Abstract-The purpose of this study was to determine if there are gender differences in stress-induced pressure natriuresis and to examine the effects of adiposity on these differences. The subjects were 151 boys and 141 girls 15 to 18 years of age who underwent a 5-hour stress protocol (2-hour prestress, 1-hour stress, 2-hour poststress) after being brought into similar levels of sodium balance. The gender-by-condition interaction was significant for systolic and diastolic blood pressure (Pϭ0.001 for both), and the effect of condition was significant for sodium excretion (Pϭ0.001). Key Words: gender Ⅲ obesity Ⅲ stress Ⅲ sodium Ⅲ blood pressure Ⅲ natriuresis Ⅲ hypertension, sodium-dependent W e hypothesized 1 that impaired stress-induced pressure natriuresis contributes to the development of essential hypertension (HTN) and blood pressure (BP)-related target organ damage by increasing the cardiovascular load experienced as a result of the stress. Our definition of impaired stress-induced pressure natriuresis is an increase in BP during an extended period of stress without an adequate compensatory increase in urinary sodium excretion (U Na V). We provided indirect support for our hypothesis in a recent study 1 in which black compared with white youths had slower natriuresis across a series of stressors. This pattern was associated with cardiac remodeling. We provided additional support for our hypothesis in another recent study 2 that demonstrated that a significant percentage of black youths showed impaired stress-induced pressure natriuresis during an extended stress period, with BP remaining elevated as long as 2 hours after the cessation of the stressor. Subsequently, we reported 3 that obese compared with lean youths had slower natriuresis during an extended stress period despite similar levels of BP.The well-documented gender differences in cardiovascular disease and HTN have received increased attention in recent years (for recent reviews, see References 4 through 7) 4 -7 . Furthermore, gender differences in cardiovascular responses to acute stress have long been recognized. 8,9 The first goal of this study was to determine if there are gender differences in changes in BP and U Na V during extended stress. A second goal was to determine if these differences are related to adiposity. A final goal was to examine the roles of angiotensin (Ang) II and insulin on the response patterns in a subgroup of boys and girls. Methods Study PopulationThe protocol was approved by the Human Assurance Committee of the Medical College of Georgia. Written informed parental consent and subject assent were obtained before testing. The subject characteristics are provided in ProtocolOur protocol has been described previously in detail. 2,3 Briefly, the subjects were placed on a controlled sodium diet of 4000Ϯ200 mg/d for 3 days before testing. 10 On the fourth day, the subjects performed the stress protocol. The stress protocol included a pretest period of 2 hours, during which the subjects watched movies and/or listened to
We determined the efficacy of a soy-based formula compared with a cow's milk formula in infant refeeding after acute diarrhea in a randomized controlled double-blind clinical trial. Infants 2-12 months of age with diarrhea of less than one week's duration and mild or moderate dehydration admitted to a pediatric hospital or in the practice of a participating primary care pediatrician were investigated. Seventy-six patients were enrolled and 73 completed the study; 39 infants received a soy-based formula (Isomil) and 34 received a cow's milk formula (SMA). Hospitalized patients were rehydrated with an oral glucose-electrolyte solution or an iv dextrose-sodium solution. Outpatients received oral glucose-electrolyte solution. In all patients, the study formula was commenced ad libitum during the first 24 h as determined by the attending pediatrician. The primary outcome measure was duration of diarrhea, defined as time to first normal stool, when subsequent stools were normal for a 24-h period. In addition, a predetermined secondary outcome was proportion of treatment failures, defined as the need to reinstitute clear fluids because of emesis, refusal to accept study formula, need for iv fluids due to negative fluid balance or diarrhea persisting beyond 7 days after enrollment. Total duration of diarrhea was significantly longer (p = 0.03) in those receiving cow's milk (mean +/- SD 6.6 +/- 4.2 days) than in those receiving soy-based formula (4.5 +/- 3.6 days). Volume of formula intake and weight gain at 14 days were not different in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
In order to determine whether there is serologic evidence of Chlamydia pneumoniae infection in young infants with acute lower respiratory tract infection, serum samples from 86 subjects aged less than 6 months were assayed for IgG and IgM antibodies to Chlamydia pneumoniae using a microimmunofluorescence method. Infants hospitalized in Toronto, Canada, were enrolled between 15 March 1991 and 15 March 1992. No patient had infection determined by the serologic results. IgG antibody was detected at low concentrations in 32 patients, with an inverse relationship between titer and chronological age. In our setting, Chlamydia pneumoniae does not appear to be an important lower respiratory pathogen in young infants.
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