Research Electronic Data Capture (REDCap) in an outpatient oncology surgery setting to securely email, collect, and manage survey data.

BACKGROUND: Nursing interventions in the post-operative time period including psychological and emotional support, adverse event education, and instructions for follow-up care contribute patient satisfaction, safety, and quality of life. However, the time spent in the post-anesthesia care unit (PACU) and hospital continues to shorten around the world to reduce health care spending and improve patient outcomes. Nurses conducting research during the important post-operative recovery period need to utilize unique techniques and emerging technologies to contact, recruit and collect data outside of the hospital setting including the Research Electronic Data Capture (REDCap) platform. AIMS: This paper describes the feasibility and acceptability, facilitators and barriers of the software application, REDCap, to complete a repeated-measures, descriptive correlational study in patients undergoing outpatient breast cancer surgeries. METHODS & MATERIALS: The recruitment, data collection and storage were completed utilizing the secure REDCap Platform. The Institutional Research Board (IRB)-approved study was a repeated-measures, descriptive, correlational study with data collection at three time points. The data points aligned with important transitions and routine visits to improve data collection feasibility and increase relevance to clinical practice. RESULTS: The sample consisted of women diagnosed with breast cancer undergoing breast conserving surgery between August 15 and October 15, 2020. There were 123 potential participants, of which 76 started the surveys and 75 participated (61%) responded and participated in the study on Post-operative Day 1. Fifty-nine participants (78%) completed the surveys on post-operative Day 14. DISCUSSION: As the frequency of outpatient treatment increases, nurses conducting post-operative research will need to collect the data outside of the hospital setting. CONCLUSION: Email provides a method of studying new phenomena by recruiting participants, providing information about the study, and collecting results in a non-traditional setting. REDCap provides a method to facilitate nursing research through a securely encrypted integrated process.

[Hypoglycaemia in patients without diabetes mellitus]. / Hypoglykemie bij patiënten zonder diabetes mellitus.

A structured approach in the diagnostic process of hypoglycemia is important to find the right diagnosis. The first step is to recognize the symptoms of hypoglycemia, confirming the hypoglycemia during symptoms and dissolvement of complaints once the glucose level is restored to normal. This confirms the Whipple triad. The second step is to exclude common causes. The third, and most important, step is a diagnostic fasting test. Measurement of insulin and C-peptide during hypoglycemia will guide to exogenic or endogenic causes of hyperinsulinism. Targeted additional investigation is then required. Often the underlying cause is treatable. This justifies the need to measure a well-timed serum glucose when hypoglycemia is suspected to make a quick diagnosis.

Just-in-Time Qualitative Research: Methodological Guidelines Based on the COVID-19 Pandemic Experience.

BACKGROUND: Methodological guidelines are required to ensure both the rigor and feasibility of just-in-time, qualitative research addressing the human experience and response to the COVID-19 pandemic and major public health crises. OBJECTIVES: This article presents methodological guidelines for just-in-time qualitative research based on our current, pandemic-relevant research. METHODS: The processes followed while conducting two longitudinal, online qualitative studies addressing the lived experience and response to the COVID-19 pandemic were analyzed. Methodological challenges faced were then identified, and specific design and implementation guidelines were developed. The ways in which these guidelines can be applied to conduct just-in-time research during the COVID-19 pandemic and future public health crises were further delineated using examples from our pandemic-relevant research. RESULTS: Six guidelines were identified: (a) capitalize on fast track review and reporting processes; (b) prioritize accessibility during sample specification and selection; (c) optimize recruitment and retention strategies; (d) maximize current and future data use through strategic research design; (e) tailor data collection to participants' characteristics, preferences, and priorities; and (f) incorporate timeline mapping of personal and contemporaneous phenomena. DISCUSSION: Public health measures taken to slow disease spread during the current COVID-19 pandemic and future public health crises may slow the pace of research and make its implementation all the more challenging. However, just-in-time qualitative research advances our understanding of the human experience and response to the COVID-19 and major public health crises. It also complements existing behavioral theory and research. The guidelines presented may assist researchers to initiate necessary qualitative research more rapidly, with fewer logistic challenges, and with methodological rigor. They may also help expand research on groups experiencing collateral effects of the pandemic and major public health crisis. Lastly, the guidelines may support the development of more robust data for alternate analysis at a later date.

Severe Hypokalemia Secondary to Transient Distal Renal Tubular Acidosis in a Previously Healthy Woman.

Normal anion gap (non-gap) hyperchloremic acidosis with hypokalemia is a medical emergency. There are several causes of this metabolic phenomenon, of which distal renal tubular acidosis is among the very rare causes. In this report, we present an unusual case of a previously healthy woman who was admitted to the intensive care unit with a short history of severe muscle weakness. She had no significant past medical history and was not taking any regular medication. There was also no history of recent drug or herb ingestion. Investigations demonstrated a combination of severe hypokalemia, hyperchloremia, hypobicarbonatemia (non-gap metabolic acidosis), and relatively raised urinary potassium and urinary pH in the presence of severe hypokalemia and metabolic acidosis. Results suggested a diagnosis of distal renal tubular acidosis. The patient responded rapidly to a short course of electrolyte replacement therapy and the condition resolved spontaneously thereafter. This case highlights the fact that distal renal tubular acidosis can occur as a transient phenomenon in previously healthy individuals.

Clinical characteristics, culprit drugs and outcome of patients with Acute Generalised Exanthematous Pustulosis seen in Hospital Sultanah Aminah, Johor Bahru.

BACKGROUND: Acute generalised exanthematous pustulosis (AGEP) is a rare, cutaneous reaction characterised by sudden onset of numerous, non-follicular, sterile pustules on oedematous erythematous skin, accompanied by fever and neutrophilia. AGEP is predominantly drug-induced. Skin lesions appear rapidly within 1-3 days of drug exposure and upon drug withdrawal, resolve rapidly within 15 days. OBJECTIVE: To determine the clinical characteristics, culprit drugs and outcome of patients with AGEP. METHODS: A retrospective note review of all AGEP patients seen from 2001-2015. RESULTS: Among 21 AGEP patients, 76% were Malays, 9.5% Chinese, 9.5% Indians, and 5% Iban. Sixteen were females and 5 were males. Median age of patients was 40 years (IQR: 26). The main culprit drug was amoxicillin (10 cases), followed by cloxacillin (three cases), phenytoin (two cases) and one case each of carbamazepine, sulphasalazine, allopurinol, cephalexin, ceftriaxone, celecoxib and herbal product. The median time from drug initiation to onset of AGEP was 3 days (IQR: 5.5). Fever was documented in 52.4 %, mucosal involvement 9.5%, purpura 4.7% and blisters 4.7%. Neutrophilia was observed in 63.6% of patients and eosinophilia in 28.5%. While most patients required admission (67%), all achieved complete recovery within 15 days without any sequela. CONCLUSIONS: AGEP predominantly affects Malay females in this study. The most common culprit drug was amoxicillin. Our patients exhibited the classic clinical manifestations of AGEP and confirmed the generally benign nature of this reaction upon drug withdrawal. Although the overall prognosis is good, prompt diagnosis of AGEP is important because drug withdrawal is the mainstay therapy.

Theory and Theorizing in Nursing Science: Commentary from the Nursing Research Special Issue Editorial Team.

BACKGROUND: Articles from three landmark symposia on theory for nursing-published in Nursing Research in 1968-1969-served as a key underpinning for the development of nursing as an academic discipline. The current special issue on Theory and Theorizing in Nursing Science celebrates the 50th anniversary of publication of these seminal works in nursing theory. OBJECTIVE: The purpose of this commentary is to consider the future of nursing theory development in light of articles published in the anniversary issue. APPROACH: The Editorial Team for the special issue identified core questions about continued nursing theory development, as related to the nursing metaparadigm, practice theory, big data, and doctoral education. Using a dialogue format, the editors discussed these core questions. DISCUSSION: The classic nursing metaparadigm (health, person, environment, nursing) was viewed as a continuing unifying element for the discipline but is in need of revision in today's scientific and practice climates. Practice theory and precision healthcare jointly arise from an emphasis on individualization. Big data and the methods of e-science are challenging the assumptions on which nursing theory development was originally based. Doctoral education for nursing scholarship requires changes to ensure that tomorrow's scholars are prepared to steward the discipline by advancing (not reifying) past approaches to nursing theory. CONCLUSION: Ongoing reexamination of theory is needed to clarify the domain of nursing, guide nursing science and practice, and direct and communicate the unique and essential contributions of nursing science to the broader health research effort and of nursing to healthcare.

Radiosensitizing potential of rutin against human colon adenocarcinoma HT-29 cells.

AIM: The present study was focused at evaluating the potential of rutin to improve the radiotherapeutic index and thereby the cytotoxicity towards colon cancer cells. MATERIALS AND METHODS: HT-29 cells were pre-treated with rutin and the effect on cell proliferation was determined by MTT assay followed by exposure to radiation. After irradiation, experimental groups were sham control, rutin alone, radiation alone, rutin along with radiation-treated HT-29 cells. RESULTS: Cytotoxicity study illustrated that treatment of HT-29 cells with different concentrations of rutin reduced cell proliferation in a dose- and time-dependent manner. After irradiation, the HT-29 cells revealed that the combined effect of 4 Gy radiation and rutin at 80 µM concentration showed a decrease in cell viability as compared to rutin­alone treated and 4 Gy­alone irradiated HT-29 cells. Furthermore, the increase in apoptotic cells, change from normal nuclei to abnormal nuclei, alterations in mitochondrial membrane potential, increase in DNA damage, increase in levels of lipid peroxidative markers, and decrease in antioxidant status were observed in 4 Gy­ and rutin-treated group as compared to the other treated groups. CONCLUSIONS: Combined effect of rutin and radiation in HT-29 cells leads to a more pronounced cell death rate. Thus, rutin exhibits radiosensitizing effects on HT-29 cells (Tab. 4, Fig. 8, Ref. 42).

Impaired quality of life in treatment-seeking obese children of Dutch, Moroccan, Turkish and Surinamese descent.

OBJECTIVE: To determine the health-related quality of life (HRQOL) of overweight and obese multi-ethnic children compared with normal-weight children; and to investigate differences in HRQOL between self- and parent-proxy reports and ethnic groups. DESIGN: Prospective cross-sectional study. SETTING: Out-patient clinic where children and their parents filled out a validated HRQOL questionnaire (KIDSCREEN-52) and height, weight, waist circumference and fat percentage were measured. SUBJECTS: Overweight and obese children, aged 8-18 years (mean BMI Z-score 3·2 (sd 0·6)), from the obesity out-patient clinic. RESULTS: Three hundred and eight self- and 213 parent-proxy reported questionnaires were completed. Global HRQOL and the Physical Wellbeing, Moods & Emotions and Self-Perception subscales were markedly reduced in our multi-ethnic obese cohort, relative to the Dutch reference values. Parent proxies reported significantly lower on the global HRQOL and the Physical Wellbeing, Moods & Emotions and Bullying subscales. In Caucasian children, multivariate analyses showed that BMI was associated with the quality-of-life subscales Moods & Emotions, Self-Perception and Bullying. CONCLUSIONS: HRQOL was markedly reduced in our multi-ethnic overweight and obese out-patient clinic cohort, with significantly lower parent-proxy scores compared with self-reported scores. We believe intervention programmes aiming to improve HRQOL should be directed to both parents and children, while ethnic-specific programmes to enhance HRQOL seem of less importance.

Effect of sinapic acid on 1,2 dimethylhydrazine induced aberrant crypt foci, biotransforming bacterial enzymes and circulatory oxidative stress status in experimental rat colon carcinogenesis.

AIM: This study was aimed to investigate the effect of sinapic acid (SA) on 1,2-dimethylhydrazine (DMH) induced experimental rat colon carcinogenesis. MATERIALS AND METHODS: Rats were assorted into six groups, group 1 served as control, group 2 received SA (80 mg/kg b.w.) post orally every day until the end of the experimental period of 16 weeks, groups 3-6 rats were injected DMH (20 mg/kg b.w.) subcutaneously once a week for first four weeks. In addition, groups 4-6 rats received different doses of SA (20, 40 and 80 mg/kg b.w.). RESULTS: Our results showed that DMH induced rats revealed significantly increased ACF development and multiplicity, which were significantly inhibited on supplementation with SA. Moreover, elevated levels/activities of circulatory oxidative stress markers, faecal and colonic mucosal bacterial enzymes were observed in DMH exposed rats, which were diminished on supplementation with SA. CONCLUSION: Overall, our findings revealed that supplementation with SA offers significant protection against DMH induced rat colon carcinogenesis and the effect of SA at the dose of 40 mg/kg b.w. was more pronounced as compared to the other two doses. (Tab.5, Fig. 3, Ref. 46)

Gastric bypass may promote weight loss in overweight partners.

INTRODUCTION: Following bariatric surgery, patients are expected to implement diet and lifestyle changes that may be imitated by cohabitating family members. We hypothesize that cohabitating family members will lose weight and improve their eating behavior within 1 year after surgery. METHODS: In this observational prospective study, family members of patients who had gastric bypass surgery (88 partners, 20 children ≥18 years old, and 25 children between 12 and 17 years old) were repeatedly assessed. Family members were asked to assess their weight and height before and 3, 6, and 12 months following bariatric surgery, and they filled out the Dutch Eating Behavior Questionnaire. RESULTS: Between baseline and 1 year following surgery, 49 partners of patients who underwent gastric bypass surgery (66.2%) lost weight, 6 (8.1%) remained stable, and 19 (25.7%) gained weight. Body mass index of partners (P = .002), particularly of overweight partners (P < .001)-but not children-showed a small, significant decrease over time. No significant changes in eating behavior among partners or children were found. CONCLUSION: The study indicates that gastric bypass surgery may have a ripple effect, with body weight in partners of patients decreasing over time. However, there is considerable variation in the postoperative weight loss of partners.

Volumetric analysis of hippocampal sub-regions in late onset depression: a 3 tesla magnetic resonance imaging study.

BACKGROUND: While many studies have reported reduced volume of hippocampus in late onset depression (LOD), the status of hippocampus sub-regions (anterior/posterior) is yet to be explored. Evaluating hippocampal sub-regions might facilitate better elucidation of the neurobiological basis of LOD. METHODS: Twenty five elderly subjects with LOD (mean age=65.28yr, SD=5.73, 15 females) and 20 healthy controls (mean age=65.35yr, SD=5.67, 7 females) were examined using 3-tesla magnetic resonance imaging (MRI). They were also evaluated with Montgomery Asberg Depression Rating Scale (MADRS) and Hindi Mental State Examination (HMSE). We examined the difference in volume of Hippocampal sub-regions between the LOD group and control group controlling for the age, sex and intracranial volume. RESULTS: Left posterior hippocampus volume was significantly smaller in LOD group than the control group (1.01±0.19ml vs 1.16±0.25ml, F=7.50, p=0.009). There was a similar trend for the right posterior hippocampus (1.08±0.19ml vs 1.18±0.27ml, F=3.18, p=0.082). Depression severity (mean MADRS score=20.64±8.99) had a significant negative correlation with volumes of right posterior hippocampus (r=-0.37, p=0.012) and left posterior hippocampus (r=-0.46, p=0.001) in the LOD group. CONCLUSIONS: Specific reduction of posterior hippocampus volume and its relationship with depression severity indicates sub region specific hippocampal volumetric abnormalities in LOD. Future studies need to evaluate sub region specific hippocampal volume in LOD longitudinally for better understanding of the pathogenesis of LOD in view of the functional differences between anterior and posterior hippocampus.

Silibinin modulates caudal-type homeobox transcription factor (CDX2), an intestine specific tumor suppressor to abrogate colon cancer in experimental rats.

To authenticate the colon cancer preventive potential of silibinin, the efficacy of silibinin needs to be tested by evaluating an organ-specific biomarker. The aim of this study was to evaluate the impact of silibinin on the colonic expression of the caudal-type homeobox transcription factor (CDX2) an intestine specific tumor suppressor gene and its downstream targets in the colon of rats challenged with 1,2 dimethyl hydrazine (DMH). Rats of groups 1 and 2 were treated as control and silibinin control. Rats under groups 3 and 4 were given DMH (20 mg/kg body weight (b.w.) subcutaneously) once a week for 15 consecutive weeks from the 4th week of the experimental period. In addition, group 4 rats alone were treated with silibinin (50 mg/kg b.w. per os) everyday throughout the study period of 32 weeks. Histological investigation and messenger RNA and protein expression studies were performed in the colonic tissues of experimental rats. Findings of the study revealed that DMH administration significantly decreased the expression of CDX2 and Guanylyl cyclase C (GCC) in the colon of experimental rats. Further the decreased levels of CDX2 protein, colonic mucin content, and increased number of mast cells in the colon of DMH alone-administered rats reflects the onset of carcinogenesis. The pathological changes caused due to CDX2 suppression were attenuated by silibinin supplementation.

Efficacy and tolerability of a high loading dose (25,000 IU weekly) vitamin D3 supplementation in obese children with vitamin D insufficiency/deficiency.

BACKGROUND: The recommended dose of vitamin D supplementation of 400 IU/day might be inadequate to treat obese children with vitamin D insufficiency. Therefore, we tested the efficacy and tolerability of a high loading dose vitamin D3 supplementation of 25,000 IU weekly in multiethnic obese children, 8-18 years of age, with vitamin D insufficiency/deficiency. METHODS: Fasting blood samples were drawn for the assessment of vitamin D. Vitamin D-insufficient/-deficient children (<50 nmol/l) were supplemented, using a high loading dose of 25,000 IU weekly, and measured again 9 weeks later. Vitamin D supplementation was considered effective and tolerable when an increase to vitamin D sufficiency (25(OH)D >50 nmol/l) was reached in >75% without side effects nor reaching toxic levels. RESULTS: In total, 109 children (mean ± SD age 11.1 ± 3.0, 34.2% boys, 90.8% obese) received vitamin D supplementation. In 84.4% of the children, the vitamin D status improved from insufficiency/deficiency (<50 nmol/l) to sufficiency (≥50 nmol/l). The majority of children that did not reach vitamin D sufficiency reported non-compliance. No side effects were reported, and the highest level reached was far below the threshold for toxicity. CONCLUSION: A high loading dose vitamin D3 supplementation is effective and well-tolerated in our cohort of multiethnic obese children with vitamin D insufficiency/deficiency.

Chemopreventive effect of sinapic acid on 1,2-dimethylhydrazine-induced experimental rat colon carcinogenesis.

Sinapic acid (SA) is a naturally occurring phenolic acid found in various herbal plants which is attributed with numerous pharmacological properties. This study was aimed to investigate the chemopreventive effect of SA on 1,2-dimethylhydrazine (DMH)-induced rat colon carcinogenesis. Rats were treated with DMH injections (20 mg kg(-1) bodyweight (b.w.) subcutaneously once a week for the first 4 consecutive weeks and SA (20, 40 and 80 mg kg(-1) b.w.) post orally for 16 weeks. At the end of the 16-week experimental period, all the rats were killed, and the tissues were evaluated biochemically. Our results reveal that DMH alone treatment decreased the levels/activities of lipid peroxidation by-products such as thiobarbituric acid reactive substances, conjugated dienes and antioxidants such as superoxide dismutase, catalase, glutathione reductase, glutathione peroxidase and reduced glutathione in the intestine and colonic tissues which were reversed on supplementation with SA. Moreover, the activities of drug-metabolizing enzymes of phase I (cytochrome P450 and P4502E1) were enhanced and those of phase II (glutathione-S-transferase, DT-diaphorase and uridine diphosphate glucuronosyl transferase) were diminished in the liver and colonic mucosa of DMH alone-treated rats and were reversed on supplementation with SA. All the above changes were supported by the histopathological observations of the rat liver and colon. These findings suggest that SA at the dose of 40 mg kg(-1) b.w. was the most effective dose against DMH-induced colon carcinogenesis, and thus, SA could be used as a potential chemopreventive agent.

Oral supplementation with troxerutin (trihydroxyethylrutin), modulates lipid peroxidation and antioxidant status in 1,2-dimethylhydrazine-induced rat colon carcinogenesis.

The present study was aimed to investigate the chemopreventive potential of troxerutin on 1,2-dimethylhydrazine (DMH) induced rat colon carcinogenesis by evaluating the antioxidant and lipid peroxidation (LPO) status. Rats were randomly divided into six groups. Group I rats served as control. Group II rats received troxerutin (50 mg/kgb.w., p.o.) for 16 weeks. Groups III-VI rats received subcutaneous injections of DMH (20 mg/kgb.w., s.c.) once a week, for the first 4 weeks. In addition to DMH, groups IV-VI rats received troxerutin at the doses of 12.5, 25 and 50 mg/kgb.w., respectively. In DMH treated rats, our results showed decreased activities of antioxidants and increased levels of LPO in the liver. Moreover, LPO and antioxidants in the colon were found to be significantly diminished in DMH the treated rats. Furthermore, enhanced activity of colonic vitamin C and vitamin E levels were observed in DMH alone treated rats (group III), which was significantly reversed on troxerutin supplementation. Troxerutin at the dose of 25 mg/kgb.w. had shown profound beneficial effects by exhibiting near normal biochemical profile and well-preserved colon histology as compared to the other two tested doses (12.5 and 50 mg/kgb.w.). These findings suggest that troxerutin could serve as a novel agent for colon cancer chemoprevention.

Modulating effect of d-carvone on 1,2-dimethylhydrazine-induced pre-neoplastic lesions, oxidative stress and biotransforming enzymes, in an experimental model of rat colon carcinogenesis.

OBJECTIVES: The present study has aimed to evaluate chemopreventive potential of d-carvone on oxidative stress markers, biotransforming enzymes, incidence of colonic polyps and aberrant crypt foci (ACF) in 1,2-dimethylhydrazine (DMH)-induced experimental colon carcinogenesis. MATERIALS AND METHODS: Rats were randomly divided into six groups, with group I serving as control. Group II animals received d-carvone every day orally (20 mg/kg body weight) for 16 weeks; groups III-VI received subcutaneous injections of DMH (20 mg/kg body weight) once a week, for the first 4 weeks. In addition, groups IV-VI received different doses of d-carvone (5, 10 and 20 mg/kg body weight everyday orally) along with DMH injections. RESULTS: Our results revealed that supplementation with d-carvone significantly reduced incidence of polyps/ACF and ACF multiplicity in DMH-exposed rats compared to DMH-alone-exposed rats. Moreover, our results showed reduced activities of liver and circulatory antioxidants and increased levels of lipid peroxidation by products in DMH-exposed animals, which were significantly reversed on supplementation with d-carvone. In addition, colonic antioxidants and lipid peroxidation were significantly diminished in DMH-exposed rats, which were significantly elevated on supplementation with d-carvone. Furthermore, we also determined activities of biotransforming enzymes, which were found to be altered in DMH-exposed rats, but reversed on d-carvone supplementation. All these observations of changes were supported by histochemical findings. CONCLUSION: Overall, results obtained from this study suggest that d-carvone at 10 mg/kg body weight provided optimum protection and could be used as an effective chemopreventive agent against colon carcinogenesis induced by DMH.

Increasing thyroid-stimulating hormone is associated with impaired glucose metabolism in euthyroid obese children and adolescents.

BACKGROUND: Contrasting data exist regarding the relationship between thyroid-stimulating hormone (TSH) and obesity-related risk factors in children. In the present study, we investigated the association between TSH, free T4 (fT4) and cardiometabolic risk factors in euthyroid obese children and adolescents. METHODS: A retrospective analysis of patient records was performed on data from 703 multi-ethnic obese children and adolescents who visited an obesity-outpatient clinic. We performed anthropometric measurements, an oral glucose tolerance test, and measured serum TSH, fT4 and lipid levels. RESULTS: A positive association between TSH and the standard deviation score of the body mass index (BMI-Z) was found. After adjustment for ethnicity, sex, pubertal stage and BMI-Z, logistic regression analysis showed significant associations between TSH levels and impaired fasting glucose, impaired glucose tolerance, high total cholesterol, high low-density lipoprotein cholesterol and high triglycerides. No significant associations between fT4 levels and cardiometabolic risk factors were found in linear/logistic regression analysis. CONCLUSION: In our multi-ethnic cohort of euthyroid obese children and adolescents increasing TSH was associated with impaired glucose metabolism and dyslipidemia.

Limited value of routine microalbuminuria assessment in multi-ethnic obese children.

BACKGROUND: To determine the prevalence of microalbuminuria and its association with cardiometabolic risk factors in a multi-ethnic cohort of overweight and obese children. CASE-DIAGNOSIS/TREATMENT: A retrospective analysis of prospectively collected data was performed using data from 408 overweight and obese children (age 3-19 years). In addition to administering an oral glucose tolerance test, we measured anthropometric variables, plasma lipid levels, alanine aminotransferase and the urinary albumin/creatinine ratio (ACR). Microalbuminuria was defined as an ACR of between 2.5 and 25 mg/mmol in boys and 3.5 and 25 mg/mmol in girls. In total, only 11 (2.7 %) of the children analyzed presented with microalbuminuria, with no differences between ethnic groups, sex or in the prevalence of hypertension compared to the children with normoalbuminuria. After adjustment for confounders, the body mass index Z-score tended to be different between the group with microalbuminuria versus that without (3.6 vs. 3.2, respectively; P = 0.054). ACR was not associated with hypertension, impaired glucose tolerance, high triglycerides or low high-density lipoprotein-cholesterol. CONCLUSIONS: In a large multi-ethnic cohort of overweight and obese children, we found a low prevalence of microalbuminuria (11 children, 2.7 %), and in this small number of individuals, we found no association with any of the cardiometabolic risk factors assessed. Therefore, our data do not support the routine measurement of microalbuminuria in asymptomatic overweight and obese children and adolescents.

Modulatory efficacy of rosmarinic acid on premalignant lesions and antioxidant status in 1,2-dimethylhydrazine induced rat colon carcinogenesis.

Colorectal cancer is one of the leading causes of cancer related deaths in Western countries and is becoming increasingly common in Asia. Rosmarinic acid (RA), one of the major components of polyphenol possesses attractive remedial features. The purpose of this study is to investigate the possible chemopreventive mechanism of action of RA against 1,2-dimethylhydrazine (DMH) induced rat colon carcinogenesis by evaluating the circulatory antioxidant status and colonic bacterial enzymes activities. Additionally, we analyzed the aberrant crypt foci (ACF) formation and multiplicity in the colon of experimental groups. Wistar male rats were divided into six groups. Group 1 was control rats, group 2 rats received RA (10 mg/kg b.w., p.o. everyday), rats in groups 3-6 received DMH (20 mg/kg b.w., s.c.) for the first 4 weeks. In addition to DMH, groups 4-6 received 2.5, 5, and 10 mg/kg b.w. RA respectively. The results revealed that supplementation with RA significantly reduced the formation of ACF and ACF multiplicity in DMH treated rats. Moreover RA supplementation prevented the alterations in circulatory antioxidant enzymes and colonic bacterial enzymes activities. Overall, our results showed that all three doses of RA inhibited carcinogenesis, though the effect of the intermediary dose of 5 mg/kg b.w. was more pronounced.