Search

Patients with end-stage renal disease often have derangements in calcium and phosphorus homeostasis and resultant secondary hyperparathyroidism (sHPT), which may contribute to the high prevalence of arterial stiffness and hypertension. We conducted a secondary analysis of the Evaluation of Cinacalcet Hydrochloride Therapy to Lower Cardiovascular Events (EVOLVE) trial, in which patients receiving hemodialysis with sHPT were randomly assigned to receive cinacalcet or placebo. We sought to examine whether the effect of cinacalcet on death and major cardiovascular events was modified by baseline pulse pressure as a marker of arterial stiffness, and whether cinacalcet yielded any effects on blood pressure. As reported previously, an unadjusted intention-to-treat analysis failed to conclude that randomization to cinacalcet reduces the risk of the primary composite end point (all-cause mortality or non-fatal myocardial infarction, heart failure, hospitalization for unstable angina or peripheral vascular event). However, after prespecified adjustment for baseline characteristics, patients randomized to cinacalcet experienced a nominally significant 13% lower adjusted risk (95% confidence limit 4–20%) of the primary composite end point. The effect of cinacalcet was not modified by baseline pulse pressure (Pinteraction=0.44). In adjusted models, at 20 weeks cinacalcet resulted in a 2.2 mm Hg larger average decrease in systolic blood pressure (P=0.002) and a 1.3 mm Hg larger average decrease in diastolic blood pressure (P=0.002) compared with placebo. In summary, in the EVOLVE trial, the effect of cinacalcet on death and major cardiovascular events was independent of baseline pulse pressure.

Fifty new ternary compounds Ln2T3Zn14 were isolated from alloys with a high zinc content by dissolving the zinc-rich matrix in hydrochloric acid. They crystallize with an ordered version of a binary structure type first reported for Th2Zn17. The structure of the ternaries was determined from four-circle X-ray diffractometer data of the four compounds Gd2Co3Zn14, Ce2Rh3Zn14, Pr2Ni3Zn14, and Sm2Pd3Zn14. It is rhombohedral, space group R&thremacr;m, with Z = 3 formula units in the corresponding hexagonal cell and the lattice constants a = 887.2(2) pm and c = 1300.2(3) pm for Gd2Co3Zn14. The transition metal atoms T are located essentially at one atomic site corresponding to the ideal occupancy in the compounds Gd2Co3Zn14 and Pr2Ni3Zn14. For the other two compounds significant deviations from the ideal composition could be observed for three of the four zinc sites of Th2Zn17, with mixed T/Zn occupancy, resulting in the compositions Ce2Rh1.90(2)Zn15.10(2) and Sm2Pd1.92(1)Zn15.08(1). The structure may be viewed as consisting of layers extending perpendicular to the hexagonal axis. One layer contains all of the rare earth atoms, the other all of the transition metal atoms, and both with additional zinc atoms, with unit mesh contents of Ln2Zn6 and T3Zn8. These layers alternate, corresponding to the formula Ln2Zn6·T3Zn8 = Ln2T3Zn14. The structure contains two kinds of voids. One of these is filled by carbon and nitrogen atoms in ternary magnetic materials Ln2Fe17C3-x and Ln2Fe17N3-x. The structure refinements show that both of these voids are unoccupied in the ternary zinc compounds Ln2T3Zn14. Similarly, a structure refinement of the known binary compound La2Zn17 did not reveal any significant amounts of impurity atoms (e.g., oxygen) at these voids. The refinement of the occupancy parameters for this compound resulted in the composition La2Zn16.06(6).

Circadian pacemakers that drive rhythmicity in retinal function are found in both invertebrates and vertebrates. They have been localized to photoreceptors in molluscs, amphibians, and mammals. Like other circadian pacemakers, they entrain to light, oscillate based on a negative feedback between transcription and translation of clock genes, and control a variety of physiological and behavioral rhythms that often includes rhythmic melatonin production. As a highly organized and accessible tissue, the retina is particularly well suited for the study of the input-output pathways and the mechanism for rhythm generation. Impressive advances can now be expected as researchers apply new molecular techniques toward looking into the eye's clock.

The National Cancer Institute diet questionnaire was evaluated for use in a low-income black population. Data were collected from 91 women aged 30-69 years who were hospital outpatients in Atlanta, Georgia, June through August, 1988. Six ethnic and regional foods added to the questionnaire were found to be important contributors to intakes of several nutrients. Although 17 records were identified as containing probable recording or reporting errors, intakes of carotenes, alpha-carotene, beta-carotene, cryptoxanthin, and vitamin E were significantly and positively associated with serum levels of their referent nutrients. Among nonsmokers, correlation coefficients ranged from 0.32 to 0.45, adjusted for age, body mass index, alcohol and calorie intakes, medications and vitamin supplement use, and serum cholesterol and triglycerides. When questionnaires containing identified errors were omitted, correlations ranged from 0.30 to 0.54. There were no correlations between dietary intakes of lycopene and lutein and blood levels (-0.06 to 0.09). Among smokers, diet-serum correlations were reduced (0.00 to 0.32). These correlations are similar to those reported in research on vitamin E and carotenoids in other populations. These results suggest that the questionnaire is as valid for use in this population as it is in other populations.

The food sources of provitamin A carotenoids were estimated from data from the Second National Health and Nutrition Examination Survey (NHANES II) carried out in 1976-1980. Carrots contribute over 30% of total population intake. Dark green leafy vegetables and sweet potatoes are also major contributors. However, several items often omitted from questionnaires to assess carotenoids are also major contributors, including salad, orange juice, beef stew, and milk. Conversely, many foods often included on such questionnaires are unimportant contributors, including papayas, plums, okra, and grapes. Recent changes in databases or food habits might change some rankings, but are unlikely to change the items in a list covering the top 90% of provitamin A intake. Questionnaires should include the important sources and exclude trivial sources, to minimize misclassification.

Data from the 1987 National Health Interview Survey show that 51.1% of the adults aged 18-99 years in the United States consumed a vitamin/mineral supplement in the past year, but that only 23.1% did so daily. Whites, women, and older individuals were more likely than blacks, men, and younger individuals to consume supplements regularly. Multivitamins were the most commonly consumed supplement, followed by vitamin C, calcium, vitamin E, and vitamin A. Results suggest that supplementation practices have changed little since the 1970s. Results regarding the amounts of nutrients obtained from supplements show that a food frequency type of methodology collects reasonably accurate data reflecting intake of supplements over the past year. Few, if any, individuals were consuming nutrients in amounts considered toxic. Although vitamin and mineral supplementation is a common health habit, it appears not to pose a significant health risk for most of the population.

The primary purpose of these studies was to determine whether photoperiodic signals could influence seasonal egg-laying behavior in the marine mollusk, Aplysia californica. Egg-laying behavior was monitored from groups of animals that were collected at four times of year and maintained in different temperature and photoperiodic conditions in the laboratory. Animals that were obtained in autumn and kept in warm water laid eggs more frequently than those in cold water, regardless of photoperiod. Furthermore, animals maintained on short days and warm water laid eggs more frequently than those on long days and warm water. Animals in cold water showed little to no egg laying, and a photoperiodic response was not evident. Animals that were collected in either winter or spring and maintained in warm water showed little or no spontaneous egg laying throughout the study, regardless of photoperiod. As with the autumn animals, Aplysiaindividuals obtained in summer and kept on short days and warm water laid eggs more frequently than those kept on long days and warm water. These results provide the first evidence that the reproductive system of A. californicais responsive to photoperiod. Overall, the data suggest that warm water is permissive for egg laying, and that short days can further stimulate this behavior. However, there is a strong inhibition of spontaneous egg laying during the winter and spring, which neither warm water nor short photoperiod can overcome. The role of the eyes in mediating the photoperiodic response was also investigated. A control group of intact animals kept on short days laid eggs more frequently than those on long days, but this photoperiodic response was not evident in eyeless animals. These results suggest that the eyes play a role in mediating the effects of photoperiod on egg laying behavior.

The eye of the marine mollusk Aplysia californica contains an oscillator that drives a circadian rhythm of spontaneous compound action potentials in the optic nerve. Both light and serotonin are known to influence the phase of this ocular rhythm. The aim of the present study was to evaluate the role of extracellular calcium in both light and serotonin-mediated phase shifts. Low calcium treatments were found to cause phase shifts which resembled those produced by the transmitter serotonin. However, unlike serotonin, low calcium neither increased ocular cAMP levels nor could these phase shifts be prevented by increasing extracellular potassium concentration. Low calcium-induced phase shifts were prevented by the simultaneous application of the translational inhibitor anisomycin and low calcium treatment resulted in changes in [35S]methionine incorporation into several proteins as measured by a two-dimensional electrophoresis gel analysis. Finally, light treatments failed to produce phase shifts in the presence of low calcium or the calcium channel antagonist nickel chloride. These results are consistent with a model in which serotonin phase shifts the ocular pacemaker by decreasing a transmembrane calcium flux through membrane hyperpolarization while light-induced phase shifts are mediated by an increase in calcium flux.

Detailed data on vitamin supplement use are presented for nine specific vitamins and minerals by a wide range of demographic and behavioral characteristics. Previously recorded but uncoded data from the first National Health and Nutrition Examination Survey (1971-1974) have been coded and analyzed, providing the only detailed vitamin use data in a representative sample large enough to examine joint distributions and multivariate analyses of numerous characteristics. Significantly fewer black persons than white persons consume vitamins regularly, and the difference is especially pronounced for specific vitamins: fourfold for vitamin E, sixfold for vitamin A, and 10-fold for vitamin C. Significant differences were also seen for age, sex, geographic region, education, poverty, type of alcoholic beverage consumed, and Quetelet index. Data are presented indicating that supplement use has not increased notably between the time of the survey and 1983, and thus the supplement use data are considered to be reasonably representative of current patterns of supplementation practice in the United States.

Zusammenfassung: Bei zwei Patienten im Alter von 44 bzw. 52 Jahren mit frischem Myokardinfarkt kam es nach außerklinischer kardiopulmonaler Reanimation (CPR) und nachfolgender klinischer systemischer Thrombolysetherapie zu einer bedrohlichen Verschlechterung der Kreislaufsituation. Bei unauffälligem radiologischen Thoraxbefund war sonographisch in beiden Fällen freie intraabdominale Flüssigkeit nachweisbar, was trotz Lysetherapie die notfallmäßige Laparotomie unvermeidlich machte. In beiden Fällen fand sich eine reanimationsbedingte Leberverletzung. Das anästhesiologische Vorgehen war neben der Anlage eines zentralen Venenkatheters und einer invasiven Druckmessung durch ausreichenden Ersatz von Volumen und Sauerstoffträgern über leistungsfähige venöse Zugänge, die Substitution des plasmatischen Gerinnungspotentials durch Gefrierplasmen und eine vorsichtige, blutdruckorientierte Narkoseführung als „modifizierte Neuroleptanästhesie“ gekennzeichnet. Postoperativ traten typische, aber beherrschbare Komplikationen auf, so daß beide Patienten ihre lebensbedrohliche Erkrankung ohne schwere Folgeschäden überlebten. Instabile Kreislaufverhältnisse nach CPR sind zwar in der Regel einem myokardialen Pumpversagen zuzuordnen, bei ausbleibendem Erfolg der typischen therapeutischen Maßnahmen muß jedoch umgehend eine Reanimationsverletzung mit konsekutivem hämorrhagischen Schock ausgeschlossen werden. Bei systemischer Thrombolysetherapie nach vorausgegangener CPR sollten entsprechende diagnostische Maßnahmen (Röntgenaufnahme der Thoraxorgane, Sonographie von Abdomen und Thorax) auch prophylaktisch erfolgen.

Use of vitamin and mineral supplements was assessed in a population-based case-control study of oral and pharyngeal cancer, conducted during 1984-1985 in four areas of the United States. There was no association with intake of multivitamin products, but users of supplements of individual vitamins, including vitamins A, B, C, and E, were at lower risk after controlling for the effects of tobacco, alcohol, and other risk factors for these cancers. After further adjustment for use of other supplements, vitamin E was the only supplement that remained associated with a significantly reduced cancer risk. The adjusted odds ratio of oral and pharyngeal cancer for "ever regularly used" vitamin E was 0.5 (95% confidence interval 0.4-0.6). To the authors' knowledge, this is the first epidemiologic study to show a reduced oral cancer risk with vitamin E use. Although it is not clear that the lower risk among consumers of vitamin E supplements is due to the vitamin per se, the findings are consistent with experimental evidence and should prompt further research on the role of vitamin E and other micronutrients as inhibitors of oral and pharyngeal cancer.

In 1985, 216 men, participants in the Baltimore Longitudinal Study of Aging, were asked to report on their usual diet during the period 1971-1975. The reference data for past diet consisted of multiple seven-day records collected between 1971 and 1975. The group was randomly assigned to complete the diet history either by personal interview or by mailed self-administered questionnaire. The items and response categories were identical in both cases. For both groups, the mean nutrient intake estimated by questionnaire was within +/- 10 per cent of the past diet record values for most nutrients. When the questionnaire was administered by an interviewer, correlations with past diet were approximately as good as those obtainable with present diet in other studies and indicate that useful studies of past diet can be performed with this questionnaire. Correlations for the mail group were considerably lower and suggest that assessment of past diet using this questionnaire format without personal instruction or callbacks may yield poor results. The effect of age was negligible, but response errors and change in diet since the target period had important effects on correlations with past diet in both interview and mail groups.

The authors report the adaptation of a dietary and risk factor questionnaire and analysis system for use with IBM (or compatible) personal computers. This system includes a flexible computer-assisted interview program which may be modified to suit investigator needs while preserving a standard output format. It also includes a nutrient analysis program for calculation of usual dietary intake. Each of these two major components has its own set of utilities and options, so that investigators may tailor the system to particular research areas. The nature and capabilities of the two main programs are described, as well as the development of the underlying system and the general flow of data in the system.

The software for analysis of the Health Habits and History Questionnaire (HHHQ) has been revised and is available to researchers. As in earlier versions of the software, questionnaires other than the standard National Cancer Institute versions can be analyzed. Foods can be added or dropped, nutrients can be added or changed, and many other revisions and options are facilitated. Estimates of 33 nutrients and up to 20 user-defined food groups are produced. The validity is unchanged from the previous software. Other features include a data entry key-and-verify system, standardized editing, a computer-assisted interview, and the calculation of health indices including pack-years of smoking and social network index.

The requirement for protein synthesis in the mechanism of a circadian pacemaker was investigated by using inhibitors of protein synthesis. Continuous treatment of the ocular circadian pacemaker of the mollusc Bulla gouldiana with anisomycin or cycloheximide substantially lengthened (up to 39 and 52 hr, respectively) the free-running period of the rhythm. To determine whether high concentrations of inhibitor could stop the pacemaker, long pulse treatments of various durations (up to 44 hr) were applied and the subsequent phase of the rhythm was assayed. The observed phases of the rhythm after the treatments were a function of the time of the end of the treatment pulse, but only for treatments which spanned subjective dawn. The results provide evidence that protein synthesis is required in a phase-dependent manner for motion of the circadian pacemaker to continue.

To assess the ability of food frequency methods to measure current dietary calcium intake in elderly women, the authors administered two types of food frequency instruments to 37 randomly selected women who attended two senior citizens centers in San Francisco, and they compared those responses to seven-day food records. A 34-item food frequency instrument (with portion sizes rated as small, medium, or large) correlated well (r = 0.76) with the estimated calcium intake from seven-day records. Limiting the instrument to the top 15, 10, or five foods that contribute to dietary calcium intake had little effect on this correlation (r = 076, 0.75, and 0.67, respectively). Rating all portions as "medium" reduced these correlations somewhat. An 18-item instrument, which asks respondents to rate portion sizes in ounces or cups, did not correlate as well with the seven-day records (r = 0.49). The authors conclude that brief food frequency instruments which rate portion sizes on a simple qualitative scale may be suitable for many clinical uses and adequate for some types of epidemiologic studies of calcium intake in elderly women.

A self-administered diet history questionnaire has been developed for epidemiologic and clinical use. Both the food list and the nutrient values to be associated with it were developed using dietary data from 11,658 adult respondents to the Second National Health and Nutrition Examination Survey (NHANES II). Food items were selected on the basis of their contribution to total population intake of energy and each of 17 nutrients in the NHANES II data, and represent over 90% of each of those nutrients. Associated nutrient composition values were determined from the NHANES II database using frequency of consumption data in that survey. Portion sizes to be associated with each food item were derived from observed portion size distributions in NHANES II, based on three-dimensional models. The resulting food list and its corresponding brief data base, when used to calculate nutrients from a diet record, yielded correlations of r greater than 0.70 with the more detailed method. Field administration produced mean values comparable to national data.

Dietary data from 11,658 adult respondents in the second National Health and Nutrition Examination Survey were used to provide quantitative information regarding the contribution of specific foods to the total population intake of the following 10 nutrients: vitamin A, thiamine, riboflavin, niacin, vitamin C, iron, phosphorus, calcium, sodium, and potassium. Data are reported in the companion paper regarding the number of adults in the US population consuming each of 147 food items, representing all foods reported by these respondents. The percentage of total nutrient intake which each food provides is presented for the top 50 contributors of each of the nutrients listed above. Foods sometimes overlooked as important sources are found in some instances to be quantitatively important to population intake, such as spaghetti dishes as an independent source of carotenoids. These data should be useful to epidemiologists with a substantive interest in dietary etiologies or a methodological interest in the development of dietary assessment instruments. In addition, they may be useful to health care planners or nutrition educators.

Dietary data from 11,658 adult respondents in the second National Health and Nutrition Examination Survey were used to provide quantitative information regarding the contribution of specific foods to the total population intake of the following nutrients: calories, protein, carbohydrate, total fat, saturated fat, oleic acid, linoleic acid, and cholesterol. The percentage of total nutrient intake which each food provides is presented for the top 50 contributors of each of these nutrients, as well as the proportion of the population consuming them. These data may provide a basis for the selection of foods to be included in dietary assessment instruments. They may also be useful to health care planners or nutrition educators.

A method for estimating year of birth using only Social Security number is described. The method relies on estimating the year of issue of the Social Security number, using either precise information from a Social Security Administration table (for numbers issued since 1950) or extrapolation (for numbers issued before 1951). Age at issue was estimated using data from individuals in an occupationally defined population for whom both birth date and Social Security number were known. Year of birth is then year of issue minus age at issue. A highly statistically significant correlation of 0.91 for known vs. estimated year of birth was observed. Predictions correct within +/- 5 years were achieved for 78 per cent of the entire study population. For individuals born after approximately 1934, predictions within +/- 5 years of the correct year were achieved 95 per cent of the time, and within +/- 2 years 77 per cent of the time. The method may be useful in epidemiologic research in situations in which date of birth is missing. Some applications are discussed.

Abstract.: The forward elastic scattering of light on light, i.e., the reaction in the forward direction, is analyzed utilizing real analytic amplitudes. We calculate , the ratio of the real to the imaginary portion of the forward scattering amplitude, by fitting the total cross section data in the high energy region 5 GeV GeV, assuming a cross section that rises asymptotically as ln2 s. We then compare , the ratio of the even portions of the pp and forward scattering amplitudes, as well as to [1], the value for Compton scattering. Within errors, we find that the three -values in the c.m.s. energy region 5 GeV 130 GeV are the same, as predicted by a factorization theorem of Block and Kaidalov [2].

The title compound, prepared by arc melting of the elements (8:5:12), crystallizes in the tetragonal system, space group P4/mbm with Z=2.