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Barton BA, Bollig H, Hauskins BL, Jansen CR. Juvenile pallid (Scaphirhynchus albus) and hybrid pallidxshovelnose (S. albusxplatorynchus) sturgeons exhibit low physiological responses to acute handling and severe confinement. Comp Biochem Physiol A Mol Integr Physiol 2000; 126:125-34. [PMID: 10908860 DOI: 10.1016/s1095-6433(00)00192-6] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Following a 7.5-h transport haul, juvenile pallid sturgeon (Scaphirhynchus albus) showed a small but significant increase in plasma cortisol to 4.7 ng ml(-1) but similar increases did not occur after fish were handled in a net held in the air for 30 s. Subsequent experiments on yearling pallid sturgeon and hybrid pallidxshovelnose (S. albusxplatorynchus) sturgeon using the same 30-s handling stressor failed to evoke increases in plasma cortisol, lactate or glucose. Plasma cortisol increased significantly from about 2 to 13-14 ng ml(-1) in both pallid and hybrid sturgeon during a 6-h severe confinement stressor with handling. Plasma cortisol in 2-year-old pallid sturgeon subjected to the same stressor demonstrated a linear pattern of increase during the initial 1 h. Plasma lactate increased from 1.11 to about 2.11 mmol l(-1) in hybrid sturgeon during the first hour of severe confinement but did not change throughout the entire confinement period in pallid sturgeon. A significant increase in plasma cortisol to 5.4 ng ml(-1) in 2-year-old pallid sturgeon 1 h after being subjected to 30 s handling at 19:00 h but not at 07:00 or 13:00 h suggests that a small diurnal variation in their stress response may exist. Although both pallid and hybrid sturgeons were responsive to stress, they exhibited very low physiological responses compared with those following equivalent stressors in most teleostean fishes or another chondrostean, the paddlefish (Polyodon spathula). Reasons for the apparent low responses to handling and confinement in scaphirhynchid sturgeons are not known but may relate to their evolutionary history, neuroendocrine mechanisms involved in their corticosteroid responses, or anatomy of their interrenal tissue structure.
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Wang Y, Barton BA, Nielsen PF, Conlon JM. Tachykinins (substance P and neuropeptide gamma) from the brains of the pallid sturgeon, Scaphirhynchus albus and the paddlefish, Polyodon spathula (Acipenseriformes). Gen Comp Endocrinol 1999; 116:21-30. [PMID: 10525358 DOI: 10.1006/gcen.1999.7348] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A peptide with substance P-like immunoreactivity was isolated from extracts of the brains of the pallid sturgeon, Scaphirhynchus albus and the North American paddlefish, Polyodon spathula. The primary structure of the peptide (Lys-Pro-Lys-Pro-His-Gln-Phe-Phe-Gly-Leu-Met.NH(2)) is the same in both species and contains 2 amino acid substitutions (Arg(1) --> Lys and Gln(5) --> His) compared with human substance P and 1 substitution (Arg(3) --> Lys) compared with substance P from the trout (Teleostei). Scyliorhinin I, a tachykinin previously isolated from an extract of sturgeon intestine, was not detected in either brain extract. A peptide with neurokinin A-like immunoreactivity (Ser-Ser-Ala-Asn-Arg-Gln-Ile-Thr-Gly-Lys(10)Arg-Gln-Lys-Ile-Asn-Ser-P he-Val-Gly-Leu(20)Met.NH(2)) was isolated from sturgeon brain and contains 10 amino acid substitutions compared with human neuropeptide gamma (a specific product of the posttranslational processing of gamma-preprotachykinin A) but only 4 substitutions compared with trout neuropeptide gamma. It was not possible to obtain the paddlefish neurokinin A-related peptide in pure form. The structural similarity between the sturgeon and the trout tachykinins supports the hypothesis that the Acipenseriformes (sturgeons and paddlefish) represent the sister group of the Neopterygii (gars, bowfin, and teleosts).
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Morrison JA, Barton BA, Biro FM, Daniels SR, Sprecher DL. Overweight, fat patterning, and cardiovascular disease risk factors in black and white boys. J Pediatr 1999; 135:451-7. [PMID: 10518096 DOI: 10.1016/s0022-3476(99)70167-8] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the relationships of overweight and fat patterning with cardiovascular disease (CVD) risk factors in black and white boys. DESIGN Cross-sectional analysis of CVD risk factors by weight and central adiposity groups in black and white boys, aged 10 to 15 years. Mean adiposity, lipid, and blood pressure variables were compared between weight and central adiposity groups within race by using linear regression models. Observed clustering of risk factors within weight and adiposity groups was compared with the expected clustering under an assumption of no association. RESULTS Within each racial group, overweight boys had greater skinfolds, lower high-density lipoprotein cholesterol levels, higher low-density lipoprotein cholesterol and triglyceride levels, and higher systolic and diastolic blood pressure than non-overweight boys. Among overweight boys, greater central adiposity was associated with higher risk factor levels and increased clustering of risk factors. CONCLUSION Overweight and central adiposity together profoundly affect CVD risk factor levels and risk factor clustering in black and white boys.
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Morrison JA, Sprecher DL, Barton BA, Waclawiw MA, Daniels SR. Overweight, fat patterning, and cardiovascular disease risk factors in black and white girls: The National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 1999; 135:458-64. [PMID: 10518079 DOI: 10.1016/s0022-3476(99)70168-x] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the association of overweight and central adiposity with cardiovascular disease risk factors in black and white 9- and 10-year-old girls. DESIGN Cross-sectional analysis of baseline data collected from participants in the National Heart, Lung, and Blood Institute Growth and Health Study. Girls were classified as overweight or not with the use of the age- and sex-specific 85th percentiles of the body mass index (kilograms per square meter) distributions from the combined NHANES (I and II) data set. Mean indexes of central adiposity, blood pressure levels, and lipid concentrations and the clustering of risk factors based on published cut points were compared between weight groups by race and by central adiposity group within weight and race groups. RESULTS Overweight was associated with increased risk factor levels and with increased clustering in both black and white girls. Among overweight girls greater central adiposity was associated with higher risk factor levels and increased clustering. CONCLUSIONS Given the associations between cardiovascular disease risk factors and both overweight and central adiposity, the secular trends toward increased obesity in American youth portend a worsening of cardiovascular disease risk profiles.
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Anand KJ, Barton BA, McIntosh N, Lagercrantz H, Pelausa E, Young TE, Vasa R. Analgesia and sedation in preterm neonates who require ventilatory support: results from the NOPAIN trial. Neonatal Outcome and Prolonged Analgesia in Neonates. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 1999; 153:331-8. [PMID: 10201714 DOI: 10.1001/archpedi.153.4.331] [Citation(s) in RCA: 259] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Preterm neonates are exposed to multiple painful procedures after birth and exhibit acute physiological responses to pain. Occurrence of early intraventricular hemorrhage within 24 to 72 hours after birth suggests a role of pain and stress in the multifactorial causation of severe intraventricular hemorrhage and periventricular leukomalacia. We proposed that such neurologic outcomes in preterm neonates who require ventilatory support may be reduced by morphine analgesia or midazolam sedation compared with a placebo. OBJECTIVES To define the incidence of clinical outcomes in the target study population, to estimate the effect size and adverse effects associated with analgesia and sedation, and to calculate the sample size for a definitive test of this hypothesis. METHODS Sixty-seven preterm neonates were randomized in a pilot clinical trial from 9 centers. Neonates of 24 to 32 weeks gestation were eligible if they had been intubated and required ventilatory support for less than 8 hours and if they were enrolled within 72 hours after birth. Exclusion criteria included major congenital anomalies, severe intrapartum asphyxia, and participation in other research studies. Severity of illness was assessed by the Clinical Risk Index for Babies, and neonates were randomized to receive continuous infusions of morphine sulfate, midazolam hydrochloride, or 10% dextrose (placebo). Masked study medications were continued as long as clinically necessary, then weaned and stopped according to predefined criteria. Levels of sedation (COMFORT scores) and responses to pain (Premature Infant Pain Profile scores) were measured before, during, and 12 hours after discontinuation of drug infusion. Cranial ultrasound examinations were performed as part of routine practice, and poor neurologic outcomes were defined as neonatal death, severe intraventricular hemorrhage (grade III or IV), or periventricular leukomalacia. RESULTS No significant differences occurred in the demographic, clinical, and socioeconomic variables related to mothers and neonates in the 3 groups or in the severity of illness at birth as measured by Clinical Risk Index for Babies scores. Two neonates in the placebo group and 1 neonate in the midazolam group died; no deaths occurred in the morphine group. Poor neurologic outcomes occurred in 24% of neonates in the placebo group, 32% in the midazolam group, and 4% in the morphine group (likelihood ratio chi2 = 7.04, P = .03). Secondary clinical outcomes and neurobehavioral outcomes at 36 weeks' postconceptional age were similar in the 3 groups. Responses elicited by endotracheal tube suction (Premature Infant Pain Profile scores) were significantly reduced during the morphine (P<.001) and midazolam (P = .002) infusions compared with the placebo group. CONCLUSIONS This pilot trial suggests that preemptive analgesia given by continuous low-dose morphine infusion may reduce the incidence of poor neurologic outcomes in preterm neonates who require ventilatory support. Limitations in the sample size of this pilot study suggest that these results should be confirmed in a large multicenter randomized trial.
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Wang Y, Barton BA, Thim L, Nielsen PF, Conlon JM. Purification and characterization of galanin and scyliorhinin I from the hybrid sturgeon, Scaphirhynchus platorynchus x Scaphirhynchus albus (Acipenseriformes). Gen Comp Endocrinol 1999; 113:38-45. [PMID: 9882542 DOI: 10.1006/gcen.1998.7174] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The sturgeons (order Acipenseriformes) are extant representatives of a group of ancient Actinopterygian (ray-finned) fish. Galanin and scyliorhinin I (a tachykinin with limited structural similarity to mammalian substance P) have been isolated from an extract of the gastrointestinal tract of a sturgeon (an F1 hybrid between the shovelnose sturgeon, Scaphirhynchus platorynchus, and the pallid sturgeon, Scaphirhynchus albus). The primary structure of sturgeon galanin (Gly-Trp-Thr-Leu-Asn-Ser-Ala-Gly-Tyr-Leu10-Leu-Gly-Pro-His-Ala-Val -As p-Gly-His-Arg20-Ser-Leu-Ser-Asp-Lys-His-Gly-Leu-Pro.NH2) contains only two amino acid substitutions (Ser23 --> Asn and Pro29 --> Ala) compared with galanin from the bowfin, Amia calva (Amiiformes), but five amino acid substitutions compared with galanin from the trout (Teleostei). Similarly, the sturgeon tachykinin (Ser-Lys-Tyr-His-Gln-Phe-Tyr-Gly-Leu-Met.NH2) contains only one amino acid substitution (Tyr3 --> Ser) compared with scyliorhinin I previously isolated from bowfin stomach but five amino acid substitutions compared with trout substance P. The data support the hypothesis that the Acipenseriformes and the basal Neopterygians (gars and bowfin) share a close phylogenetic relationship.
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Kertz AF, Barton BA, Reutzel LF. Relative efficiencies of wither height and body weight increase from birth until first calving in Holstein cattle. J Dairy Sci 1998; 81:1479-82. [PMID: 9621252 DOI: 10.3168/jds.s0022-0302(98)75712-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Female Holstein calves from the Purina Research Center herd averaged 74 cm of height at withers and 40 kg of body weight (BW) at birth. At first calving (24 mo of age), calves averaged 138 cm of height at withers, 611 kg at precalving BW, and 547 kg at postcalving BW. Fifty percent of the total height increase occurred from birth to 6 mo of age, 25% occurred during 7 to 12 mo of age, and 25% occurred during 13 to 24 mo of age. Twenty-five percent of the total BW increase occurred from birth to 6 mo of age, 25% occurred from 6 to 12 mo of age, and the remaining 50% occurred from 13 to 24 mo of age. The increase in BW for 2-mo intervals, expressed as a proportion of the BW of the previous 2-mo interval, declined most rapidly during the first 6 mo, intermediately during the second 6 mo, and more slowly and progressively during the final 12 mo. Feed cost per unit of BW gain was lowest during the first 6 mo and then increased at a decreasing rate over the final 18 mo. The proportion of BW to height linearly increased over the 24-mo period. The increase in wither height as a proportion of the wither height during the previous period was greatest during the first 6 mo, intermediate during the second 6 mo, and lowest in the final 12 mo. Feed cost per unit of height increase was lowest in the first 6 mo, intermediate during the second 6 mo, and highest with a rapid increase during the final 12 mo. The increases in relative BW and wither height are the most rapid and cost efficient during the first 6 mo of life.
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Morrison JA, Barton BA, Biro FM, Sprecher DL. The conjoint trait of low high-density lipoprotein cholesterol and high triglycerides in adolescent black and white males. Metabolism 1998; 47:514-21. [PMID: 9591740 DOI: 10.1016/s0026-0495(98)90233-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
To evaluate the interrelationships among body composition, blood pressure, and lipid phenotypes in adolescent black and white boys, we assessed racial distributions of lipids, blood pressure, and obesity and their joint occurrence in black and white boys aged 10 to 15 years. Subjects were recruited from Cincinnati (OH) schools. Because the differences in high-density lipoprotein cholesterol (HDL-C) and triglycerides (TGs) are the most profound coronary heart disease (CHD) risk factor differences between black and white males, we assigned subjects to one of four low-HDL-C and high-TG categories (normal and increased risk) using the age/race-specific 25th (HDL-C) and 75th (TG) percentiles. We then assessed racial distributions of lipids, blood pressure, and obesity by these phenotypes. Age differences between the black and white participants were significant, with the former about 3 months younger (P=.03), but black boys were more mature and were significantly taller and heavier and had a greater body mass index ([BMI] weight in kilograms divided by height in centimeters squared). Differences in the sum of the triceps, subscapular, and suprailiac skinfolds were not significant. Blacks had significantly higher HDL-C, lower TG, and higher diastolic blood pressure (DBP), but differences in systolic blood pressure (SBP) were not significant. In both racial groups, the body composition measures were significantly correlated with HDL-C, TG, and blood pressure levels; the correlations between HDL-C and both weight and BMI were significantly stronger in white boys. The proportion of boys of each race with low HDL-C and high TG was similar by design. In both racial groups, subjects with the conjoint trait had a significantly greater BMI, triceps skinfold, and sum of skinfolds than subjects in the other phenotypic groups. For white boys, participants with the conjoint trait had the highest SBP and DBP; differences in SBP were significant for comparisons to the normal- and high-TG group alone, and differences in DBP were significant for the comparison between normal and low HDL-C alone. For black boys, subjects with both normal HDL-C and TG had significantly lower SBP than boys with either the conjoint trait or high TG alone; none of the group differences in DBP were significant. Black had significantly less dense LDL (more LDL-C per apolipoprotein [apo] B). In each racial group, boys with the conjoint trait had the most dense LDL, significantly more dense than in any of the other phenotypes in black boys and significantly more dense than in boys with low HDL-C alone and normal boys in the white group. In both racial groups, the occurrence of no risk factors (>75th percentile TG, BMI, SBP, and DBP or <25th percentile HDL-C) and three or more risk factors was greater than expected by chance alone, and the occurrence of exactly one risk factor and two factors was less. When examined by phenotypic groups within race, boys in each racial group with the normal phenotype had a greater than expected percentage with no risk factors, and white boys with the conjoint trait were more likely to have a marked increase in multiple risk factors. Possible mechanisms for this clustering of risk factors and for the racial differences in the patterns are discussed.
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Daniels SR, McMahon RP, Obarzanek E, Waclawiw MA, Similo SL, Biro FM, Schreiber GB, Kimm SY, Morrison JA, Barton BA. Longitudinal correlates of change in blood pressure in adolescent girls. Hypertension 1998; 31:97-103. [PMID: 9449398 DOI: 10.1161/01.hyp.31.1.97] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The objective of this study was to assess the longitudinal changes in blood pressure in black and white adolescent girls and evaluate potential determinants of changes in blood pressure, including sexual maturation and body size. A total of 1213 black and 1166 white girls, ages 9 or 10 years at study entry, were followed up through age 14 with annual measurements of height, weight, skinfold thickness, stage of sexual maturation, systolic and diastolic blood pressures, and other cardiovascular risk factors. Average blood pressures in black girls were generally 1 to 2 mm Hg higher than in white girls of similar age over the course of the study. Age, race, stage of sexual maturation, height, and body mass index (kg/m2) were all significant univariate predictors of systolic and diastolic blood pressures in longitudinal regression analyses. Black girls had a significantly smaller increase in blood pressure for a given increase in body mass index compared with white girls. The predicted increases in blood pressure per unit increase in body mass index (mm Hg per kg/m2) were as follows: systolic, 0.65+/-0.04 in whites and 0.52+/-0.04 in blacks (P<.001); diastolic fourth Korotkoff phase, 0.31+/-0.04 in whites and 0.15+/-0.03 in blacks (P<.001); and diastolic fifth Korotkoff phase, 0.31+/-0.05 in whites and 0.16+/-0.04 in blacks (P<.001). Understanding of the determinants of the racial differences in blood pressure could provide the rationale for future interventions to reduce the excess cardiovascular mortality in black compared with white women.
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Li Z, Smith MP, Duff DW, Barton BA, Olson KR, Conlon JM. Purification and cardiovascular activity of [Met1, Met5]-bradykinin from the plasma of a sturgeon (Acipenseriformes). Peptides 1998; 19:635-41. [PMID: 9622017 DOI: 10.1016/s0196-9781(97)00479-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The sturgeons (Order Acipenseriformes) are extant representatives of a group of primitive Actinopterygian (ray-finned) fish that probably shared a common ancestor with present-day teleosts. Incubation of heat-denatured plasma from a sturgeon (a hybrid of the shovelnosed sturgeon Scaphirhynchus platorynchus and the pallid sturgeon Scaphirhynchus albus) with either trypsin or porcine pancreatic kallikrein generated bradykinin-like immunoreactivity. The primary structure of sturgeon bradykinin was established as Met-Pro-Pro-Gly-Met-Ser-Pro-Phe-Arg. This amino acid sequence contains two amino acid substitutions (Arg1 --> Met and Phe5 --> Met) compared with mammalian bradykinin. Bolus injections of synthetic sturgeon bradykinin in doses as low as 1 pmol/kg into the dorsal aorta of unanesthetized sturgeon resulted in an immediate and significant fall in arterial blood pressure with a maximum depressor response at 300 pmol/kg. Thus, the cardiovascular response of the sturgeon to bradykinin resembles more closely the response of mammals rather than the predominantly pressor response seen in teleost fish. Sturgeon bradykinin produced a strong and concentration-dependent (EC50 = 4.7 +/- 0.7 x 10(-10) M) relaxation of rings of vascular tissue from the sturgeon ventral aorta that had been pre-contracted with acetylcholine. The data indicate that sturgeon tissues are particularly responsive to native bradykinin and suggest that the kallikrein-kinin system may have evolved before the appearance of the neopterygians (gars, bowfin and teleosts).
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Kimm SY, Barton BA, Berhane K, Ross JW, Payne GH, Schreiber GB. Self-esteem and adiposity in black and white girls: the NHLBI Growth and Health Study. Ann Epidemiol 1997; 7:550-60. [PMID: 9408551 DOI: 10.1016/s1047-2797(97)00124-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Obesity is assumed to have a negative impact on self-esteem because of the associated social stigmatization in Western society. Studies of the psychological effect of obesity in children are inconclusive and limited, particularly pertaining to minority populations. Most studies have assessed global rather than domain-specific measures of self-esteem and hence, may have lacked specificity to detect impairment of certain aspects of self-esteem most closely associated with obesity. The purpose of this study is to examine the effect of adiposity and other environmental factors on measures of perceived competence and self-adequacy in 2205 black and white girls aged 9-10 years. METHODS Domain-specific measures of self-esteem were studied by race and degree of adiposity, using Harter's "Self-Perception Profile for Children". Three Harter scales deemed more relevant to obesity (social acceptance (SA), physical appearance (PA), and global self-worth (GSW)) were selected for univariate and multivariate linear regression models to examine relationships between self-esteem level and adiposity (measured by the sum of triceps, subscapular, and suprailiac skinfolds (SSF)), race, pubertal maturation, and parental education. The relationship between adiposity and Harter scores was further examined with LOESS curves and also by comparing the mean scores of each quintile of SSF by race, as well as inter-quintile differences within race. RESULTS Adiposity in general impacted negatively on the scores of all three selected Harter scales. There was also racial variation in the relationship between the scores and adiposity, with the magnitude of the effect somewhat less in black girls. White girls exhibited a significant inverse relationship between SSF and SA scores while, in striking contrast, there was no variation in scores in black girls across all ranges of adiposity. Although there was a significant inverse relationship between adiposity and PA and GSW in both groups, the slope was steeper in white girls, particularly at higher ranges of SSF. Non-linearity in the relationship between SSF and the scores was seen in SA and PA scales. CONCLUSIONS The present study demonstrated a significant negative association between adiposity and the level of self-esteem in girls as young as 9 to 10 years. There were also intriguing racial differences in the selected domains of esteem. These results may help better understand cultural differences regarding the psychological impact of obesity and could be used to formulate appropriate strategies for public health policy.
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Kwiterovich PO, Barton BA, McMahon RP, Obarzanek E, Hunsberger S, Simons-Morton D, Kimm SY, Friedman LA, Lasser N, Robson A, Lauer R, Stevens V, Van Horn L, Gidding S, Snetselaar L, Hartmuller VW, Greenlick M, Franklin F. Effects of diet and sexual maturation on low-density lipoprotein cholesterol during puberty: the Dietary Intervention Study in Children (DISC). Circulation 1997; 96:2526-33. [PMID: 9355889 DOI: 10.1161/01.cir.96.8.2526] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Dietary Intervention Study in Children (DISC) is a multicenter, randomized, controlled clinical trial designed to examine the efficacy and safety of a dietary intervention to reduce serum LDL cholesterol (LDL-C) in children with elevated LDL-C. METHODS AND RESULTS The effects of dietary intake of fat and cholesterol and of sexual maturation and body mass index (BMI) on LDL-C were examined in a 3-year longitudinal study of 663 boys and girls (age 8 to 10 years at baseline) with elevated LDL-C levels. Multiple linear regression was used to predict LDL-C at 3 years. For boys, LDL-C decreased by 0.018 mmol/L for each 10 mg/4.2 MJ decrease in dietary cholesterol (P<.05). For girls, no single nutrient was significant in the model, but a treatment group effect was evident (P<.05). In both sexes, BMI at 3 years and LDL-C at baseline were significant and positive predictors of LDL-C levels. In boys, the average LDL-C level was 0.603 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<.01). In girls, the average LDL-C level was 0.274 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<.05). CONCLUSIONS In pubertal children, sexual maturation, BMI, dietary intervention (in girls), and dietary cholesterol (in boys) were significant in determining LDL-C. Sexual maturation was the factor associated with the greatest difference in LDL-C. Clinicians screening for dyslipidemia or following dyslipidemic children should be aware of the powerful effects of pubertal change on measurements of lipoproteins.
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Laufenburg HF, Barton BA. Attitudes of family practice residency program directors toward mandatory preemployment drug testing. Fam Med 1997; 29:625-8. [PMID: 9354868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVES As health care institutions adopt policies on substance use and abuse and mandatory substance abuse testing in the workplace, applicants for house staff positions may become the subjects of testing as a requirement for acceptance into a residency program. This study attempted to learn what directors of family practice residency programs feel about mandatory preemployment drug testing and its effect on house staff recruitment. METHODS We surveyed the directors of 420 US family practice residency programs, as listed by the American Academy of Family Physicians, in November 1994. All programs (community based, university affiliated, university based, and military) were included in the survey. RESULTS A total of 308 (73%) program directors responded. Of these, almost half disagreed with mandatory substance abuse testing and felt it should not be a condition of acceptance for a house staff position. Eighty-eight percent believed that the existence of a policy did not hinder recruitment. None felt it was an enhancement. CONCLUSIONS Preemployment drug testing for potential house staff remains a controversial issue, and it is unlikely that it will be universally implemented in the near future.
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Obarzanek E, Hunsberger SA, Van Horn L, Hartmuller VV, Barton BA, Stevens VJ, Kwiterovich PO, Franklin FA, Kimm SY, Lasser NL, Simons-Morton DG, Lauer RM. Safety of a fat-reduced diet: the Dietary Intervention Study in Children (DISC). Pediatrics 1997; 100:51-9. [PMID: 9200359 DOI: 10.1542/peds.100.1.51] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To assess the relationship between energy intake from fat and anthropometric, biochemical, and dietary measures of nutritional adequacy and safety. DESIGN Three-year longitudinal study of children participating in a randomized controlled trial; intervention and usual care group data pooled to assess effects of self-reported fat intake; longitudinal regression analyses of measurements at baseline, year 1, and year 3. PARTICIPANTS Six hundred sixty-three children (362 boys and 301 girls), 8 to 10 years of age at baseline, with elevated low-density lipoprotein cholesterol, who are participants of the Dietary Intervention Study in Children. MEASURES Energy intake from fat assessed from three 24-hour recalls at each time point was the independent variable. Outcomes were anthropometric measures (height, weight, body mass index, and sum of skinfolds), nutritional biochemical determinations (serum ferritin, zinc, retinol, albumin, beta-carotene, and vitamin E, red blood cell folate, and hemoglobin), and dietary micronutrients (vitamins A, C, E, thiamin, riboflavin, niacin, vitamins B-6, B-12, folate, calcium, iron, zinc, magnesium, and phosphorus). RESULTS Lower fat intake was not related to anthropometric measures or serum zinc, retinol, albumin, beta-carotene, or vitamin E. Lower fat intake was related to: 1) higher levels of red blood cell folate and hemoglobin, with a trend toward higher serum ferritin; 2) higher intakes of folate, vitamin C, and vitamin A, with a trend toward higher iron intake; 3) lower intakes of calcium, zinc, magnesium, phosphorus, vitamin B-12, thiamin, niacin, and riboflavin; 4) increased risk of consuming less than two-thirds of the Recommended Dietary Allowances for calcium in girls at baseline, and zinc and vitamin E in boys and girls at all visits. CONCLUSIONS Lower fat intakes during puberty are nutritionally adequate for growth and for maintenance of normal levels of nutritional biochemical measures, and are associated with beneficial effects on blood folate and hemoglobin. Although lower fat diets were related to lower self-reported intakes of several nutrients, no adverse effects were observed on blood biochemical measures of nutritional status. Current public health recommendations for moderately lower fat intakes in children during puberty may be followed safely.
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Simons-Morton DG, Hunsberger SA, Van Horn L, Barton BA, Robson AM, McMahon RP, Muhonen LE, Kwiterovich PO, Lasser NL, Kimm SY, Greenlick MR. Nutrient intake and blood pressure in the Dietary Intervention Study in Children. Hypertension 1997; 29:930-6. [PMID: 9095079 DOI: 10.1161/01.hyp.29.4.930] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Delineating the role that diet plays in blood pressure levels in children is important for guiding dietary recommendations for the prevention of hypertension. The purpose of this study was to investigate relationships between dietary nutrients and blood pressure in children. Data were analyzed from 662 participants in the Dietary Intervention Study in Children who had elevated low-density lipoprotein cholesterol and were aged 8 to 11 years at baseline. Three 24-hour dietary recalls, systolic pressure, diastolic pressure, height, and weight were obtained at baseline, 1 year, and 3 years. Nutrients analyzed were the micronutrients calcium, magnesium, and potassium; the macronutrients protein, carbohydrates, total fat, saturated fat, polyunsaturated fat, and monounsaturated fat; dietary cholesterol; and total dietary fiber. Baseline and 3-year longitudinal relationships were examined through multivariate models on diastolic and systolic pressures separately, controlling for height, weight, sex, and total caloric intake. The following associations were found in longitudinal analyses: analyzing each nutrient separately, for systolic pressure, inverse associations with calcium (P < .05); magnesium, potassium, and protein (all P < .01); and fiber (P < .05), and direct associations with total fat and monounsaturated fat (both P < .05); for diastolic pressure, inverse associations with calcium (P < .01); magnesium and potassium (both P < .05), protein (P < .01); and carbohydrates and fiber (both P < .05), and direct associations with polyunsaturated fat (P < .01) and monounsaturated fat (P < .05). Analyzing all nutrients simultaneously, for systolic pressure, direct association with total fat (P < .01); for diastolic pressure, inverse associations with calcium (P < .01) and fiber (P < .05), and direct association with total and monounsaturated fats (both P < .05). Results from this sample of children with elevated low-density lipoprotein cholesterol indicate that dietary calcium, fiber, and fat may be important determinants of blood pressure level in children.
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Kertz AF, Reutzel LF, Barton BA, Ely RL. Body weight, body condition score, and wither height of prepartum Holstein cows and birth weight and sex of calves by parity: a database and summary. J Dairy Sci 1997; 80:525-9. [PMID: 9098803 DOI: 10.3168/jds.s0022-0302(97)75966-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Measurements of body weight (BW), body condition score, wither height, calf birth weight, and calf sex were recorded by parity from 728 Holstein cows and heifers at the Purina Research Center during the 8-wk prepartum period. Data were compiled over 5 yr. Mean daily BW gain was 0.93 kg. Loss of BW at parturition was 11.1%. Mean body condition score was 3.35 (five-point scale where 1 = thin to 5 = obese) and did not change during the 8-wk period. However, body condition score was lower for second parity cows than for heifers or cows in third or greater parity. Wither height averaged 138 cm at first parity and increased 3 cm from first to second parity. During fifth and sixth parities, wither height peaked at an additional 2 to 3 cm. Birth weights for all calves averaged 41.4 kg. Male calves were 8.5% heavier than female calves. Calves born to cows in second or greater parity had increased BW by 7 to 8%. Mean BW of twin calves was 15% less than that of single calves.
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Sprecher DL, Morrison JA, Simbartl LA, Schreiber GB, Sabry ZI, Biro FM, Barton BA. Lipoprotein and apolipoprotein differences in black and white girls. The National Heart, Lung, and Blood Institute Growth and Health Study. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 1997; 151:84-90. [PMID: 9006534 DOI: 10.1001/archpedi.1997.02170380088014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To define racial differences in lipoprotein and apolipoprotein levels in girls aged 9 to 10 years. DESIGN Baseline analysis of a prospective cohort study. SETTING Three clinical sites. SUBJECTS A total of 1871 black and white girls, aged 9 to 10 years, with complete maturation data (pubic hair and areolar development and menarche) and an 8-hour fast before blood draw. MAIN OUTCOME MEASURES Anthropometric measures and serum lipid, lipoprotein, and apolipoprotein levels. RESULTS All analyses were adjusted for maturational differences between blacks and whites (areolar or pubic hair development and menarche). The mean body mass index was marginally higher in black girls than in white girls (18.9 vs 18.3 kg/m2; P = .002), while the sum of skinfolds (34.5 vs 34.8 mm; P = .77) was equivalent. However, both body mass measures were skewed higher at the upper percentiles in black girls. The low-density lipoprotein cholesterol level was similar between black and white girls. Mean triglyceride values were higher in white girls than in black girls (0.92 vs 0.79 mmol/L [81 vs 70 mg/dL]; P < .001); however, these differences were most pronounced in the upper percentiles. Conversely, mean high-density lipoprotein cholesterol and apolipoprotein A-I levels were higher in black girls than in white girls (1.44 vs 1.37 mmol/L [56 vs 39 mg/dL] and 147 vs 138 mg/dL, respectively; both P < .001); and again the differences were most evident at the upper end of the distributions. CONCLUSIONS Racial differences in the mean levels of triglycerides, high-density lipoprotein cholesterol, and body mass in girls in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) at age 9 to 10 years were predominantly the result of differences observed at the upper end of the distributions. The reported black-white differences for mean high-density and low-density lipoprotein cholesterol and triglyceride levels in adult women are comparable to NGHS results. Distributional characteristics of these risk factors as well as trends in lipids, lipoproteins, and apolipoproteins, will be evaluated in an ongoing longitudinal assessment that covers the full maturational period.
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Barton BA, Rosario HA, Anderson GW, Grindle BP, Carroll DJ. Effects of dietary crude protein, breed, parity, and health status on the fertility of dairy cows. J Dairy Sci 1996; 79:2225-36. [PMID: 9029361 DOI: 10.3168/jds.s0022-0302(96)76599-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A study was conducted to determine the impact of dietary CP (13% vs. 20%), parity (first vs. second lactation or later), and breed (Holstein vs. Jersey) on the reproductive efficiency of dairy cows. Sixty-four cows were blocked by parity and breed and assigned to one of two treatments. Cows were removed from treatments on d 100 or 120 depending on pregnancy status. Cows were categorized by health status based on the occurrence of postparturient disorders. Plasma urea N concentrations were influenced by diet (8.6 vs. 21 mg/dl, 13 and 20% CP, respectively), parity, and breed. Reproductive indices were not influenced by diet except that days to first estimated ovulation increased for cows fed the 20% CP diet when health status was added to the model. Days to first observed estrus, first AI service, and cumulative pregnancy rate were affected by health status. Regression analysis for survival showed an interaction of diet and health status for days open. High CP diets tended to increase days open when cows had major health problems; otherwise, a high CP diet decreased days open. The implementation of a strict reproductive management program allowed high reproductive efficiency goals to be achieved regardless of plasma urea N concentrations.
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Bohn MJ, Barton BA, Barron KE. Psychometric properties and validity of the obsessive-compulsive drinking scale. Alcohol Clin Exp Res 1996; 20:817-23. [PMID: 8865954 DOI: 10.1111/j.1530-0277.1996.tb05257.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Abstinent alcoholics' self-reports of distressing alcohol-associated thoughts and compulsions to drink were evaluated by the Obsessive-Compulsive Drinking Scale (OCDS). Exploratory and confirmatory factor analyses on separate subject samples revealed that subjects' OCDS responses were best described by four correlated dimensions: alcohol obsessions, alcohol consumption, automaticity, and interference due to drinking. The validity of this four-factor solution was supported by the pattern of associations with drinking and coping style measures. In particular, alcohol obsessions were positively associated with alcohol dependence and use of passive/ avoidant coping. Automaticity was positively associated with the intensity and salience of drinking, and inversely associated with use of active/approach coping, as well as abstinence duration. The obsession and automaticity subscales of the OCDS may be useful in evaluating cognitive-motivational processes associated with recovery from alcoholism.
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Daniels SR, Obarzanek E, Barton BA, Kimm SY, Similo SL, Morrison JA. Sexual maturation and racial differences in blood pressure in girls: the National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 1996; 129:208-13. [PMID: 8765617 DOI: 10.1016/s0022-3476(96)70244-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate racial differences in blood pressure in girls aged 9 to 10 years in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) and to evaluate the extent to which racial differences in blood pressure are explained by other factors, including sexual maturation and body size. METHODS The NGHS enrolled 539 black and 616 white girls aged 9 years, and 674 black and 550 white girls aged 10 years. Racial differences in blood pressure were examined. Relationships of stage of sexual maturation, height, and skinfold thickness with systolic and diastolic blood pressure were evaluated by multiple regression analysis. RESULTS The black girls had significantly higher systolic (102.0 +/- 8.90 vs 100.5 +/- 9.42 mm Hg, p <0.001) and diastolic (58.0 +/- 12.0 vs 56.5 +/- 12.51 mm Hg, p <0.01) blood pressures than the white girls. The black girls were also more advanced in sexual maturation and were taller (142.9 +/- 7.94 vs 139.6 +/- 7.05, p <0.001) and heavier (39.6 +/- 11.24 vs 35.3 +/- 8.73 kg, p <0.001) than the white girls. Both systolic and diastolic blood pressure were significantly correlated with level of maturation, height, weight, and sum of skinfolds. Stage of maturation was found to account for the difference in blood pressure between black girls and white girls. In a multiple regression analysis, controlling for height (for diastolic blood pressure) and for both height and sum of skinfolds (for systolic blood pressure) eliminated the effects of race and stage of maturation on blood pressure. CONCLUSION Racial differences in blood pressure were observed for 9- and 10-year-old girls and are explained by the fact that black girls were more mature than white girls. The effect of sexual maturation on blood pressure appears to operate through height and body fat. The effect of obesity may be more important for systolic than for diastolic blood pressure. Continuation of racial differences in blood pressure may result in a higher prevalence of hypertension for black women.
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Kimm SY, Obarzanek E, Barton BA, Aston CE, Similo SL, Morrison JA, Sabry ZI, Schreiber GB, McMahon RP. Race, socioeconomic status, and obesity in 9- to 10-year-old girls: the NHLBI Growth and Health Study. Ann Epidemiol 1996; 6:266-75. [PMID: 8876836 DOI: 10.1016/s1047-2797(96)00056-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The purpose of this investigation was to determine whether measures of socioeconomic status (SES) are inversely associated with obesity in 9- to 10-year-old black and white girls and their parents. Subjects were participants in the Growth and Health Study (NGHS) of the National Heart, Lung, and Blood Institute. Extensive SES, anthropometric, and dietary data were collected at baseline on 2379 NGHS participants. The prevalence of obesity was examined in the NGHS girls and parents in relation to SES and selected environmental factors. Less obesity was observed at higher levels of household income and parental education in white girls but not in black girls. Among the mothers of the NGHS participants who were seen, lower prevalence of obesity was observed with higher levels of income and education for white mothers, but no consistent patterns were seen in black mothers. Univariate logistic models indicated that the prevalence of obesity was significantly and inversely associated with parental income and education and number of parents in the household in white girls whereas caloric intake and TV viewing were significantly and positively associated with obesity. Among black girls, only TV viewing was significantly and positively associated with the prevalence of obesity. Multivariate logistic regression models revealed that lower parental educational attainment, one-parent household, and increased caloric intake were significantly associated with the prevalence of obesity in white girls; for black girls, only increased hours of TV viewing were significant in these models. It is concluded that socioeconomic status, as measured by education and income, was related to the prevalence of obesity in girls, with racial variation in these associations. A lower prevalence of obesity was seen at higher levels of socioeconomic status in white girls, whereas no clear relationship was detected in black girls. These findings raise new questions regarding the correlates of obesity in black girls.
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Biro FM, Daniels SR, Similo SL, Barton BA, Payne GH, Morrison JA. Differential classification of blood pressure by fourth and fifth Korotkoff phases in school-aged girls. The National Heart, Lung, and Blood Institute Growth and Health Study. Am J Hypertens 1996; 9:242-7. [PMID: 8695023 DOI: 10.1016/0895-7061(95)00295-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The use of the onset of the fourth (K4) or fifth (K5) Korotkoff phase to determine diastolic blood pressure in children has been controversial; most recently, the Second Task Force recommended the use of K4 for children up to age 13 years and K5 for children age 13 and above. We performed a cross-sectional analysis of 1,155 nine-year old (53% white and 47% black) and 1,224 ten-year old girls (45% white and 55% black) in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS). The mean blood pressures for the first, fourth, and fifth Korotkoff phases were 100.1 (+/- 8.9) mm Hg, 66.6 (+/- 9.8) mm Hg, and 56.8 (+/- 11.8) mm Hg for nine-year-olds and 102.8 (+/- 9.0) mm Hg, 68.1 (+/- 10.1) mm Hg, and 58.1 (+/- 11.9) mm Hg for ten-year-olds. The mean difference between K4 and K5 was 9.9 (+/- 6.4) mm Hg. The correlation between K1 and K4 was 0.45, between K1 and K5 was 0.34, and between K4 and K5 was 0.84. Elevation of blood pressure was defined at or above the 95th percentile based on the NGHS distribution for K1, K4, or K5; the relative risk of having an elevated K1 was 10.1 if K4 was elevated and 5.9 if K5 was elevated. Of the 159 subjects potentially classified with elevated diastolic pressure, 95 subjects (60%) would be classified differently depending on whether K4 or K5 was used to define elevated diastolic blood pressure. The choice of the onset of the fourth or fifth Korotkoff phase for determining diastolic blood pressure in children may have important implications for which individuals are classified as having hypertension.
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Morrison JA, Payne G, Barton BA, Khoury PR, Crawford P. Mother-daughter correlations of obesity and cardiovascular disease risk factors in black and white households: the NHLBI Growth and Health Study. Am J Public Health 1994; 84:1761-7. [PMID: 7977914 PMCID: PMC1615214 DOI: 10.2105/ajph.84.11.1761] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES This study sought to evaluate obesity as a potential explanatory factor for the increased relative risk for cardiovascular disease in Black compared with White women. METHODS Familial associations for obesity and cardiovascular disease risk factors were assessed in 720 White and 580 Black mother-daughter pairs from the National Heart, Lung, and Blood Institute's Growth and Health Study by using Pearson's chi square, Spearman's correlations, and partial correlations. RESULTS Black girls and mothers were significantly heavier and had higher body mass indices than their White counterparts. In each racial group, significant, positive mother-daughter correlations existed for weight, body mass index, and triceps skinfolds, and for all cardiovascular disease risk factors. Obesity measures correlated positively with systolic blood pressure and triglycerides and inversely with high-density lipoprotein cholesterol in girls and mothers of both races. Correlations between mothers and daughters for exercise and ideal body shape were weak and did not explain obesity associations. CONCLUSIONS Intrafamilial associations of obesity, cardiovascular disease risk factors, and the obesity-cardiovascular disease risk factor relationship support the position that increased cardiovascular disease morbidity and mortality rates in Black women may be linked to excess obesity in Black women compared with White ones.
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Cassida KA, Barton BA, Hough RL, Wiedenhoeft MH, Guillard K. Feed intake and apparent digestibility of hay-supplemented brassica diets for lambs. J Anim Sci 1994; 72:1623-9. [PMID: 8071189 DOI: 10.2527/1994.7261623x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Animal performance on brassica diets often does not reflect laboratory estimates of the nutritive value of the herbage. Hay supplementation of brassica pastures should increase diet DM and fiber intake and dilute anti-quality factors. The optimal hay:brassica ratio needed to achieve desirable animal performance, however, has not been established. Effects of changing the hay:brassica ratio on feed and water intake, apparent digestibility of diets, thyroid status, and anemia were examined in five Dorset-cross wether spring lambs (initial BW 32.8 +/- 3.2 kg). The experimental design was a 5 x 5 Latin square with 21-d periods (7 d of adaptation, 6 d of intake measurement, and an 8-d digestion trial with jugular blood drawn on last day). Diets contained chopped grass hay and tyfon (turnip x Chinese cabbage hybrid) at five hay:tyfon ratios (DM basis): 100:0; 75:25; 50:50; 25:75; and 0:100. As the proportion of tyfon in the diet increased, there were linear increases (P < .05) in ad libitum DMI (922 to 1,359 g/d), total water intake (1.75 to 13.06 L/d), digestible DMI (401 to 952 g/d), and apparent digestibility of DM (55.9 to 86.3%), CP (52.9 to 84.5%), and neutral detergent solubles (57.2 to 88.5%). Hay plus tyfon diets exhibited negative associative effects for apparent digestibility of NDF, ADF, and cellulose. Plasma thyroxine and triiodothyronine, packed cell volume, red blood count, and hemoglobin concentration were not affected by diet. Tyfon influenced DMI and apparent digestibility of diets in a manner similar to that of a concentrate.
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Prout GR, Barton BA, Griffin PP, Friedell GH. Treated history of noninvasive grade 1 transitional cell carcinoma. The National Bladder Cancer Group. J Urol 1992; 148:1413-9. [PMID: 1433540 DOI: 10.1016/s0022-5347(17)36924-0] [Citation(s) in RCA: 153] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A total of 178 patients with grade 1 noninvasive (stage Ta) bladder tumors followed from 1 to 10 years (median 58 months) was prospectively evaluated by cystoscopy, transurethral resection, mucosal biopsies, cytology, size and number of tumors at diagnosis, recurrences, progression in grade and stage, number of negative or positive cystoscopies and death from all causes. Histopathological and cytological studies were confirmed by a Central Pathology Laboratory using the criteria for grade 1 as described previously. Of the patients 122 (68.5%) had a single tumor. Three-quarters of the patients had tumors of less than 2 cm., 95% had mild or no urothelial dysplasia and 1 had positive cytology results. There were 419 recurrent tumors in 109 patients (61%). Patients with multiple tumors were at a significantly greater risk for recurrences (p < 0.001). Size of tumor significantly affected the rate of recurrence in the first 2 years after initial diagnosis in single tumor patients only. Of the multiple tumor patients 90% experienced a recurrence compared to 46% of the single tumor patients. Of the 1,112 cystoscopies performed in 122 single tumor patients 18% were positive, compared to 33% of the 686 cystoscopies performed in 56 multiple tumor patients. A total of 29 patients had a change in grade, 5 having grade 3 and 24 having grade 2 tumors. Progression to stage T1 occurred in 5 patients and to stage T2 or greater in 3. Of the 36 patients who died, 1 died of obstruction due to bladder cancer. Experimental evidence supports the opinion that the cells of stage Ta, grade 1 tumors are different in several ways from normal urothelium. There are little data to support the use of the term papilloma to describe stage Ta, grade 1 tumors without reservation. The data demonstrate that the tumor diathesis being expressed ceases with time and for unknown reasons. Multiple tumor patients with stage Ta, grade 1 disease might be included in chemotherapy trials only with stratification and a control arm of transurethral resection/fulguration alone.
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