Documentation of body mass index and control of associated risk factors in a large primary care network

<p>Abstract</p> <p>Background</p> <p>Body mass index (BMI) will be a reportable health measure in the United States (US) through implementation of Healthcare Effectiveness Data and Information Set (HEDIS) guidelines. We evaluated current documentation of BMI, and documentation and control of associated risk factors by BMI category, based on electronic health records from a 12-clinic primary care network.</p> <p>Methods</p> <p>We conducted a cross-sectional analysis of 79,947 active network patients greater than 18 years of age seen between 7/05 - 12/06. We defined BMI category as normal weight (NW, 18-24.9 kg/m²), overweight (OW, 25-29.9), and obese (OB, ≥ 30). We measured documentation (yes/no) and control (above/below) of the following three risk factors: blood pressure (BP) ≤130/≤85 mmHg, low-density lipoprotein (LDL) ≤130 mg/dL (3.367 mmol/L), and fasting glucose <100 mg/dL (5.55 mmol/L) or casual glucose <200 mg/dL (11.1 mmol/L).</p> <p>Results</p> <p>BMI was documented in 48,376 patients (61%, range 34-94%), distributed as 30% OB, 34% OW, and 36% NW. Documentation of all three risk factors was higher in obesity (OB = 58%, OW = 54%, NW = 41%, p for trend <0.0001), but control of all three was lower (OB = 44%, OW = 49%, NW = 62%, p = 0.0001). The presence of cardiovascular disease (CVD) or diabetes modified some associations with obesity, and OB patients with CVD or diabetes had low rates of control of all three risk factors (CVD: OB = 49%, OW = 50%, NW = 56%; diabetes: OB = 42%, OW = 47%, NW = 48%, p < 0.0001 for adiposity-CVD or diabetes interaction).</p> <p>Conclusions</p> <p>In a large primary care network BMI documentation has been incomplete and for patients with BMI measured, risk factor control has been poorer in obese patients compared with NW, even in those with obesity and CVD or diabetes. Better knowledge of BMI could provide an opportunity for improved quality in obesity care.</p

Synthesis of 6-dimethyl amino-9- [3'- (O-methyl)S) -[UL-14C] -tyrosinylamino) -3'-deoxy-b-D -ribofuranosyl] Purine.

In order to investigate and further refine the mechanism of the unique cleavage activity of the 18 amino acid 2A region of the foot-and-mouth-disease virus (FMDV), the synthesis of C-14-labelled puromycin is required. Puromycin is an inhibitor of protein synthesis and is an analogue of the terminal aminoacyl-adenosine portion of aminoacyl-tRNA. A short and expedient four step synthesis of 6-dimethylamino-9-[3'-(O-methyl) (2S)-[UL-C-14]tyrosinylamino)-3'-deoxy-beta-D-ribofuranosyl] purine (C-14-labelled puromycin) starting from (2S)-[UL-C-14]-tyrosine is therefore described.</p

Synthesis of 6-dimethyl amino-9- [3'- (O-methyl)S) -[UL-14C] -tyrosinylamino) -3'-deoxy-b-D -ribofuranosyl] Purine.

In order to investigate and further refine the mechanism of the unique cleavage activity of the 18 amino acid 2A region of the foot-and-mouth-disease virus (FMDV), the synthesis of C-14-labelled puromycin is required. Puromycin is an inhibitor of protein synthesis and is an analogue of the terminal aminoacyl-adenosine portion of aminoacyl-tRNA. A short and expedient four step synthesis of 6-dimethylamino-9-[3'-(O-methyl) (2S)-[UL-C-14]tyrosinylamino)-3'-deoxy-beta-D-ribofuranosyl] purine (C-14-labelled puromycin) starting from (2S)-[UL-C-14]-tyrosine is therefore described.</p

Acromesomelic dysplasia (Marotaeux type) associated with craniovertebral junction anomaly: A report of a rare case and review of literature

Acromesomelic dysplasia Maroteaux type (AMDM) is a rare autosomal recessive osteochondrodysplasia. The responsible gene, AMDM gene, in human beings, has been mapped on 9p13-q12 chromosome by homozygous mapping and pathogenic mutation was later identified in natriuretic receptor B (NPR-B) which has been implicated in the regulation of skeletal growth. Till now, around 40 to 50 cases of AMDM have been described in the world literature. Association of the congenital craniovertebral (CV) junction anomaly has not been reported. Here we are presenting a case of AMDM, with CV junction anomaly. A 10-year boy presented with short stature (122 cm) with short distal limbs, symptomatic for thoracic kyphoscoliosis with back pain. On examination there were no neurological deficits. On radiological investigation, he was found to have short and broad phalanges and toes, thoracic kyphoscoliosis, abnormal pelvic ring, mild ventriculomegaly, cervical syringomyelia and tonsillar descent below foramen magnum, hydrocephalus, os odontoideum with Klippel-Feil anomaly. This was diagnosed as AMDM with congenital os odontoideum, Klippel-Feil anomaly with Arnold-Chiari malformation (ACM) type-1. The patient underwent posterior fossa decompression by removal of foramen magnum ring along with C1 arch for ACM type-1. Kyphosis was left for conservative treatment till further observation and required orthopedic correction in his further age. To the best of our knowledge this is a very rare entity of AMDM with congenital CV junction anomaly