Plate size does not affect perception of food portion size.

BACKGROUND: Evidences have suggested that larger utensils may provoke 'size-contrast illusions', influencing the perceived volume and food consumption. OBJECTIVE: To analyse the influence of plate size on the visual estimate of food portion size. METHODS: Two 400 g portions of pasta with tomato sauce were presented on two plates of different diameters (24.0 and 9.0 cm). Each participant visually estimated on an individual basis the quantities of the pasta portions (g) present on each plate. In addition, each subject classified the size of the portions on each plate as 'small', 'medium' and 'large'. The mean estimates of the amount of pasta on each plate were compared by the nonparametric Mann-Whitney. The differences in the frequencies of portion classifications between plates were evaluated by the chi-squared test. RESULTS: Forty-eight students (average 25.8 ± 8.9 years) participated in the study. There was no difference in the median amount of pasta estimated for the large and small plates (150 g; range 50-500 and 115 g; range 40-500 g, respectively). The classification of the portion size as 'large' was reported by a significantly greater number of persons when they evaluated the amount of pasta arranged on the large plate compared to the small plate (47.9 versus 22.9%, respectively; P = 0.018). CONCLUSION: The size of the plate did not influence the estimate of food portions, even though it did influence the classification of portion size.

[Update on prevention of infections in patients without spleen or with diminished splenic function]. / Update sulla prevenzione delle infezioni nei pazienti splenectomizzati o con iposplenismo funzionale.

Patients without spleen or with diminished splenic function are at high risk (10-50 times higher than in normal population) of developing life-threatening infections (OPSI). Mortality from OPSI is estimated at 50 to 80% of cases. More frequent causative agents are encapsulated bacteria: Streptococcus Pneumoniae, Haemophilus influenzae type b and Neisseria Meningitidis. The risk of OPSI can be reduced by immunizing patients against these pathogens and by prescribing antibiotic prophylaxis. Continuous antibiotic prophylactic for 2-5 years after splenectomy (longer periods might expose the patients to the risk of antibiotic resistance) with penicillin or amoxicillin/clavulanate acid is mandatory. Asplenic individuals should take empirical antibiotic therapy - so called "self-treatment" - and immediate medical consultation in presence of febrile illness. All patients and their parents should be carefully educated about the risk of infections in order to obtain a good long-term compliance with these recommendations.

The use of body circumferences for the prediction of intra-abdominal fat in obese women with polycystic ovary syndrome / El uso de circunferencias corporales para la predicción de la grasa intra-abdominal en mujeres obesas con el síndrome del ovario poliquístico

Introduction: Computerizd tomography (CT) is the gold standard for the evaluation of intra- (IAF) and total (TAF) abdominal fat; however, the high cost of the procedure and exposure to radiation limit its routine use. Objective: To develop equations that utilize anthropometric measures for the estimate of IAF and TAF in obese women with polycystic ovary syndrome (PCOS). Methods: The weight, height, BMI, and abdominal (AC), waist (WC), chest (CC), and neck (NC) circumferences of thirty obese women with PCOS were measured, and their IAF and TAF were analyzed by CT. Results: The anthropometric variables AC, CC, and NC were chosen for the TAF linear regression model because they were better correlated with the fat deposited in this region. The model proposed for TAF (predicted) was: 4.63725 + 0.01483 x AC - 0.00117 x NC - 0.00177 x CC (R2 = 0.78); and the model proposed for IAF was: IAF (predicted) = 1.88541 + 0.01878 x WC + 0.05687 x NC -0.01529 x CC (R2=0.51). AC was the only independent predictor of TAF (p < 0.01). Conclusion: The equations proposed showed good correlation with the real value measured by CT, and can be used in clinical practice (AU)

Introducción: La tomografia computarizada (TC) es el estándar de oro para la evaluación de la grasa intra-abdominal (GIA) y abdominal total (GAT), pero los altos costos y la exposición a la radiación limitan su uso rutinario. Objetivo: Desarrollar ecuaciones para la estimación de la GIA y la GAT en mujeres obesas con el sindrome del ovario poliquistico, utilizando medidas antropométricas. Métodos: Se evaluó el peso, la altura, el IMC y las circunferencias abdominal (CA), cintura (CC), pecho (CP) y cuello (Ccu) de 30 mujeres obesas con SOP. La GIA y GAT fueron analizados por la TC. Resultados: El modelo propuesto fue: GAT = 4,63725 + 0,01483 x CA - 0.00117 x CCu - 0,00177 x CP (R2 = 0,78); y para la GIA fue: GIA = 1, 88541 + 0, 01878 x CC + 0,05687 x CCu - 0,01529 x CP (R2 = 0,51). La CA fue La única variable predictora independiente de la GAT (p < 0,01). Conclusión: Las equaciones propuestas correlacionaronse bien con el valor real, medido a través de la TC, y se puede utilizarlas en la práctica clínica (AU)

The impact of TACI mutations: from hypogammaglobulinemia in infancy to autoimmunity in adulthood.

Common variable immunodeficiency (CVID) is considered the most common symptomatic antibody deficiency and, although mainly reported in adults, it may present from childhood. Few data on the impact of TACI defects on the clinical and immunological status of children are available. We screened 42 hypogammaglobulinemic children to investigate the frequency and mutational features of TACI defects. The genetic, clinical and immunological characterization was extended to 31 relatives of 11 children with TACI mutations. Of interest, our analysis showed a considerably higher mutation frequency in hypogammaglobulinemic children (13/42; 31%) than in other cohorts of adult patients. In seven out of nine families with the C104R variant, the prevalence of autoimmunity was significantly higher in C104R heterozygous relatives (8/15; 53%) than in those with no C104R mutation (1/11; 9%). Our data suggest a different impact of TACI mutations, from hypogammaglobulinemia in children to autoimmune disease in adulthood.

The use of body circumferences for the prediction of intra-abdominal fat in obese women with polycystic ovary syndrome.

INTRODUCTION: Computerizd tomography (CT) is the gold standard for the evaluation of intra- (IAF) and total (TAF) abdominal fat; however, the high cost of the procedure and exposure to radiation limit its routine use. OBJECTIVE: To develop equations that utilize anthropometric measures for the estimate of IAF and TAF in obese women with polycystic ovary syndrome (PCOS). METHODS: The weight, height, BMI, and abdominal (AC), waist (WC), chest (CC), and neck (NC) circumferences of thirty obese women with PCOS were measured, and their IAF and TAF were analyzed by CT. RESULTS: The anthropometric variables AC, CC, and NC were chosen for the TAF linear regression model because they were better correlated with the fat deposited in this region. The model proposed for TAF (predicted) was: 4.63725 + 0.01483 x AC - 0.00117 x NC - 0.00177 x CC (R² = 0.78); and the model proposed for IAF was: IAF (predicted) = 1.88541 + 0.01878 x WC + 0.05687 x NC -0.01529 x CC (R²=0.51). AC was the only independent predictor of TAF (p < 0.01). CONCLUSION: The equations proposed showed good correlation with the real value measured by CT, and can be used in clinical practice.

Thrombocytosis in children.

In healthy pediatric subjects normal count platelet ranges between 250,000 µL and 450,000 µL. An elevated platelet count greater than 2 SD defines a condition of thrombocytosis. On a clinical level, thrombocytosis is classified "mild" at a platelet count between >500,000 µL and <700,000 µL; "moderate" at a platelet count between >700,000/µL and <900,000/µL; "severe" at a platelet count >900,000/µL; and "extreme" at a platelet count >1,000,000/µL. Thrombocytosis can be classified as primary or secondary. Primary thrombocytosis is divided into familial and essential. Primary thrombocytosis is an extremely rare clonal disease in childhood with incidence of one per million children, i.e., 60 times lower than in adults. It is classified as a myeloproliferative disorder with polycythemia vera, chronic myeloid leukaemia and myelofibrosis and may be associated with thrombotic or haemorrhagic events. Platelet count is generally above 1,000,000/µL. The median age at diagnosis is about 11 years. On the contrary, secondary or reactive thrombocytosis (RT) is very common in pediatric age, occurring in 3-13% of hospitalized children because of several causes. Generally, it is a reactive process caused by infection, chronic inflammation, iron deficiency, tissue damage, cancer, drugs and surgical or functional splenectomy. Thrombocytosis is mild in 72-86% of children, moderate in about 6-8%, and extreme in 0.5-3%. Consultation with a pediatric hematologist is required if elevation of platelet count persists, is unexplained or symptomatic. In the majority of cases no treatment is necessary, and the patient must be only closely monitored.

Reimbursement of burns by DRG in four European countries: an analysis.

PURPOSE: To analyze the German, Austrian, Italian and Spanish Diagnosis-Related Group (DRG)-systems regarding burns. METHODS: We analyzed 78 cases of inpatients with burns which were processed by national DRG-groupers. DRGs were linked to thresholds concerning length of stay as well as reimbursement tables of the respective countries. MAIN FINDINGS: Fifty-one % of cases showed higher reimbursement in Germany compared to Austria, 55% compared to Italy and 67% as against Spain. Total proceeds are highest in Austria with 1,577,000 €, followed by Italy with 1,569,000 €, Germany with 1,502,000 € and Spain with 902,596 €. No correlation was found between macroeconomic key figures and our data. CONCLUSIONS: International comparison of reimbursement of burns by DRG could be a useful instrument for benchmarking while not depending solely on political decisions or country-specific cost data. For better comparability, hospital indices based on healthcare baskets should be discussed.

Upper trunk fat assessment and its relationship with metabolic and biochemical variables and body fat in polycystic ovary syndrome.

BACKGROUND: Fat accumulation in the upper region of the body is common in polycystic ovary syndrome (PCOS) and is associated with metabolic complications. The present study aimed to assess the relationship between trunk circumference, metabolic indicators, and abdominal and visceral fat in obese PCOS women. METHODS: The weight, fat mass, and subcutaneous arm fat (SAF) of 30 obese PCOS women and 15 healthy controls matched for age and body mass index were evaluated by bioelectrical impedance analysis. Trunk (TrC), neck (NC) and hip circumferences were measured, and the trunk/hip (Tr/H) ratio was determined. Total abdominal fat (TAF), visceral fat (VF) and trunk fat (TrF) were determined by computed tomography. Biochemical evaluation included glycaemia, insulinaemia, testosterone and lipid profile, insulin resistance (IR) was assessed by the QUICKI index. RESULTS: In the PCOS group, there were positive correlations between NC and TAF (r = 0.49, P < 0.0006), TrC and VF (r = 0.62, P = 0.01), and NC and VF (r = 0.70, P < 0.0002). There was good correlation between TrC and TrF (r = 0.69, P = 0.003). TrF correlated with triglycerides levels positively (r = 0.44, P = 0.02). Women with PCOS and IR had a larger quantity of VF and TrF, but a smaller amount of SAF. Within the PCOS group, women with Tr/H ratio above the median had higher basal insulin levels and lower QUICKI indices compared to women presenting a Tr/H ratio below the median. CONCLUSIONS: TrC is associated with important metabolic variables in PCOS, proving to be a valuable and innovative tool for assessment of body adiposity distribution in obese PCOS women.

Increased folate intake with no changes in serum homocysteine and decreased levels of C-reactive protein in patients with inflammatory bowel diseases.

In order to increase dietary folic acid intake and to improve nutritional status regarding folate by controlling homocysteine concentrations, ten patients with inflammatory bowel diseases (Crohn's disease in the colon and ulcerative colitis) received individualized nutritional guidance and were followed up as outpatients for 2 months. The following procedures were performed at the beginning of the study (T0), after 1 month (T1) and at the end of the study (T2): collection of anthropometric data (weight and height), dietary data (24 h diet recall), and blood under fasting condition for the determination of serum folic acid, homocysteine, C-reactive protein, and vitamin B12. Plasma folic acid deficiency was not detected but hyperhomocysteinemia was present in six individuals and C-reactive protein (CRP) was increased (>0.5 mg/dl) in seven patients. After the patients were instructed there was a significant increase in vitamin B6 intake (about 35%) and in folate intake (49.6%). Mean plasma levels of folic acid, homocysteine, and vitamin B12 did not change, but there was a significant decrease of CRP at T1, 0.36 mg dl(-1) on average (P = 0.01), which was maintained at T2. We conclude that the increased folate intake reported by this group of patients was not reflected in improved serum concentrations of folic acid and homocysteine. However, the guidelines for the patients probably induced them to choose a more adequate diet, providing nutrients that help control the inflammatory process.

[Study about noise pollution in the Nomentano quarter of Rome and its perception by residents]. / Indagine sull'inquinamento acustico nel quartiere Nomentano di Roma e sulla sua percezione da parte dei residenti.

The Authors describe the results of an investigation, carried out in the Nomentano quarter of Rome, to evaluate noise pollution level by road traffic and the annoyance in a resident sample. The measurement places have been subdivided according to three categories of streets ("flowing ", "quarter" and "local" streets); the LAeq (equivalent continuous level of noise) was taken during the day (from 7 am to 19 pm), the evening (from 19 pm to 23 pm) and the night (from 23 pm to 7 am). The results have been compared with previous study's data taken in 1988 and with the prescribed noise's limit values of the current national regulations. Lden values, the Community recommended acoustic parameter were also calculated. At the same time an interview was carried out to investigate resident's annoyance level; the results are discussed in relationship with registered noise levels.

Effect of a necrogenic dose of diethylnitrosamine on vitamin E-deficient and vitamin E-supplemented rats.

In order to evaluate the effects of a necrogenic dose of diethylnitrosamine (DEN) on vitamin E-deficient and vitamin E-supplemented rats, a single dose of the drug (200 mg/kg body weight) was injected intraperitoneally at the end of 10 weeks of treatment with the diets. The hepatic necrosis and lipoperoxidation provoked by DEN were evaluated 24, 48, 72 and 120 hours after the injection and were found to be more intense in the deficient group (thiobarbituric acid reactive substances (TBARS): 5.20 +/- 1.48 nmol/mg protein; necrosis volume: 68.99 +/- 8.36%; P < 0.05) during the second period. Also, in the same group and during the same period, mean plasma and hepatic vitamin E concentrations and mean liver glutathione concentration were the lowest detected, suggesting the occurrence of antioxidant consumption due to the toxic action of DEN. In contrast to vitamin E deficiency, which permitted the drug to exert stronger toxic effects, 20-fold supplementation with vitamin E did not provide additional protection against the lipoperoxidation and necrosis provoked by DEN (P < 0.05). The results suggest that other mechanisms in addition to lipoperoxidation provoked by free radicals originating from the metabolism of nitrosamines by the cytochrome P-450-dependent enzymatic system may be involved in the hepatotoxic action of these substances.

Effect of different dietary levels of vitamin E on lipid peroxidation in rats.

The regulation of normal oxidative balance include the maintenance of adequate levels of dietary antioxidants such as vitamin E. The objective of this investigation was to study the effect of three different dietary levels of vitamin E (normal, supplemented 20 times higher and deficient) on plasma and liver lipid peroxidation, assayed by determination of thiobarbituric acid reactive substances (TBARS) and vitamin E in plasma and liver and hepatic reduced glutathione. Administration of dietary vitamin E caused a dose-dependent increase in liver and plasma concentration of this vitamin to 42.11 micrograms/g liver and 29.52 mumol/l respectively, in the supplemented group, and a low concentration of TBARS, 0.67 nmol/mg protein, in liver. The group receiving the diet without vitamin E showed high values of hepatic TBARS, 2.95 nmol/mg protein, and low values of reduced glutathione and reduced concentration of hepatic and plasma vitamin E (1.75 micrograms/g liver and 3.67 mumol/l, respectively). In conclusion, the vitamin E deficiency alone induces the liver lipid peroxidation in rats, and maintenance of adequate or higher vitamin E levels acts as a protective factor against free radical generation.