Search

Background: Inflammatory Bowel Diseases (IBD) remain significant health problems in the US and worldwide. IBD is most often associated with eastern European ancestry, and is less frequently reported in other populations of African origin e.g. African Americans ('AAs'). Whether AAs represent an important population with IBD in the US remains unclear since few studies have investigated IBD in communities with a majority representation of AA patients. The Louisiana State University Health Sciences Center in Shreveport (LSUHSC-S) is a tertiary care medical center, with a patient base composed of 58% AA and 39% Caucasian (W), ideal for evaluating racial (AA vs. W) as well and gender (M vs. F) influences on IBD., Methods: In this retrospective study, we evaluated 951 visits to LSUHSC-S for IBD (between 2000 to 2008) using non-identified patient information based on ICD-9 medical record coding (Crohn's disease 'CD'-555.0- 555.9 and ulcerative colitis 'UC'-556.0-556.9)., Results: Overall, there were more cases of CD seen than UC. UC and CD affected similar ratios of AA and Caucasian males (M) and females (F) with a rank order of WF > WM > AAF > AAM. Interestingly, in CD, we found that annual visits per person was the highest in AA M (10.7 ± 1.7); significantly higher (* -p < 0.05) than in WM (6.3 ± 1.0). Further, in CD, the female to male (F: M) ratio in AA was significantly higher (*- p < 0.05) (1.9 ± 0.2) than in Caucasians (F:M = 1.3 ± 0.1) suggesting a female dominance in AACD; no differences were seen in UC F: M ratios., Conclusion: Although Caucasians still represent the greatest fraction of IBD (~64%), AAs with IBD made up >1/3 (36.4%) of annual IBD cases from 2000-2008 at LSUHSC-S. Further studies on genetic and environments risks for IBD risk in AAs are needed to understand differences in presentation and progression in AAs and other 'non-traditional' populations.

In this exploratory study, we evaluated weight status and dietary intake patterns during painful episodes in adult patients with SCD. Specifically, we explored the relation between pain severity and body mass index (BMI), and we tested the hypothesis that dietary intake would be reduced and dietary content altered during periods of increased pain. We conducted an analysis of survey data from 62 patients involved in a longitudinal evaluation of the relationship of medical and psychosocial factors to pain. Nearly half of patients with SCD were overweight, and 20% were obese. BMI was positively related to interference associated with pain. Although BMI was not statistically associated with reported pain severity, >40% of patients reported that they perceived their pain to be affected by their weight. Less than 20% of patients reported that they perceived that their weight affected their pain. Regarding dietary patterns, the majority of patients reported eating less during episodes of pain and significantly decreasing their intake of fats and proteins. We conclude that there is a need to better understand the relation among weight, dietary patterns and pain in patients with SCD in order to provide patients with accurate education and effective treatment recommendations for managing their disease and reducing current and future risks of lifestyle and disease-related morbidities.

We report four cases of cerebral histoplasmosis and discuss features of six additional cases reported in the medical literature in the past 10 years, when azoles have been available for therapy. Most patients with this disease are immunocompromised or have a history that suggests heavy exposure to Histoplasma capsulatum. Fever and other clinical findings of systemic toxicity caused by disseminated histoplasmosis may be absent; 5 of 10 patients did not manifest these findings. Although the mainstay of treatment for central nervous system histoplasmosis remains amphotericin B, 9 of the 10 patients received itraconazole or fluconazole either as initial therapy or after a course of treatment with amphotericin B.

Pearl millet grain was blended with corn in 1:1 or 2:1 ratios in beef finishing diets fed in two metabolism and two feedlot trials. In Exp. 1, diets contained 1) 79.5% corn and 4.5% soybean meal (C-SBM), 2) 28% corn, 54.5% sorghum, and 1.5% soybean meal [GSC(2:1)], and 3) 28% corn and 56% pearl millet [PMC(2:1)]. In Exp. 2, diets contained 1) 81.5% corn and 3.5% soybean meal (C-SBM) or 2) 42.5% corn and 42.5% pearl millet [PMC(1:1)]. Diets fed to steers in metabolism trials in Exp. 1 and 2 had similar (P > .10) apparent digestion coefficients for OM, crude fiber, NDF, and ADF. However, ether extract digestibility was higher (P < .05) for C-SBM than for GSC(2:1) and PMC(2:1) in Exp. 1, and it was higher (P < .10) for C-SBM than for PMC(1:1) in Exp. 2. In both experiments CP digestibility was higher (P < .10) for C-SBM diets, and N retention was similar (P > .10) for diets within each experiment. In each experiment, TDN calculated from apparent digestion coefficients was converted to NEm and NEg. The TDN, NEm, and NEg were lower (P < .10) for GSC(2:1) and PMC(2:1) than for C-SBM in Exp. 1. Experimental diets were fed to steers (n = 45; 396 +/- 19 kg initial BW; 70-d ad libitum feeding) in Exp. 1 and to heifers (n = 30; 318 +/- 15 kg initial BW; 92-d ad libitum feeding) in Exp. 2. The ADG, empty body weight gain (EBG), and predicted EBG were not different (P > .10) for diets composed of the different grain sources. Feed DMI and DM per gain were higher (P < .05) for PMC(1:1) than for C-SBM in Exp. 2. Pearl millet supplied approximately 88% as much NEm and 85% as much NEg as the corn-SBM portion of diets having similar CP concentrations.

The effects of supplemental fish meal on site and extent of digestion were determined using four steers equipped with ruminal, duodenal, and ileal cannulas. Fish meal was included in diets to supply 0 (0FM), 25 (25FM), 50 (50FM), or 75 (75FM) g of N daily above the CP requirement of a 400-kg steer gaining 1.2 kg/d. Total tract starch digestibility tended to be greatest for 25FM (95%), lowest for 0FM (90%), and intermediate for 50FM (94%) and 75FM (92%). Total tract N digestibility was greatest for 25FM, lowest for 0FM, and intermediate for 50FM and 75FM (cubic, P < .05). Total tract starch digestibility increased .46 percentage units for each unit increase in N digestibility (n = 16, P = .03). Ruminal starch digestibility was greatest for 25FM, intermediate for 50FM and 75FM, and lowest for 0FM (quadratic; P < .10). Starch flow to the duodenum was decreased for 25FM and 50FM vs 0FM and 75FM (quadratic, P < .10) and N flow to the duodenum was increased (linear, P < .01) by fish meal. Fish meal supplementation increased N digestibility (quadratic, P < .05) but had no effect (P > .10) on starch digestibility in the small intestine. Starch digestibility in the small intestine was not related to N flow to the duodenum; however, starch digestibility increased .9 percentage units for each percentage unit increase in N digestibility (n = 16, P = .02). Fish meal supplementation tended to increase total tract starch digestibility by increasing ruminal, but not small intestinal, digestibility.

The effect of high-dosage E treatment (Rx) initiated at the stage of 3-plus active disease (target serum E levels, 5-6 mg/dl) was evaluated by a standardized scoring system of visual morbidity at the one to two year eye exam among infants cared for in the University of Pennsylvania Neonatal Complex (1976-1978). The incidence of legal blindness in both eyes or worse was decreased from 71 to 40% in E Rx (n = 10) as compared to non-E Rx (n = 14) infants, and the number of infants with minimal visual morbidity was increased. Pilot studies (1972-76; target serum E level, 1.5 and 3.0 mg/dl) of the prophylactic effect of E Rx from birth on showed a decrease in mean severity of acute stage disease and a decrease in sequelae at one to two years. A strikingly difference in visual morbidity following resolved low-grade ROP was seen when prestudy infants (1968-72) who were fed early iron supplements and given formulas with low E:PUFA ratios were compared to non-E Rx as well as to E Rx 1972-76 infants. Vitamin E seems to exert a beneficial effect at all stages of ROP, perhaps because of its broadly based regulatory role.