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Hulme K, Werno A, White K, Spark A. A ruptured thoracic aortic aneurysm and the difficulties of confirming syphilis. Forensic Sci Med Pathol 2023; 19:215-220. [PMID: 36763091 PMCID: PMC9912213 DOI: 10.1007/s12024-023-00582-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/11/2023]
Abstract
A 43-year-old woman died suddenly and was found at PM to have a ruptured thoracic aortic aneurysm. The endothelial surface of the aorta showed a 'tree-bark' appearance. Histology of the aneurysm wall showed a patchy, mainly perivascular, plasma cell infiltrate. Multiple spirochete-like organisms were identified on T. pallidum IHC. However, PM syphilis serology (screen including rapid plasma reagin (RPR) and T. pallidum particle agglutination (TPPA)) on femoral blood was negative. PCR testing on FFPE aortic wall tissue was negative. Further history revealed routine antenatal syphilis screening tests had been negative, no known history or risk of exposure to syphilis or other treponemes. This case raises the possibility of false negative syphilis testing. While acknowledged in RPR testing, with the modern testing regime using multiple methods, the rate of false negative results is now thought to be markedly reduced, and false positive results are a much greater problem in clinical medicine. The most common cause of false negative results is early in primary infection before an immune response has been mounted and in those patients that are immunocompromised. False negative results are also more often seen in tertiary syphilis, as in this case. Newer testing methods which include 16S rRNA sequencing have become available and early discussion with a microbiologist would be recommended. Strong macroscopic and microscopic suggestion of syphilis as the cause of the aneurysm makes it necessary to include the possibility of infection in the Post Mortem Report to Coroner as this will have implications for her sexual partners and children.
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Affiliation(s)
- Katherine Hulme
- Northern Forensic Pathology Service, Palmerston North, New Zealand.
| | - Anja Werno
- Canterbury Health Laboratories, Christchurch, New Zealand
- Department of Pathology, University of Otago, Christchurch, New Zealand
| | - Katherine White
- Northern Forensic Pathology Service, Palmerston North, New Zealand
| | - Amy Spark
- Northern Forensic Pathology Service, Palmerston North, New Zealand
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Morrow PL, Stables S, Kesha K, Tse R, Kappatos D, Pandey R, Russell S, Linsell O, McCarthy MJ, Spark A, Vertes D, Triggs Y, McCarthy S, Cuthers N, Massey R. An outbreak of deaths associated with AMB-FUBINACA in Auckland NZ. EClinicalMedicine 2020; 25:100460. [PMID: 32743487 PMCID: PMC7385440 DOI: 10.1016/j.eclinm.2020.100460] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 06/29/2020] [Accepted: 06/29/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND AMB-FUBINACA is a synthetic cannabinoid that has been associated with periodic outbreaks of acute poisonings, but few fatalities. In late May, June and July 2017 Auckland, New Zealand, experienced an outbreak of deaths associated with AMB-FUBINACA that continued at a rate of about 2-3 per month through February 2019. The aim of this study was to define the demographic, circumstantial, pathological and toxicological characteristics of this outbreak. METHODS All records of the Northern Forensic Pathology Service, Auckland Hospital, were reviewed in which the word "AMB-FUBINACA" was referenced, including initial police reports, autopsy reports and toxicology reports. Recorded data included age, sex, race/ethnicity, times and locations, cause of death, autopsy and toxicology findings, and a brief summary of the circumstances of death. Descriptive statistics were performed using IBM® SPSS® Statistics Version 24 and Microsoft® Excel® Version 14.7.2. FINDINGS Sixty-four cases were identified. One sudden infant death and five cases where cause of death was due to trauma were excluded. Of the remaining 58 cases, 88% were male. Mean age was 42 years. In 95% of the deaths, AMB-FUBINACA alone or in combination with alcohol or another drug was listed as the primary or contributory cause of death. In 41 cases postmortem blood concentrations of AMB-FUBINACA acid were available, ranging from <45 ng/mL to >1000 ng/mL, mean 229 ng/mL, median 140 ng/mL. Comorbidities identified included mixed intoxications (29%), heart disease (47%) and obesity (16%). A mental health diagnosis was reported in 50%, and 40% were on antipsychotic medications. INTERPRETATION This study presents characteristics, comorbidities and toxicological findings in a unique outbreak of deaths associated with the synthetic cannabinoid AMB-FUBINACA in Auckland, NZ. FUNDING All work was funded as part of the usual employment of the authors in their respective institutions. No special funding sources are reported.
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Affiliation(s)
- Paul L Morrow
- Northern Forensic Pathology Service, LabPlus, Gate 4 Grafton Rd, Auckland City Hospital, PO Box 110031, Auckland 1148, New Zealand
- Corresponding author.
| | - Simon Stables
- Northern Forensic Pathology Service, LabPlus, Gate 4 Grafton Rd, Auckland City Hospital, PO Box 110031, Auckland 1148, New Zealand
| | - Kilak Kesha
- Northern Forensic Pathology Service, LabPlus, Gate 4 Grafton Rd, Auckland City Hospital, PO Box 110031, Auckland 1148, New Zealand
| | - Rexson Tse
- Northern Forensic Pathology Service, LabPlus, Gate 4 Grafton Rd, Auckland City Hospital, PO Box 110031, Auckland 1148, New Zealand
| | - Diana Kappatos
- Institute of Environmental Science and Research (ESR), 34 Kenepuru Dr, Kenepuru, Porirua 5022, New Zealand
| | - Rishi Pandey
- Institute of Environmental Science and Research (ESR), 34 Kenepuru Dr, Kenepuru, Porirua 5022, New Zealand
| | - Sarah Russell
- Institute of Environmental Science and Research (ESR), 34 Kenepuru Dr, Kenepuru, Porirua 5022, New Zealand
| | - Oliver Linsell
- Institute of Environmental Science and Research (ESR), 34 Kenepuru Dr, Kenepuru, Porirua 5022, New Zealand
| | - Mary Jane McCarthy
- Institute of Environmental Science and Research (ESR), 34 Kenepuru Dr, Kenepuru, Porirua 5022, New Zealand
| | - Amy Spark
- Northern Forensic Pathology Service, LabPlus, Gate 4 Grafton Rd, Auckland City Hospital, PO Box 110031, Auckland 1148, New Zealand
| | - Dianne Vertes
- Northern Forensic Pathology Service, LabPlus, Gate 4 Grafton Rd, Auckland City Hospital, PO Box 110031, Auckland 1148, New Zealand
| | - Yvonne Triggs
- Northern Forensic Pathology Service, LabPlus, Gate 4 Grafton Rd, Auckland City Hospital, PO Box 110031, Auckland 1148, New Zealand
| | - Sinead McCarthy
- Northern Forensic Pathology Service, LabPlus, Gate 4 Grafton Rd, Auckland City Hospital, PO Box 110031, Auckland 1148, New Zealand
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Garland J, Philcox W, McCarthy S, Kesha K, Lam L, Spark A, Palmiere C, Elstub H, Cala A, Stables S, Tse R. Post-mortem biochemistry differences between vitreous humour and cerebrospinal fluid. AUST J FORENSIC SCI 2019. [DOI: 10.1080/00450618.2019.1597920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J. Garland
- Hornsby Ku-Ring-Gai Hospital, Hornsby, New South Wales, Australia
| | - W. Philcox
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sinead McCarthy
- Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - K. Kesha
- Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - L. Lam
- Department of Biochemistry, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - A. Spark
- Wellington Hospital Mortuary, Wellington, New Zealand
| | - C. Palmiere
- CURML, University Center of Legal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - H. Elstub
- Department of Forensic Medicine, Newcastle, Forensic & Analytical Science Service (FASS), NSW Health Pathology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - A.D. Cala
- Department of Forensic Medicine, Newcastle, Forensic & Analytical Science Service (FASS), NSW Health Pathology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - S. Stables
- Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - R. Tse
- Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
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Garland J, Philcox W, Kesha K, Morrow P, Lam L, Spark A, Palmiere C, Elstub H, Cala AD, Stables S, Tse R. Differences in Sampling Site on Postmortem Cerebrospinal Fluid Biochemistry. ACTA ACUST UNITED AC 2018; 39:304-308. [DOI: 10.1097/paf.0000000000000420] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Philcox W, Garland J, Zaidi F, Morrow P, Kesha K, Stables S, Wong CX, Spark A, Tse R. Higher Heart Weight in New Zealand Māori and Pacific Islanders. Am J Forensic Med Pathol 2018; 39:208-212. [PMID: 29698247 DOI: 10.1097/paf.0000000000000403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Heart weight is dependent on sex, age, height, and weight. Although previous autopsy studies showed no differences in heart weight between different ethnic groups, none have examined the New Zealand population of Māori and Pacific Islanders (Polynesians). The presented study compared heart weights between 101 European and 85 Polynesian suicide hanging deaths from New Zealand. Univariate linear regression coefficients for age, male sex, height, body weight, body mass index, and Polynesian ethnicity were positive and significant (P < 0.05). Apart from body mass index, subsequent multivariate analysis showed that all regression coefficients remained positive and significant (P < 0.05). Polynesian ethnicity seemed to be an independent predictor for increased heart weight in the study population. Apart from possible genetic factors, the higher heart weight in Polynesians may have other underlying reasons. Caution is required when interpreting heart weight in cases of sudden natural deaths, especially in this population.
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Affiliation(s)
| | - Jack Garland
- Hornsby Ku-Ring-Gai Hospital, Hornsby, New South Wales, Australia
| | | | - Paul Morrow
- Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Kilak Kesha
- Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Simon Stables
- Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Christopher X Wong
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Amy Spark
- Wellington Hospital Mortuary, Wellington, New Zealand
| | - Rexson Tse
- Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
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Beasley JM, Deierlein AL, Morland KB, Granieri EC, Spark A. Is Meeting the Recommended Dietary Allowance (RDA) for Protein Related to Body Composition among Older Adults?: Results from the Cardiovascular Health of Seniors and Built Environment Study. J Nutr Health Aging 2016; 20:790-796. [PMID: 27709227 PMCID: PMC5348248 DOI: 10.1007/s12603-015-0707-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Studies suggest protein intake may be associated with lower body weight, but protein has also been associated with preservation of lean body mass. Understanding the role of protein in maintaining health for older adults is important for disease prevention among this population. DESIGN Cross-sectional study of the relationship of dietary protein on body composition. SETTING New York City community centers. PARTICIPANTS 1,011 Black, White, and Latino urban men and women 60-99 years of age. MEASUREMENTS Protein intake was assessed using two interviewer-administered 24-hour recalls, and body composition was assessed using bioelectrical impedance analysis (BIA) of fat mass (kg) (FM), fat free mass (kg) (FFM), and impedance resistance (Ohms). STATISTICAL ANALYSIS Indices of FM and FFM were calculated by dividing BIA measurements by height squared (m2), and percent FFM was calculated by dividing FFM by the sum of FM and FFM. Log linear models adjusting for age (continuous), race/ethnicity, education, physical activity (dichotomized at the median), hypertension, diabetes, and total calories (continuous). RESULTS Just 33% of women and 50% of men reported meeting the RDA for protein. Both fat free mass index (FFMI) and fat mass index (FMI) were negatively associated with meeting the RDA for protein (Women: FFMI -1.78 95%CI [-2.24, -1.33], FMI -4.12 95% CI [-4.82, -3.42]; Men: FFMI -1.62 95% CI [-2.32, -0.93] FMI -1.80 95% CI [-2.70, -0.89]). After accounting for confounders, women and men consuming at least 0.8 g/kg/day had a 6.2% (95% CI: 5.0%, 7.4%) and a 3.2% (95% CI 1.1%, 5.3%) higher percent fat free mass, respectively. CONCLUSIONS FFM, FFMI, FM, and FMI were inversely related to meeting the RDA for protein. Meeting the RDA for protein of at least 0.8g/kg/day was associated with a higher percentage of fat free mass among older adults. These results suggest meeting the protein recommendations of at least 0.8 g/kg/day may help to promote lower overall body mass, primarily through loss of fat mass rather than lean mass.
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Affiliation(s)
- J M Beasley
- Jeannette M. Beasley, PhD, MPH, RD, Assistant Professor, Division of General Internal Medicine and Clinical Innovation, NYU School of Medicine, 462 First Avenue, 6th Floor CD686, New York, NY 10016, T: 646-501-4681,
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Spark A. Health at any size: the size-acceptance nondiet movement. J Am Med Womens Assoc (1972) 2001; 56:69-72. [PMID: 11326800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
A controversial new approach to obesity treatment has emerged during the last two decades in response to traditional programs that do not result in sustained reductions in weight. Goals of the size-acceptance nondiet movement include improving self-image, normalizing eating behavior, and increasing physical activity independent of body weight. This commentary presents the basic tenets and early voices in the movement, reviews government weight recommendations, and suggests strategies for the size-sensitive physician.
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Affiliation(s)
- A Spark
- Urban Public Health, School of Health Sciences, Hunter College of the City University of New York, USA
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Abstract
OBJECTIVE To determine mean intake of energy and protein, total fat, saturated fat, percent energy from total and saturated fat, cholesterol, carbohydrate, calcium, iron, zinc, folate, vitamins A, C, E, B-6 and B-12, thiamin, niacin, riboflavin, magnesium, sodium and fiber of preschool Head Start children at school and away from school. DESIGN Twenty-four-hour food intakes for 358 Head Start children were obtained by observing food intake at school and acquiring intake recalls from parents or guardians specifying food their children consumed for the balance of the day. After determining group estimates of energy and nutrient intake, mean intake was compared to standard nutrient recommendations for the entire 24-hour day, i.e., for the time the children were in school and for the remaining hours away from school ("home" intake). SUBJECTS The 358 Head Start children attended school either half-day (2- to 3-hour AM and PM sessions) or all-day (5 to 6 hours). STATISTICAL ANALYSES Differences in nutrient intake among class times were analyzed using one-way analysis of variance (ANOVA) followed by Tukey's multiple comparison test. Differences with a p-value <0.05 (two-tailed) were considered to be statistically significant. Total energy, protein, calcium, iron, zinc, vitamins A, C, E, B6, and B12, thiamin, niacin, riboflavin as well as folate and magnesium were compared to the Recommended Dietary Allowances for the 4- to 6-year-old age group. Other standards that were used for comparisons included the National Cholesterol Education Program (fat, saturated fat and cholesterol), the 1989 National Research Council's Diet and Health Report (carbohydrate and sodium) and the recommendation for fiber proposed by the American Health Foundation. RESULTS At school, half-day children consumed up to 25% of the daily recommendation for energy and nutrients, while all-day children achieved at least a third of the recommended intakes. When intakes at home and school were combined, all three groups of children (AM, PM and all-day) exceeded dietary recommendations for protein, vitamins and minerals. Energy intake remained below 100% of the recommendation, while intake of total fat, saturated fat and cholesterol exceeded recommendations. APPLICATION Further research is required to explore energy needs and determine nutritional status and nutrient needs of minority and low-income preschool children. Strategies are required to increase nutrient density, but not fat density, of meals and snacks served to children who attend day care for part of the day. Finally, school meals and nutrition education programs such as Team Nutrition should broaden their base to include healthful eating habits for all school children, including the very youngest children in preschool programs.
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Affiliation(s)
- M C Bollella
- The American Health Foundation, Child Health Center, Valhalla, New York 10595, USA
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Williams CL, Squillace MM, Bollella MC, Brotanek J, Campanaro L, D'Agostino C, Pfau J, Sprance L, Strobino BA, Spark A, Boccio L. Healthy Start: a comprehensive health education program for preschool children. Prev Med 1998; 27:216-23. [PMID: 9578999 DOI: 10.1006/pmed.1998.0278] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Healthy Start is a 3-year demonstration and education research project designed to evaluate the effectiveness of a multidimensional cardiovascular (CV) risk reduction intervention in preschool centers over a 3-year period of time. METHODS Two primary interventions are employed. The first is the preschool food service intervention program designed to reduce the total fat in preschool meals and snacks to less than 30% of calories and reduce the saturated fat to less than 10% of calories. The second major intervention is a comprehensive preschool health education curriculum, focused heavily on nutrition. RESULTS Effectiveness of the intervention will be determined through evaluation of changes in dietary intake of preschool children at school meals and snacks, especially with respect to intake of total and saturated fat. Evaluation of the education component will include assessment of program implementation by teachers, assessment of changes in nutrition knowledge by preschool children, and assessment of changes in home meals that children consume (total and saturated fat content). Blood cholesterol will be evaluated semiannually to evaluate changes that may be due to modification of dietary intake. Growth and body fatness will also be assessed. CONCLUSIONS While substantial efforts have targeted CV risk reduction and health education for elementary school children, similar efforts aimed at preschool children have been lacking. The rationale for beginning CV risk reduction programs for preschool children is based upon the premise that risk factors for heart disease are prevalent by 3 years of age and tend to track over time, most commonly hypercholesterolemia and obesity, both related to nutrition. Since the behavioral antecedents for nutritional risk factors begin to be established very early in life, it is important to develop and evaluate new educational initiatives such as Healthy Start, aimed at the primary prevention of cardiovascular risk factors in preschool children. The purpose of this publication is to describe the rationale and methods for the Healthy Start project.
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Affiliation(s)
- C L Williams
- Child Health Center, American Health Foundation, Valhalla, New York 10595, USA
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Abstract
BACKGROUND Psyllium, a water-soluble fiber, has been shown to have a cholesterol-lowering effect in studies of adults. A small number of studies in children have produced variable results. METHODS A 12-week, randomized, single-blind, placebo-controlled, parallel clinical trial was conducted to test the effectiveness of psyllium in lowering total (TC) and low-density lipoprotein cholesterol (LDL-C) in 50 healthy 2 to 11 year old children. Children with two baseline LDL-C levels > or = 110 mg/dL were invited to participate in the trial, and were randomly assigned to follow a usual Step I (Control) diet of low dietary fat, saturated fat and cholesterol, or a Step I diet enriched with psyllium. Children consumed two 1-oz boxes of cereal per day, with each box of psyllium-enriched cereal containing 3.2 g of soluble fiber, and each box of placebo cereal containing less than 0.5 g of soluble fiber. RESULTS Greater reduction of total and LDL-cholesterol, and increase in HDL-cholesterol were noted after 12 weeks of the psyllium-enriched Step I diet compared to the Step I control diet. Total cholesterol decreased 21 mg/dL for the high fiber group compared with 11.5 mg/dL for the control group. LDL-C decreased 23 mg/dL for the high fiber group compared with 8.5 mg/dL for the control group. HDL-C increased 4 mg/dL for the high fiber group compared with 1 mg/dL for the controls. TC/HDL and LDL/HDL ratios decreased significantly more so for the high fiber group as well. CONCLUSIONS In this 12-week study, soluble fiber (psyllium) provided added benefit to the Step I diet in the treatment of hypercholesterolemia.
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Affiliation(s)
- C L Williams
- American Health Foundation, New York Medical College, Valhalla, USA
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Spark A. Children's diet and health requirements: preschool age through adolescence. Compr Ther 1992; 18:9-20. [PMID: 1458817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- A Spark
- Program in Nutrition, Graduate School of Health Sciences, New York Medical College, Valhalla 10595
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Affiliation(s)
- C L Williams
- Department of Pediatrics, New York Medical College, Valhalla 10595
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Affiliation(s)
- A Spark
- Preventive Cardiology Center, New York Medical College, Valhalla 10595
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Glassman M, Spark A, Berezin S, Schwarz S, Medow M, Newman LJ. Treatment of type IIa hyperlipidemia in childhood by a simplified American Heart Association diet and fiber supplementation. Am J Dis Child 1990; 144:973-6. [PMID: 2168676 DOI: 10.1001/archpedi.1990.02150330033016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Thirty-six children identified as having primary type IIa hypercholesterolemia were treated with a diet restricting the intake of saturated fat to 10% of total energy and supplemented with soluble fiber for 8.1 +/- 2.4 (mean +/- SEM) months. In 14 of 36 patients first treated with the American Heart Association "Step-One" diet for 8.0 +/- 1.1 months, total cholesterol level dropped from 257.9 +/- 15.8 mg/dL to 240.6 +/- 10.9 mg/dL; the low-density lipoprotein cholesterol level dropped from 191.8 +/- 17.4 mg/dL to 175.0 +/- 11.7 mg/dL; the high-density lipoprotein cholesterol level dropped from 42.8 +/- 1.94 mg/dL to 41.6 +/- 1.68 mg/dL; and triglyceride concentration rose from 115.9 +/- 13.7 mg/dL to 128.1 +/- 14.1 mg/dL. The 36 patients treated with saturated fat-restrictive diets and supplemental soluble fiber diets had a reduction of total cholesterol levels from 249.2 +/- 7.66 mg/dL to 207.1 +/- 6.31 mg/dL and a low-density lipoprotein cholesterol level reduction from 184.7 +/- 7.55 mg/dL to 142.6 +/- 6.7 mg/dL, a reduction of 18% and 23%, respectively. There was no significant change in high-density lipoprotein cholesterol levels (46.4 +/- 1.9 mg/dL vs 44.3 +/- 2.1 mg/dL) or in triglyceride concentrations (94.2 +/- 7.43 mg/dL vs 102.2 +/- 8.45 mg/dL). In addition, the reduction in serum lipoprotein concentrations resulting from this program was significantly greater than the concentrations resulting from the American Heart Association diet alone. The different responses to these regimens suggest that a simplified diet and soluble fiber supplementation is well tolerated and reduces total and low-density lipoprotein cholesterol levels more effectively than the standard American Heart Association diet in children.
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Affiliation(s)
- M Glassman
- Department of Pediatrics, New York Medical College, Valhalla 10595
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Berger GM, Spark A, Baillie PM, Huskisson J, Stockwell G, van der Merwe E. Absence of serum-stimulated lipase activity and altered lipid content in milk from a patient with type I hyperlipoproteinaemia. Pediatr Res 1983; 17:835-9. [PMID: 6634247 DOI: 10.1203/00006450-198310000-00014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We measured the serum-stimulated lipase activity, fatty acid content, and various biochemical parameters in the breast milk of a lactating mother suffering from familial lipoprotein lipase deficiency and of healthy control subjects. Serum-stimulated lipase activity was virtually undetectable in milk from our patient and the total fatty acid content was low. The fatty acid composition differed from normal showing a marked absolute and relative increase in the content of lauric (C12:0) and myristic (C14:0) fatty acids and considerably reduced levels of oleic (C18:1) and especially linoleic (C18:2) acids. Other fatty acid species showed lesser changes in concentration. Besides a reduced calcium concentration in the milk from our patient, other biochemical parameters were not significantly different from control subjects.
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