Switching between foods is reliably associated with intake across eating events in children

Emerging evidence suggests switching between foods during an eating event is positively associated with intake. However, it is unclear whether switching is a stable behavior that predicts consumption across multiple eating events. The current study explored whether switching is consistent within children and reliably associated with intake across varied eating events. We analyzed data from 88 (45 F), 7-8-year-old children without obesity participating in a 7-visit prospective cohort study (ClinicalTrials.gov NCT03341247). Amount consumed and energy intake were measured at 4 separate meals of foods that varied by portion sizes served. Meals included macaroni and cheese, chicken nuggets, broccoli, and grapes (all 0.7-2.5 kcal/g). Children's intake was also assessed during 2 eating in the absence of hunger (EAH) paradigms separated by ≥ 1 year. The EAH paradigm included 9 sweet and savory snack foods (all 1.9-5.7 kcal/g). All eating events were video-recorded and switching was assessed by counting the number of times a child shifted between different food items. Results demonstrated that switching was reliably associated with intake at both the meals and the EAH paradigms (ps < 0.01). Specifically, at meals each additional switch was associated with 11.7 ± 1.3 kcal (7.7 ± 0.8 g) more consumed, and during EAH each additional switch was associated with 8.1 ± 2.1 kcal (2.1 ± 0.5 g) more consumed. Switching behavior was also moderately consistent across meals (ICC = 0.70) and EAH paradigms (ICC = 0.50). However, switching at meals was not related to switching at EAH paradigms. This study demonstrates the consistency of switching behavior and its reliable association with intake across eating events, highlighting its potential to contribute to chronic overconsumption and childhood obesity.

MR imaging of trauma: elbow and wrist

The use of magnetic resonance imaging (MRI) in the setting of acute trauma is increasing due to many factors including availability and demand. The ability to evaluate for occult fractures in addition to concomitant soft tissue injuries has a significant impact on patient management and MRI is the ideal adjunct to plain radiography. Occult fractures in the forearm, particularly the radial head and scaphoid, are common and often lead to repeated examinations and delayed diagnosis, which can be avoided by the use of MRI early in patient investigation. Orthopedists are increasingly performing ligament repairs at the time of fracture fixation and therefore benefit from preoperative MRI to assess the extent of soft tissue injury.

Patterns of Bone and Soft-Tissue Injury at the Symphysis Pubis in Soccer Players: Observations at MRI

OBJECTIVE

The objectives of our study were, first, to use MRI to determine the prevalence of osteitis pubis and of adductor dysfunction at the symphysis pubis in soccer players presenting with pubalgia and, second, to determine whether the two entities are mechanically related and whether one of the entities precedes or predisposes the development of the other.

MATERIALS AND METHODS

One hundred consecutive soccer players with debilitating groin pain were referred for MRI. One hundred asymptomatic age- and sex-matched elite athletes were included as control subjects. The "secondary cleft" sign was used to indicate an adductor microtear at the symphyseal enthesis. Osteitis pubis was recorded if paraarticular bone edema was identified along the symphyseal margins but was remote from the adductor attachment. Images were reviewed independently by two radiologists who were blinded to the side of symptoms. Statistical analysis was performed using the chi-square test.

RESULTS

Of 100 patients, groin pain was directly attributed to inflammation at the symphysis pubis or its muscular attachments in 97 (isolated adductor microtears, n = 47; isolated osteitis pubis, n = 9; both, n = 41). An "accessory cleft," reflecting an adductor enthetic microtear, was identified in 88 of these patients (p < 0.001); it correlated with the side of symptoms in all cases. Bone edema was identified in 91 of 100 patients: 49 had focal edema at the attachment site of the adductor tendons accompanying an adductor microtear, two patients had focal edema without an adductor tear, and 40 patients had diffuse edema in the pubic bones secondary to osteitis pubis. There was no evidence of either adductor dysfunction or symphyseal inflammation in the control subjects (p < 0.001).

CONCLUSION

In soccer players with pubalgia, adductor dysfunction is a more frequent MRI finding than osteitis pubis. The findings of this study suggest that both entities are mechanically related and that osteitis pubis and adductor dysfunction frequently coexist but, because adductor dysfunction is commonly identified in the absence of osteitis, that adductor dysfunction most likely precedes the development of osteitis pubis in soccer players. The presence of edema on fat-suppressed images of the symphysis is a strong predictor of abnormality at this site in soccer players when compared with age- and sex-matched control subjects.

High-field MRI

High-field MRI is moving rapidly from the research realm to clinical use. This modality has intrinsic advantages in signal to noise ratio, which allows images that have im-proved resolution, are obtained faster, or have less noise. Perhaps most importantly these scanners will allow functional imaging to become a reality in the musculoskeletal system. Care must be used in protocols because of the energy deposition and worsened artifacts at higher fields.

MR imaging of the diabetic foot: diagnostic challenges

Pedal complications of diabetes have long presented a challenge for the clinician and radiologist predominately related to the difficulty in distinguishing infection from neuroarthropathy. The spectrum of diabetic foot infections is broad, ranging from callous and ulcer formation, to septic arthritis, abscess formation, and osteomyelitis. This article summarizes the MR imaging findings in the diabetic foot and the optimal pulse sequences. Focus is placed on aids in differentiating diabetic infection from other entities and increasing the specificity of diagnosing diabetic foot complications.

Effect of acetylstrophanthidin on action potential duration and relation with extracellular potassium in sheep isolated Purkinje fibers

AIM

To study the relation between the effect of acetylstrophanthidin on action potential duration (APD) and the extracellular potassium concentration.

METHODS

Effect of acetylstrophanthidin (AS 0.15 mmol.L-1) on APD at different extracellular potassium concentrations was studied at the stimulation cycle lengths of 990 and 690 ms in sheep isolated cardiac Purkinje fibers using the standard microelectrode technique.

RESULTS

At [K+]o 4.0 mmol.L-1, the biphasic effect of AS on APD appeared obviously. Both APD50 and APD90 were lengthened within the first 10 min of drug exposure. After 10 min, they were shortened at all pacing cycle lengths. On the other hand, at [K+]o 5.4 mmol.L-1, AS only shortened APD markedly without lengthening effect on it. The biphasic and monophasic effects of AS on APD were found at [K+]o 4.0 mmol.L-1 and 5.4 mmol.L-1, respectively.

CONCLUSION

The effect of AS on APD was related to the concentration of [K+]o.

Donor sepsis is not a contraindication to cadaveric organ donation

Systemic donor infection is regarded as being an absolute contraindication to cadaveric organ donation for transplantation. This is largely due to fear of transmitting pathogenic organisms to the immunosuppressed recipient. However, due to the current shortage of organs available for transplantation, clinicians are faced with the option of using organs from 'non-ideal' donors, such as those patients with documented evidence of infection. We report the successful outcome of six orthotopic liver transplants, 11 renal transplants, one combined heart lung transplant and one simultaneous kidney and pancreas transplant with organs from eight donors in whom bacterial meningitis (n = 7) and acute bacterial epiglottitis (n = 1) were the antecedent causes of death.

Digoxin-induced delayed afterdepolarizations: biphasic effects of digoxin on action potential duration and the Q-T interval in cardiac Purkinje fibers

Few reports exist of digoxin-induced delayed afterdepolarizations (DADs) and triggered activity recorded in cardiac fibers, and the electrophysiological characteristics of digoxin-induced DADs and triggered activity have not been reported in detail. We studied the electrophysiological properties of digoxin-induced DADs and triggered activity is sheep cardiac Purkinje fibers. Transmembrane voltage was recorded using conventional microelectrodes and extracellular electrograms were recorded using a high-gain, signal averaging method. DADs were induced by digoxin (1.25 microM, n = 9 fibers). After exposure to the drug for 20.8 +/- 2.0 min at the pacing cycle lengths of 990, 690, and 490 msec, the DAD amplitudes were 3.7 +/- 0.3, 5.7 +/- 0.6, 6.4 +/- 0.8 mV, respectively. The coupling intervals of DADs to the previous action potential at the same cycle lengths were 845.8 +/- 37.6, 581.3 +/- 23.1, 434.6 +/- 7.0 msec, respectively. Thus, digoxin-induced DADs show typical frequency dependence. Digoxin-induced DADs also occasionally caused triggered action potentials. DADs also were recorded simultaneously using an extracellular signal averaging technique. DADs were easily detected an most of the DAD characteristics measured intracellular could be confirmed in the extracellular electrograms. Digoxin induced a biphasic effect on the action potential duration (measured at 50% of repolarization (APD50) and on the Q-T interval measured from the extracellular electrograms, and in an additional group of fibers (n = 5) this was studied in detail. Digoxin initially lengthened the APD50 and the Q-T interval within the first 10 min of drug exposure, at a time when DADs had not yet developed.(ABSTRACT TRUNCATED AT 250 WORDS)

Medial hypothalamic stimulation produces analgesia to facial heating in unrestrained rats

Gradual heating of the face in unrestrained conscious rats produced a behavioural response at a mean threshold temperature of 41.9 degrees C (S.E.M. +/- 0.02, 174 tests). This temperature did not change with tests repeated at 5-min intervals over one hour. During stimulation of the preoptic area of the hypothalamus the response temperature was consistently raised by about 3 degrees C but returned to the control level within 5 min.