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There is a direct correlation between being overweight and iron deficiency. Physiological changes occur in obese adipose cells that contribute to the development of iron deficiency (ID) and iron deficiency anemia (IDA). These changes disrupt the normal iron metabolic checks and balances. Furthermore, bariatric surgery can lead to long-term ID and IDA. Oral iron supplementation may not be effective for many of these patients. Intravenous iron infusions can significantly increase the quality of life for individuals experiencing this condition but are also associated with potentially serious complications. Adequate knowledge about intravenous (IV) iron administration can greatly increase the safety of this beneficial therapy. This review article explains the relationship between obesity, ID/IDA, bariatric surgery and the safe administration of IV iron.

Study objectives: Black smokers have been reported to have higher serum cotinine levels than do white smokers, and have higher rates of most smoking-related diseases, despite smoking fewer cigarettes per [...]

Proper diagnosis of testotoxicosis requires careful monitoring of the development of sexual organs and testosterone levels. Testotoxicosis is a rare disorder in male children that involves unusually early development of the sexual organs. A 15-month old male had unusually large genitals, pubic hair, a deep voice, and somewhat overly developed muscles. His serum testosterone level was 220 ng/dL and his penis was 7.2 cm in length. He was treated with ketoconazole, which inhibits the production of steroids. His serumtestosterone level dropped to 74 ng/dL, his pubic hair was reduced, and his voice and muscles returned to normal. The symptoms of testotoxicosis generally include an enlarged penis, pubic hair, and accelerated growth of muscles and bones. The disease is associated with a gene mutation and treated with drugs that slow the production of male sex hormones. Early treatment is necessary to prevent abnormal growth.

ObjectivesWe examined two waterpipe tobacco smoking components advertised to reduce harm to determine if they result in lower levels of biomarkers of acute exposure.MethodsWe conducted a crossover study of 34 experienced waterpipe smokers smoking a research-grade waterpipe in three configurations ad libitumin a controlled chamber: control (quick-light charcoal), electric (electric heating) and bubble diffuser (quick-light charcoal and bubble diffuser). We collected data on smoking topography, environmental carbon monoxide (CO), subjective effects, heart rate, plasma nicotine and exhaled CO and benzene.ResultsSmokers’ mean plasma nicotine, heart rate, and exhaled benzene and CO boost were all significantly lower for electric compared with control. However, smokers puffed more intensely and took significantly more and larger volume puffs for a larger total puffing volume (2.0 times larger, p<0.0001) when smoking electric; machine yields indicate this was likely due to lower mainstream nicotine. Smokers rated electric smoking experience less satisfying and less pleasant. For charcoal heating, the mean mass of CO emitted into the chamber was ~1 g when participants smoked for a mean of 32 minutes at a typical residential ventilation rate (2.3 hr−1).ConclusionWaterpipe smokers engaged in compensation (i.e., increased and more intense puffing) to make up for decreased mainstream nicotine delivery from the same tobacco heated two ways. Waterpipe components can affect human puffing behaviours, exposures and subjective effects. Evidence reported here supports regulation of waterpipe components, smoking bans in multifamily housing and the use of human studies to evaluate modified or reduced risk claims.

Stresses encountered during human islet isolation lead to unavoidable β-cell death after transplantation. This reduces the chance of insulin independence in chronic pancreatitis patients undergoing total pancreatectomy and islet autotransplantation. We tested whether harvesting islets in carbon monoxide-saturated solutions is safe and can enhance islet survival and insulin independence after total pancreatectomy and islet autotransplantation. Chronic pancreatitis patients who consented to the study were randomized into carbon monoxide (islets harvested in a carbon monoxide-saturated medium) or control (islets harvested in a normal medium) groups. Islet yield, viability, oxygen consumption rate, β-cell death (measured by unmethylated insulin DNA), and serum cytokine levels were measured during the peri-transplantation period. Adverse events, metabolic phenotypes, and islet function were measured prior and at 6 months post-transplantation. No adverse events directly related to the infusion of carbon monoxide islets were observed. Carbon monoxide islets showed significantly higher viability before transplantation. Subjects receiving carbon monoxide islets had less β-cell death, decreased CCL23, and increased CXCL12 levels at 1 or 3 days post transplantation compared with controls. Three in 10 (30%) of the carbon monoxide subjects and none of the control subjects were insulin independent. This pilot trial showed for the first time that harvesting human islets in carbon monoxide-saturated solutions is safe for total pancreatectomy and islet autotransplantation patients.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.annemergmed.2007.08.021 Byline: David W. Wright (a), Pamela L. Clark (a), Rebecca D. Pentz (c), Vicki Hertzberg (b), Arthur L. Kellermann (a) Abstract: For clinical research, the consent process plays a critical role in protecting human subjects. In emergency research, proxy consent can impose substantial delays or even render a study infeasible if the intervention involves a highly time-sensitive treatment. The objective of this study is to compare the time required to enroll brain-injured trauma patients in a study with proxy consent versus exception from consent. Author Affiliation: (a) Department of Emergency Medicine, School of Medicine, Emory University School of Medicine, Atlanta, GA (b) Rollins School of Public Health, Emory University School of Medicine, Atlanta, GA (c) The Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA. Article History: Received 21 February 2007; Revised 28 June 2007; Revised 19 August 2007; Accepted 22 August 2007 Article Note: (footnote) Supervising editor: Robert K. Knopp, MD, Author contributions: DWW, PLC, and ALK conceived and designed the study. VH and ALK provided statistical support for the study and analyzed the data. DWW, PLC, RDP, and ALK drafted the article, and all authors contributed substantially to its revision. DWW, PLC, VH, and ALK were investigators for the parent ProTECT clinical trial. DWW takes responsibility for the paper as a whole., Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This work was supported in part by a grant from the National Institute of Neurological Diseases and Stroke (NINDS), National Institutes of Health (1 RO-1 NS-39097A1) and the NIH-funded General Clinical Research Center at Emory University and Grady Memorial Hospital. Scott Janis was the NINDS Project Officer who assisted with this project. The opinions, findings, and recommendations contained herein are those of the authors and do not necessarily represent those of the NIH or the NINDS., Publication dates: Available online October 15, 2007., Reprints not available from the authors.

This article explores the benefits of under-skilled readers' participation in a summer reading program. Twelve middle school students who scored in the lowest percentile on the Iowa Test of Basic [...]

Background: Estimates of energy intake are required for an understanding of growth and disease; however, few methods of energy intake in children have been validated. Objective: Our objective was to validate energy intake estimated by the Youth-Adolescent Food-Frequency Questionnaire (YAQ) against the criterion total energy expenditure (TEE) by doubly labeled water (DLW). Design: Twenty-three boys and 27 girls (8.6-16.2 y of age) completed the YAQ and TEE measurements in 1 y. Results: Energy intake by the YAQ (10.03 [+ or -] 3.12 MJ) and energy expenditure by DLW (9.84 [+ or -] 1.79 MJ) were similar (P = 0.91) with large lower (-6.30 MJ) and upper (6.67 MJ) [+ or -] 2 SD limits of agreement. When within-subject CVs of repeated measures of the DLW and YAQ methods were used, 25 of the 50 subjects were deemed to have misreported their energy intake. The discrepancy in energy intake (YAQ - TEE) was related to body weight (r = -0.25, P = 0.077) and percentage body fat (r = -0.24, P = 0.09) but not to age (r = -0.07, P = 0.63) or the time between measures. From logistic regression, fatter boys were more likely to underreport energy intake than were fatter girls. Conclusion: The YAQ provides an accurate estimation of mean energy intake for a group but not for an individual. Am J Clin Nutr 2000;72:1455-60. KEY WORDS Children, adolescents, youth-adolescent questionnaire, Youth-Adolescent Food-Frequency Questionnaire, food-frequency questionnaire, energy expenditure, energy intake, doubly labeled water

The longitudinal growth of an individual child is a dynamic statement of the general health of that child. Measurements should be performed often and accurately to detect alterations from physiologic growth. Although any single point on the growth chart is not very informative, when several growth points are plotted over time, it should become apparent whether that individual's growth is average, a variant of the norm, or pathologic. Somatic growth and maturation are influenced by several factors that act independently or in concert to modify an individual's genetic growth potential. Linear growth within the first 2 y of life generally decelerates but then remains relatively constant throughout childhood until the onset of the pubertal growth spurt. Because of the wide variation among individuals in the timing of the pubertal growth spurt, there is a wide range of physiologic variations in normal growth. Nutritional status and heavy exercise training are only 2 of the major influences on the linear growth of children. In the United States, nutritional deficits result from self-induced restriction of energy intake. That single factor, added to the marked energy expenditure of training and competition for some sports, and in concert with the self-selection of certain body types, makes it difficult to identify the individual factors responsible for the slow linear growth of some adolescent athletes, for example, those who partake in gymnastics, dance, or wrestling. Am J Clin Nutr 2000;72(suppl):521S-8S. KEY WORDS Growth, adolescent development, growth potential, athlete, nutrition, gymnastics, wrestling, nutritional dwarfism, athletic training

Several recipes are presented including the bacon, egg & pumpkin feast bruschetta, chicken & watercress pasta salad, and mussels in chilli broth.

Several Christmas recipe are presented including Scallop tarts with pea and mint purée, Green salad with redcurrants and orange dressing, and Pumpkin, rosemary and thyme gratin.

To profile the reactivity of CSF-derived immunoglobulin from patients with multiple sclerosis (MS) against a large panel of antigens, to identify disease-specific reactivities.

The article evaluates several products including Market Analyser service provider from OneSource UK, new regulatory database from 10-K Wizard and the Universal ID Check from Experian.

Several letters to the editor are presented in response to articles in the July/August 2008 issue including "Introducing The Balmoral," "Stormy Weather," and "Port of the Month."

The article focuses on food and cookery. The process of reheating rice safely is described. It outlines information on astringent and non-astringent persimmons and how they can be eaten. Tips on peeling and seeding a tomato are presented. The steps in peeling horseradish and grating it finely are provided.

Presents several recipes for French dishes, including Roasted Chicken With 40 Cloves of Garlic.

Presents several Australian cuisine recipes, including Slow-Cooked Lamb With Artichokes.

A comprehensive, coordinated rehabilitation program can reduce mortality and improve functional outcomes following stroke. Such services are often variable and limited especially in rural areas of the country. The need for alternative health care delivery models is real and critical. TeleRehab is a versatile and viable option for delivering rehabilitation services that incorporates 2way interactive video. This specialized approach demonstrates promising signs of facilitating the transition for specialized stroke followup care and services in the home and communitybased settings. This paper describes a stroke teletherapy case that was successfully managed for 17 months by an interdisciplinary team of rehabilitation specialists. Lessons learned in both technology and human domains are discussed.

Abstract—We report major element ratios determined for the S‐class asteroid 433 Eros using remote‐sensing x‐ray fluorescence spectroscopy with the near‐Earth asteroid rendezvous Shoemaker x‐ray spectrometer (XRS). Data analysis techniques and systematic errors are described in detail. Data acquired during five solar flares and during two extended “quiet Sun” periods are presented; these results sample a representative portion of the asteroid's surface. Although systematic uncertainties are potentially large, the most internally consistent and plausible interpretation of the data is that Eros has primitive Mg/Si, Al/Si, Ca/Si and Fe/Si ratios, closely similar to H or R chondrites. Global differentiation of the asteroid is ruled out. The S/Si ratio is much lower than that of chondrites, probably reflecting impact‐induced volatilization and/or photo‐ or ion‐induced sputtering of sulfur at the surface of the asteroid. An alternative explanation for the low S/Si ratio is that it reflects a limited degree of melting with loss of an FeS‐rich partial melt. Size‐sorting processes could lead to segregation of Fe‐Ni metal from silicates within the regolith of Eros; this could indicate that the Fe/Si ratios determined by the x‐ray spectrometer are not representative of the bulk Eros composition.

Whereas there are general guidelines for acceptable transfusion therapy, optimal transfusion therapy has not been determined for most clinical settings. Recent research has focused on controlled studies of red cell transfusion in specific clinical settings. Better determinations of oxygen delivery and consumption are needed to guide clinicians in determining whether transfusion is justified for patients during the perioperative period, those with coronary artery disease, and those in intensive care units. For sickle cell disease, the role of transfusion for acute complications can be life saving; however, the role of chronic transfusion regimens awaits further research into efficacy. Finally, whereas criteria for the prophylactic transfusion of platelets in hematologic diseases are well described, relatively little information is available on the value of platelet transfusion where the absolute count is less than 100,000 but greater than 50,000. The value of fresh frozen plasma components, both standard and sterilized, also requires elucidation.

With the insertion of the NEAR spacecraft into orbit around the asteroid 433 Eros, a new stage of asteroid exploration has begun, with the return of spatially resolved mineralogical, geological, and chemical information from specific asteroids. In this paper, we outline the features of a partially differentiated asteroid using the acapulcoite and lodranite meteorites as a guide. Such a body would likely contain a variety of lithologies, including chondritic rocks largely unaltered by melting, residues of partial melts, and basaltic and Fe,Ni–FeS rocks crystallized from the partial melts. The presence or nature of the regolith remains largely unconstrained. Mineralogical and isotopic heterogeneities preserved in these rocks suggest spatial separation of these rock types by distances in excess of 200 m. Spacecraft-based remote sensing instrumentation should detect substantial spectral heterogeneity (most prominently manifested in the band area ratio) and chemical heterogeneity. Observation of these various lithologies in situ would provide important new constraints on the processes involved during the earliest differentiation of asteroids. Copyright 2000 Academic Press.

Remote sensing X-ray and gamma-ray spectrometers can be used to infer elemental composition on atmosphereless bodies, such as asteroids, the Moon, and Mercury. For Discovery class missions a combined geochemical experiment package has been proposed that can meet the mission science objectives while still remaining within the mass, power, and cost constraints of the mission. Calculations for two asteroid missions (NEAR and MASTER) indicate that surface mapping at up to ten's of kilometer spatial resolution is possible, and that the relation of the asteroid composition to that of meteorite classes should be determined relatively early in the mission. Datasets from each of the two experiments provide independent, yet complimentary measures of elemental abundances. Comparisons between results for the same elements can give information on near-surface regolith statigraphy and/or differences between local and regional rock types.

Roemmich, James N., Pamela A. Clark, Arthur Weltman, and Alan D. Rogol. Alterations in growth and body composition during puberty. I. Comparing multicompartment body composition models.J. Appl. Physiol.83(3): 927–935, 1997.—A four-compartment (4C) model of body composition was used as a criterion to determine the accuracy of three-compartment (3C) and two-compartment (2C) models to estimate percent body fat (%BF) in prepubertal and pubertal boys (genital I & II,n= 17; genital III & IV,n= 7) and girls (breast I & II, n= 8; breast III & IV,n= 15). The 3C water-density (3C-H2O) and 3C mineral-density models, dual-energy X-ray absorptiometry, the Lohman age-adjusted equations, the Slaughter et al. skinfold equations, and the Houtkooper et al. and Boileau bioelectrical impedance equations were evaluated. Agreement with the 4C model increased with the number of compartments (i.e., body water, bone mineral) measured. Except for the 3C-H2O model, the limits of agreement were large and did not perform well for individuals. The mean %BF by dual-energy X-ray absorptiometry (23.6%) was greater than that of the criterion 4C method (21.7%). For the field methods, the Slaughter et al. skinfold equations performed better than did the Houtkooper et al. and Boileau bioimpedance equations. The hydration of the fat-free mass decreased (genital I & II = 75.7%, genital III & IV = 74.8%, breast I & II = 75.5%, breast III & IV = 74.4%) and the mineral content increased (genital I & II = 4.9%, genital III & IV = 5.0%, breast I & II = 5.1%, breast III & IV = 5.7%) with maturation. The density of the fat-free mass also increased (genital I & II = 1.084 g/ml, genital III & IV = 1.087 g/ml, breast I & II = 1.086 g/ml, breast III & IV = 1.091 g/ml) with maturation. All of the models reduced the %BF overprediction of the Siri 2C model, but only the 4C and 3C-H2O models should be used as criterion methods for body composition validation in children and adolescents.

Available lunar orbital data were studied in detail to determine the nature and origin of geochemical variation in a portion of the farside highlands east of the Smythii basin. Such data exist for the elements Al, Mg, Fe, Ti, and Th (Clark and Hawke, 1981; Davis, 1980; Metzger et al., 1977). As in our previous studies (Clarke and Hawke, 1981, 1987), averages and ranges of concentrations for these elements are calculated and correlated for photogeologically defined units associated with features such as Babcock, King, Al-Khwarezmi, Langemak, Pasteur, and Sklodowska and with the region as a whole. In addition, comparisons are made between this and other highland regions which have been investigated by other workers in a similar manner (Andre et al., 1977; Haines et al., 1978; Maxwell and Andre, 1981). The region is shown to be distinctively enriched in the anorthositic end-members of the ANT-suite. Anomalies which have been reported for this region (Hawke et al., 1985) are confirmed by this study. An area south of Pasteur shows enrichment in some mafic components, giving evidence for the presence of buried mare basalt, and lending support to the hypothesis that volcanic activity may be fairly widespread even in the farside highlands. The units just southeast of Mare Smythii appear to be geochemically related to the area partly surrounding the Smythii on the west (Clark and Hawke, 1987). Considerable geochemical heterogeneity exists in this area, as in areas of the nearside highlands (Clark and Hawke, 1981, 1982, 1987; Hawke et al., 1985).

The developing facial neurons of a series of hamsters ranging in age from the 14-day fetus to the 9 day postnatal were axotomized. Postoperative times were graded for each age so that the retrograde response could be observed before any significant amount of cell degeneration or death occurred. The incorporation of tritiated uridine was followed by the autoradiographic procedure. Although grain counts, relative to control values, were significantly reduced only in the axotomized fetus and at 24 hours postoperatively in 4-day postnatal animals, there was also a repression of isotopic incorporation in all the other axotomized animals. These results support data obtained from previous work with the hamsters which indicate that it is not until after the nerve cell nucleolus reaches full cytomorphic maturity (between 15 and 20 days postnatal age in hamster facial neurons) that the axotomized neurons respond with significantly increased incorporation levels of isotope over that of control neurons.