Vitamin D nutritional status and bone turnover markers in childhood acute lymphoblastic leukemia survivors: A PETALE study.

BACKGROUND: The remarkable progress in the treatment of childhood acute lymphoblastic leukemia (cALL) has led to a survival rate reaching 90%. This success story is unfortunately linked to increased risk of impaired skeletal mass accumulation during childhood and adolescence, predisposing the patients to osteoporosis and pathological fractures at adulthood. OBJECTIVE: This study aims at characterizing the vitamin D status and bone health biomarkers in a well-characterized cohort of cALL survivors. RESULTS: Food frequency questionnaires reveal that (i) the total vitamin D intake varies greatly (44-2132 IU/d), (ii) only 16.8% of the participants consume vitamin D supplements, and (iii) 74% of survivors' intakes are below the Recommended Daily Intakes (400 IU/d). For the 42 participants taking vitamin D supplements, the median (2.5-97.5%iles) intake is 600 IU/d (21.2-1972 IU/d). Sixteen participants are vitamin D deficient (<30 nM) and 66 insufficient (≥30 - <50 nM). Serum 24,25(OH)2D3 concentrations are directly related to those of 25OHD3, and those of 3-epi-25OHD3 below the Lower Limit of Quantification in most samples. The participants' serum concentrations of cross-linked C-telopeptide of type-I collagen and intact amino-terminal pro-peptide of type-I collagen decrease steadily with age, leveling at adulthood, and are at all times higher in males. CONCLUSION: The present study shows that the prevalence of vitamin D insufficiency or deficiency is not greater in cALL survivors compared to the general Canadian population despite low vitamin D food and supplement intakes. Furthermore, there seem to be no overt imbalance in the gender- and age-adjusted serum bone turnover marker concentrations.

Data for the measurement of serum vitamin D metabolites in childhood acute lymphoblastic leukemia survivors.

This article describes data related to a companion research paper entitled "Vitamin D nutritional status and bone turnover biomarkers in childhood acute lymphoblastic leukemia (cALL) survivors." (Delvin et al., submitted for publication) [1]. Various methods for the measurement of serum 25OHD3, the accepted biomarker for assessing vitamin D nutritional status, have been described (Le Goff et al., 2015; Jensen et al., 2016) [2], [3]. This article describes a novel mass spectrometry-QTOF method for the quantification of circulating 25OHD3, 3-epi-25OHD3 and 24,25(OH)2D3. It provides the description of the extraction, chromatography and mass spectrometry protocols, a sample of mass spectra obtained from standards and extracted serum, and a comparison with another HPLC-MS/MS (Jensen et al., 2016) [3] method for the measurement of serum concentrations of 25OHD3.

The Canadian Palliative Care Education Group.

The Canadian Palliative Care Education Group, a committee of the Canadian Society of Palliative Care Physicians, carries out surveys from time to time on the status of palliative care education in Canadian medical schools. We describe the organization of the Canadian Palliative Care Education Group and report on a survey carried out in the 1996-97 academic year. Our data suggest that the emphasis on palliative care varies widely amongst the 16 Canadian medical schools, in concert with the availability of academic staff positions in palliative care. We conclude that the need for palliative care education is supported by rhetoric which remains to be matched by proportionate tangible investment.

A system for the automated recording of feeding behavior and body weight.

A method that uses passive integrated transponder (PIT) tags for the continuous recording of feeding behavior and body weight from multiple individual animals is described. We have used this method in the field and in semi-natural captive conditions with black-capped chickadees (Poecile atricapillus) to determine daily and seasonal patterns in body weight and to estimate the proportions of food cached and consumed.

Successful part-whole perception in young children using multiple-choice tests.

In 3 experiments involving young children (N = 164), excellent perceptual integration of parts and wholes was revealed, unlike findings of earlier Piagetian studies (D. Elkind, R. R. Koegler, & E. Go, 1964). In Experiment 1, 5-year-olds' performance in part-whole perception was raised nearly sixfold when a multiple-choice task was substituted for the Piagetian verbal task used earlier. Performing the multiple-choice first rather than second also raised verbal scores. Experiment 2, with 3- to 5-year-olds, tested whether the children could have been confusing "whole made of parts" with "whole and parts" stimuli. Equal performance was found with 2 versions of a multiple-choice task, including either a whole and parts or a whole and different parts picture, which contradicts the confusion hypothesis. In Experiment 3, with 2- to 4-year-olds, good part-whole perception was demonstrated through the use of a 2-alternative, forced-choice procedure. The lower age bounds for this type of performance are much earlier than hitherto proposed.

The relation between accuracy of self-perception and cognitive development.

BACKGROUND: It is now widely recognised that student's self-perceptions of competence have an effect on their behaviours and learning. Previous studies have shown that children only gradually develop the ability to evaluate accurately their own competence. One possible explanation for this is that younger children have not reached a level of cognitive development required to perform such evaluations. AIMS: The objective of these two studies was to examine the hypothesis that children at higher levels of cognitive development should be more accurate in their self-appraisal of competence than children of the same age at lower levels of cognitive development. STUDY 1. SAMPLE: The sample included 173 elementary school children, with almost equal gender representation. Children were first examined in fourth grade (mean age = 10.0, SD = .77) and for the next two years. METHOD: Each child responded to questionnaires of self-perceptions about reading and to a standardised test of reading. Year-end grades in reading were used as a measure of performance. RESULTS: The results show that there was no significant difference between high and low children in grade 6, but that the correlation between self-perceptions and performance was significantly higher among high ability children than among low ability children both in grades 4 and 5. STUDY 2. SAMPLE: The sample included 153 elementary school children in grade 3 (mean age = 9.1, SD = .73) and 185 in grade 5 (mean age = 11.2, SD = .75), with almost equal gender representation. METHOD: Each child responded to questionnaires of self-perceptions about mathematics and to a standardised IQ test. Year-end grades in mathematics were used as a measure of performance. RESULTS: The correlation between self-perception and performance was significantly higher among high IQ children than among low IQ children in grade 3. However, in grade 5, high and low IQ children were similarly accurate in their self-perceptions. CONCLUSIONS: These results suggest that the development of accurate self-perceptions is not strictly a matter of age or school level but is also related to cognitive development.

Clinical reassessment of malignant hyperthermia in Abitibi-Témiscamingue.

PURPOSE: In 1992, 1812 individuals (1.2% of the population) were labelled at risk for malignant hyperthermia (MH) in seven families from Abitibi-Témiscamingue. To evaluate the effective risk in this population, a multidisciplinary study was undertaken which included clinical, genealogical and molecular aspects. This paper presents the clinical aspects of the study. METHOD: For each of the 1546 individuals reached, all anesthetic exposures were screened for elements relevant to MH. Malignant hyperthermia events were analyzed with "the clinical grading scale." All 44 reports of caffeine halothane contracture tests were reappraised. Finally, genealogical study was done to complete each family tree up to the initial French settlers in order to identify links between these seven families through common ancestors. RESULTS: Following this reassessment, the families were compared and classified into four groups. Two families (1097 individuals) are not considered to be at a higher risk for MH than the population in general. Two families are still considered possibly at risk. Finally, one family (402 individuals) is highly at risk and two other families are probably at risk. Family trees did not show any link up to the colonization of Abitibi-Témiscamingue in the beginning of this Century but common ancestors were found around the 9th generation. CONCLUSION: This clinical reassessment will help to focus education and prevention on a much smaller group of individuals still considered potentially at risk for MH. By adequate evaluation of phenotypes, combined with the use of a genealogical approach, it will be possible to target families for molecular research.

Opioid use in advanced malignant disease: why do different centers use vastly different doses? A plea for standardized reporting.

This paper reviews several recent publications concerning the use of opioids to control cancer pain and highlights the wide variation in mean daily dose. Present methods of reporting do not provide an explanation for these widely different doses used. It is essential that we understand the circumstances in which high doses are required, as higher doses are associated with greater toxicity and higher cost. Several factors that may influence the dose of opioid required are discussed. It is suggested that reporting of cancer pain, patient population, pharmacological and nonpharmacological interventions, and toxicity be standardized to allow for rational guidelines to be established for opioid use in pain due to advanced cancer.

Developing a standard data structure for medical language--the SNOMED proposal.

The Systematized Nomenclature of Medicine, Third Edition, SNOMED International, is a comprehensive structured nomenclature of human and veterinary medicine, the terms of which are detailed, fine grained and semantically typed. Terms are assigned to eleven independent modules (fields), each of which is systematized. Terms may be linked to on another to represent complex entities or manifestations or alternately complex terms dissected into their elemental parts. Terms are illustrated utilizing a frame representation. Efforts are in progress to build both a conceptual graph and a frame-based semantic network encompassing each SNOMED term, effectively building a knowledge base. In this way, the knowledge contained in each alphanumeric representation is made explicit. SNOMED is a linked data structure capable of faithfully representing the activities, observations and diagnoses found in the medical record in a computer processable form.