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Resumen Introduccion La asociacion entre la presencia de sobrepeso/obesidad y el estado clinico de la artritis reumatoide (AR) es un tema aun no resuelto. Objetivo Evaluar la asociacion entre el tipo de composicion corporal y el estado clinico en pacientes con AR. Metodos Estudio prospectivo, comparativo y transversal que incluyo a 123 pacientes (98,4% mujeres, 86,3% FR+, 9,3±8,7 anos de duracion) con AR (criterios ACR/EULAR 2010) en quienes se determino actividad inflamatoria (DAS 28), estado funcional (HAQ-Di) y tipo de tratamiento; ademas, el tipo de composicion corporal evaluada por IMC, circunferencias de cintura, cadera y brazo medio, indice cintura/cadera, plicometria y bioimpedancia electrica. Resultados Las prevalencias de sobrepeso y obesidad (IMC-OMS) fueron del 30,9% y del 45,5%. Cuando se reclasificaron mediante los puntos de corte de Stavropoulos-Kalinoglou, las prevalencias aumentaron a 31,7 y 58,5%, respectivamente. Con este criterio, los pacientes con sobrepeso/obesidad tuvieron mas articulaciones inflamadas que los pacientes con composicion corporal subnormal/normal (3,8±3,3 vs. 1,9±2,5; p=0,02). El conteo de articulaciones inflamadas mostro correlacion positiva significativa con 6 de 11 metodos antropometricos: IMC, circunferencia de brazo y cadera, pliegue tricipital y porcentaje de grasa corporal (determinado por bioimpedancia electrica y plicometria). Conclusiones El sobrepeso y la obesidad se asociaron a mayor actividad inflamatoria caracterizada por mayor cantidad de articulaciones inflamadas. Encontramos correlacion positiva significativa entre el numero de articulaciones inflamadas y la mayoria de los indicadores de masa grasa corporal estudiados. La evaluacion y optimizacion de la composicion corporal podria llegar a ser una parte importante para el abordaje clinico de pacientes con AR. Introduction The effect of overweight/obesity on clinical status in rheumatoid arthritis (RA) is still a controversial topic. To assess the association between body composition and clinical status in RA patients. Methods A prospective, comparative, cross-sectional study was performed on 123 (98.4% women, 86.3% FR+, 9.3±8.7 duration years) RA patients diagnosed according to ACR/EULAR 2010 criteria who were assessed for inflammatory activity (DAS 28), functional status (HAQ-Di), and type of treatment. Body composition was evaluated by BMI, waist, hip, and middle arm girths, waist/hip ratio, skin fold measurements, and bioelectrical impedance analysis. Results The prevalence of overweight and obesity (BMI-WHO cut-off points) was 30.9% and 45.5% respectively. Using Stavropoulos-Kalinoglou cut-off points, each corresponding prevalence increased to 31.7% and 58.5%, respectively. Pooled patients in the overweight/obesity classification (Stavropoulos-Kalinoglou classification) exhibited a significantly higher number of swollen joints as compared to subnormal/normal body composition subjects (3.8±3.3 vs. 1.9±2.5; p=.02). Swollen joint count showed significant positive correlation with 6 out of 11 body composition parameters: BMI; arm and hip girths, triceps skin fold, body fat average determined by bioelectrical impedance analysis, and skin fold measurements. Conclusions Prevalence of obesity in RA varies according to BMI cut-off points. Overweight and obesity were associated with higher inflammatory activity characterized by a higher count of tender and swollen joints. A positive correlation was found between swollen joint amount and the majority of the body fat mass indicators assessed. Body composition assessment/improvement should be an important part of the routine care of RA patients.

Background Ayurveda, the Indian system of medicine offers many herbs and formulations for management of obesity. Baidyanath Bhawan Pvt. Ltd has designed a formulation, HFO-02, based on Ayurvedic literature. Objective To evaluate the efficacy of Herbal Formulation for Obesity (HFO-02) in overweight individuals. Materials & methods With approval from the Institutional Ethics Committee, a proof of concept study was carried out in overweight individuals (Body Mass Index, BMI ≥25.0 and ≤ 30.0 kg/m2), devoid of any endocrinological disorders. Tablet HFO-02 (500 mg) was administered to these individuals twice daily for 90 days, during which they were called at study site fortnightly. After stopping the treatment, they were further followed up for 30 days off-medication and the last follow up was scheduled on day 120. Anthropometric parameters were assessed at every visit, while biochemical parameters viz. lipid profile, blood sugar & insulin levels (both fasting and post prandial), C- reactive protein and adipocytokines (leptin & adiponectin) were estimated monthly. Results Of the 18 participants recruited in the study; 14 completed the study. HFO-02 did not show reduction in weight, however a significant decrease in the body circumference and skin fold was demonstrated. This decrease was maintained till day 120. The levels of all biochemical parameters were maintained and no adverse events were reported throughout the study. Conclusion Tablet HFO-02 reduced body circumferences and skinfold thickness indicating its potential for obesity management. Clinical trial registration number CTRI/2016/07/007067.

An open label, randomized, comparative, interventional pilot study was done to assess the effect of Lekhana Basti (medicated enema) and Rechana Nasya Karma (Errhine therapy) in the management of Sthoulya with special reference to obesity. In the study 30 clinically diagnosed patient of either sex were randomly divided into two groups. In Basti group, Lekhana Basti in Karma Basti manner was given for 30 days. Anuvasana Basti (enema with Triphaladi Taila) in the dose of 120 mL and Asthapana Basti (enema with Triphaladi decoction etc.) in the dose of approximately 960 mL was given. In Nasya group, Rechana nasya on alternate days was given with Triphaladi (oil) in the dose of 0.5 mL per nostril for total 28 days. The patients were assessed on objective criteria such as such as weight, chest circumference, mid-arm circumference, mid-thigh circumference, triceps skin fold thickness, sub-scapular skin fold thickness, abdominal skin fold thickness, waist-hip ratio and lipid profile. It was observed that Basti group was a better intervention in providing relief, however there intergroup standard deviation was low on most of the variable expect the lipid profile. The results suggest that the Nasya Karma may be developed as a better practical approach in obesity management.

Introduction Epiblepharon is a congenital eyelid malposition due to a horizontal skin fold and redundant orbicular muscle, resulting in the inturning of the eyelashes. Objective We report our experience in the non surgical correction of symptomatic epiblepharon using a pretarsal injection of 5IU of Botulinum toxin type A (BoNT-A) in the orbicular muscle. Materials and methods Patients with epiblepharon younger than 2 year were included in the study and their charts were reviewed. Symptoms and signs of epiblepharon were evaluated before and after treatment with BoNT-A. Results 40 patients were included (28 girls [70%]). Average age at treatment was 11 months (range, 4–24 months). 76 eyelids were treated with BoNT-A. A statistically significant improvement in symptoms, lash-corneal touch and punctate corneal epitheliopathy were reported after the treatment with 5IU BoNT-A. Average final follow-up was 25.5 weeks (range, 4–92 months). Conclusions The present study evidences that a pretarsal BoNT-A injection is an effective and safe treatment for the correction of symptomatic epiblepharon in patients younger than 2 years.

The objective of this study was to elucidate whether the use of the McLintock syringe, used to inject tuberculin in cattle in several countries and based on an intradermal inoculation by needle, may, in itself, cause skin reactions that can be interpreted as positive reactions regardless of the real tuberculosis (TB) infection status of the animals. Forty-four cattle from an officially TB-free (OTF) herd were selected for the experiment. Each animal received four inoculations [one with sterile phosphate buffer saline (PBS) with 10% of glycerol and three with bovine purified protein derivative (PPD), as performed during the single intradermal tuberculin (SIT) test], two on each side of the neck (n = 176 inoculations). Three different McLintock syringes (n = 132 inoculations, PBS and bovine PPD) and one Dermojet syringe (n = 44 inoculations, PBS) were used to carry out the inoculations. No positive reactions (increase in skin-fold thickness 3 mm) in response to the bovine PPD or PBS inoculations were observed regardless of the syringe used. No significant differences (p 0.05) in the skin fold thickness increase (in mm) were observed between inoculation sites. Significant differences (p 0.05) in the skin fold thickness were observed when PPD was injected in comparison to the PBS but no differences between McLintock and Dermojet were detected when PBS was injected. The McLintock syringe did not cause reactions per se that could be misunderstood as positive in TB-free cattle demonstrating that it is not a significant factor associated with the previously reported imperfect specificity of the SIT test.

Poor dietary intake is commonly associated with malnutrition in the dialysis population and oral nutritional supplementation is strategized to redress dietary inadequacy. Knowledge on clinical efficacy of whey protein supplementation (WPS) as an option to treat malnutrition in continuous ambulatory peritoneal dialysis (CAPD) patients is limited.This multicenter, parallel, open-label, randomized controlled trial investigated the clinical efficacy of WPS in 126 malnourished CAPD patients with serum albumin40 g/L and body mass index (BMI)24 kg/mSeventy-four patients (n = 37 per group) completed the study. Significantly more IG patients (59.5%) achieved dietary protein intake (DPI) adequacy of 1.2 g/kg per ideal body weight (p 0.001) compared to CG (16.2%) although difference in the adequacy of dietary energy intake between groups was non-significant (p 0.05). A higher DPI paralleled significant increases in serum urea (mean Δ: IG = +2.39 ± 4.36 mmol/L, p = 0.002, d = 0.57 vs CG = -0.39 ± 4.59 mmol/L, p 0.05, d = 0.07) and normalized protein catabolic rate, nPCR (mean Δ: IG = +0.11 ± 0.14 g/kg/day, p 0.001, d = 0.63 vs CG = +0.001 ± 0.17 g/kg/day, p 0.05, d = 0.09) for IG compared to CG patients. Although not significant, comparison for changes in post-dialysis weight (mean Δ: +0.64 ± 1.16 kg vs +0.02 ± 1.36 kg, p = 0.076, d = 0.58) and mid-arm circumference (mean Δ: +0.29 ± 0.93 cm vs -0.12 ± 0.71 cm, p = 0.079, d = 0.24) indicated trends favoring IG vs CG. Other parameters remained unaffected by treatment comparisons. CG patients had a significant decline in QOL physical component (mean Δ = -6.62 ± 16.63, p = 0.020, d = 0.47). Using changes in nPCR level as a marker of WPS intake within IG, 'positive responders' achieved significant improvement in weight, BMI, skinfold measures and serum urea (all p 0.05), while such changes within 'negative responders' were non-significant (all p 0.05).A single macronutrient approach with WPS in malnourished CAPD patients was shown to achieve DPI adequacy and improvements in weight, BMI, skin fold measures, serum urea and nPCR level. CLINICAL TRIAL REGISTRY: www.clinicaltrials.gov (NCT03367000).

Purpose To determine the effect of OBERAY capsules on serum lipid profiles, plasma adiponectin levels, body fat, skin fold thickness and an anthropometric measurements in overweight and obese individuals. Methods In this randomized, double-blind, placebo-controlled study, 72 overweight and obese participants were randomly assigned to receive either 1000 mg of OBERAY or a placebo, daily for 180 days. At baseline, after 90 days and 180 days of treatment, anthropometric parameters, total cholesterol, high density lipoprotein, low density lipoprotein, very low density lipoprotein, triglycerides, plasma adiponectin, body fat and skin fold variables were measured. Results 180 days of OBERAY treatment resulted in a significant increase in mean high density lipoprotein and decrease in other lipid profiles, plasma adiponectin, BMI, Waist Circumference, total body fat, skin fold parameters, subcutaneous and skeletal muscle fat. Conclusion Our findings suggests that, OBERAY is an effective treatment of weight control in overweight and obese Indian population.

Purpose The aim of this study was to determine the malnutrition status at the time of diagnosis in children with Type 1 Diabetes Mellitus (T1DM). Materials and methods 72 children who applied to the Okmeydani Training and Research Hospital Child Endocrinology Outpatient Clinic between February 2019 and June 2019 and were diagnosed with type 1 diabetes were included in this study. Anthropometric measurements used in the diagnosis of malnutrition including head and mid-upper arm circumference and skin fold thickness as well as body weight and height of children were evaluated. In addition, the STRONGkids screening scale was also used for screening malnutrition and the results were compared with anthropometric measurements regarding consistency. Results Only 4 patients out of 72 were under age 5; thus, we did not include head circumferences in the comparative analysis. There was no significant difference in terms of frequency and severity of malnutrition according to gender or age groups (p > 0.05). The negative correlation between STRONGkids risk levels and anthropometric measurements was not statistically significant (p > 0.05). Conclusion Weight loss, one of the most common symptoms in the pre-diagnosis process, should be considered among children with diabetes.

Several studies have shown that low cardiorespiratory fitness (CRF) is a significant independent risk factor for future cardiometabolic disease in adult life. The aim of this study was to examine the relationship between CRF and health status in children and adolescents in Bogota, Colombia.A cross-sectional study was conducted in 921 children and adolescents aged 9-17 years living in the metropolitan area of the District of Bogota, Colombia (2,480m asl). CRF was assessed with the 20m shuttle run test (Course-Navette) according to ALPHA-FITNESS and FITNESSGRAM standards. Blood pressure, waist circumference, hip circumference, body composition (body fat percentage, fat body mass, and fat-free mass by bioimpedance), skin fold calipers, body mass index, and sexual maturity (Tanner) were used as indicators of physical health.After adjusting for sex, age, and sexual maturity, significant inverse relationships were seen between CRF and body mass index (r=-0.107), body fat percentage (r=-0.197), fat body mass (r=-0.159), skin fold (r=-0.246), and waist circumference (r=-0.169); P

The official technique for diagnosis of bovine tuberculosis (bTB) worldwide is the tuberculin skin test, based on the evaluation of the skin thickness increase after the intradermal inoculation of a purified protein derivative (PPD) in cattle. A number of studies performed on experimentally infected or sensitized cattle have suggested that the relative sensitivity of the cervical test (performed in the neck) may vary depending on the exact location in which the PPD is injected. However, quantitative evidence on the variation of the test accuracy associated to changes in the site of inoculation in naturally infected animals (the population in which performance of the test is most critical for disease eradication) is lacking. Here, the probability of obtaining a positive reaction (>2 or 4 millimeters and/or presence of local clinical signs) after multiple inoculations of bovine PPD in different cervical and scapular locations was assessed in animals from five bTB-infected herds (818 cattle receiving eight inoculations) using a hierarchical Bayesian logistic regression model and adjusting for the potential effect of age and sex. The effect of the inoculation site was also assessed qualitatively in animals from four officially tuberculosis free (OTF) herds (two inoculations in 210 animals and eight inoculations in 38 cattle). Although no differences in the qualitative outcome of the test were observed in cattle from OTF herds, a statistically important association between the test outcome and the inoculation site in animals from infected herds was observed, with higher probabilities of positive results when the test was performed in the neck anterior area. Our results suggest that test sensitivity may be maximized by considering the area of the neck in which the test is applied, although lack of effect of the inoculation site in the specificity of the test should be confirmed in a larger sample.

Superficial fungal infections are widespread, regardless of age and gender, in populations all around the world and may affect the skin and skin appendages. Although there are thousands of fungal infections from various genera and families in nature, those that are pathogenic for humans and nesting in skin folds are limited in number. The prevalence and distribution of these fungi vary according to the patients and certain environmental factors. Because the areas including the lids, external auditory canal, behind the ears, navel, inguinal region, and axillae, also called flexures, are underventilated and moist areas exposed to friction, they are especially sensitive to fungal infections. Fungi can both directly invade the skin, leading to infections, and indirectly stimulate immune mechanisms due to tissue interaction and their antigenic character and contribute to the development or exacerbation of secondary bacterial infections, seborrheic dermatitis, atopic dermatitis, and psoriasis. Superficial fungal infections can be classified and studied as dermatophyte infections, candidal infections, Malassezia infections, and other superficial infections independently from the involved skin fold areas.

Objectives The aim of this study was to compare the effect of diet and an abdominal resistance training program to diet alone on abdominal subcutaneous fat thickness and waist circumference of overweight and obese women. Methods This randomized clinical trial included 40 overweight and obese women randomly divided into 2 groups: diet only and diet combined with 12 weeks of abdominal resistance training. Waist and hip circumferences and abdominal skin folds of the subjects were measured at the beginning and 12 weeks after the interventions. In addition, abdominal subcutaneous fat thickness of the subjects was measured using ultrasonography. Percentage body fat and lean body mass of all the subjects were also measured using a bioelectric impedance device. Results After 12 weeks of intervention, the weight of participants in both groups decreased; but the difference between the 2 groups was not significant (P = .45). Similarly, other variables including abdominal subcutaneous fat, waist circumference, hip circumference, body mass index, body fat percentage, and skin fold thickness were reduced in both groups; but there were no significant differences between the groups. Conclusions This study found that abdominal resistance training besides diet did not reduce abdominal subcutaneous fat thickness compared to diet alone in overweight or obese women.

Objective High infancy levels of insulin-like growth factor-I (IGF-I) have been associated with increased linear growth and fat-free mass (FFM) but also with risk of obesity. This paper examines how IGF-I at 9 and 36months relates to diet and body composition. Design Healthy term infants from the prospective cohort study, SKOT, were examined at 9 and 36months with anthropometry, bioelectrical impedance (36months), 7-day food records and blood analysis of IGF-I and IGFBP-3 by chemiluminescent immunometric assay. Results IGF-I at 36months (n=229) was positively correlated with 9months values and values were considerably higher in girls (43%). Children breastfed at 9months had lower IGF-I concentrations at 9months but reached the same IGF-I concentrations at 36months as infants not breastfed at 9months. IGF-I at 36months was positively associated with height, weight, BMI, predicted FFM and FFM index (FFM/height (kg/m 2 )). Although there also was a positive association with predicted fat mass (FM) there was no association with FM index (FM/height (kg/m 2 )). Further, a negative association with skin fold thickness was observed. A change in IGF-I from 9–36months was positively related to FFM and FFM index but not BMI, FM and FM index. No associations were seen between IGF-I and current intake of milk, meat or protein energy percentage, but both fat and saturated fat energy percentage were negatively associated with IGF-I. Conclusion IGF-I concentrations were positively associated with growth but not with adiposity at this age. However, the higher tempo of growth may influence age at adiposity rebound and thereby later risk of obesity. Milk and protein intake at 36months did not influence IGF-I but there was a negative association with intake of fat and saturated fat. The implications of this finding for development of obesity need further exploration.

This experiment aimed to investigate ameliorative efficacy of vitamin E in the goat ( Capra hircus ) kids exposed to arsenic (As). Twenty-one Black Bengal male goat kids (4–6 months age, 6.71 ± 0.49 kg body weight) were divided into seven blocks of three animals in each after arranging them in an ascending order on the basis of their body weight and then one animal from each block was randomly allotted to three groups. The kids were fed either basal diet as such (control, T1), or supplemented with 60 mg As/kg diet (T2) and 60 mg As/kg diet + 250 IU vitamin E/kg diet (T3) for 180 days including a 6 days metabolic trial. Daily feed intake and fortnightly body weight were recorded throughout the experimental period. To assess humoral immune response, animals were inoculated with Pasteurella multocida inactivated antigen after 135 days of experimental feeding and blood samples collected on day 0, 7, 14, 21, 28 and 35 post-inoculation. For assessing cell mediated immune response, kids were exposed to phytohaemaglutinin-p antigen after 170 days of experimental feeding and skin fold thickness was measured up to 96 h of exposure. Growth rate, feed conversion efficiency and intake and digestibility of different nutrients viz. dry matter, crude protein, ether extract, acid detergent fibre and neutral detergent fibre did not vary (P>0.05) among the three groups. However, absorption as well as retention of As were higher (P

Goats can act as reservoirs for tuberculosis (TB) infection. The main etiological agents of TB in goats are Mycobacterium caprae and Mycobacterium bovis and they infect also a wide range of domestic and wild animals and humans. Control programmes based mainly on the application of single and comparative intradermal tuberculin (SIT and SCIT respectively) tests are being implemented in certain regions of Spain with a high density of caprine flocks as Castilla y León, including goats with epidemiological relationship with cattle. The aim of this study was to evaluate the performance of the intradermal tests in naturally TB-infected caprine flocks from this region. The study was performed using data from 17,450 goats in 54 different flocks that were classified as TB-infected in the control programmes executed in 2010 and 2011. Data from 1237 goats from 7 dairy flocks depopulated after the first intradermal testing were used to estimate the sensitivity (Se) using bacteriology as the gold-standard. Overall Se of the SIT test using the severe interpretation was 43.9% (CI 95%, 40.4-47.4) and decreased to 38.8% (CI 95%, 35.5-42.3) using the standard interpretation. Overall Se of the SCIT test ranged between 21.3% (CI 95%, 17.6-25.4) and 7% (CI 95%, 4.9-9.8) depending of the interpretation criteria. A significant weak positive correlation was found between age and skin fold thickness (Spearman's test p0.05). Results from this study yielded, in general, low Se values probably due the systematic detection and slaughter of reactors as a consequence of the eradication programme in previous years or the presence of factors that may interfere in the diagnosis. Therefore, these results suggest the necessity of including ancillary diagnostic tools and/or strict interpretation criteria to maximize detection of positive animals in infected settings.

To compare body composition and abdominal fat partitioning between 5- to 7-year old children born preterm and born at term. We hypothesized children born preterm to have a higher body fat percentage and higher percentage of intra-abdominal adipose tissue (%IAAT) compared with their peers born at term.A total of 236 children aged 5-7 years, ie, 116 children born preterm (gestational age 29.8 ± 2.6 [30; 24-33] weeks [mean ± SD {median; range}]) and 120 children born at term were included. Body composition was measured by bioelectrical impedance analysis and %IAAT by magnetic resonance imaging. Body mass index, skin fold thickness, and waist-to-hip ratio were investigated as further measures of body composition. Dietary records were compared between both groups.Children born preterm were shorter (120 cm vs 123 cm, P.001), lighter (21.8 kg vs 24.3 kg, P.001), and had a lower body mass index (15.1 kg/m(2) vs 15.9 kg/m(2), P = .003) compared with controls. There were no differences in %IAAT (n = 154), and body fat mass although energy uptake was higher in preterms (335 kJ/kg/d vs 302 kJ/kg/d, P = .03).At the age of 5-7 years, children born preterm showed neither increased fat mass nor intra-abdominal adiposity.

Background Subcutaneous injection into an elevated skin fold poses a risk of "bilateral exposure" injury whereby the needle pierces the opposite side of a skin fold and subsequently enters the tissue of the health care worker (HCW). Methods Retrospective review was conducted examining the Exposure Prevention Information Network (EPINet) needlestick surveillance data. Data from 2,402 injuries occurring during subcutaneous injection were included for analysis. Descriptive data, statistical comparisons, and a logistic regression model reporting relative risk are provided. Results Eighty-five bilateral exposure injuries were identified between 2000 and 2009, representing 3.5% (n/N=85/2,402) of all injection-related percutaneous injuries. 65.4% Of the variance in bilateral exposure injury occurrence is explained through examination of the following: (1) manual elevation ("pinching") subcutaneous tissue prior to injection; (2) thin/emaciated patient; (3) injection of insulin; (4) injection of heparin; (5) injection of enoxaparin (Lovenox); (6) if a safety device was used; and (7) whether the health care worker was wearing gloves at the time of the injury (χ 2 7 = 424.2; P Conclusion Manual tissue elevation should be avoided to minimize the risk of bilateral exposure injuries.

Summary Background In adolescents with asthma, information on factors associated with cardiorespiratory fitness levels is limited. The present study aimed to determine if objectively measured physical activity as well as potential relevant factors such as lung function, asthma exacerbations, use of inhaled corticosteroids or skin fold thickness are associated with direct measurements of peak oxygen uptake ( V ˙ O 2 peak ) in adolescents with asthma. Methods From a nested case-control study at 13-years in the Environment and Childhood Asthma birth cohort study in Oslo, Norway, 86 13-years old adolescents with and 76 without asthma performed maximal running on a treadmill with V ˙ O 2 peak measured. The sum of four skin fold thicknesses was recorded, followed by wearing an activity monitor for four consecutive days. Lung function was measured by maximum forced expiratory flow-volume curves and body plethysmography. Asthma exacerbations and use of medication were registered by parental structured interview. Data were analysed using multiple regression analysis. Results Vigorous physical activity (coefficients with 95% confidence intervals; 1.73 (0.32, 3.14)) and skin fold thickness −0.35 (−0.41, −0.28)) were significantly associated with V ˙ O 2 peak in adolescents with asthma. Neither use of inhaled corticosteroids, lung function nor number of asthma exacerbations was associated with V ˙ O 2 peak when taking physical activity and skin fold thickness into account. In the adolescents without asthma only skin fold thicknesses was negatively associated with V ˙ O 2 peak −3.5 (−4.1, −2.8). Conclusions V ˙ O 2 peak appears to be determined by vigorous physical activity level in Norwegian adolescents with asthma and not by asthma-related factors such as use of inhaled corticosteroids, lung function nor number of asthma exacerbations.

Egypt has the highest prevalence of hepatitis C virus (HCV) all over the world, with an estimated 8-10 million among a population of 68 million having been exposed to the virus and 5-7 million active infections (Frank et al., 2000). It is considered the most common aetiology of chronic liver disease (CLD) in Egypt, where prevalence of antibodies to HCV (anti-HCV) is 10-fold greater than in the United States and Europe (Goldstone et al., 2002; Strickland et al., 2002). We have studied the role of plasma ghrelin, an orexigenic hormone that was found to correlate with malnourishment in CLD depending on Child classification. Sixty patients were divided in three groups according to Child classification and were compared to normal healthy controls (20 subjects). There was a highly significant correlation of plasma ghrelin and body mass index (BMI), mid arm circumference (MAC), waist circumference (WC) and tricuspid skin fold thickness (TSF). Also plasma ghrelin was specific and sensitive by the ROC curve analysis to BMI, which would indicate a new marker for malnourishment and possibility of a novel therapeutic approach.

Sensitivity to the taste of 6-n-propylthiouracil (PROP) (a bitter chemical related to the phenylthiocarbamide found in cruciferous vegetables) has been related to dietary intake or preferences of cruciferous vegetables among adults and young children but not middle-aged children or adolescents. We hypothesized that PROP taste sensitivity is related to lower reported dietary intake of cruciferous vegetables, primarily among younger children (ie, a moderating effect of child age). This study examined the relationship of PROP sensitivity to reported dietary intake across 3 days in 2 age groups of youth (9-10 and 17-18 years) while statistically controlling for physical activity, social desirability, and reporting bias. Cross-sectional design was used with a multiethnic (white, African American, Hispanic, etc) sample of 843 men and women. Children were recruited from and data were collected in local elementary and high schools that had at least 30% ethnic minority enrollment. Children providing nonplausible reports of dietary intake were deleted from the analyses. Body mass index was calculated and expressed in z scores. Energy intake and physical activity were measured by 3 telephone-conducted 24-hour dietary recalls with the Nutrient Data System for Research and 5 days of Actigraph (ActiGraph, Shalimar, Florida) activity monitor. The primary analyses included 347 students. 6-n-Propylthiouracil sensitivity was not related to intake of cruciferous vegetables. Intakes of the cruciferous vegetables were low, which may explain the lack of relationship.

Background and Objective OHR118 represents a new class of immunomodulatory and cytoprotective drugs in managing anorexia cachexia. Previously in patients with advanced HIV-AIDS, increases in appetite, strength, and alertness were noted. The objective was to determine the effect of OHR118 on appetite, early satiety, and nutritional intake in patients with advanced cancer. Secondary end points included changes in performance status, lean muscle mass, and quality of life (QOL). Methods Eligible patients received 4.0 mL of OHR118 in subcutaneous daily injections. Patients underwent bi-monthly evaluations during the 28-day initial treatment (phase A). Evaluations included Karnofsky performance status, Edmonton Symptoms Assessment Scale (ESAS), Patient-Generated Subjective Global Assessment (PG-SGA), Simmonds Functional Assessment (SFA), Dyspepsia Symptom Severity Index (DSSI), weight, lean body mass, skin fold thickness, and grip strength. Patients who benefited from phase A could elect to continue with therapy (phase B). Results Of 21 enrolled patients, 11 completed phase A. Eight patients chose to continue with OHR118 treatment (phase B). Weight stabilization or gain was observed in 7 of 11 patients. Total PG-SGA scores improved significantly (P ≤ .01). Appetite (P ≤ .01) and depression (P = .05) scores improved on ESAS. Frequent burping/belching (P = .02), feeling full (P = .04), and stomach distention (P = .03) improved on the DSSI. A deterioration in the timed sit to stand was noted (P = .01). OHR118 was well tolerated with no serious side effects reported. Conclusions OHR118 again mediated statistically significant improvements in anorexia, dyspepsia, strength, and depression in this trial, consonant with the previous AIDS trial results.

This study aimed to maximize the sensitivity of bovine tuberculosis detection in living wild fallow deer (Dama dama) under field conditions. We evaluated the rapid test (RT; CervidTB STAT-PAK Assay, Chembio Diagnostic Systems, Inc., USA) in comparison with the comparative cervical skin test (CCT). A total of 134 fallow deer were captured between January and March 2008. At time 0, 0.1 ml of avian purified protein derivative (avian PPD; Cooper-Zeltia, Spain), 0.1 ml bovine PPD (Cooper-Zeltia, Spain), 0.1 ml negative control PBS and 0.1 ml of a positive control (the mitogen phytohaemagglutinin, PHA; containing 250 mg PHA, diluted in PBS) were injected intradermally at four shaved sites in the neck. The skin fold thickness at each injection site was measured at time 0 and 72 h (3 repeats each time). Animals with a skin test response of 2 mm or more at the bovine PPD injection site and animals with any visible reactivity in the RT were necropsied and tissues submitted for culture and for histopathology. A total of 36 fallow deer were considered reactors to bovine PPD or to the RT (apparent prevalence 27%). Regarding both bovine PPD reactivity and the skin fold increase at the PHA injection site, we found significant effects of age and sex by age interaction. Adult males had the largest responses. Mycobacterium bovis was isolated from lymphoid tissues of 21 fallow deer. Skin test sensitivity, as compared to M. bovis culture confirmed deer, was 80.1% (17/21). But, the CCT alone would have missed 4 of 21 culture confirmed animals. RT sensitivity, based on culture confirmed deer, was also 80.1% (17/21). Similarly, the RT alone would have missed another 4 of 21 culture confirmed deer. However, combining the CCT and the RT allowed for detecting all 21 culture positive fallow deer. We conclude that the combined application of the RT and the skin testing can maximize the sensitivity of bTB detection in living fallow deer, thus facilitating control programs for wildlife disease surveillance., This study was funded by Patrimonio Nacional (special thanks to M. Moreno and A. Jacoste) through contracts to IREC and TRAGSEGA (A. Rosón). This is a contribution to MCINN Plan Nacional Research grant AGL2008-03875 and FEDER, and to EU grant TB-STEP 212414. Studies on diseases shared between domestic animals and wildlife are also supported by grants and contracts from INIA and Ministerio de Medio Ambiente y Medio Rural y Marino (OAPN and SDGSPP), and Grupo Santander – Fundacion Marcelino Botin. MPM-H acknowledges a post-doctoral contract from Instituto de Salud Carlos III.

Abnormal reactions to environmental cold have been observed in some patients with Anterior Knee Pain (AKP). The aims of this study were to investigate whether palpation of the knee could classify patients into those with and those without cold knees; whether this classification could be objectively validated using thermal imaging; whether the cold and not cold knee groups varied in response to a cold stress test and in patient-reported measures. Fifty eight patients were recruited; palpation classified them into cold and not cold groups. Twenty-one (36%) patients were classified as having a cold knee by palpation: fourteen (36%) females and seven males (37%). Preliminary analysis suggested gender might be an effect modifier and the number of men was small, therefore the analysis focussed on females. Women with cold knees had a significantly smaller patellar skin fold, lower levels of activity and worse scores on the MFIQ, there also appeared to be an association with a traumatic onset. Women with cold knees were more likely to report cold weather affected their knees and they preferred a hot water bottle compared to an ice-pack on their knee; there was also a trend towards having to wear extra tights/long johns in the winter. This study has helped to define a clinical profile for a group of females with AKP and cold knees. This group appears to demonstrate a mild form of Reflex Sympathetic Dystrophy.

We studied the effect of management on the responsiveness of red deer (Cervus elaphus) to skin testing with mycobacterial and non-mycobacterial antigens. We hypothesized that individuals from populations of the same species under different management conditions would have a different immune responsiveness. Deer sampled in this study included 1041 adult animals from 6 Spanish farms and 111 adult wild deer. We injected four sites of the neck with 0.1 ml bovine purified protein derivative (PPD), 0.1 ml avian PPD, 0.1 ml negative control PBS and 0.1 ml of Phytohaemagglutinin (PHA, containing 250 μg) as positive control, and measured the skin fold increase at time 72 h. Bovine PPD reactors were identified in 5 of 6 farms and among wild deer. Apparent prevalence among wild deer (18.9%) was not significantly higher than among farmed deer (14.5%). Avian PPD reactors were found among all 7 study populations, but apparent prevalence was lower among wild deer (, This work was supported by projects ‘‘Control of Tuberculosis in Wildlife’’ of Grupo Santander and Fundacio´n Marcelino Botı´n, CICYT – MEC research grant AGL2008-03875, and FEDER (Spain). It is also a contribution to agreements with the National Parks and MARM. The team acknowledges support from the TB-STEP grant, FP7. I.G. Fernandez-de- Mera was funded by European Social Fund and Junta de Comunidades de Castilla-La Mancha (Program FSE 2007- 2013), Spain.

Summary Background & aims There is little information regarding the effect of different definitions of obesity on nutritional epidemiology. The aim was thus to assess: (a) the values of percentage of body fat (%BF) by gender and age; (b) the prevalence of obesity according to different %BF cut-offs; and (c) the sensitivity and specificity of BMI according to different %BF cut-offs used to define obesity. Methods Cross-sectional study on 2494 boys and 2519 girls aged 10–18 years from the Lisbon area. %BF was measured using a hand-held device. In a sub sample of 211 boys and 724 girls %BF was assessed using skin folds. Results %BF levels were higher in girls and decreased with age in both genders. Prevalence of obesity varied considerably according to the %BF cut-off used: in boys, it ranged from 4.7% (age-specific 95th percentile) to 26.5% (fixed 25% cut-off), whereas by BMI it was 5.3%. In girls, prevalence of obesity ranged from 0.4% (age-specific BMI-derived %BF values) to 25.4% (fixed 30% cut-off), whereas by BMI it was 4.7%. The specificity of BMI criteria was over 95% irrespective of the %BF cut-off used; conversely, most sensitivities were below 40%. Sensitivities over 50% were obtained for the age-specific BMI-derived %BF values in boys and the age-specific 95th %BF percentile in both genders. Using %BF derived from the skin fold measurements leads to similar results. Conclusions Prevalence of obesity varies considerably according to the %BF cut-off used. BMI cut-offs have a low sensitivity but a high specificity. Age- and gender-specific cut-offs for %BF should be used to define pediatric obesity.

Objective It has been shown that finger circumference negatively correlates with sensory nerve action potential amplitude (SNAP-A). Also fat people have lower sensory nerve amplitudes. Factors that cause electrodes displaced further away from underlying nerves, such as increased cutaneous and subcutaneous tissue, will lower SNAP-A. This study was designed to evaluate correlation between skin thickness and SNAP amplitude. Methods Thirty-seven healthy 22–40-year-old subjects were selected. Nineteen (51.4%) were males and 18 (48.6%) were females, without significant difference between males and females regarding their ages. For all subjects, height and weight were measured. Anteroposterior and mediolateral diameters of the proximal phalanges of the index and little fingers and also finger circumferences were measured. Palmar digital skin thickness was measured in two ways: first with sonography machine, and second with skin fold caliper. Median and ulnar nerve sensory and motor conduction studies were performed. Results In bivariate analysis, SNAP-A correlated negatively with female sex, height, anteroposterior diameter of the fingers, finger circumference and skin thickness measured by sonography, but in multiple regression analysis only skin thickness measured by sonography could predict SNAP-A. Conclusions This study demonstrates that among physiological factors of sex, height, BMI and also finger size measures, skin thickness is the best predictor of SNAP-A. Significance In clinical practice, this effect must be taken into account when making determination of abnormality based on sensory nerve amplitude.

Electroporation is an effective alternative to viral methods to significantly improve DNA transfection after intradermal and topical delivery. The aim of the study was to check whether a combination of a short high-voltage pulse (HV) to permeabilize the skin cells and a long low-voltage pulse (LV) to transfer DNA by electrophoresis was more efficient to enhance DNA expression than conventional repeated HV or LV pulses alone after intradermal injection of DNA plasmid. GFP and luciferase expressions in the skin were enhanced by HV+LV protocol as compared to HV or LV pulses alone. The expression lasted for up to 10 days. Consistently, HV+LV protocol induced a higher Th2 immune response against ovalbumin than HV or LV pulses. Standard methods were used to assess the effect of electric pulses on skin: the application of a combination of HV and LV pulses on rat skin fold delivered by plate electrodes was well tolerated. These data demonstrate that a combination of one HV (700 to 1000 V/cm; 100 micros) followed by one LV (140 to 200 V/cm; 400 ms) is an efficient electroporation protocol to enhance DNA expression in the skin.

OBJETIVO: Alguns autores demonstraram que a obesidade gera restrição pulmonar, levando a uma redução dos volumes pulmonares. Entretanto, ainda existem controvérsias acerca da existência dessa restrição e do possível mecanismo responsável por essa alteração. Frente a isso, esse estudo teve como objetivo avaliar a influência do excesso de peso corporal na espirometria, em três diferentes posições corporais, avaliado pelo Índice de Massa Corpórea (IMC), percentual de gordura e relação cintura/quadril. MÉTODOS: Quarenta e seis universitários sedentários, com idades entre 20 e 40 anos, foram avaliados e distribuídos em cinco grupos, de acordo com o IMC. Os voluntários foram submetidos ao exame físico e à mensuração das pregas cutâneas e da circunferência da cintura e do quadril. CVF, VEF1 e VEF1/CVF foram avaliados em três diferentes posições - sentado, deitado e em pé. RESULTADOS: Quando comparados os valores obtidos e previstos entre os grupos, nenhuma diferença estatisticamente significante foi detectada. Quando comparadas as posições corporais, a posição deitada apresentou valores menores que as posições sentado e em pé (p

Objective To investigate motor responses to stimulation during the transition from ‘deep’ (burst suppression) to ‘light’ isoflurane anaesthesia in pigs. Study design Prospective, randomized observational study. Animals Five castrated male and five female Norwegian landrace pigs, weighing 19–29 kg. Materials and methods Anaesthesia was induced with isoflurane and the inspired concentration gradually increased until a burst suppression electroencephalogram (EEG) was recorded. End–tidal isoflurane concentration (F E’ ISO ) was then allowed to equilibrate for 30 minutes after which the eyelashes, cornea, nasal septum, anus, interdigital skin fold, periople, tail and claw were stimulated. The motor response to stimulation at each location was graded from 0 to 5. End–tidal isoflurane concentration was decreased 0.3% and the areas re–stimulated; this was repeated three times in each pig. A linear regression analysis using response as dependent and anaesthetic level as independent variable was performed for each stimulus in each pig. Using Student's t –statistic a 95% confidence interval for the mean slope of each stimulus was constructed. Results No pig responded to eyelash brushing. The mean slopes for the other stimuli indicated increasing responses with decreasing F E’ISO . Responses to periople pinching and tail and claw clamping showed significant increases. No stimuli consistently increased the magnitude of response in all pigs, and the appearance and absence of a response was inconsistent between pigs. Motor responses occurred in at least one pig during isoflurane burst suppression anaesthesia to all stimuli except eyelash brushing. Conclusions All the stimuli investigated may elicit movement responses during burst suppression anaesthesia with isoflurane except eyelash brushing. No consistent response pattern between pigs was observed with decreasing isoflurane concentration. Of the stimuli evaluated, clamping the tail or claw and pinching the periople appear the most reliable indicators of anaesthetic depth. Clinical relevance The absence or presence of single reflexes does not accurately reflect the degree of isoflurane–induced cortical depression in individual pigs.

Background. Some chronic diseases have been associated to an impairment of nutritional status. Objective. To analyze nutritional status and its relation to dietary intake, disease activity and treatment in rheumatoid arthritis. Patients and methods. We have included 93 patients (43 men and 50 women) and 93 age- and sex-matched healthy controls. The assessment of nutritional status included anthropometric (body mass index, tricipital skin fold and midarm muscular circumference) and biochemical (serum albumin, prealbumin and retinol binding protein) parameters. Dietary intake was calculated from a food frequency questionnaire. As a measure of disease activity, we used the Health Assessment Questionnaire, Ritchie index, tender and swollen joint count and C-reactive protein. Statistical analysis was performed in the whole series and in every functional class. Results. In the whole series, midarm muscular circumference and serum albumin were significantly lower in patients than in controls. All anthropometric parameters and serum albumin were significantly lower in patients in functional class IV than in their respective controls. The dietary intake of energy, carbohydrates, vegetal proteins and lipids was higher in patients than in controls. Midarm muscular circumference and serum albumin had a significant inverse relation with disease activity parameters; body mass index, midarm muscular circumference and serum albumin correlated inversely with the cumulative dose of glucocorticoids. Conclusions. Patients with rheumatoid arthritis in functional class IV have an impairment of nutritional status without a deficient dietary intake. The differences found in other functional classes are explained by rheumatoid arthritis itself. Nutritional parameters are related to disease activity and glucocorticoid treatment.

All patients attending the outpatient department were screened for hypertension. An attempt was made to correlate presence of hyperinsulinaemia (HI), dyslipidaemia and anthropometric characteristics in these hypertensives. Effect of angiotensin converting enzyme inhibitor (ACEI) and beta blockers on serum insulin was also studied. 85 patients with blood pressure (BP) ≥ 160/90 mm Hg and 94 controls with a BP of < 130/85 mm Hg were studied. All underwent clinical examination, anthropometric measurements (body mass index (BMI), waist hip ratio (WHR), skin fold thickness (SFT) and laboratory investigation (serum insulin, glucose, lipid profile) and post oral glucose load (POGL) for insulin and glucose. Serum insulin was estimated by I125 radio immuno assay. Patients were randomly divided into group A (Tab enalapril) and group B (Tab atenolol). In 51 patients who completed the study, fasting and POGL insulin and fasting lipid profile were estimated two months after treatment. Mean age of cases was 38.91 years. 50% of patients had stage II hypertension. BMI was increased in 36 cases (42.35%) as compared to 9 in (9.57%) controls. Increased WHR was found in 40 cases as compared to 26 in controls. The SFT was more in cases compared to controls. 47 (55.29%) of 85 cases had abnormal lipid profile as compared to 25 (26.60%) in 94 controls. The fasting and POGL insulin levels (13.85 and 60.05 micro u/ml respectively) in cases were significantly higher than in controls (6.87 and 16.16 micro u/ml respectively). The mean POGL insulin values were much higher in obese compared to non-obese hypertensives. The decrease in mean fasting and POGL insulin values in patients taking ACEI and beta blockers were similar. Abnormal lipid profile was significantly more in cases than controls. Increased total cholesterol (TC), Low density lipoprotein cholesterol (LDLC) and total cholesterol (TC)/high density lipoprotein (HDL) ratio were the most frequent abnormality. The mean insulin (both fasting and POGL) levels were higher in obese hypertensives and those with abnormal lipid profile. Both drugs had equal efficacy in reducing the insulin values.

Objective To determine the prevalence of malnutrition among liver transplant (LT) candidates. Materials and methods A prospective study evaluated 219 adult LT candidates including 141 men and 78 women. Cholestatic disease was present in 21 (Child: A = 1, B = 11, and C = 9) and noncholestatic disease in 198 (Child: A = 12, B = 93, and C = 93. The mean age was respectively 45.6 and 46.5 years. Anthropometric and biochemical assessments were performed for statistical analysis using Student t test (P Results In the noncholestatic group, 41.5% were obese according to keep a body mass index (BMI); 61.6% were depleted according to adequacy of tricipital skin fold (%TSF); and 71.1% were above normal levels for generalized adipose reserve (%F). In terms of adequacy of mid–upper arm muscle circumference (%MMC), 58% were depleted and 50.5% were depleted for the current body weight/usual body weight (%CBW/UBW). Otherwise 52.2% of current body weight/ideal body weight (%CBW/IBW) values were above normal. Serum albumin was below normal in 64.9% of cases. In the cholestatic group 62% were normal for BMI; 66.7% were depleted for %TSF; 77.8% were above normal for %F. As to %MMC, 47.6% were depleted and 47.6% were depleted for %CBW/UBW. Otherwise 47.6% were above normal weight for %CBW/IBW. Serum albumin was below normal in 53.9% and %MMC values showed statistically significant differences (P = .02) when compared with Child B and C in the noncholestatic group, as well as %F (P = .01) and serum albumin (P = .0002) in the cholestatic and noncholestatic groups. Serum albumin values also showed statistically significant differences (P = .0004) when noncholestatic Child B and C patients were compared. Conclusion Patients with cholestatic disease were more affected by calorie depletion compared to noncholestatic patients who were more affected by protein depletion.

In a prospective open study, 24 patients with cancer pain receiving parenteral opioids were administered highly concentrated solutions of hydromorphone in order to assess the local tolerance to the subcutaneous infusion. Patients received a mean concentration of hydromorphone of 30 ±15 mg/mL at a mean rate of infusion of 0.3 ± 0.25 mL/hr. Of 22 evaluable patients, 17 (77%) had a site duration of more than 7 days with their first subcutaneous site (mean concentration of 34 ± 8 mg/mL of hydromorphone). Four of the five remaining patients (80%) had site duration of more than 7 days with their second subcutaneous site. Only one patient (5%) did not reach a 7-day duration after three consecutive site changes. Out of 7 subcutaneous sites that presented signs of toxicity before 7 days of infusion, the main problem was erythema in three cases, swelling in two cases, and bleeding in two cases. All sites improved spontaneously and did not require any medical treatment. No correlation was found between the concentration or rate of infusion of hydromorphone and the duration of the subcutaneous site. The duration of the site was significantly correlated with weight, tricep skinfold, subscapular skin fold, and age of the patients. Our findings suggest that hydromorphone can be safely administered in concentrations that are much higher than those commercially available. The availability of highly concentrated formulations of different opioids for parenteral use will make home management simpler and cheaper.

Male mate choice and female-female competition for access to mates were studied in the pipefish Nerophis ophidion , with the aim of evaluating the function and importance of female size and ornamental skin folds. Nerophis ophidion is sex role-reversed in the sense that paternal care limits female reproductive success. Furthermore, females are larger, possess a sexual coloration, and develop an ornamental skin fold during the spawning season. Females are also more active than males during courtship. In mate-choice experiments males actively preferred both larger females and females with larger skin folds. When several females were kept together, only one female in each group developed a large skin fold. Females interacting only with males invariably developed skin folds whereas isolated females did not. The skin fold affects choice of females by males, and since females are socially stimulated to develop their skin fold, interaction with conspecifics indirectly affects male mate choice. Female-female interactions may suppress the development of the skin fold. Hence, both active male mate choice based upon female secondary sexual characters and female-female interactions determine the non-random mating pattern observed.

Rationale: In France, the number of people with epilepsy (PWE) is estimated to 500000. Their nutritional status is poorly studied. Impaired nutritional status might play a role in the response to treatment. Vit D might be involved in some forms of epilepsy. The main purpose of this study was to describe the nutritional status of patients with epilepsy and analyze their serum vit D level. Methods: After consent, a nutritional assessment was performed in 46 PWE with or without drug resistance. Weight, height, body mass index (BMI), waist circumference, triceps skinfold (TS), biceps, supra-iliac, subscapular skinfolds, arm circumference, fat mass (FM) and fat-free mass (FFM) by bioimpedance were measured. The serum vit D dosage was realized before supplementation (deficiency < 30 ng/mL). Statistical analysis used Student’s t test, chi2and ANOVA. Results: The mean age was 44.5 ± 14.3 years, with a sex ratio M/F at 1.3. 60.9% were drug-resistant. BMI was 28.7±7.0 kg/m 2 , with 2.2% of malnourished and 30.4% obese. Vit D concentration was 15.3 ± 9.9 ng/mL with 87% of deficient patients, and 40% with severe deficiency (

We report the first case of an intrauterine treatment for cystic hygroma. Guided by ultrasonography, we first removed intracystic fluid from two cysts and then injected OK-432 into each fetal cyst at 21 and 28 weeks of gestation. No re-enlargement of the cysts was subsequently observed. At 38 weeks of gestation, a male infant was delivered transvaginally. Only a slight skin fold was observed in the nuchal area of the neonate, indicating the effectiveness of OK-432 for the intrauterine treatment of cystic hygroma.

Rationale: Mildly underweight children have twofold higher risk of death as compared to well-nourished children in developing countries. This study aims to explore the efficacy of Solid Ready-To-Use Food (RTUF) and milk based Liquid Ready-To-Use proprietary Supplement (LRUS) in promoting weight gain and appetite regulation in mild to moderate underweight children. Methods: An open labelled randomized controlled trial was conducted in primary school of Pakistan. 68 mild to moderate underweight children (between 2 and 1 WAZ score) aged 8.2±1.2 yrs were randomly allocated to receive either RTUF or LRUS providing 500 kcal/day in addition to regular diet for 4 wks. Children were measured and they marked visual analogue scale before (baseline) and at the end of the supplementation. Those who were screened (n = 128) and did not meet inclusion criteria (WAZ > 1 SD) were measured after 4 wks and acted as a control group (CG). Results: After 4 wks of supplementation change from the baseline in WAZ (RTUF, 0.10±0.09; LRUS, 0.15±0.13, P = 0.15), HAZ (RTUF, 0.04±0.07; LRUS, 0.05±0.08, P = 0.72), triceps and sub-scapular Z score and appetite measures were not significantly different between the two groups. After 4 wks the change from the baseline in supplemented group (RTUF+LRUS) and CG in WAZ (0.14±0.11 SD compared to 0.01±0.20 SD, P < 0.0001) and HAZ (0.04±0.08 SD compared to 0.00±0.15 SD, P = 0.02) were significantly higher in SG as compared to CG. The excess mean weight gain in SG was (0.62±0.37 kg). The total extra energy supplied for 4 wks would have been expected to lead to an excess gain of 2 kg. Thus, at least 2/3 of the energy ingested appears to have been compensated. Conclusion: RTUF and LRUS had similar impact on promoting weight, height and skin fold thickness in mild to moderate underweight children but the overall rate of weight gain was lower than expected.

A cu te Li ve r Fa ilu re from malnutrition, a host factor known to cause reduced immunocompetence leading to greater risk of multiple viral infections. Aims: To evaluate the role of maternal nutritional factors in acute viral hepatitis (AVH) and acute liver failure (ALF) patients with HEV infection during pregnancy. Methods: The study included 180 pregnant cases of which 72 HEV infected pregnant cases, 78 Non-HEV pregnant cases and 30 control cases were recruited in the study during February 2011 to December 2012. Serological evaluation of virological markers like IgM anti-HAV, HBsAg, anti-HCV Ab and IgM anti-HEV was done by ELISA. Nutritional factors were evaluated by measuring the anthropometric parameters such as body mass index (BMI), height, weight, triceps skin fold thickness, mid arm circumference (MAC), arm span using appropriate readings. Results: The meanmaternal age, gestational age at delivery and hemoglobin levels of HEV infected pregnant patients were 24.32+4.25years, 33.41+3.94weeks and 10.4+1.87 g/ dl respectively. BMI, mid arm circumference and tricep skin fold thickness were found to be significantly lower in ALF pregnant patients compared to their AVH counterparts in the HEV group (P

Malnutrition has been shown to be an important risk factor for increased mortality in the dialysis patients, and insufficient amino acid intake is one of the causes. Especially in Korea, the protein wasting would be more prevalent and severe because protein is relatively deficient in traditional Korean diet. We investigated the nutritional parameters of 72 hemodialysis (HD) patients(men : 35, women : 37) and 63 continuous ambulatory peritoneal dialysis (CAPD) patients (men : 30, women : 33) by measureing %IBW (ideal body weight), %TSF (tricep skin fold), %MAC (mid arm circumference), %MAMC (mid arm muscle circumference), serum albumin, serum transferrin, TLC (total lymphocyte count), SGA (subjective global assessment), and by estimating energy and protein intakes with 1-month food frequency method. Between HD and CAPD group, mean age (55 ±12 vs. 56 ±12 yr), dialysis durations (45 ±31 vs. 41 ±24 mon), dietary energy intakes (28.3 ±9.0 vs. 28.8 ±8.6 kcal/kg/day), dietary protein intakes (1.1 ±0.3 vs. 1.0 ±0.5 g/kg/day) and incidence of co-morbid conditions (67.0% vs. 67.6%) were not significantly different. Data by using SGA showed a higher incidence of malnutrition in CAPD patients (47.8%) than in HD patients (35.2%). %IBW (p < 0.001), %TSF (p < 0.001) and %MAC (p < 0.001) were higher in CAPD patients than were in HD patients. But serum albumin (p < 0.001) and transferrin (p < 0.001) were significantly lower in CAPD patients than were in HD patients. A higher incidence of malnutrition was shown in CAPD Patients than in HD Patients due to different dialysis type. A significant finding was that CAPD showed protein deficient malnutrition and HD did calorie deficient malnutrition. In conclusion, specialized nutrition education depending on dialytic modality should be necessary to efficiently improve nutritional status, and it can be postulated that essential amino acid and other supplement are helpful for improving nutritional status in dialysis patients, especially in peritoneal dialysis patients

Objectives: Evaluation of tolerance and clinical efficacy of nutritional support with high energy milk formula in Russian young children with CF. Methods: During the planned hospitalization (average 12.6 days) 30 children aged 1.5−10 years old with CF and pancreatic insufficiency were given milk formula (protein 4.2 g, fat 7.7 g, carbohydrates 16.39 g, energy 150 kcal/100ml, enriched with fiber and prebiotic, vanilla taste) up to 200ml/day (1−3 years), 300ml (4−6 years), 400ml (>6 years) between meals, with addition of 2500 IE (lipase) of Creon to each 100ml of formula. Results: Four (13.3%) children rejected. 26 (86.7%) of children accepted the formula well, no allergic reactions, intolerance or stool worsening. 23 (88.5%) patients gained weight by av. 415 g, with maximum gain of 2.3 kg in a boy who received formula the longest (24 days). Skin fold thickness increased in 23 (88.5%) children by average +0.364mm over triceps, in 17 (65.4%) by av. +0.372mm over biceps, and upper arm muscle circumference increased in (84.6%) by av. +0.332 cm. The daily Creon dose per 1 kg of body weight decreased in 11 (42.3%) cases because of patient’s weight gain, and increased insignificantly in the rest. Conclusions: The formula was well-tolerated and had an overall positive influence on the nutritive status indices, despite of the short terms of application and fact that Creon daily dose wasn’t significantly increased. Thus, it can be used as the additional feeding source in the most of young children with CF. However, taking into account the cases of refusal and peculiarities of taste preferences, children with CF require wider taste spectrum of products for additional feeding.

Objective. To study the expression of angiopoietin 1 (Ang1) and angiopoietin 2 (Ang2) in human placentas of dizygotic dichorionic twins in relation to fetal growth.Study design. Placentas from dizygotic-dichorionic twins (n = 14) obtained from normal uncomplicated pregnancies were collected immediately after delivery. A quantitative assessment of the placental expression of Ang1 and Ang2 was done using quantitative PCR. Birth weight and anthropometric parameters were measured. Statistical analysis was preformed.Results. Ang1 and Ang2 were expressed in the placentas. We found a significant positive correlation between birth weight and expression of both Ang1 and Ang2 (p

Cancer patients (pts) undergoing chemotherapy (CT) are often at nutritional risk. The nutritional status of 102 colorectal cancer pts receiving 2, 5 day courses of (5FU/LV) was examined. Prior to CT, pts received nutritional counseling regarding their energy/protein (pro) needs and combating chemo-toxicity related complications. Pts recorded food diaries for the 3 days prior to, 5 days during, and 2 days following each CT course. Height, weight (WT), albumin (Alb), total pro, tricep skin fold (TSF), and mid-arm muscle circumference (MAMC) were collected. There were 54 males and 48 females with a mean age of 64.5 years. The mean baseline WT was 172lbs, and 122% of ideal body WT (143lbs). WT increased from baseline to the 2nd CT course (p