This cross-sectional study aimed to provide an assessment of the needs for health promotion in university freshmen, based on lifestyle variables and the interest in health-promoting activities. A questionnaire survey was performed using a sample of 288 male and 362 female university freshmen from 19 to 33 years of age. Male students were significantly more likely to engage in drug-taking behaviors, referring to alcohol and cannabis use, and had a higher body mass index. No gender difference was noted in the numbers of regular smokers. Preventive behaviors with respect to healthy nutrition and dental hygiene were reported more often in females, whereas the duration of physical activity per week and the use of condoms with a new sexual partner showed no gender difference. There was a strong demand for group health-oriented programs (79.5% of respondents). Substantial proportions of students had a high interest in individual counseling aiming at stress management (24.5%), healthy nutrition (19.3%) and prevention of sexually transmitted diseases (18.2%). Women expressed a greater interest in most programs than men. Multivariate regression analyses showed that a disposition for alcohol abuse was the strongest predictor of interest in health counseling in male students (p < 0.001), while psychosocial stress was the most important predictor in female students (p < 0.001). From the prevalence of health risks and the students' interest in health promotion programs it was concluded that there is a strong need for health promotion in the university setting in Germany. Results suggested that individuals at risk would probably benefit most from an individual counseling program.

No abstract

The pathogenesis of some components of the lipodystrophy (LD) syndrome might be linked to the use of nucleosides. Earlier reports did not compare treatment regimens according to the nucleoside backbone. We studied a cohort of individuals who did not switch between stavudine and zidovudine. LD was defined to be present if one of three criteria was met: self-report by the patient, observation by an investigator who had known the patient since commencement of highly active antiretroviral therapy (HAART), or examination by a physician masked to therapy. The mean duration of therapy was 101 weeks (range: 26-234 weeks). Overall prevalence of LD was 48.7%. Lipoatrophy and lipohypertrophy occurred in 33.9% and 28.7% of patients, respectively. Logistic regression showed four parameters to be significantly associated with lipoatrophy: HAART longer than 2 years (p =.002, odds ratio [OR] = 4.4, 95% confidence interval [CI]: 1.608-11.965), baseline viral load >100,000 copies/ml (p =.004, OR = 4.3, CI: 1.726-11.197), age >40 years (p =.016, OR = 3.2, CI: 1.247-8.373), and white ethnicity (p =.041, OR = 5.4, CI: 1.070-28.184). Cholesterol levels of >200 mg/dl at baseline were associated with a risk reduction (p =.047, OR = 0.36, CI: 0.130-0.987). Use of lipohypertrophy as a dependent variable resulted in a significant association with HAART duration (p = 0.028, OR = 2.7, CI: 1.2-6.5) and protease inhibitor use (p =.014, OR = 3.8, CI: 1.3-11.2). LD prevalence is similar with both backbones using stavudine or zidovudine. This is the first time that baseline cholesterol was shown to be significantly associated with lipoatrophy.

Details of 25 cases of neonatal systemic air embolism, including three of our patients, are reviewed. This rare complication of respiratory distress syndrome (RDS) was observed in 21 premature infants and 4 fullterm newborns, of whom 23 required intermittent positive pressure ventilation (IPPV). In 21 of these patients air embolism was preceded by pulmonary interstitial emphysema, pneumomediastinum, pneumothorax and/or pneumopericardium. Air embolism occurred between 3 and 288 hours after delivery. The outcome was lethal in 24 cases, only one patient survived. Two main pathogenic mechanisms are discussed; entrance of air from ruptured alveoli into the lung capillaries and introduction of air via catheters in umbilical vessels.

The role of oral contraceptives (OC) in the aetiology of cutaneous malignant melanoma (CMM) has been controversially discussed over the last two decades. In an extensive literature search we identified 18 case-control studies, published between 1977 and 1996, offering information on this relationship. Using a meta-analytical approach we combined the study-specific risk estimates and derived a summary odds ratio of 0.95 (95% confidence interval: 0.87-1.04). Based on the data of 3796 cases and 9442 controls, we thus found no evidence for an aetiological role of OC use in the development of CMM.

No abstract

Summaryvreterm infants have not led to conclusive results (2. 8. 15). This Patency of the ductus arteriosus in preterm infants is mediated by vasodilating prostanoids; however, reliable methods to monitor prostanoid activity or production in preterm infants are lacking. We measured the excretion rates of major and characteristic urinary metabolites of prostacyclin (PG12), PGEl, and PGE2, 6-keto-PGF1,, and 7cr-hydroxy-5,ll-diketotetranorprostane-1,16-dioic acid (PGE-M), respectively. Besides these parameters which reflect total body prostanoid turnover and production, the urinary levels of PGE2 and PGFz,, the primary prostaglandins, were measured as an index of renal prostanoid synthesis. There were four study groups. One contained 11 thriving preterm infants; a second, six preterm infants with respiratory distress syndrome (RDS); a third, 30 preterm infants with RDS and patent ductus arteriosus (PDA); and a fourth, nine fullterm infants. All infants with RDS required artificial ventilation. There were no significant differences in PGE-M, PGE2, and PGF2, excretion rates among the various groups; however, a significant increase of the 6-keto-PGF,, excretion rates was observed in the groups of infants with RDS and with and without PDA (P < 0.01 and P < 0.02, respectively). Spontaneous (n = 2) or indomethacin-induced (n = 6) closure of PDA was associated with weaning from the respirator and a concomitant drop into the normal and subnormal range of the excretion rates of 6-keto-PGF,, ( P < 0.01) and PGE-M ( P < 0.02).Abbreviations GC-MS, gas chromatography-mass spectrometry PDA, patent ductus arteriosus PG, prostaglandin PGE-M, 7cu-hydroxy-5,ll-diketotetranorprostane-l,16-dioic acid PG12, prostacyclin RDS, respiratory distress syndrome There is increasing evidence that persistent PDA in preterm infants with RDS is mediated by vasodilating prostanoids (4, 18). But it is still a matter of debate whether increased prostanoid production or increased prostanoid sensitivity of ductal tissue is the major cause of PDA persistence in preterm infants with RDS (2, 3). It is not known whether PGIz or PGE,, both vasodilating prostanoids, is the actual mediator of ductal dilation in these infants. Nor is it known which organ or tissue is mainly involved in the production of these prostanoids.Several attempts to assess prostanoid activity by radioimmunologic determinations of PGE2 in the peripheral circulation of is not unexpected due to the numerous drawbacks related to measurements of primary (parent) PGs (1 1). There are four major concerns of this approach. 1) Very low circulating levels of primary PGs are expected because of the very rapid metabolism of these compounds and single blood measurements might easily miss rapid fluctuation of PG release. 2) Primary PGs might be released from platelets and white cells during collection and handling of blood samples. 3) Protein binding of prostanoid in blood and plasma may interfere with several conventional extraction procedures. 4) Radioimmunologic assays of prostanoids may lack the...

Twenty cases of hemothorax in newborns, including 4 of our own patients, are reviewed in detail. This unusual cause of acute respiratory distress within the neonatal period was observed in 14 males and 6 females. Most of the patients were fullterm newborns. As causal factors hemorrhagic disease of the newborn (vitamin K deficiency), disseminated intravascular coagulation, arteriovenous malformations and pleural/vascular rupture are considered. The time of occurrence of bleeding symptoms ranged from 1 to 28 days of life. Sixteen out of 20 patients survived without sequelae, but in 4 cases the outcome was lethal.