Public Health.

Background: Short sleep duration, low physical activity and high sedentary time are associated with higher dementia risk. To date, previous studies have considered these behaviors in isolation, and not as inter-related behaviors part of the 24-h day. Compositional data analysis (CoDA) treats these behaviors as inter-related within a constrained 24hrs.

A Comprehensive CT Dose Reduction Program Using the ACR Dose Index Registry.

Purpose: The purpose of this article is to demonstrate the role of the ACR Dose Index Registry(®) (DIR) in a dose reduction program at a large academic health care system.

Methods: Using the ACR DIR, radiation doses were collected for four common CT examination types (head without contrast, chest with contrast, chest without contrast, and abdomen and pelvis with contrast). Baseline analysis of 7,255 CT examinations from seven scanners across the institution was performed for the period from December 1, 2011, to March 15, 2012.

A 500-kiloton airburst over Chelyabinsk and an enhanced hazard from small impactors.

Most large (over a kilometre in diameter) near-Earth asteroids are now known, but recognition that airbursts (or fireballs resulting from nuclear-weapon-sized detonations of meteoroids in the atmosphere) have the potential to do greater damage than previously thought has shifted an increasing portion of the residual impact risk (the risk of impact from an unknown object) to smaller objects. Above the threshold size of impactor at which the atmosphere absorbs sufficient energy to prevent a ground impact, most of the damage is thought to be caused by the airburst shock wave, but owing to lack of observations this is uncertain. Here we report an analysis of the damage from the airburst of an asteroid about 19 metres (17 to 20 metres) in diameter southeast of Chelyabinsk, Russia, on 15 February 2013, estimated to have an energy equivalent of approximately 500 (±100) kilotons of trinitrotoluene (TNT, where 1 kiloton of TNT = 4.

Menorrhagia II: is the 80-mL blood loss criterion useful in management of complaint of menorrhagia?

Objective: Menorrhagia is defined in terms of statistical"abnormality"as blood loss of >80 mL. We examined the usefulness of this definition in women who were referred to gynecology clinics with heavy periods.

Study Design: A questionnaire survey of 952 menstrual complaint referrals at 3 hospital gynaecology clinics in Glasgow and Edinburgh included 226 women with heavy periods who had also consented to the measurement of their blood loss.

Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods: a survey with follow-up data.

Objective: Menorrhagia is defined as blood loss of >80 mL, but in routine clinical practice measurement is seldom undertaken. Our aim was to identify the features of the clinical history that best predict menorrhagic blood loss.

Study Design: A questionnaire survey of 952 menstrual complaint referrals at 3 hospital gynecology clinics in Glasgow and Edinburgh included 226 women with putatively heavy periods who also had consented to the measurement of their blood loss.

Maternal consumption of a high-meat, low-carbohydrate diet in late pregnancy: relation to adult cortisol concentrations in the offspring.

Recent studies have linked maternal consumption of an unbalanced high-protein, low-carbohydrate diet in late pregnancy with raised adult blood pressure in the offspring. Because high-protein diets stimulate the hypothalamic-pituitary-adrenal axis, we hypothesized that an unbalanced maternal diet might increase maternal cortisol levels, exposing the fetus to excess cortisol and programming lifelong hypersecretion of cortisol. We therefore measured fasting plasma cortisol concentrations in 251 subjects, 28-30 yr old, whose mothers had been advised to eat 0.

High-meat, low-carbohydrate diet in pregnancy: relation to adult blood pressure in the offspring.

To examine the hypothesis that a high-animal protein, low-carbohydrate diet in pregnancy is associated with raised blood pressure in the adult offspring, we performed a follow-up study of 626 men and women in Motherwell, Scotland, whose mothers' food intake had been recorded during pregnancy. The mothers had taken part in a dietary intervention in which they were advised to eat 1 lb (0.45 kg) of red meat per day and to avoid carbohydrate-rich foods during pregnancy.

Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral, and management.

Objectives: To describe the menstrual experience of women referred for menstrual problems, in particular menorrhagia (excessive menstrual loss), and to assess associations with reasons for referral given by their general practitioners, the women's understanding of the reasons for their attendance at the hospital clinics, and clinic outcome.

Design: Questionnaire survey, with partial review of case notes after 8 months.

Setting: Three hospital gynaecology clinics in Glasgow and Edinburgh.

GnRH analogue in everyday gynecology: is it possible to rationalize its use?

Background: The study was an audit of patients who attended the Menstrual Disorders Clinic at Glasgow Royal Infirmary over a five year period, and received gonadotrophin-releasing hormone analog (GnRHa). We aimed to identify the clinical indications for the use of GnRHa, and the effect of the latter in terms of symptom resolution and ultimate outcome. We aim to use this information to formulate a strategy for the use of GnRHa by targeting this expensive therapy to those situations where maximum benefit will be achieved.

Endometrial apoptosis in patients with dysfunctional uterine bleeding.

Aims: To assess glandular apoptosis in the zona functionalis of proliferative phase endometrium in normal individuals and in patients with dysfunctional uterine bleeding (DUB).

Methods And Results: Routinely processed, haematoxylin and eosin-stained endometrial biopsies were assessed in 26 patients with symptomatic menstrual abnormality, mainly menorrhagia, and in 24 controls. All biopsies were in the proliferative phase and had been reported as within normal limits and consistent with the menstrual cycle dates provided.

Randomised comparative trial of the levonorgestrel intrauterine system and norethisterone for treatment of idiopathic menorrhagia.

Objective: To compare the efficacy and acceptability of the levonorgestrel intrauterine system and norethisterone for the treatment of idiopathic menorrhagia.

Design: A randomised comparative parallel group study.

Setting: Gynaecology outpatient clinic in a teaching hospital.

Scottish gynaecologists: their views on hormone replacement therapy.

In a postal questionnaire Scottish gynaecologists were asked their views on the use of Hormone Replacement Therapy (HRT). They were almost unanimous in support of HRT, but varied in the circumstances in which they would recommend it and in the length of time they would prescribe it. The need for designated Menopause Clinics was seen to be limited, with most smaller Units preferring the present practice of menopausal patients being seen at general Gynaecology Clinics.

Is screening for bacteriuria in pregnancy worth while?

A total of 4470 pregnant women were screened for bacteriuria by the dipslide method and significant growth found in 226 (5.1%). In 198 cases the urine was re-examined, in 119 by using suprapubic aspiration or catheterisation (62 (52%) samples contained bacteria) and in 79 by using midstream urine samples (26 (33%) samples contained greater than 10(8) colony forming units/1), showing the maximum prevalence of confirmed bacteriuria to be 2.

Single-dose treatment of bacteriuria in pregnancy.

Comparison of the results of single-dose treatment of urinary tract infection in women is confused by differences between published series in the duration of follow-up and in the diagnosis of infection. Pregnancy allows prolonged follow-up in a motivated population, but increases the possibility of false positive diagnosis of infection from midstream urines due to increased vulvovaginal contamination. Suprapubic aspiration (SPA) is safe in pregnancy and accurately confirms the presence or absence of bacteria in the bladder urine.

The effects of maternal cigarette smoking on placental morphology, histomorphometry, and biochemistry.

We related cigarette smoking during pregnancy to the macroscopic and microscopic morphology, histomorphometry, and biochemistry of the placenta among participants in The Prenatal Project, a randomized, controlled trial of nutritional supplementation during pregnancy. The aim was to ascertain if the harmful effects of cigarette smoking on the fetus were reflected, and possibly mediated, by changes in the placenta, and whether such changes might be modified by the nutritional supplements, parallel to the nutritional reversal of birthweight depression among heavy smokers. Maternal smoking was associated with increased alkaline ribonuclease (RNase) levels, possibly resulting in disturbed protein synthesis.

Zinc and copper in Asian pregnancies--is there evidence for a nutritional deficiency?

In 92 Hindu Asians, 59% of them vegetarian, and 51 Europeans longitudinal measurements were made during pregnancy of the zinc and copper concentrations in plasma and hair together with urinary zinc excretion, as indices of their zinc and copper status. Maternal diets were assessed once at booking. Zinc intakes ranged from 3.

Diet during pregnancy in an Asian community in Britain--energy, protein, zinc, copper, fibre and calcium.

Dietary intake of 813 pregnant Harrow Asians of mainly Gujarati descent was compared with the intake of 54 pregnant Europeans living in the same area. The diet of the Europeans had more protein and zinc but less fibre and fat that that of the Harrow Asians. The average rate of weight gain and the energy intakes were similar in both groups.

Factors affecting birthweights in Hindus, Moslems and Europeans.

The birthweights of 664 Hindu and 132 Moslem babies were compared with those of 486 European babies born at the same hospital. The mean birthweight of the Europeans was 3362 g, compared with 3146 g for the Moslems and 2960 g for the Hindus. The Asian women were smaller than the European and tended to have a shorter length of gestation.

Bacteriuria in pregnancy treated with a single dose of cephalexin.

Of 87 women in whom bacteriuria was diagnosed on dip slides at between 9 and 22 weeks gestation only 51 (59%) had true bacteriuria in urine obtained by suprapubic aspiration. A single oral dose of cephalexin (3 g) was given to 37 of these patients, 10 were Indian and none of them had recurrence of infection after treatment, whereas 11 of the 27 (41%) 'indigenous' women again had bacteriuria within 2 weeks of treatment. None of the other 26 patients had recurrent bacteriuria in the pregnancy studied.

Effects of prenatal nutritional supplementation on the placenta: report of a randomized controlled trial.

Protein and nucleic acid content, and RNase levels were measured in placentas collected at birth in a randomized controlled trial of prenatal nutritional supplementation in New York City. These biochemical indices were explored to understand better the effects of nutritional supplementation. (With high-protein supplements, gross measures had shown no improvement in outcome at birth and adverse effects on fetal growth, prematurity, and newborn survival; with balanced protein-calorie supplements, there was a nonsignificant rise in birth weight and longer gestation.