two groups: control group and intervention group. A 3-day-dietary-recall combined with weighing method and a healthy diet education program were used in the study. The results indicated that the dietary pattern was not reasonable in the hypertensive high risk population. After two-year-intervention, the dietary pattern of people in the intervention group has changed distinctively. Compared with the results in 1997, the dietary risk factors decreased obviously in the intervention group, but increased in control group, such as high energy, fat, oil and cholesterol which can promote hypertension. Furthermore, in the past two years, the number of over weight + obese people increased by 24.6% in control group, but was no change in the intervention group. The intervention group subjects experienced an average decline of 3.7 and 5.1 mmHg of systolic blood pressure(SBP) and diastolic blood pressure(DBP) respectively, and new cases of hypertension observed in the intervention group were significantly lower than in control group. Thus it can be considered that the dietary intervention may be effective for the high risk population and play a very important role in the prevention of hypertension.

Adult↗

[Genomics in psychology and psychiatry].

The review considers the most interesting data on the molecular genetic basis of mental disorders and personality traits, which were obtained within the framework of the Russian program Human Genome. Polymorphic markers Taq1A of the dopamine receptor gene and T102C of the serotonin receptor type 2A gene were associated with schizophrenia, in particular, chronic forms with poor prognosis. In mentally healthy people, the insertion/deletion polymorphism of the serotonin transporter gene was associated with schizoid traits.

Carrier Proteins↗

Declining serum total cholesterol levels among US adults. The National Health and Nutrition Examination Surveys.

OBJECTIVE: To examine the secular trend in serum total cholesterol levels of the US adult population. DESIGN: Nationally representative cross-sectional surveys with both an in person interview and a medical examination that included the measurement of blood lipid levels. SETTING/PARTICIPANTS: Between 6000 and 13,000 adults aged 20 through 74 years examined in each of four separate national surveys during 1960 through 1962, 1971 through 1974, 1976 through 1980, and 1988 through 1991. RESULTS: Mean serum total cholesterol levels in US adults aged 20 through 74 years have consistently declined over the time period 1960 through 1991. More than half of the decline occurred during the time period 1976 through 1991. This decline occurred across the entire distribution of serum cholesterol levels and in all age-sex groups. High-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels have not changed, suggesting that the decline in total cholesterol levels is due to a decline in low-density lipoprotein cholesterol levels. CONCLUSIONS: These results document a continuing and substantial decline in serum cholesterol levels among US adults. They suggest that public health programs, designed to reduce cholesterol levels, are proving successful. The observed downward trend in serum cholesterol levels has coincided with a continuing decline in coronary heart disease mortality. These observations suggest that the Healthy People 2000 goal of reducing the mean serum cholesterol level of US adults to no more than 200 mg/dL (5.17 mmol/L) is attainable.

Adult↗

Strategies for promoting a healthy dietary intake.

Strategies for promotion of a healthy dietary intake must emphasize sound, up-to-date nutritional knowledge that supports broad dietary guidelines for healthy eating. Effective dietary intervention does not rely on a "good food, bad food" approach. The plethora of nutritional studies reported in the popular press must be critically examined at their sources, and information from the studies incorporated into wellness programs only after they have been substantiated to be applicable to the groups of people to whom the wellness programs are addressed. This article briefly describes the 10th revision of the RDAs that was recently released by the National Academy of Sciences in the United States. The US RDA labeling information is also described, and its difference from the RDAs is identified. In addition, the article discusses the recent US Dietary Guidelines and modified four-food-groups daily diet plan which are based on the most recent RDA. Pender's health promotion model is presented as a workable model on which to base healthy dietary intake programs, and three programs that have used elements similar to this model are presented, one in detail. Cost effectiveness as an outcome and tracking technique is highlighted for one of the programs. Nutrition is an important part of nursing care for well clients. Nurses must maintain interdisciplinary contacts with nutritionists and continually update information in this rapidly growing body of knowledge in order to respond to clients' needs and to promote health in this important area.

Animals↗

Modulation of the withdrawal reflex during hemiplegic gait: effect of stimulation site and gait phase.

OBJECTIVE: The objective of the study was to investigate the sensitivity of the nociceptive withdrawal reflex to stimulation of different locations on the sole of the foot during hemiplegic gait. METHODS: Reflexes were evoked by cutaneous electrical stimulation of 4 locations on the sole of the foot of 7 hemiplegic and 6 age-matched healthy persons. The stimuli were delivered at heel-contact, during foot-flat, at heel-off, and during mid-swing. Reflexes were recorded from muscles of the stimulated and the contralateral leg. Ankle, knee, and hip joints angles were recorded using goniometers. RESULTS: In the hemiplegic persons, the size of tibialis anterior reflexes, and the latency of soleus reflexes were site- and phase-modulated. In both groups, the tibialis anterior reflexes were significantly smaller with stimulation to the fifth metatarsophalangeal joint and the heel compared with the first metatarsophalangeal joint and the arch of the foot. The tibialis anterior reflexes evoked at heel-off and mid-swing were larger in hemiplegic persons than in healthy persons. Reflexes in the proximal and contralateral limb muscles were not site-modulated during hemiplegic gait. The kinematic response at the ankle joint was also different in the two groups during mid-swing. CONCLUSIONS: Hemiplegic and healthy middle-aged people presented different phase-modulation of the kinematic and muscle nociceptive reflex responses evoked by stimulation delivered on the sole of the foot. SIGNIFICANCE: The results have potential application in programs to rehabilitate hemiplegic gait.

Aged↗

Universal newborn hearing screening: fine-tuning the process.

PURPOSE OF REVIEW: Universal newborn hearing screening (UNHS) is rapidly becoming the standard of care in hospitals across the country. The goals of Healthy People 2010 are to provide newborn hearing screening to all infants, ensure follow-up audiologic evaluations by 3 months of age, and provide smooth transition to early intervention by 6 months of age. Programs implemented in the 1990s are beginning to report data that will be useful to states new to screening. This article reviews recent trends, suggests appropriate screening protocols, and identifies areas for improvement in UNHS. RECENT FINDINGS: Recent studies indicate the following: (1) screening programs can be cost-effective with low referral rates; (2) maternal stress is not necessarily a byproduct of screenings that end in referral; and (3) developmental outcomes for hearing-impaired infants born in screening hospitals are particularly encouraging. Areas for improvement include the following: (1) compliance in follow-up testing and (2) the establishment of a cohesive multidisciplinary team to manage the infant and provide support to the family. SUMMARY: Hearing screening is only the first step in the care of a hearing-impaired infant. Programs need to ensure that families understand the necessity of follow-up testing without creating undue stress. The transition to early intervention should be seamless, with a cohesive team of health care professionals capable of providing medical, audiologic, communication, and educational management for the infant as well as emotional support for the family.

Hearing Disorders↗

[Role of certified geriatric medical doctors in university hospitals in Japan].

The role of certified specialists in geriatric medicine in Japanese University Hospitals is discussed in this section. First, they should act as geriatric general physicians to provide a comprehensive medical care for elderly patients against a background complicatedly divided medical departments in university hospitals. Second, they should create attractive undergraduate programs for geriatric education in medical schools and training programs in geriatric medicine for doctors to develop certified specialists in geriatric medicine in the future. Finally, they should perform clinical research to provide an evidence to construct better social policies to keep older people healthy.

Aged↗