Extrapontine Myelinolysis following Extreme Hypernatremia and Hyperosmolarity.

We present a case of a nearly 3-year-old girl who was admitted to hospital due to severe hypernatremia (196 mmol/l). Her medical history included central hypothyreosis and growth hormone deficiency. Rehydration and normalization of sodium was achieved according to guidelines. On the fourth day of hospitalization, the patient developed tremor, ataxia, and rigor. Cranial magnetic resonance imaging (cMRI) was performed and (mis)interpreted for meningoencephalitis, with corresponding diagnostic and therapeutic implications. The patient had extrapontine myelinolysis. The child recovered completely after hospitalization for nearly 2 weeks.

Elevated milk ß-carotene and lycopene after carrot and tomato paste supplementation.

OBJECTIVES: To measure concentrations of ß-carotene and lycopene in the breast milk of healthy, well-nourished, lactating women supplemented with fresh carrot or tomato paste. METHODS: Twelve women were given fresh carrot paste and another 14 were given fresh tomato paste once a day for 3 d with a high-lipid-content meal. The women were instructed to avoid any food containing ß-carotene or lycopene, other than the test meal. Milk carotenoid levels were measured before, during, and after the trial. The carrot and tomato meals contained 15 mg of all-trans ß-carotene and 15 mg of all-trans lycopene, respectively. RESULTS: We demonstrated a significant increase in milk ß-carotene and elevated milk lycopene levels after the lipid-rich fresh carrot and tomato meals, respectively. CONCLUSIONS: We suggest that breast milk carotenoid levels reflect the mother's level of intake and can thus be raised by simple nutritional intervention. The results of this study may be relevant to breast-feeding mothers of both preterm and term infants by raising antiinflammatory and antioxidant properties in their milk.

Plasma and buccal mucosal cell response to short-term supplementation with all trans-beta-carotene and lycopene in human volunteers.

Despite interest in the health-beneficial role of carotenoids little is known about the specific storage metabolism and mechanisms involved in various target tissues. The aim of the study was to search for a relatively simple non-invasive method to detect and determine the cellular effects of supplemented dosage of beta-carotene and lycopene to peripheral tissues such as the buccal mucosa in relation to the plasma concentrations. Subjects (30) were allocated into five different subgroups of 6 volunteers. The change in concentration of all-trans-beta-carotene and lycopene in plasma and in buccal mucosal cells was measured in groups of volunteers supplemented with either 15 mg, 30 mg or placebo capsules in a randomised double blind study for a period of 7 days. With the exception of supervised high fat (40 g carotenoid free sunflower oil) breakfasts and capsule ingestion the volunteers ate their habitual diets. Plasma lycopene and beta-carotene concentrations were determined at baseline and following one week of capsule ingestion. In all the supplemented groups the plasma carotenoid levels were significantly higher than in the placebo group indicating absorption of the supplement. Carotenoid concentrations, expressed per unit protein, assayed in buccal mucosal cells before (at baseline) and at the end of the study were found to be significantly higher in the groups supplemented at 30 mg/d, of either carotenoid as compared to the 15 mg/d or placebo supplemented groups. We conclude that buccal mucosal cells respond readily to changes in plasma beta-carotene and lycopene concentration. These observations suggest that dietary carotenoids are quickly incorporated into rapidly turning over mucosal tissues. It is not clear if the change in carotenoid content of the plasma is reflected in existing cells or only in those concurrently produced during the elevated plasma concentration. If desquamated buccal mucosal cells reflect habitual plasma carotenoid concentration then it is not an appropriate tissue for the measurement of acute changes.

Ethiopian-born and native Israeli school children have different growth patterns.

OBJECTIVE: Nutrition status of preschool children in Azezo, North West Ethiopia, and Ethiopian-born and native Israeli children aged 7 to 11 y and 12 to 15 y was studied. The aim of the study was to determine the growth patterns of immigrant children after changes in their nutritional habits. METHODS: The Ethiopian-born and native school children were recruited from a caravan-dwelling site and a boarding school and from a town adjacent to the caravan site and a boarding school, respectively. RESULTS: Weight for age was lower than -2 standard deviations of the Z score in 40.5%, 55.6%, 31.9%, and 61% of children aged 1 to 24, 25 to 36, 37 to 48, and 49 to 60 mo, respectively. Similarly, 18.9%, 59.3%, 39.1%, and 19.5% of children aged 1 to 24, 25 to 36, 37 to 48, and 49 to 60 mo had a height for age lower than -2 standard deviations of the Z score. The Ethiopian-born boys aged 7 to 11 y had lower body weight (P < 0.03), mean arm muscle circumference, plasma transthyretin and magnesium (P < 0.0001), and higher triceps skinfold thickness (P < 0.01) compared with the controls. Similarly, the Ethiopian-born girls had lower body weight (P < 0.006), weight-to-height ratio (P < 0.02), mean arm muscle circumference and plasma transthyretin, calcium, and magnesium (P < 0.0001), and higher triceps skinfold thickness (P < 0.0001) than their Israeli counterparts. Weight, weight-to-height ratio, mean arm muscle circumference, plasma calcium and magnesium (P < 0.0001), and transthyretin (P < 0.01) were lower and triceps skinfold thickness (P < 0.0001) was higher in the Ethiopian-born boarding school children than in the native Israelis of the same age range. CONCLUSIONS: The Azezo study confirmed that malnutrition-induced developmental impairment in preschool children is a major problem in Ethiopia. It is a manifestation of a rural economic and educational poverty and cannot be eradicated by palliative short-term nutritional programs. Although ethnicity and prenatal and postnatal malnutrition may have contributed, an insufficiency or imbalance of vital nutrients appeared to be the determinant factor for the lower relative growth of the Ethiopian-born children. The children from Ethiopia may have a propensity to avoid certain foods because of digestive intolerance or early childhood dietary habituation. Parental financial constraint may have been a factor in the younger group. These findings have implications for nutrition and welfare policies for children emigrating from developing countries.