Biomedical subjects

R D Lewis

Publications and source records attributed to R D Lewis.

At least 19 recordsLinked to original sources

PubMed2000

Carpet properties that affect the retention of cat allergen.

BACKGROUND: Although the importance of carpeting on airborne levels of cat allergen (Fel d 1) has been demonstrated, no studies have been performed to determine specific properties of carpet that may affect its retention and removal. OBJECTIVES: This study characterizes factors that affect the retention of cat allergen on tufted carpets. The experiments were designed to test the hypothesis that the amount of allergen-containing dust recovered from vacuum samples of tufted carpet sources was dependent on micro (fiber) or macro (construction) retention properties of carpets. METHODS: Twenty-six types of custom manufactured carpet were spiked and embedded with reference dust containing Fel d 1. A standardized vacuum surface sampler was used to recover dust from the samples. Allergen was assayed using a standard, monoclonal antibody ELISA. RESULTS: Carpet-surface area and fluorocarbon-fiber treatments were found to have the largest effects on retention and recovery of cat allergen. The style per se of a carpet, such as loop or cut pile, does not affect allergen retention. These results are generally in agreement with previous studies on dust mite allergen retention. CONCLUSIONS: Carpets that are easiest to clean would have the following properties for release of cat allergen and in this order: low pile density and height, fluorocarbon coating of fibers, high denier per filament, and a fiber shape with a low surface area.

Allergens↗

PubMed2000

Lead abatement training for underserved populations: lessons learned.

An environmental-justice (equity) grant program was used to make accessible an existing lead-training program to minority persons and residents of low-income communities. The purpose of the program was to enhance the knowledge base within the communities concerning lead hazards and intervention strategies and expand possibilities for employment in the lead abatement industry. Barriers to attendance were anticipated and addressed, and included transportation, meals, license application fees, reminders of course date and location, and day care. The program was evaluated through measures of recruitment rates, pre- and post-testing scores, and change in perception of confidence at pre-test, post-test, and at four-month follow-up. Fee-paying registrants over the same time period were used as a comparison group. First day attendance rates for individuals recruited into the equity-grant was 59 percent, of these 94 percent completed all days. Equity and fee-paying groups had similar scores on the pre-test (p = .209), while mean scores on the final exam differed significantly (p < .001) between the groups and were 77 percent and 85 percent, respectively. After adjusting for demographic and course type attended, perceptions of self-efficacy (benefit) and outcome-effectiveness (confidence) increased significantly from pre- to post-tests for both groups and remained at post-course levels at four months follow-up. Lessons learned include: (1) Lead abatement and other related activities can be successfully taught through traditional training methods; (2) A necessary element for delivery of educational services to minority groups is forming workable ties with local community groups, but eligibility requirements must be maintained; (3) Once barriers to first-day attendance are overcome, the information necessary to perform specific work skills can be taught; (4) Positive changes in belief are not dependent on minority status, income, or education levels; (5) Training and education increased confidence in ability to perform learned skills, and belief that there will be a beneficial outcome when performed for themselves, their families, and communities; and, (6) A consensus regarding applicability of regulations must be achieved among federal, state, and local communities.

Adult↗

PubMed2000

Quantitative tests of a dual circalunidian clock model for tidal rhythmicity in the sand beach isopod Cirolana cookii.

In constant conditions (constant darkness DD[, 20 degrees C), the sand beach isopod Cirolana cookii exhibits spontaneous rhythmic swimming activity with an average free-running period of 12.5 h. The rhythms are seen as temporal adaptations to a complex interidal environment. These results support a dual circalunidian clock model for tidal rhythms in which two components of the rhythm have characteristic periods and active phase lengths and are hypothesized to be controlled by separate circalunidian clocks. A quantitative model successfully simulates many of the properties of endogenous swimming rhythms of C. cookii, including free-running behavior, entrainment, and phase-response curves (PRCs).

Animals↗

PubMed2000

Premenarcheal gymnasts possess higher bone mineral density than controls.

PURPOSE: The purpose of this study was to examine bone mineral density (BMD), body composition, dietary intake, physical activity, and energy expenditure (EE) in premenarcheal gymnasts (N = 16; age = 10.5 +/- 1.5 yr) in comparison to age- (+/- 0.35 yr), height- (+/- 2.6 cm), and weight- (+/- 1.5 kg) matched controls (N = 16; age = 10.5 +/- 1.3 yr). It was hypothesized that premenarcheal gymnasts would have higher BMD, fat-free soft tissue (FFST) mass, physical activity, and EE, but lower fat mass, percent body fat, and dietary intake than controls. METHODS: Dual energy x-ray absorptiometry was used to measure whole body, femur, and lumbar spine (L1-4) BMD, FFST, and fat mass. Three-day diet records were used to estimate mean daily dietary energy, macronutrient, and calcium intakes. Physical activity and EE were estimated by the Seven-Day Physical Activity Recall. RESULTS: The BMD means of the gymnasts were significantly higher (P < 0.05) than controls at all sites, except whole body, as were lumbar spine and femoral neck bone mineral apparent densities, despite lower protein intake expressed per kg FFST mass. Fat mass was significantly lower in gymnasts versus controls (P < 0.01) as was percent body fat (P < 0.001). Very hard physical activity during weekdays (P < 0.0001) and estimated EE (P < 0.01) were significantly higher in gymnasts compared with controls. CONCLUSION: Premenarcheal gymnasts have higher BMD than age-, height-, and weight-matched controls.

Absorptiometry, Photon↗

PubMed1999

Evaluation of four sampling methods for determining exposure of children to lead-contaminated household dust.

Childhood exposure to lead has been demonstrated to result in health effects and lead-contaminated household dust is a primary exposure source. There is a need to establish reliable methods for sampling surfaces to determine levels of lead contamination. Three vacuums (HVS3, GS80, and MVM) and one wipe method were evaluated for the collection of household floor dust under field sampling conditions within a Superfund site and demographically similar control area. Side-by-side floor samples were taken from three locations within 41 randomly selected households between August and September 1995: a child's bedroom, primary play area, and primary entrance. Analysis was performed to assess the relative collection performance of each sampler, spatial distribution of lead within a household, and correlation of lead loading with observed blood lead level, and to determine if discrete or composites samples were more predictive of blood lead levels. Approximately 90% of the floor surfaces were carpeted. The rank order of sampling methods from greatest to lowest collection efficiency was HVS3 > GS80 > wipe > MVM. The HVS3 had the highest level of precision (CV=0.05), with the GS80 and wipe precisions 0.48 and 0.053, respectively. Lead loadings for samples collected in bedrooms and living areas and composite samples using the HVS3 and wipe methods were significantly correlated with blood lead levels. Correlations between blood lead levels and composite samples were stronger for the HVS3 (R(2)=0.33, P=0.003) and wipe (R(2)=0.25, P=0.002) methods than the respective discrete samples. Regression analysis indicated that a blood lead level of 10 microgram/dl corresponds to a carpet wipe sample geometric mean of 68 microgram/ft(2). For ongoing public health purposes, such as screening and clearance testing, use of the wipe sampling method is the most appropriate. This investigation supports findings by others that the present HUD risk levels for lead in floor wipe samples may not be adequate for reducing children's blood lead levels below 10 microgram/dl.

Child↗

PubMed1999

Evidence of large particle allergen inhalation from contact with surfaces.

BACKGROUND: To establish a more accurate relationship between dust mite allergen on surfaces such as bedding with respiratory uptake, an exposure method is needed which correlates exposure of allergen on surfaces with respiratory dose. OBJECTIVES: Assess if aerodynamically large allergen particles (> 10 microm), similar in nature to dust mite allergen, is inhaled into the nose from direct head-and-hand contact with allergen contaminated surfaces. METHODS: Short ragweed pollen (20-microm diameter) was used as a surrogate for dust mite allergen exposure because of its similar aerodynamic and physiologic properties. Pillows and a section of linoleum (followed by a hand press) were embedded with 99MTechnetium labeled pollen. Particles on the linoleum were transferred to the sampler after a hand press to the surface. Simulated human exposure was performed by surface-sampling particles, at a capture velocity of the nose, onto a filter. Human evaluation of hand transfer to the nose or direct inhalation from a pillow was performed with three subjects. Percentage respiratory uptake and deposition location was determined by gamma camera imaging. RESULTS: Simulated respiratory uptake of pollen by hand-to-nose transfer and directly off pillows was 20% and 1.4%, respectively. Human subject respiratory uptake by hand-to-nose transfer and directly off pillows was 6.6% and 1.5%, respectively. Most of the regional activity was found immediately in the nasal vestibule with 13% to 39% of the total activity localized in the pharyngeal region. CONCLUSIONS: Aerodynamically large allergen particles (pollen) are inhaled and deposited into the anterior nose and pharyngeal areas of the respiratory tract from direct contact with allergen-containing surfaces.

Administration, Inhalation↗

PubMed1999

A soiling system for evaluation of house dust, allergens, and lead retention on carpets and other surfaces.

Artificial soiling of carpeted or other floor surfaces has several important applications in human exposure assessment and textile research including evaluation of textile properties, sampling devices, and cleaning regimens. A method was developed and validated to deposit uniform and reproducible known quantities of house dust, allergens, and leaded dust on carpets. The soiling apparatus consisted of a 100 cm x 60 cm inclined steel track and a plastic cylinder, with a series of staggered holes, that contains a known volume of reference house dust. After deposition, the dust is embedded by dragging a steel rod over the carpet surface. Deposition tests were performed with bulk house dust, sodium chloride, and house dust with reference quantities of dust mite allergen and lead. The apparatus deposited equivalent (arithmetic mean) amounts of dust, sodium chloride, and dust mite allergen on the front and back halves of test carpets. The introduction of inert fumed silica to the reference sample aided in dispersal of dust over test surfaces. Little to no variation in mean deposition was found within or between 4 days of testing. Using a grid containing weighing boats under the apparatus, spatial deposition was found to vary across a 92 x 46 cm surface by 13 percent. The apparatus deposited reproducible mean quantities of bulk dust on test surfaces from 7 g/m2 to 28 g/m2 with a coefficient of variation ranging from 4-6 percent. The apparatus could be altered to deliver smaller or larger amounts of dust.

Allergens↗

PubMed1999

An MCNP-based model of a linear accelerator x-ray beam.

The Monte Carlo N-Particle radiation transport computer code (MCNP) has been employed on a personal computer to develop a simple model simulating the major components within the beam path of a linear accelerator radiation head, namely the electron target, primary conical collimator, beam flattening filter, wedge filter and the secondary collimators. The model was initially used to calculate the energy spectra and angular distributions of the x-ray beam for the Philips SL 75/5 linear accelerator, in a plane immediately beneath the flattening filter. These data were subsequently used as a 'source' of x-rays at the target position, to assess the emergent beam from the secondary collimators. The depth dose distributions and dose profiles at constant depth for various field sizes have been calculated for a nominal operating potential of 4 MV and found to be within acceptable limits. It is concluded that the technique may be used to calculate the energy spectra of any linear accelerator upon specification of the component dimensions, materials and nominal accelerating potential. It is anticipated that this work will serve as the basis of a quality control tool for linear accelerators and treatment planning systems.

Biophysical Phenomena↗

PubMed1999

Body-composition changes with diet and exercise in obese women: a comparison of estimates from clinical methods and a 4-component model.

BACKGROUND: Most methods available to clinicians for estimating body-composition changes have been validated against estimates from densitometry, based on a 2-component (fat mass and fat-free mass) model. OBJECTIVE: Estimates of changes in percentage body fat (%BF) from dual-energy X-ray absorptiometry (DXA), skinfold thicknesses (SFTs), bioelectrical impedance analysis (BIA), and body mass index (BMI; in kg/m2) were compared with estimates from a 4-component (fat, water, mineral, and protein) model (%BFd,w,m), a more accurate method. DESIGN: Determinations of body density from hydrostatic weighing, body water from deuterium dilution, bone mineral and %BF from whole-body DXA, resistance from BIA, and anthropometric measures were made in 27 obese women (BMI: 31.1 +/- 4.9) assigned to 1 of 3 groups: control (C; n = 9), diet only (DO; n = 9), or diet plus aerobic exercise (DE; n = 9). RESULTS: After the 16-wk intervention, changes in body mass (BM) averaged 0.5 +/- 2.0, -7.2 +/- 7.4, and -4.0 +/- 3.3 kg and changes in %BFd,w,m averaged 2.1 +/- 1.0%, -1.2 +/- 1.4%, and -2.4 +/- 1.6% in the C, DO, and DE groups, respectively. Compared with changes in %BFd,w,m, the errors (SD of bias) for estimates of changes in %BF by DXA, BIA, SFTs, and BMI were similar (range: +/-2.0-2.4% of BM). BIA, SFTs, and BMI provided unbiased estimates of decreases in %BFd,w,m, but DXA overestimated decreases in %BF in the DO and DE groups. CONCLUSIONS: DXA, BIA, SFTs, and BMI are comparably accurate for evaluating body-composition changes induced by diet and exercise interventions; however, small changes in %BF may not be accurately detected by these clinical methods.

Absorptiometry, Photon↗

PubMed1999

Effects of diet and exercise on the density and composition of the fat-free mass in obese women.

PURPOSE: The purpose of this study was to determine whether the density (D(FFM)) and composition of the fat-free mass (FFM) and the accuracy of estimates of body composition from body density (%Fat(d)) are affected by diet and exercise. METHODS: Twenty-nine obese women (body mass index (BMI) = 25.0-43.7 kg x m(-2) and %Fat(d) = 35.7-47.1%) were assigned to one of three groups: diet only (DO, N = 9); diet and aerobic exercise (DE, N = 9); or control (C, N = 11). Measures of body density by hydrostatic weighing, body water by deuterium dilution, and bone mineral by whole-body dual-energy x-ray absorptiometry, and estimates of body composition from body density and from a four-component model were obtained before and after a 16-wk diet and exercise intervention. RESULTS: Mean (+/- SD) changes in body mass were -7.2 +/- 7.4, -3.9 +/- 3.3, and +1.2 +/- 2.8 kg for the DO, DE, and C, respectively. The density and composition of the FFM did not change significantly (P > 0.05) in any of the groups. Individual changes in D(FFM) (-0.011 to +0.011 g x mL(-1)), and differences between changes in %Fat estimated using a four-component model and %Fat(d) (-2.1 to +2.7% body mass) were not related to changes in body mass (r = -0.08). Individual changes in D(FFM) were most strongly related to changes in water fraction (r = -0.95) and protein fraction (r = +0.88), and were unrelated to changes in the mineral fraction (r = +0.04) of the FFM. CONCLUSIONS: We conclude that in obese women, the density and composition of the FFM are unaltered and densitometry correctly assesses group mean changes in body composition with moderate weight loss induced by diet or diet and aerobic exercise. However, individual deviations in D(FFM) from the assumed value of 1.1 g x mL(-1) are substantial, and a multi-component model in which body water is measured is needed to accurately assess individual body composition changes resulting from diet and exercise.

Adult↗

PubMed1999

Impact of bone mineral estimates on percent fat estimates from a four-component model.

PURPOSE: The primary purpose of this study was to determine the impact of bone mineral content (BMC) from QDR 1000/W and DPX-L dual-energy x-ray absorptiometers (DXA(QDR) and DXA(DPX-L) on percent fat (%fat) estimates from a four-component model. A secondary purpose was to test the accuracy of %fat estimates from DXA(QDR) and DXA(DPX-L) using %fat estimates from a four-component model as the criterion. METHODS: Percent fat, fat mass, and fat-free mass (FFM) were determined from DXA(QDR) and DXA(DPX-L) and from a four-component model based on measures of body density from underwater weighing, body water from deuterium dilution, and BMC from DXA(QDR) (4C(QDR)) or DXA(DPX-L) (4C(DPX-L)) in young men (N = 14) and women (N = 10). RESULTS: BMC was significantly lower using DXA(QDR) compared with DXA(DPX-L) (approximately 11%), resulting in slightly lower estimates of %fat and fat mass and slightly higher estimates of FFM from 4C(QDR) than 4C(DPX-L). Although estimates of %fat, fat mass, and FFM from DXA(QDR) and DXA(DPX-L) were not different than those from a four-component model, there was considerable individual variability between methods. Furthermore, %fat from DXA(QDR) was lower than %fat from 4C(DPX-L). CONCLUSIONS: We conclude that using BMC from different DXA instruments has a minimal impact on %fat, fat mass, and FFM estimates from a four-component model. The large variability in %fat estimates between the two DXA instruments and those from a four-component model does not support DXA as a criterion method of body composition. Further studies involving larger sample sizes and specific population groups are needed to assess the validity of body composition measurements from DXA.

Absorptiometry, Photon↗

PubMed1999

Control systems models for the circadian clock of the New Zealand weta, Hemideina thoracica (Orthoptera: Stenopelmatidae)

The New Zealand weta, Hemideina thoracica, is a nocturnal orthopteran insect which emerges from holes in trees or from under bark soon after sunset to forage for several hours on plant and animal material before returning to its refuge before dawn. In tests of the internal clock hypothesis it exhibits clear circadian locomotor rhythms in which the period is initially somewhat less than 24 h, but frequently spontaneously increases to over 25 h. The rhythms are entrainable by light and temperature cycles, obey Aschoff's Law and are temperature compensated. A single oscillator feedback model accounts for these basic properties of the weta clock, but does not explain a variety of examples of rhythm lability, such as day skipping, spontaneous change in period, scalloping and desynchrony typically found in the real data. To account for these characteristics the model is expanded into two linked populations of oscillators, which retain the basic properties of the simple model and in addition interact through their coupling to show the various types of free-run lability. To make these control systems models compatible with the molecular interpretation of circadian biology, each of the components in the feedback loop is matched with molecular function and structure.

Animals↗

PubMed1999

Longitudinal bone mineral density changes in female child artistic gymnasts.

Changes in bone mineral density (BMD), and related factors, in female child artistic gymnasts (n = 9) and their age- (+/-0.3 years), height- (+/-2.8 cm), and weight- (+/-1.7 kg) matched controls (n = 9) were prospectively examined. It was hypothesized that gymnasts would possess higher BMD at baseline, 6, and 12 months later and have greater gains in BMD over 1 year compared with controls. BMD (g/cm2) of the total proximal femur (TPF), Ward's triangle (WT), trochanter (Troch), femoral neck (FN), lumbar spine (LS, L1-L4), and total body (TB) were measured by dual-energy X-ray absorptiometry. Physical activity was measured by a 7-day recall; daily dietary intakes of energy and nutrients were estimated from 3-day records. Serum osteocalcin and urinary pyridinium cross-links were measured by radioimmunoassay and high performance liquid chromatography, respectively. Gymnasts versus controls possessed significantly higher BMD at all sites measured. Although not significantly different (p > 0.05), gymnasts compared with controls had moderately larger percentage changes in Troch (% Delta = 8.6 +/- 3.0 vs. 3.8 +/- 5.1%, d = 0.41), FN (% Delta = 6.1 +/- 1.2 vs. 3.9 +/- 1.6%, d = 0.55), LS (% Delta = 7.8 +/- 1.1 vs. 6.8 +/- 1.6%, d = 0.26), and TB BMD (% Delta = 5.6 +/- 0.8 vs. 3.4 +/- 0.7%, d = 0.98) as evidenced by the magnitude of the effect sizes (d). Gymnasts versus controls possessed a lower percentage body fat (p < 0.01) and engaged in more hours of very hard activity (p < 0.0001). Calcium, as a percentage of adequate intake, decreased over 12 months (p < 0.01), and urinary cross-links significantly decreased over 6 months in both groups. Female child gymnasts possess higher BMD at the TPF and related sites, LS, and TB compared with nongymnast controls, and 1 year of gymnastics training moderately increases Troch, FN, LS, and TB BMD for gymnasts compared with controls. These findings lend support to the idea that gymnastics training in childhood helps maximize peak BMD.

Adipose Tissue↗

PubMed1998

Pollen and fungal spores indoor and outdoor of mobile homes.

BACKGROUND: Allergenic diseases triggered by aeroallergens extract a health cost in quality of life and in economic impact. People generally spend 90% to 95% of their time indoors, so understanding the environmental factors that affect the presence of aeroallergens indoors are important in understanding health impact and potential intervention methods. OBJECTIVE: Describe the relationship of indoor airborne pollen and fungal spores in occupied mobile homes with outdoor concentrations and other environmental factors within geographically diverse areas of Texas. METHODS: Airborne pollen and fungal spores were collected during the daytime with RotoRod samplers indoor and outdoor of mobile homes in Houston and El Paso, Texas. Samples were counted simultaneously with a dual eyepiece microscope and identified morphologically and through staining techniques. RESULTS: Geometric mean concentrations (counts/m3) indoors and outdoors for pollen, respectively, were Houston 7.1 and 196.4; and El Paso 17.5 and 71.5. Geometric mean concentrations (counts/m3) indoors and outdoors for spore, respectively, were Houston 98.5 and 196.4; and El Paso 36.9 and 71.5. Indoor to outdoor ratios (I/O) for pollen and fungal spores were found to be higher on average than has been previously reported. Modeling of predictive factors in Houston demonstrate that 62% and 41% of indoor levels of pollen and fungal spores, respectively, can be explained by their corresponding outdoor levels. These data suggest that the many factors associated with individual exposure to airborne pollen and fungal spores indoors are under the control of the occupant, and may additionally be influenced by the physical characteristics of mobile homes, in particular the high surface area to volume ratio and restricted flow patterns.

Air Pollution, Indoor↗

PubMed1998

Factors affecting the retention of dust mite allergen on carpet.

Carpeting is one of the most common and perhaps the most important reservoir of aeroallergens and other components of dust found in residential or commercial settings. This research evaluated factors that affect the retention of dust mite allergens on different types of tufted carpet commonly found in homes and offices. Twenty-six types of carpet were custom manufactured as part of a two-stage factorial experiment using 182 carpet samples. Carpets differed with respect to fiber denier, cross-sectional shape, presence of fluorocarbon treatment, carpet style, pile height, and pile density. The major hypothesis tested was that the amount of allergen-containing dust recovered from vacuum samples of tufted carpet sources was dependent on micro (fiber) or macro (construction) retention characteristics of the carpets. Carpet samples were doped in a uniform and reproducible manner using an allergen-containing reference dust. A standardized vacuum surface sampler was used to recover dust from samples. Allergen was assayed using a standard, monoclonal antibody ELISA. Carpet-surface area and presence of fluorocarbon were found to have the largest effects on retention and recovery of dust and allergen. Specifically, fluorocarbon treatment of fibers, square-hollow fiber shape, high-denier fiber, low-pile height in cut-pile carpets, and low-pile density in loop carpets were significantly associated with increased release and recovery of allergen. Results from this study suggest that carpet type be considered for both allergen avoidance and allergy and asthma risk assessment.

Allergens↗

PubMed1998

Whole body composition of rats determined by dual energy X-ray absorptiometry is correlated with chemical analysis.

The use of dual energy X-ray absorptiometry (DXA) is increasing in animal research, but data comparing whole body composition by DXA and chemical analysis (CHEM) in rats are limited. Lean and obese Zucker female rats were used to compare DXA (QDR1000W, Hologic, Waltham, MA) values with CHEM data for percent fat (%FATDXA, %FATCHEM), lean body mass (%PROTDXA, %PROTCHEM) and bone mineral content (%BMCDXA, %ASHCHEM). Four groups of rats (n = 9) were tested for differences in body composition due to consumption of a 100 g guar gum supplement/kg to see if DXA was as sensitive as CHEM in detecting body composition differences induced by diet. The study was analyzed using a split-plot ANOVA where the main plot was a 2 x 2 factorial with phenotype (obese or lean) and treatment (guar gum or control) as the effects, and the subplot was method of detecting body composition (DXA and CHEM), which was treated as a repeated measure. Absolute values for percent fat differed significantly (P < 0.0001) between the two methods as %FATDXA was consistently higher than %FATCHEM. There was not a statistically significant difference due to method for %PROT (P = 0.13). Values for %BMCDXA were significantly (P < 0.0049) lower than %ASHCHEM values. The differences in body composition due to diet treatment were detected similarly by DXA and CHEM. Significant correlations were found between the methods (P < 0.0001) for %FAT (r = 0.99), %PROT (r = 0.96) and %BMC or ASH (r = 0.81). Bland-Altman plots showed good agreement between methods, and regression equations were developed to estimate CHEM values from DXA readings. DXA may provide an alternative method for assessing changes in whole body composition.

Absorptiometry, Photon↗

PubMed1998

The impact of vasodilators on random-pattern skin flap survival in the rat following mainstream smoke exposure.

This study demonstrates that acute mainstream cigarette smoke exposure is deleterious to dorsal random-pattern skin flap survival in the rat. Three vasodilators were also studied for their ability to mediate flap survival after smoke exposure. Sprague-Dawley rats (10 per group) were exposed to two cigarettes per day over a 14-day period. This is an exposure equivalent to that of an average cigarette smoker. Dorsal McFarlane caudally based random-pattern skin flaps (4 x 10 cm) were created on day 7 of the smoke exposure. Enteral phenoxybenzamine (0.56 mg per kilogram per day), enteral nifedipine (10 mg per kilogram per day), and topical nitroglycerin (1.3 cm or 7.5 mg per day) were administered after creation of the dorsal skin flaps in two doses daily during smoke exposure. Fluorescein was used to delineate areas of viability accurately. A pad digitizer was utilized to calculate designated skin flap areas to +/-1.0 mm2. Experimental animals demonstrated a 23% decrease (p < 0.01) in skin flap area survival compared with the control animals. The phenoxybenzamine group demonstrated a 5.5% increase in flap area survival (p=0.068), the nifedipine group demonstrated a 4.1% increase in flap area survival (p=0.049), and the nitroglycerin group demonstrated an 8.9% increase in flap area survival (p=0.049). These data suggest that phenoxybenzamine appears to affect skin flap survival marginally after smoke exposure. However, nifedipine and nitroglycerin improve random-pattern skin flap survival significantly after mainstream cigarette smoke exposure in the rat. These results imply that pharmacological intervention with vasodilators may ultimately prove clinically useful for random-pattern skin flap salvage in the cigarette-smoking patient.

Animals↗

PubMed1998

Nutrition, physical activity, and bone health in women.

Calcium and vitamin D can significantly impact bone mineral and fracture risk in women. Unfortunately, calcium intakes in women are low and many elderly have poor vitamin D status. Supplementation with calcium (approximately 1000 mg) can reduce bone loss in premenopausal and late postmenopausal women, especially at sites that have a high cortical bone composition. Vitamin D supplementation slows bone loss and reduces fracture rates in late postmenopausal women. While an excess of nutrients such as sodium and protein potentially affect bone mineral through increased calcium excretion, phytoestrogens in soy foods may attenuate bone loss through estrogenlike activity. Weight-bearing physical activity may reduce the risk of osteoporosis in women by augmenting bone mineral during the early adult years and reducing the loss of bone following menopause. High-load activities, such as resistance training, appear to provide the best stimulus for enhancing bone mineral; however, repetitive activities, such as walking, may have a positive impact on bone mineral when performed at higher intensities. Irrespective of changes in bone mineral, physical activities that improve muscular strength, endurance, and balance may reduce fracture risk by reducing the risk of falling. The combined effect of physical activity and calcium supplementation on bone mineral needs further investigation.

Accidental Falls↗