No abstract

Fig 1-Mean changes in blood flow, diastolic diameter, and distensibility ofbrachial artery in 12 diabetic subjects and 12 controls during reactive hyperaemia, 1Oug glyceryl trinitrate, and 400 ,ug glyceryl trinitrate. Bars show 95% confidence intervals (9) mm Hg; blood flow 45 (28) v 49 (41) m/min; diastolic diameter 482 (0 60) v 4-47 (1P05) mm; distensibility 4-8 (1-4) v 5 9 (1-6) per kPa). During reactive hyperaemia, heart rate, blood pressure, and the increase in brachial artery blood flow (5548% (99 5%) v 590% (106&6%)) were similar in diabetic and normal subjects (figure 1) but the increases in brachial artery diastolic diameter (1 2% (2-7%) v 9-1% (4-4%); difference 6-9% (95% confidence interval 4.9% to 11%)) and distensibility (-15-3% (10-4%) v 31% (31-7%); difference 46-3% (25-5% to 67<1%)) were significantly less in diabetic subjects (both P < 0-00 1). After 10 ,ug glyceryl trinitrate or 400 ,ug glyceryl trinitrate the increase in flow, diameter, and distensibility was similar in diabetic and normal subjects (figure 1). 700-Comment Endothelium dependent, flow related dilatation and increase in distensibility of the brachial artery are greatly impaired in patients with non-insulin dependent diabetes, but endothelium independent responses induced by glyceryl trinitrate are similar to those in normal subjects. Loss of flow related increase in arterial distensibility will augment systolic pressure, myocardial wall stress, and heart work relative to stroke output, potentially promoting left ventricular hypertrophy and lowering ischaemic threshold. Late systolic pressure will be further augmented by early wave reflection from the periphery3 because pulse wave velocity is increased when distensibility is reduced. Loss of flow mediated vasodilatation reflects endothelial dysfunction and may thus also provide a marker of atherogenetic susceptibility. Our data provide evidence ofvascular dysfunction in non-insulin dependent diabetes before the appearance of microalbuminuria, previously regarded as its earliest marker.4We thank Dr J R Peters for allowing us to study patients under his care and Wendy Simons and Julie-Ann Davies for their secretarial assistance.Funding: British Heart Foundation. Conflict of interest: None.

OBJECTIVE. The objective of this study was to determine whether healthy 2-to 3-day-old newborns have better memory of a spoken word after a typical feeding (breast milk or formula) than before a feeding and, if so, whether memory is related to blood glucose. METHODS.A naturalistic study was conducted in which delayed recognition memory of a spoken word was examined in 60 healthy 2-to 3-day-old newborns either 120 minutes after their previous feeding (preprandial) or 30 minutes after their last feeding (postprandial). In this procedure, infants initially turn their head toward a novel word (orientation) and with repeated presentations cease turning toward it (habituation). Mean number of trials to reach orientation and habituation criteria provides measures of attention and rate of learning, respectively. After a 100-second delay, the word is presented again. Infants either turn toward it, indicating that they have forgotten it, or remain habituated, indicating that they remembered the word. Percentage of trials with head turns toward the word after the delay is the principal dependent measure.RESULTS. The postprandial group was split at the median for blood glucose to define high-and low-glucose groups. All 3 groups showed similar rates of orientation and habituation. On reexposure to the word during postdelay trials, the preprandial group displayed less retention than the postprandial high and low groups. No correlation was found between memory and blood glucose levels. The postprandial high blood glucose level differed statistically from the preprandial level, whereas the postprandial low level did not.CONCLUSIONS. Memory for spoken words in newborns is better after a typical milk feeding than before a feeding. This feeding effect is specific to memory and does not include attention or rate of learning. Also, it is not necessarily associated with increased blood glucose. It remains to be seen whether feeding enhances memory for other types of stimuli and what implications this may have for development. T HE INTAKE OF food affects memory in both wellnourished human and non-human animals across different ages. In adult and preweanling infant rats, subcutaneous injections of the carbohydrate glucose (versus saline) enhance memory storage and retrieval. [1][2][3] In humans, ingestion of a glucose drink, compared with placebo, improves declarative verbal memory as well as storage and retrieval processes in healthy young adults, 4 the elderly, 5,6 and populations that are known to exhibit memory deficits, such as patients with mild Alzheimer's disease. 7,8 This may explain why eating breakfast as opposed to missing breakfast leads to improved performance on memory and learning tasks in well-nourished school-aged children and university students. 9 Altogether, these data suggest an important role of nutrient intake on memory across different ages and raise the question of whether fluctuations in memory with acute nutritional intake are present from birth.We recently assessed whether ingestion of a glucose sol...

A case-control study was conducted to study the association between breast-feeding and inguinal hernia. The case group was significantly less often breast fed than control subjects (odds ratio, 0.49; 95% confidence interval, 0.29 to 0.83) and exclusive breast-feeding was associated with a significant dose-response risk reduction. The association was not confounded by birth weight, maternal education, type of birth, number of other children in the family, or gender. Breast-feeding may represent a protective factor against inguinal hernia.