During a survey of young subjects not receiving treatment for hypertension in Tecumseh, Michigan, clinic and self-monitored blood pressures taken at home (14 readings in 7 days) were obtained in 737 subjects (387 men, 350 women, average age 31.5 years). Hypertension in the clinic was diagnosed if the clinic blood pressure exceeded 140 mm Hg systolic or 90 mm Hg diastolic. In the absence of firm criteria for what constitutes hypertension at home, subjects whose average home blood pressure was in the upper decile of the whole population were considered to have hypertension at home. By these criteria, 7.1% of the whole population had "white coat" hypertension (i.e., high clinic but not elevated home readings). The prevalence of "sustained" hypertension (i.e., high readings in the clinic and at home) was 5.1%. Subjects with white coat and sustained borderline hypertension in Tecumseh were very similar. Both groups showed, at previous examinations (at ages 5, 8, 21, and 23 years), significantly higher blood pressure readings than the normotensive subjects. As young adults (average age 333 years), the parents of both hypertensive groups had significantly higher blood pressure readings than the parents of normotensive subjects. Both hypertensive groups had faster heart rates, higher systemic vascular resistance, and higher minimal forearm vascular resistance. Both hypertensive groups were more overweight, had higher plasma triglycerides, insulin, and insulin/glucose ratios than normotensive subjects. The white coat hypertensive group also had lower values of high density lipoprotein than the normotensive group. White coat hypertension is a frequent condition. In regards to excessive risk of hypertension (past blood pressures, parental blood pressures, weight, and heart rate), excessive risk for atherosclerosis (triglycerides and insulin), and hemodynamic parameters (vascular resistance and minimal forearm resistance), the white coat and sustained hypertensive groups are similarly different from the normotensive group. These findings do not support the accepted practice of using home blood pressure determination to distinguish groups of borderline hypertensive subjects with a lesser or greater clinical problem. (Hypertension 1990;16:617-623) T he clinical usefulness of ambulatory blood pressure monitoring rests on the original report of Sokolow et al 1 on patients with moderately severe hypertension. They found a strong correlation between cardiovascular morbidity and the average ambulatory blood pressure, whereas the correlation with the casual clinic blood pressure and morbidity was weaker. This finding in moderate sustained hypertension has been extrapolated to much milder forms of hypertension. It is assumed that patients with borderline blood pressure elevation who have "white coat" hypertension (i.e., show high office readings but normal values outside of the physician's office) have a less serious problem. We advocated the technique of home blood pressure readings by self-determination 2 -4 as a simple, reproduci...

The purpose of this descriptive pilot study was to evaluate an evidence-based social-networking intervention aimed at reducing the incidence of Chlamydia among 15- to 24-year-olds. The intervention consists of a Facebook site that addresses signs, symptoms, treatment, screening, and prevention of Chlamydia infection. Findings included a 23% self-reported increase in condom utilization, and a 54% reduction in positive Chlamydia cases among 15- to 17-year-olds. Study results support that social media may be an effective mechanism for information dissemination and the promotion of positive behavioral changes among this population.

Background/ObjectivesA diet rich in dairy and calcium (Ca) has been variably associated with improvements in body composition and decreased risk of type 2 diabetes. Our objective was to determine if a dietary pattern high in dairy and Ca improves weight loss and subjective appetite to a greater extent than a low dairy/Ca diet during energy restriction in overweight and obese adults with metabolic syndrome.Subjects/Methods49 participants were randomized to one of two treatment groups: CONTROL [low dairy, ~700 mg/day Ca, −500 kcal/d] or DAIRY/CA [high dairy, ~1400 mg/day Ca, −500 kcal/d] for 12wk. Body composition, subjective ratings of appetite, food intake, plasma satiety hormones, glycemic response and inflammatory cytokines were measured.ResultsCONTROL (−2.2±0.5 kg) and DAIRY/CA (−3.3±0.6 kg) had similar weight loss. Based on self-reported energy intake, the percent of expected weight loss achieved was higher with DAIRY/CA (82.1±19.4%) than CONTROL (32.2±7.7%)(P=0.03). Subjects in the DAIRY/CA group reported feeling more satisfied (P=0.01) and had lower dietary fat intake (P=0.02) over 12wk compared to CONTROL. Compared to CONTROL, DAIRY/CA had higher plasma levels of peptide tyrosine tyrosine (PYY, P=0.01) during the meal tolerance test at wk12. Monocyte chemoattractant protein-1 was reduced at 30 min with DAIRY/CA compared to CONTROL (P=0.04).ConclusionsIn conclusion, a dairy and Ca rich diet was not associated with greater weight loss than control. Modest increases in plasma PYY concentrations with increased dairy/Ca intake, however, may contribute to enhanced sensations of satisfaction and reduced dietary fat intake during energy restriction. Registered Trial: ClinicalTrials.gov (NCT00564551).

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Hospital practices to promote breastfeeding may be differentially implemented by maternal age. Encouraging teenage mothers to room-in with their babies may be particularly important for reducing breastfeeding disparities. Pacifier use among babies of teenage mothers requires further exploration.

Recent evidence showed that amyloid-β, Aβ(42), formed spherulites in vitro and, possibly, in vivo in Alzheimer's disease brain tissue. We now confirm the presence of spherulites in human brains and that they are composed of β sheets of amyloid. The spherulites were identical in appearance to spherulites of Aβ(42) formed in vitro which suggested that they may too be composed of Aβ. The physiological significance of this finding may be in its support of previous speculation that spherulites in human brain tissue are the 3-dimensional manifestations of what are otherwise identified as senile or neuritic plaques.

Wildlife are increasingly subject to perturbations, which can impact pathogen transmission and lead to disease emergence. While a myriad of factors influence disease dynamics in wildlife, behaviour is emerging as a major influence. In this review, we examine how perturbations alter the behaviour of individuals and how, in turn, disease transmission may be impacted, with a focus on the use of network models as a powerful tool. There are emerging hypotheses as to how networks respond to different types of perturbations. The broad effects of perturbations make predicting potential outcomes and identifying mitigation opportunities for disease emergence critical; yet, the current paucity of data makes identification of underlying trends difficult. Social network analysis facilitates a mechanistic approach to how perturbation-induced behavioural changes result in shifts in pathogen transmission. However, the field is still developing, and future work should strive to address current deficits. There is particular need for empirical data to support modelling predictions and increased inclusion of pathogen monitoring in network studies.

We present the first reference ranges for hematology (n = 35 animals), serum biochemistry (n = 62), and serum protein electrophoresis (n = 32) in physically restrained free-ranging roe deer (Capreolus capreolus). Animals were captured in box traps and physically restrained for blood sampling during the winter in Sweden, 2011-13. No clinically significant sex or age differences were found.