Fatal consequences of decreased sensitivity to pain and temperature in a frontotemporal dementia patient

Frontotemporal dementia (FTD) is a heterogeneous syndrome characterized by the progressive damage of frontal and temporal brain regions. These networks largely overlap with those involved in pain and temperature processing. Although the impaired perception of pain and temperature has been previously described to be relatively common in patients with FTD, these symptoms are often not consistently assessed by Neurologists. We present the case of a patient with a probable behavioral variant FTD who died due to scalding with hot water in the shower. Impairments in the perception of pain and temperature might have played a fundamental role in this accident.

Estimation of salt intake assessed by urinary excretion of sodium over 24 h in Spanish subjects aged 7-11 years

PURPOSE

High intake of salt is associated with early development of cardiovascular risk factors (e.g., hypertension, obesity). In "developed" countries, individuals frequently exceed dietary recommendations for salt intake. Taking into account the limited data on sodium intake by 24-h excretion in urine in schoolchildren, we wished to determine baseline salt intake in Spanish subjects aged 7-11 years.

METHODS

The present study was an observational study involving 205 schoolchildren (109 boys and 96 girls) selected from various Spanish provinces. Sodium intake was ascertained by measuring sodium excretion in urine over 24 h. Creatinine was used to validate completeness of urine collections. The correlation between fat-free mass determined by anthropometry and that determined via urinary excretion of creatinine was calculated (r = 0.651; p < 0.001).

RESULTS

Mean 24-h urinary excretion of sodium was 132.7 ± 51.4 mmol/24 h (salt equivalent: 7.8 ± 3.1 g/day). Hence, 84.5 % of subjects aged ≤10 years had intakes of >4 g salt/day, and 66.7 % of those aged >10 years had intakes of >5 g salt/day. Urinary excretion of sodium was correlated with systolic blood pressure and diastolic blood pressure (r = 0.1574 and r = 0.1400, respectively). Logistic regression analyses, adjusted by sex, showed that a high body mass index (odds ratio = 1.159; 95 % CI 1.041-1.290; p < 0.05) was associated with an increased likelihood of high urinary excretion of sodium.

CONCLUSIONS

Sodium intake, as estimated by 24-h urinary excretion, was (on average) higher than recommended. Reducing the sodium content children's diet is a sound policy to reduce cardiovascular risk.

[Insufficient intake of vitamin D in spanish schoolchildren: determinants of the problem and basis for its improvement]

INTRODUCTION

Different studies have observed deficiencies in vitamin D in a high percentage of schoolchildren, highlighting the importance of this problem in sunny populations, such as Spain, where this situation is frequently underestimated.

AIM

To assess the adequacy of vitamin D intake and to find out the food sources of the vitamin in a representative sample of Spanish schoolchildren.

METHODS

A sample of 903 children (7 to 11 years) was studied. Ten Spanish cities were selected to be a representative sample of the Spanish schoolchildren population. Dietetic study was carried out using a three-day food record, including a Sunday. Vitamin D was compared to that recommended (RI) and energy intake was compared with energy expenditure estimated by measuring physical activity level. Weight and height were recorded and body mass index (BMI) was calculated.

RESULTS AND DISCUSSION

Vitamin D intake (2.49 ± 0.64 [iμ/day) allowed cover only 49.7% of the RI of the children. It was below of 100% of RI in 99.9% of the children, and in 78.7% it was below of 67% of RI. The vitamin intake was lower in girls, those younger than 7 years and in children with obesity than in boys, those older than 7 years and in children with normal weight. The main sources of the vitamin were eggs (28.12%), cereals (24.23%), fish (20.06%) and milk (14.42%).

CONCLUSION

Vitamin D intake is inadequate in Spanish schoolchildren between 7 and 11 years. Taking into account that the consumption of foods which are the main source of vitamin D (fish, eggs, cereals, dairy products) is often lower than the recommended, approximating the diet to the theoretical ideal could help to improve the contribution of the vitamin.

[Food sources and average intake of calcium in a representative sample of Spanish schoolchildren]

INTRODUCTION

There is controversy about the adequacy of calcium intake to that recommended in Spanish schoolchildren. Some studies indicate that the intake is inadequate in a variable percentage of children, while others insist on the danger of an excessive intake in a huge percentage of this population.

AIM

To assess calcium intake and food sources of this nutrient in a representative sample of Spanish children and to judge the adequacy of its contribution to the coverage of recommended intakes.

METHODS

903 schoolchildren (7 to 11 years) from 10 Spanish provinces (Tarragona, Caceres, Burgos, Guadalajara, Valencia, Salamanca, Cordoba, Vizcaya, Lugo and Madrid) were studied. They constituted a representative sample of the Spanish schoolchildren population. The energy and nutrient intake was determined using a "Food record questionnaire" for 3 days, including a Sunday. Calcium intake was compared with the recommended intakes (RI) for the mineral. Weight and height were recorded and body mass index (BMI) calculated.

RESULTS

In the studied group (55.3% girls and 44.7% of children), 30.7% had an excess body weight (23.3% overweight and 7.4% obesity). Calcium intake was 859.9 ± 249.2 mg / day (79.5% of the recommendations). 76.7% of children had intakes below 100% of those recommended and 40.1% below of 67% of RI. The ratios calcium/phosphorus (0.74 ± 0.21) and calcium/protein (10.1 ± 2.8) and the index of nutritional quality for calcium (0.78 ± 0.29) were lower than recommended in 91.6%, 99.8% and 81.1% of children, respectively. Dietary calcium came from dairy products (64.7%), dietetic products and infant formulae (7.6%), cereals (7.3%), vegetables (3.5%), fruits (3.4%), pre-cooked meals (3.3%), meats (2.8%), fishes (2.8%) and pulses (2.2%), with no differences by gender.

CONCLUSION

Calcium intake was lower than recommended in 76.7% of the children and 40.1% had insufficient intake (< 67% of RI). Having in mind that the main calcium source was dairy products (64.7%), increase consumption of this food group is recommended, especially in the 37.1% of children who did not reach the 2 recommended servings per day.

Selenium status in a group of schoolchildren from the region of Madrid, Spain

BACKGROUND

To assess the selenium status of a group of schoolchildren from the Region of Madrid, Spain.

METHODS

Study subjects comprised 483 children (216 boys and 267 girls) aged between 8 and 13 years. Selenium intake was determined using a 3-day food record. The foods consumed were transformed into energy and nutrients, and the selenium intake was compared with that recommended. Serum selenium levels were also recorded.

RESULTS

Mean (SD) selenium intake [91.0 (25.2) μg day(-1) ] was above the recommended level in 99.4% of subjects; the main dietary sources were cereals, meats, fish and milk products. The serum selenium concentration [mean (SD) 71.1 (14.4) μg L(-1) ], however, was <60 μg L(-1) in 13.9% of subjects, and <45 μg L(-1) in 5.6%. The serum selenium concentration correlated with the selenium intake (r = 0.169; P < 0.05). Children with a serum selenium concentration of <75 μg L(-1) had significantly smaller selenium intakes than those with a serum concentration of ≥75 μg L(-1) .

CONCLUSIONS

Although selenium intake was generally above that recommended, the serum selenium concentration of the children could be improved. This could be achieved by increasing the relative consumption of cereals and other selenium rich foods such as fish.

[Folate status in Spanish schoolchildren and its association with parental smoking habits]

AIM

To study the folate status in a group of Spanish schoolchildren and its association with parental smoking habits.

METHODS

A group of 511 schoolchildren between 9 and 12 years old from Madrid (Spain) were studied. Parental smoking habits were self-reported by a questionnaire. Energy and nutrients intake (especially folates) were calculated with a "3-day diet record" and during two days (Monday and Tuesday) the food consumption was controlled in the school canteen using the "precise weighing method" (recording the weights of food served and leftovers on the plate). Folate intake of the sample was compared with the recommended intakes (RI) for this vitamin. Folate, vitamin B₁₂ and homocysteine were determined. Student's t-test, Mann Whitney Test, Pearson and Spearman correlation, ANCOVA, MANCOVA and multiple linear regression were applied for statistical analysis. Significance was set at P < 0.05.

RESULTS

Vegetable and fruit consumption, folate intake and its coverage to recommended folate intake (I/RI%) and serum folate levels were higher in children of nonsmoking mothers than in children of smoking mothers. Serum folate level in 13.3% of the children studied was below 6 ng/mL (moderate deficit), and in 0.26% was below 3 ng/mL (severe deficit). Taking into account others confounding factors a negative and significant correlation was observed between serum folate levels of children and smoking habits in mothers (r = -0.257, p = 0.01).

CONCLUSION

The maternal smoking habits might determine folate intake and serum folate levels on their offspring.

[An inadequate intake of manganese may favour insulin resistance in girls]

AIM

to study the relationship between an adequate manganese (Mn) intake and glucose, insulin levels and insulin resistance among healthy children from Madrid (Spain).

MATERIALS AND METHODS

573 schoolchildren between 8 and 13 years old were studied. Energy and nutrients intake (especially Mn) was calculated with a "3-day diet record". Mn intake was compared to Adequate Intakes (AI) for this mineral. Weight and height were measured and body mass index (BMI) calculated. Fasting glucose and insulin were determined and the HOMA index was calculated to establish the presence of insulin resistance in children.

RESULTS

Girls with and inadequate intake (below the 100% of the AI value) had higher insulin and HOMA values than girls with adequate AI values (equal or higher to 100% of AI). Having in mind confounding factors (energy, carbohydrates and lipids intake, BMI and age), a significant positive correlation was found between the contribution of Mn intake to AI and HOMA levels in girls.

CONCLUSION

It seems important to ensure an adequate Mn intake in girls in order to prevent insulin resistance and diabetes type 2 in the future.

[Overweight and obesity among Spanish adults]

AIM

to assess the prevalence of overweight and obesity in Spanish adults and to know the current situation and its evolution in the last years.

MATERIAL AND METHODS

The study involved 418 subjects (196 men and 222 women) from 18 to 60 years, who were selected to constitute a representative sample of the Spanish population as a whole. Sanitary, socioeconomic and anthropometric (weight, height, waist circumference and percentage body fat by bioimpedance) data was collected. Body Mass Index and waist-height were ratio calculated.

RESULTS

The prevalence of overweight was 34.2%, 43.9% in men and 25.7% in women, and the prevalence of obesity was 13.6% (it was similar in men and women). 47.8% of the population had excess of body weight and 70.2% excess of body fat, these parameters were higher in men than in women and they increased with age. 22.2% of the population had central obesity (taking waist circumference as reference) and 54.7% central obesity and high cardiovascular risk (because waist/height was > 0.5), both parameters were higher in men than in women.

CONCLUSION

Overweight and obesity prevalence among the Spanish population is very high and more than the half of the population is in risk of suffering from cardiovascular disease. Furthermore, the situation is worse than a few years ago, so it is necessary to continue working to decrease the prevalence of overweight and obesity among the Spanish population.

Vitamin D status in a group of Spanish schoolchildren

AIM

The aim was to determine the vitamin D status of a group of Spanish schoolchildren in order to help in the design of campaigns to prevent vitamin D deficiency in this subpopulation.

METHODS

This was a cross-sectional observational study, carried out in schools in Madrid (Spain), during 2007-2008. The study enrolled 102 schoolchildren (aged 9-13 years). Vitamin D intake was monitored using a three-day food record. All foods consumed were converted into energy and nutrients and the vitamin D intake compared to that recommended. The children's serum 25-OH-cholecalciferol (25[OH]D) concentrations were also recorded.

RESULTS

Vitamin D intake (2.83±3.27 mg/day) was below that recommended in 86.9% of the children, and the serum 25(OH)D concentration (49.6±15.9 nmol/L) below 50 nmol/L (moderate deficit) in 51% of the children; in 8% it was below 30 nmol/L (severe deficit). The children who showed a coverage of at least 67% of the recommended intake of vitamin D (Group HD) consumed more dairy products, fish, fruit and vegetables than those whose intakes covered <67% of the recommended intake (Group LD). The HD children had higher serum 25(OH)D concentrations than the LD children; in addition, fewer cases of deficit were seen among them.

CONCLUSION

The vitamin D status of the studied children was likely to improve, and could be ameliorated via a relatively increased consumption of dairy products, fish, cereals, fruits and vegetables, by including foods fortified in vitamin D if necessary, and by increased ‑ but safe ‑ exposure to the sun.

Review and future perspectives on recommended calcium intake

The suitability of recommended calcium intakes has been the subject of debate in recent years. The present work reviews the recommendations currently made for different population groups in Spain and other countries. To date, these recommended intakes have mainly been based on the role of calcium in the formation and maintenance of bone; less attention has been paid to its other roles in health (e. g., its effect on blood pressure, the prevention of cancer or the regulation of body weight), or the interaction of calcium with other nutrients. However, an increasing number of reports highlight the importance of calcium in these other areas - information that should be taken into account when assessing the suitability of recommended calcium intakes. It should also be remembered that the calcium intakes of a large proportion of the population are lower than those recommended. This paper reviews the suitability of current calcium recommendations for different groups of the population and highlights the areas where research is needed to help determine the intakes that would provide the greatest short and long term health benefits.

Serum heme oxygenase-1 levels are increased in Parkinson's disease but not in Alzheimer's disease

OBJECTIVE

Oxidative stress is implicated in Parkinson's disease (PD) and Alzheimer's disease (AD), and heme oxygenase-1 (HO-1) is a potent antioxidant overexpressed in PD substantia nigra and AD cerebral cortex and hippocampus, indicating a possible up-regulation of antioxidant defenses in both neurodegenerative diseases. The role of HO-1 in peripheral blood of PD and AD patients remains unresolved.

METHODS

We measured serum HO-1 levels in 107 patients with PD, 105 patients with AD, 104 controls for PD and 120 controls for AD.

RESULTS

The median serum concentration of HO-1 was significantly higher in PD patients (2.04 ng/ml) compared with that of PD controls (1.69 ng/ml, P = 0.016), with PD patients predominating over controls in the upper tertile of serum HO-1 levels, whereas there was more PD controls than PD patients in the lower tertile (P = 0.006). Median serum levels of HO-1 did not differ significantly between AD patients and AD controls.

CONCLUSION

The increase of serum HO-1 levels in PD patients could indicate a systemic antioxidant reaction related to a chronic oxidative stress state in PD brain.

Synergistic effect of two oxidative stress-related genes (heme oxygenase-1 and GSK3β) on the risk of Parkinson's disease

BACKGROUND

Oxidative stress is a central factor in the pathogenesis of Parkinson's disease (PD). Heme oxygenase-1 (HO-1) is an antioxidant protein expressed in response to oxidative challenge, and its expression levels are inversely correlated with glycogen synthase kinase-3beta (GSK3beta) activity. Underexpression of HO-1 in concert with an upregulation of GSK3beta would result in a less effective antioxidant response and might increase the risk of PD.

METHODS

We examined two functional polymorphism in the promoter regions of HO-1 (-413, rs2071746) and GSK3beta (-157, rs6438552) in a group of 251 Spanish patients with PD and 234 controls.

RESULTS

Subjects carrying both the HO-1 (-413, rs2071746) TT genotype and the GSK3beta (-157, rs6438552) TT genotype had a four times higher risk of developing PD than subjects without these genotypes (adjusted by age and sex OR = 4.12; 95% CI = 1.45-11.71; Bonferroni corrected P = 0.024).

CONCLUSIONS

Considering synergistic effects between polymorphisms in oxidative stress-related genes may help in determining the risk profile for PD.

[Body weight perception and dieting behaviour in Spanish population]

INTRODUCTION

A high percentage of the population initiate or keep diets to lose weight independently of suffering or not overweight/obesity. Nevertheless, exists a great unknowledge on the more convenient guidelines to achieve this aim.

OBJECTIVE

To analyze weight perception and types of behavior to control the corporal weight in Spanish adults in order to be able to start the campaigns most adapted to provide a correct nutritional information to the population.

METHODS

2,168 subjects (18 +/- 50 years) of 5 Spanish provinces were studied. Anthropometric and information about the worry about corporal weight data was obtained.

RESULTS

65.6% of subjects declare a desire to lose weight and 44.9% have followed diets with this purpose in some moment (especially in female population). 63.9% of subjects increase physical activity to control weight, 23.9% consumes dietetic products or medicinal herbs and 48.0% compensate the excesses when they try to lose weight. Sweets (24.5%), fats (15.4%), pastries (11.4%) and bread (11.4%) are avoided and fruits and vegetables consumption is increased (specially by women) when try to lose weight.

CONCLUSIONS

Weight loss practices use to be inadequate due to the desire to lose weight quickly and to the unknowledge about the most adecuate diet to achieve this aim. It is necessary to avoid this type of practices and to improve the knowledge on nutrition in the population.

Epistasis between tau phosphorylation regulating genes (CDK5R1 and GSK-3beta) and Alzheimer's disease risk

OBJECTIVE

Glycogen synthase kinase-3beta (GSK-3beta) and cyclin-dependent kinase 5 (CDK5) have been implicated as two major protein kinases involved in the abnormal hyperphosphorylation of tau in Alzheimer's disease (AD) brain, and the development of neurofibrillary tangles. CDK5 regulatory subunit 1 (CDK5R1) encodes for p35, a protein required for activation of CDK5. As both CDK5R1 and GSK-3beta genes are related to phosphorylation of tau, we examined the combined contribution of these genes to the susceptibility for AD.

METHODS

In a case-control study in 283 AD patients and 263 healthy controls, we examined the combined effects between CDK5R1 (3'-UTR, rs735555) and GSK-3beta (-50, rs334558) polymorphisms on susceptibility to AD.

RESULTS

Subjects carrying both the CDK5R1 (3'-UTR, rs735555) AA genotype and the GSK-3beta (-50, rs334558) CC genotype had a 12.5-fold decrease in AD risk (adjusted by age, sex and APOE status OR = 0.08, 95% CI = 0.01-0.76, P = 0.03), suggesting synergistic effects (epistasis) between both genes.

CONCLUSION

These data support a role for tau phosphorylation regulating genes in risk for AD.

[Obesity, insulin resistance and increase in adipokines levels: importance of the diet and physical activity]

With obesity the amount of pro- and anti-inflammatory adipokines released is increased within the fat tissue. These molecules are implicated in many clinical manifestations of this pathology such as diabetes, arterial hypertension, or cardiovascular disease. At the first stage, the fat tissue of the obese patient becomes resistant to the action of insulin due to the effect of some of these adipokines such as tumour necrosis alpha (TNF-alpha) or interleukine-6 (IL-6). At a second stage, this resistance occurs at other tissues and glucose and insulin levels are increased. This increase, together with high adipokines levels that occur in diabetes, lead to the occurrence of different adverse events, such as the following: increase in oxidative stress, endothelial dysfunction, increase in blood pressure, and impairments in lipoprotein metabolism, all of which are harmful for health. Practising physical activity and following a balanced diet, similar to the Mediterranean pattern with low fat and salt consumption, would be helpful for improving insulin resistance and adipokines levels in obese people, thus helping improving their health status in the long run.

[Mother's age as a conditioning factor of food consumption and energy and nutrients intake of their offspring at pre-school age]

OBJECTIVES

The aim of this study was to analyse whether the mother's age at the offspring's birth may condition food consumption and energy and nutrients intake as well as the appropriateness of the diet of their offspring at pre-school age.

MATERIALS AND METHODS

socio-economic, anthropometrical, and dietary data were collected from a group of 103 pre-school children from Madrid, and the population was divided according to the mother's age (= 26 years (percentile 25) or < 26 years) at birth.

RESULTS

Twenty-two point five of the mothers of the preschool children studied had their offspring before 26 years of age and 6.8% before 18. Children from younger mothers consumed less sugars (p < 0.01) and alcohol-free beverages (p < 0.05), but also less fruits (p < 0.01) and others (p < 0.05). The energy from fats was lower (p < 0.05) and that from carbohydrates higher (p < 0.05) among children with older mothers. Besides, the lipid profile was also better in this children, with less caloric intake from polyunsaturated fats (p < 0.05). Besides, fibre (p < 0.05) and vitamin C (p < 0.001) intake was higher in children from older mothers.

CONCLUSIONS

It seems that mother's age may have an influence on dietary habits of their children and be a protection factor against dietary inappropriateness of the offspring, so that younger mothers might need special counselling in this respect.

[Epileptiform activity in psychiatric disorders in children]

INTRODUCTION

Abnormalities are often observed in the electrical activity of the brain in patients with brain dysfunction.

PATIENTS AND METHODS

We conducted a retrospective analysis of the results of electroencephalogram studies carried out between August and December 2006 on children who had been clinically diagnosed with a psychiatric disorder, without taking into account those with epilepsy.

RESULTS

A total of 1000 electroencephalogram (EEG) studies were reviewed; the age of the patients ranged from 0 to 18 years, with an average of 9.7 years, and the ratio between sexes was 67.9% males and 32.1% females. The four most frequently observed psychiatric disorders were: attention deficit hyperactivity disorder, 422; depressive disorder, 103; mental retardation, 99; and behavioural disorder, 96. The EEG findings were divided into normal (37.8%) and abnormal patterns (61.9%). The most frequent abnormality was bioelectric immaturity (56.4% of cases). On analysing epileptiform activities, we found 26 studies (2.6%) and evidence of cortico-subcortical irritability in 6.7%. The total number of children with epileptiform patterns was 71. The most common pattern was the sharp wave (97.2%) and the most frequent location was the temporal lobe (42.3%).

CONCLUSIONS

A high percentage of patients with psychiatric disorders also have abnormalities in the electrical activity of their brains, and even epileptiform activity. Electrical abnormalities in the general population of healthy children have been reported in the literature, but the figures that we found are higher for patients with psychiatric disorders. Functioning of the neurons is incorrect and this results in a range of different pathologies. The repercussion of abnormal electrical activity of the brain on the clinical data of the patients is open to discussion, and we consider it to be an epiphenomenon.

Prognostic value of nutritional status in alcoholics, assessed by double-energy X-ray absorptiometry

OBJECTIVES

This study was performed in order to assess nutritional status of 77 alcoholic patients.

METHODS

Patients underwent a total body double-energy X-ray absorptiometry (DEXA) analysis, with estimation of lean and fat mass at different parts of the body.

RESULTS

Lean mass, but not fat mass, was significantly reduced among alcoholics, compared to 31 age-matched controls, especially at right arm, legs, and total body. Lean mass at both arms was significantly related to liver function parameters (albumin, prothrombin activity, bilirubin) and, inversely, with ethanol consumption. The 24 patients who died during a follow-up period of 88 months showed less lean mass at both arms, trunk, and left leg, and also less fat at the left arm, than survivors. When right and left arm lean mass were classified in quartiles, Kaplan-Meier curves showed significant differences between dead and survivors. Left arm lean mass was the parameter which was independently related to mortality when encephalopathy was not included in a stepwise Cox regression analysis, but was displaced by this last parameter when it was also introduced in the analysis.

CONCLUSION

Lean mass is reduced in alcoholics, is related to liver function derangement and ethanol consumption, and is related to mortality.

Inflammation-related genes and the risk of Parkinson's disease: a multilocus approach

For the first time, the multilocus approach by the set-association method has been applied for the analysis of a cluster of five genes [tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6), IL-8, IL-1alpha and IL-10] involved in the brain neuroinflammatory pathway in Parkinson's disease (PD), in a well-defined group of 197 PD patients and 173 control subjects from Spain. Set-association analysis did not reveal an independent or an interactive effect of these inflammatory genes on the PD risk.

Meta-analysis of genetic variability in the beta-amyloid production, aggregation and degradation metabolic pathways and the risk of Alzheimer's disease

BACKGROUND

Variants in genes encoding enzymes involved in production, aggregation or degradation of beta-amyloid are potential risk factors for sporadic Alzheimer's disease (AD).

METHODS

Meta-analyses on AD association with BACE1 exon 5, BACE1 intron 5, FE65 intron 13, CYP46 intron 2, alpha(1)-antichymotrypsine Ala17Thr, bleomycin hydrolase I443V, lectin-like oxidized low-density lipoprotein receptor (OLR1) 3'-UTR (+1071) and (+1073), and very-low-density lipoprotein receptor (VLDLR) 5'-UTR (CGG-repeat) polymorphisms.

RESULTS

In BACE1 exon 5, genotype CC+CT acts as a protective factor in Apolipoprotein E (ApoE) epsilon 4 carriers [odds ratio (OR) = 0.57; 95% confidence interval (CI): 0.38-0.88], and as a risk factor in ApoE epsilon 4 non-carriers (OR = 1.33; 95% CI: 1.00-1.78). OLR1 3'-UTR (+1073) allele C is associated with increased risk (OR = 1.23; 95% CI: 1.01-1.50). VLDLR 5'-UTR genotype 2 is associated with increased risk (OR = 1.70; 95% CI: 1.09-2.63) in the Asian population and is protective (OR = 0.48; 95% CI: 0.26-0.86) in the non-Asian population. Other studied polymorphisms are not associated with AD.

CONCLUSIONS

The overall impact on AD risk of the genes for which meta-analyses are now available is rather limited. Additional meta-analyses of other different genes encoding for A beta production, aggregation and degradation mediators might help in determining the risk profile for AD.

Serum levels and genetic variation of TGF-beta1 are not associated with Alzheimer's disease

OBJECTIVE

As transforming growth factor-beta1 (TGF-beta1) determines important neurotrophic and neuroprotective actions, we postulated serum TGF-beta1 levels could be low in Alzheimer's disease (AD), and TGF-beta1 genetic variation could be associated with AD risk through modulating serum TGF-beta1 levels.

METHODS

TGF-beta1 (-800) (rs 1800468), (-509) (rs 1800469) and (+869) (rs 1982073) polymorphisms were genotyped in 412 AD patients and 406 controls. We measured serum TGF-beta1 levels (by ELISA) in 63 AD patients and compared them with 77 age- and gender-matched non-demented controls.

RESULTS

Serum TGF-beta1 levels were not different in AD patients than in controls. Distribution of the allele and genotype frequencies of TGF-beta1 polymorphisms did not differ between AD patients and controls. There was no significant correlation between serum TGF-beta1 levels and TGF-beta1 polymorphisms.

CONCLUSION

Serum TGF-beta1 concentration is not a potential biomarker for AD, and TGF-beta1 genetic variants (-800, -509, and +869) are not risk factors for AD.

[Dietary habits and their relationship with the knowledge on the concept of a balanced diet in a group of young women with overweight/obesity]

OBJECTIVE

To know the dietary habits of a population of women with overweight/obesity and their knowledge on the concept of proper feeding in order to design nutrition educational campaigns focused on this population.

MATERIALS AND METHODS

A group of 67 women, aged 20 to 35 years with body mass index 24-35 kg/m2 were asked about their frequency of food intake and what they thought to be correct to achieve a balanced diet.

RESULTS

Studied women more frequently consumed oils (4.3 +/- 4.5 times/week) and sweets (2.5 +/- 3.6 times/week) and less frequently water (-19.1 +/- 22.7 times/week), vegetables (-4.3 +/- 5.7 times/week), fruits (-3.7 +/- 6.2 times/week), legumes (-1.3 +/- 2.0 times/week) and fish (-2.2 +/- 3.7 times/week) than what they thought they should consume. When comparing what they declare to consume to what has been established as minimal recommended intake for the different groups of foods it is observed that the intake of grains and legumes, fruits and vegetables, and slightly less that of fish and eggs, should de increased.

CONCLUSIONS

given the incorrect dietary habits observed in a population of women with overweight/obesity, it should be convenient to carry out nutrition educational campaigns. This education could help improve the diet of all the population and the occurrence of overweight and obesity could be prevented in many cases. Besides, in those cases in which the pathology is already present, this could prevent following regimens that are harmful for the health and for weight management.

Modification of iron status in young overweight/mildly obese women by two dietary interventions designed to achieve weight loss

AIMS

To determine the modification of iron status in a group of overweight/mildly obese women following two different weight control programs.

METHODS

The study subjects were 57 women who were assigned to one of two slightly hypocaloric diets: V (increased consumption of vegetables), or C (increased consumption of cereals, especially breakfast cereals). All data were determined at the start of the study and at 2 and 6 weeks into the dietary intervention period.

RESULTS

Both diets led to a reduction in body weight and heme iron intake, and an increase in the intake of total and non-heme iron, at 2 and 6 weeks. At 6 weeks, a reduction in transferrin levels was seen in C subjects. Subjects with the worst initial iron status (hemoglobin <P25: 12.6 g/l) following C diet showed an increase of mean corpuscular hemoglobin concentration at 2 and 6 weeks and improved hemoglobin levels at 6. Also at 6 weeks, the C subjects had more erythrocytes than similar V subjects (only considering women with hemoglobin <P25: 12.6 g/l).

CONCLUSIONS

A well-designed hypocaloric diet need not entail a risk of iron deficiency. Breakfast cereals are an important source of non-heme iron and could help to improve iron status, especially in women with poor initial iron levels.

Low serum VEGF levels are associated with Alzheimer's disease

OBJECTIVE

As vascular endothelial growth factor (VEGF) determines important neurotrophic and neuroprotective actions, we postulated serum VEGF levels could be abnormally low in patients with Alzheimer's disease (AD).

METHODS

We measured serum VEGF levels (VEGF(165) isoform by ELISA) in 51 patients with AD by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorder Association criteria and compared with 66 age- and gender-matched non-demented controls. Patients with AD were stratified into levels of dementia severity by the Clinical Dementia Rating scale. Serum VEGF levels were stratified into upper (>309 pg/ml), middle (207-309 pg/ml), and lower (<207 pg/ml) tertiles. VEGF (-2,578) (rs 699,947) and VEGF (-634) (rs 2,010,963) polymorphisms were genotyped in patients with AD and controls.

RESULTS

The mean concentration of VEGF in the serum of patients with AD (215.9 pg/ml, SD 101.5) was significantly lower than that of the controls (308.6 pg/ml, SD 223.9, P = 0.004), and decreased serum VEGF levels were associated with AD in a dose-dependent manner, the lower tertile of serum VEGF levels being associated with a fivefold increased risk for AD when compared with the upper tertile. There was no significant correlation between serum VEGF levels and age, sex, APOE alleles, AD dementia severity nor VEGF gene polymorphisms.

CONCLUSION

Decrease in serum VEGF levels could contribute to the neurodegenerative process in AD.

Changes in folate status in overweight/obese women following two different weight control programmes based on an increased consumption of vegetables or fortified breakfast cereals

The modification of folate status was analysed in a group of sixty-seven overweight/obese women of childbearing age (20-35 years). Subjects were randomly assigned to one of two slightly hypocaloric diets: diet V (increased consumption of vegetables) or diet C (increased consumption of breakfast cereals). Dietetic, anthropometric and biochemical data were collected at the start of the study and again at 2 and 6 weeks. At 6 weeks a weight loss of 2.0 (sd 1.3) kg was achieved in V subjects and of 2.8 (sd 1.4) kg in C subjects (P < 0.05). At the start of the study, 64.2 % of all subjects had a folate intake of < 67 % of the recommended intake; this fell to just 3 % (7.14 % of V subjects and 0 % of C subjects) by week 6. Significant increases were only seen in C subjects in serum folate concentrations (both at 2 and 6 weeks), accompanied by a significant reduction in serum homocysteine (at week 6). Some 62.1 % of all subjects had serum folate concentrations of > or = 13.6 nmol/l (associated with a very low risk of neural tube defects) at the start of the study, while 87.0 % (85.2 % of V subjects and 88.9 % of C subjects) had concentrations of > or = 13.6 nmol/l at 6 weeks (P < 0.01). Increasing the relative consumption of vegetables/cereals in the context of a slightly hypocaloric diet may therefore be a good way to lose body weight. Breakfast cereals may be of special help with respect to folate status and serum homocysteine levels in overweight/obese young women following energy restriction diets.

Changes in thiamin intake and blood levels in young, overweight/obese women following hypocaloric diets based on the increased relative consumption of cereals or vegetables

OBJECTIVE

To analyse the changes in thiamin intake and blood levels of young, overweight/obese women following slightly hypocaloric diets based on the increased relative consumption of foods whose intakes were most removed from the ideal: cereals and vegetables.

DESIGN

The women were randomly assigned to one of two slightly hypocaloric diets: diet V, in which the consumption of vegetables was increased, or diet C, in which the consumption of cereals (especially breakfast cereals) was increased.

SUBJECTS

The study subjects were 67 young women with a body mass index of 24-35 kg/m2.

INTERVENTIONS

Dietetic, anthropometrics and biochemical data were collected at the start of the study and again at 2 and 6 weeks.

RESULTS

The reduction in energy intake was similar in both groups. However, diet C subjects lost significantly more weight. Blood thiamin concentration was higher in group C women than in group V women at 2 and 6 weeks. Compared to initial values, group C subjects showed a higher blood thiamin level at 2 weeks. The highest blood thiamin levels seen in group C women may have been due to their greater thiamin intake, their higher thiamin dietetic density, and a higher thiamin/carbohydrates ratio at both week 2 and 6 of the intervention period.

CONCLUSIONS

Increasing the relative consumption of breakfast cereals within the context of a slightly hypocaloric diet can help in weight control and improve thiamine intake and blood levels.

[A randomised open trial comparing monotherapy with topiramate versus carbamazepine in the treatment of paediatric patients with recently diagnosed epilepsy]

INTRODUCTION

In some studies in children, topiramate showed efficacy.

AIM

To evaluate efficacy, tolerability and safety of topiramate in monotherapy in newly diagnosed epilepsy vs carbamazepine in children.

PATIENTS AND METHODS

In a multicentre, open-label, comparative and randomized study patients with partial epilepsy, were randomized to received topiramate or carbamazepine treatment. Patients with degenerative disease were excluded. Data were analysed by SPSS statistical program v. 11.0, and non parametric test. Comparisons between groups were made with chi square test and t Student's test.

RESULTS

In total were included 88 patients, 33 in group 1 (topiramate), 32 group 2 (carbamazepine), 23 were drop-outs because adverse events and lost in follow-up (13 in group 1 y 10 group 2). In both groups were observed good efficacy, in month 6 and 9 of follow-up, the average of seizures in group 1 were better than group 2 (p = 0.01, t Student's test). The percentage of free seizure patients was greater in group 1 than group 2 (statistical significance p = 0.02 chi square test). The adverse events were similar in both groups and mild, somnolence 9%, weight loss 6% in group 1 and somnolence 19%, dizziness 3% and seizure discontrol 3% in group 2.

CONCLUSIONS

Good efficacy in both groups, and topiramate in good treatment choice in newly diagnosed epilepsy in children because it's the efficacy and tolerability in comparison with the gold standard carbamazepine.

Prognostic value of cytokines in SIRS general medical patients

We studied 174 patients with SIRS criteria, 45 with sepsis, eight with severe sepsis and 13 with septic shock. Serum TNF-alpha, IL-6, IL-8 and IL-10 levels were raised in SIRS patients, even in those cases in which an infection could not be documented, and more intensely in severe sepsis and in patients who died (11%). The slope of the regression line between IL-10 and TNF-alpha was sharper in patients with severe sepsis and in those who died; an imbalance between pro- and anti-inflammatory cytokines may be related to poor prognosis. Increased IL-6 and IL-10, decreased muscle mass, raised BUN and low body temperature were all independently related to prognosis.

Alcoholic hypogonadism: hormonal response to clomiphene

To investigate the androgen, weak androgen, estrogen, and gonadotrophin response to clomiphene in alcoholics, we determined in 63 male patients (25 with and 38 without liver cirrhosis) serum testosterone, sexual hormone binding protein (SHBG), dehidroepiandrosterone, androstenedione, LH, FSH, prolactin, and estradiol levels, on the first and the sixth day after admission, and after a course of 8 days of clomiphene 200 mg/day. The same test was performed on 15 healthy volunteers. Cirrhotic patients showed decreased basal testosterone levels and a loss of the circadian rhythm with recovery after clomiphene. Although basal testosterone levels in noncirrhotic alcoholics did not differ from those of the controls, there was a significant improvement after withdrawal. SHBG levels were higher in both groups of alcoholics than in controls, pointing to a worse degree of hypogonadism, because only the free hormone is active. Before the clomiphene test, serum LH and FSH levels were nonsignificantly higher in both groups of alcoholics than in the control group. After clomiphene both LH and FSH increased. Androstenedione and estradiol showed a (parallelism) similar behavior in alcoholic and in cirrhotic groups, showing in both cases higher levels than in the control group, and an increase after clomiphene, perhaps reflecting peripheral conversion of androgens to estrogens. Because clomiphene has no effect on the adrenal cortex, the increase of androstenedione after clomiphene points to its testicular origin (directly or after testosterone conversion) and not to an adrenal one. The highest serum estradiol levels were observed in cirrhotics with ascites or gynecomastia. We have not found any relation between serum hormone levels and alcohol intake nor with nutritional status.

Cytokine levels in acute alcoholic hepatitis: a sequential study

Chronic alcoholic liver disease is associated with several immunological alterations: depressed T-cell function, low serum gamma-interferon, and high serum tumour necrosis factor (TNF-alpha) and interleukin levels. Therefore, macrophage activity seems to be enhanced. Some cytokines, such as TNF-alpha, exert adverse effects on chronic alcoholic liver disease, so that protracted activation of macrophages with continuous TNF-alpha production may aggravate alcoholic hepatitis. Based on these facts we have sequentially determined serum levels of TNF-alpha, 1 beta interleukin (IL-1 beta), gamma-interferon and neopterin--a macrophage product--at admission, and at the end of the first, third and sixth weeks after admission, of 43 patients affected by alcoholic hepatitis, and of 20 age-matched sanitary workers as controls. Our patients showed higher levels of neopterin and lower levels of IL-1 beta and gamma-interferon than the controls; TNF-alpha levels in our patients were almost significantly higher than in controls. TNF-alpha levels at admission were higher in the patients who died (P = 0.025). TNF-alpha and neopterin levels showed no trend to normalization in patients who died, with higher levels of neopterin at first and third weeks and higher TNF-alpha and gamma-interferon levels at first week. Using logistic regression analysis, serum TNF-alpha levels at admission showed significant (P = 0.045), independent effects on mortality, as well as serum neopterin (P = 0.0026) at the first week. Thus, enhanced macrophage activity, measured by serum levels of TNF-alpha and neopterin seems to be related to a worse prognosis in alcoholic hepatitis.

Serum neopterin levels in alcoholic liver disease

Serum neopterin levels have been determined by RIA in 105 patients affected by chronic alcoholic liver disease, 68 of them cirrhotics, and in 12 controls. Serum Neopterin was significantly higher in patients than in controls, correlated with Pughs' score and Child's classification, and also with serum laminin and type III collagen N-terminal propeptide, and with histomorphometrically determined liver fibrosis. Serum neopterin levels were higher in patients who died than in survivors, serum neopterin levels over 19.15 nmol/l being associated with higher mortality rates.

Ito cells and fibrogenesis in chronic alcoholic liver disease

The relationships between the number of Ito cells; serum N-terminal type III procollagen and laminin; clinical and biochemical parameters of liver function derangement; histomorphometrically assessed total amount of liver fibrosis; and daily ethanol intake were studied in 43 patients affected by chronic alcoholic liver disease (10 cirrhotics). Significant correlations were found between serum laminin and N-terminal type III procollagen and histological, clinical and biochemical data of liver function derangement, but no correlation was found between the aforementioned parameters and the percentage of Ito cells, which in turn seemed to be related to ethanol ingestion.