Dietary sources of sugars in adolescents' diet: the HELENA study.

OBJECTIVE: To report dietary sugars consumption and their different types and food sources, in European adolescents. METHODS: Food consumption data of selected groups were obtained from 1630 adolescents (45.6% males, 12.5-17.5 years) from the HELENA study using two nonconsecutive 24-h recalls. Energy intake, total sugars and free sugars were assessed using the HELENA-DIAT software. Multiple regression analyses were performed adjusting for relevant confounders. RESULTS: Total sugars intake (137.5 g/day) represented 23.6% and free sugars (110.1 g/day), 19% of energy intake. Girls had significantly lower intakes of energy, carbohydrates, total sugars and free sugars. 94% of adolescents had a consumption of free sugars above 10% of total energy intake. The main food contributor to free sugars was 'carbonated, soft and isotonic drinks,' followed by 'non-chocolate confectionary' and 'sugar, honey, jam and syrup.' Older boys and girls had significantly higher intakes of free sugars from 'cakes, pies and biscuits.' Free sugars intake was negatively associated with low socioeconomic status for 'non-chocolate confectionary' and 'sugar, honey and jam' groups; with low maternal educational level for carbonated and 'soft drinks,' 'sugar, honey and jam,' 'cakes and pies' and 'breakfast cereals' groups; and with high paternal educational level for 'carbonated and soft drinks' and 'chocolates' group. CONCLUSIONS: The majority (94%) of studied adolescents consumed free sugars above 10% of daily energy intake. Our data indicate a broad variety in foods providing free sugars. Continued efforts are required at different levels to reduce the intake of free sugars, especially in families with a low educational level.

Home-made and commercial complementary meals in German infants: results of the DONALD study.

BACKGROUND: Infant complementary food can be home-made or bought as ready-to-eat commercial products. The nutrient composition of commercial products is regularised in a European Commission guideline, whereas the preparation of home-made complementary meals is the responsibility of caregivers. In the present study, the composition of commercial and home-made complementary meals as eaten by healthy German infants was compared. METHODS: Of 8226 complementary meals (74% commercial and 26% home-made) recorded in 1083, 3-day weighed dietary records from 396 participants (6-12 months old) of the German DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) study were analysed. RESULTS: Median energy density (kcal 100 g(-1)) was highest in commercial and home-made cereal-milk meals (89 kcal 100 g(-1)). In home-made savoury and cereal-fruit meals, the energy density was significantly higher compared to their commercial counterparts. Median protein contents were highest in savoury and cereal-milk meals (>2.5 g 100 g(-1)) and dairy-fruit meals (2-4 g 100 g(-1)). Added sugars were found in less than a quarter of meals. Highest median sodium contents were found not only in commercial savoury meals (median 38 mg 100 g(-1)) and vegetable meals (32 mg 100 g(-1)), but also in home-made cereal-milk meals (36 mg 100 g(-1)). Both median fat and iron contents were higher in home-made meals compared to commercial savoury and cereal-fruit meals. CONCLUSIONS: With the exception of the higher sodium content in commercial savoury meals for older infants, the lower fat content in commercial savoury and cereal-fruit meals, and the added sugar content in some commercial dairy-fruit meals, a comparison of commercial and home-made complementary meals did not reveal any serious inadequacy.

Assessing families' and patients' attitudes toward brain donation for research purposes in a Brazilian population sample.

The neuropathological examination of postmortem human brain tissue is an essential resource for the definitive diagnosis and research on neurodegenerative diseases. Due to the growing need of donated brains to supply the Brain Banks, the understanding of the factors associated with the consent for the donation in our context is an important aspect of the process of brain donation. The verbal answers and the donation consent rate were evaluated in three groups: 30 relatives of patients who underwent verification of the cause of death, 14 patients assisted at a neurology ambulatory outpatient clinic, and 18 patients' relatives. The donation consent rates were of 46.6, 92.8 and 88.8 %, respectively. The main reasons for refusal were the disagreement with the autopsy, philosophical and religious issues, objections from other family members, and the consideration of the wishes of the deceased. The consent was specially motivated by the interest in the advances of scientific knowledge, altruistic reasons and the personal experiences with the disease. Factors as the emotional fragility at the moment of death, the beliefs, family matters, and the lack of knowledge are key elements in the donation process. Future goals include the establishment of a brain donor program with the support of academic institutions, hospitals, scientists, community, patient's associations and autopsy assistants. Approaching patients and relatives in specialized ambulatories clinic during assistance is probably the most efficient mean of obtaining brains for research.

Development of an estimated food record for 9-36-month-old toddlers.

OBJECTIVES: Adequacy of dietary intake in the sensitive period of toddler development is a key determinant of health in a short- and long-term perspective. Therefore, studies focussing the nutrition of toddlers are of importance. For this purpose, tailored dietary record methods are an important prerequisite. The objective of this work is to develop a toddler-specific estimated food record (EFR) in a booklet providing photographs of age-specific foods and portion sizes that should be accurate and simple. SUBJECTS/METHODS: For a toddler study in Germany, a 7-day consecutive EFR was developed. Data were obtained from a sample of toddlers in Germany. The basis is an evaluation of 3-day weighing food records on food choice and portion size of the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study for 227 toddlers (118 boys) aged 9-36 months from January 2004 to March 2008. RESULTS: In the analysed food records, a total of 15.147 eating occasions with 24.820 dishes were reported and grouped in 17 food groups. To estimate the portion size, the median consumption amounts of the 194 most frequently consumed dishes were calculated and photographed. Formula and commercial complementary food are collected separately. EFR was structured into seven eating occasions of the day: before breakfast, breakfast, mid-morning, lunch, mid-afternoon, dinner, and before bed. CONCLUSIONS: The EFR booklet provides a simple, feasible and validated instrument that can be used to update information on dietary habits during the transition from infant to childhood diet for families in different social classes.

Harmonisation of food categorisation systems for dietary exposure assessments among European children.

Within the European project called EXPOCHI (Individual Food Consumption Data and Exposure Assessment Studies for Children), 14 different European individual food consumption databases of children were used to conduct harmonised dietary exposure assessments for lead, chromium, selenium and food colours. For this, two food categorisation systems were developed to classify the food consumption data in such a way that these could be linked to occurrence data of the considered compounds. One system served for the exposure calculations of lead, chromium and selenium. The second system was developed for the exposure assessment of food colours. The food categories defined for the lead, chromium and selenium exposure calculations were used as a basis for the food colour categorisation, with adaptations to optimise the linkage with the food colour occurrence data. With this work, an initial impetus was given to make user-friendly food categorisation systems for contaminants and food colours applicable on a pan-European level. However, a set of difficulties were encountered in creating a common food categorisation system for 14 individual food consumption databases that differ in the type and number of foods coded and in level of detail provided about the consumed foods. The work done and the problems encountered in this project can be of interest for future projects in which food consumption data will be collected on a pan-European level and used for common exposure assessments.

Intrafamilial variability of Parkinson phenotype in SCAs: novel cases due to SCA2 and SCA3 expansions.

BACKGROUND: Parkinson's disease (PD) has been related to mutations associated with spinocerebellar ataxias (SCA); the frequency of the diagnosis of these mutations is low in general late-onset PD cases. Our aim was to investigate a selected high-risk group of PD patients. METHODS: PD patients with autosomal dominant inheritance or atypical neurological manifestations were enrolled, underwent a full neurological examination and had the CAG tracts of their SCA1, 2, 3, 6 and 7 genes analyzed. RESULTS: Of the 23 studied families, two SCA3 and one SCA2 cases were identified. All had autosomal dominant inheritance. In the SCA2 pedigree, four affected sibs had a homogeneous PD phenotype. CAG repeats varied between 35 and 44 with CAA interruptions. Intrafamilial phenotypic heterogeneity was identified in the SCA3 pedigrees; parkinsonian and ataxic phenotypes coexisted in both kindreds. CAGn varied between 69 and 71 repeats. Age of onset was lower in the SCA3 patients than in the remaining 24 cases (38 versus 46.7+/-12 years of age, p=0.003). CONCLUSIONS: SCA2 and SCA3 mutations were detected in 13% of the present sample: the strategy of selecting a high-risk group increased the rate of making these diagnoses. The SCA2 cases confirmed an association between PD and interrupted expansions, as well as PD intrafamilial phenotypic homogeneity. Clinical heterogeneity of SCA3 pedigrees suggests that disease-modifying agents outside the MJD1 gene may play a role in determining PD symptoms in this disorder.

Src kinase and pancreatic cancer.

The c-Src non-receptor tyrosine kinase is overexpressed in a large number of human malignancies. It is linked to tumour development and progression to distant metastases by promoting cell proliferation, invasion, and motility. Recently, promising anticancer therapeutics targeting c-Src have been developed that are under clinical investigation.

Measured consumption of tap water in German infants and young children as background for potential health risk assessments: data of the DONALD Study.

Contaminated tap water can become a health risk, e.g. by metals or environmental pollution particularly for sensitive population groups such as infants and young children. There is a lack of data on exactly measured water intake. In the DONALD Study, individual food and fluid intakes were measured by use of 3-day weighed diet records. Here we report on the distribution of individual intakes of tap water in 504 healthy normally nourished subjects aged 3-36 months (1962 diet records) between 1990 and 1998. We calculate scenarios for potential tap water contamination. Tap water intake per kg body weight was significantly higher in formula-fed (FF) infants than in breast-fed (BF) infants. The estimated median intake of lead and nitrate per kg body weight from tap water was higher in FF infants than in BF infants or mixed fed (MF) young children. The scenarios based on intakes at the median, P95 or maximums show that higher risks for exceeding the presently existing maximums could be expected in FF infants. Our data could also be used for estimations of potential risks from other contaminants of tap water.

Fluid-attenuated inversion recovery: correlations of hippocampal cell densities with signal abnormalities.

BACKGROUND: Hippocampal sclerosis (HS) is characterized by hippocampal atrophy and increased signal on T2-weighted images and on fluid-attenuated inversion recovery (FLAIR) images. OBJECTIVE: To quantitate cell loss and compare it with signal abnormalities on FLAIR images. METHODS: Thirty-one patients with temporal lobe resection, pathologically proven HS, and Engel class I and II outcome were included: 20 with HS only and 11 with HS associated with pathologically proven cortical dysplasia (dual pathology). The signal intensity on FLAIR was rated as present or absent in the hippocampus and correlated with the neuronal losses in the hippocampus. RESULTS: FLAIR signal increases were present in 77% (24/31) of all patients studied. In patients with isolated HS, 90% (18/20) had ipsilateral signal increases, but in patients with dual pathology, only 55% (6/11; p < 0.02) showed FLAIR signal increase. Hippocampal cell losses were significantly higher in the isolated HS group. The average cell loss in patients with FLAIR signal abnormalities was 64.8 +/- 8.0% as compared with only 32.7 +/- 5.1% in patients with no FLAIR signal abnormalities. There was a significant positive correlation between the presence of signal abnormality and average hippocampal cell loss in both pathologic groups. CONCLUSIONS: Ipsilateral FLAIR signal abnormalities occur in the majority of patients with isolated HS but are less frequent in those with dual pathology. The presence of increased FLAIR signal is correlated with higher hippocampal cell loss.

Temporal lobe epilepsy due to hippocampal sclerosis in pediatric candidates for epilepsy surgery.

OBJECTIVE: To characterize the clinical, EEG, MRI, and histopathologic features and explore seizure outcome in pediatric candidates for epilepsy surgery who have temporal lobe epilepsy (TLE) caused by hippocampal sclerosis (HS). METHODS: The authors studied 17 children (4 to 12 years of age) and 17 adolescents (13 to 20 years of age) who had anteromesial temporal resection between 1990 and 1998. RESULTS: All patients had seizures characterized by decreased awareness and responsiveness. Automatisms were typically mild to moderate in children and moderate to marked in adolescents. Among adolescents, interictal spikes were almost exclusively unilateral anterior temporal, as opposed to children in whom anterior temporal spikes were associated with mid/posterior temporal, bilateral temporal, extratemporal, or generalized spikes in 60% of cases. MRI showed hippocampal sclerosis on the side of EEG seizure onset in all patients. Fifty-four percent of children and 56% of adolescents had significant asymmetry of total hippocampal volumes, whereas the remaining patients had only focal atrophy of the hippocampal head or body. Subtle MRI abnormalities of ipsilateral temporal neocortex were seen in all children and 60% of adolescents studied with FLAIR images. On histopathology, there was an unexpectedly high frequency of dual pathology with mild to moderate cortical dysplasia as well as HS, seen in 79% of children and adolescents. Seventy-eight percent of patients were free of seizures at follow-up (mean, 2.6 years). A tendency for lower seizure-free outcome was observed in patients with bilateral temporal interictal sharp waves or bilateral HS on MRI. The presence of dual pathology did not portend poor postsurgical outcome. CONCLUSIONS: TLE caused by HS similar to those in adults were seen in children as young as 4 years of age. Focal hippocampal atrophy seen on MRI often was not reflected in total hippocampal volumetry. Children may have an especially high frequency of dual pathology, with mild to moderate cortical dysplasia as well as HS, and MRI usually, but not always, predicts this finding. Postsurgical seizure outcome is similar to that in adult series.

Hippocampal chemical anatomy in pediatric and adolescent patients with hippocampal or extrahippocampal epilepsy.

We determined whether age or seizure types were associated with hippocampal neuron loss, mossy fiber (MF) and GABAergic synaptic reorganizations or postsynaptic receptor densities. Children and adolescents were grouped into: (1) nonhippocampal sclerosis (non-HS; n = 11) and (2) hippocampal sclerosis (HS; n = 11). The most important results showed that: (1) regardless of the etiology of the seizures, there were greater cell losses in Ammon's horn with older ages in years; in the non-HS group, cell losses were greater with the older ages or with longer epilepsy durations; however, in the HS patients, the cell losses were not related to the patients' ages or epilepsy durations; (2) in both HS and non-HS, CA1 had greater cell losses than CA4; (3) in HS, CA1 and CA4 had greater cell losses than those in non-HS; (4) in non-HS, MF sprouting was greater with ages or with longer epilepsy durations; by contrast, in HS, MF sprouting was not related to the patients' age or epilepsy duration; (5) densities for AMPA GluR1, GABA-Abeta and for GABA axonal terminals were positively increased with age. These findings support the hypothesis that hippocampal cell losses and aberrant synaptic reorganizations are greater in the hippocampi of adolescents than in children, even for non-HS pathologies.

Focal cortical dysplasia in children.

Cortical dysplasia (CD) is now recognized as one of the major causes of pediatric focal neocortical epilepsy, and surgical procedures have been considered early in life. However, the mechanisms involved in seizure generation and intractability in these patients are still unknown. We analyzed with immunocytochemistry for various antibodies the brain tissue from 4 children (10 months to 6 years old) with focal epilepsy due to focal CD in order to study the inhibitory and excitatory circuits in dysplastic areas. Our group had similar histopathological and clinical characteristics. In all patients we found areas of cortical disorganization with dysplastic neurons and balloon cells. We studied distributions of glial cells with glial fibrillary acidic protein (GFAP) and neurons with microtubule-associated protein 2 (MAP-2). Gliosis was present in all cases, and GFAP stained also some balloon cells. Dysplastic neurons were darkly stained by MAP-2, and we also found balloon cells weakly stained with MAP-2 in the same areas where GFAP was positive, suggesting coexpression of neuronal and glial markers in some of these cells. There was an increased expression of glutamate receptors, especially GluR2/3, but also N-methyl-D-aspartate receptors in dysplastic cortex. The inhibitory circuit does not seem to be decreased, rather we notice an increased amount of glutamate-decarboxylase-positive terminals around some of the big neurons. We discuss the possible role of these findings as mechanisms of epilepsy.

[Neuropathology of hard to control epilepsy. Study of 300 consecutive cases]. / Neuropatologia das epilepsias de difícil controle. Estudo de 300 casos consecutivos.

We report histopathological findings in 300 consecutive surgical specimens from epilepsy surgery during 6 years. Our material was mainly from temporal lobe epilepsy (70.33%). In 44% the diagnosis was hippocampal sclerosis. There were tumors in 15% of cases and neuronal migration disorders in 10%. The most common tumors were gangliogliomas (42.22%) and dysembryoplastic neuroepithelial tumors (20%). We review the more frequent diagnosis in epilepsy surgery based on this series and comparing with literature.

Meningiomas and hormonal receptors. Immunohistochemical study in typical and non-typical tumors.

The authors assessed 116 cases of meningiomas classified as typical, atypical and anaplastic and they used an immunohistochemical technique for estrogen and progesterone receptors attempting to determine if there is any difference between typical and non-typical tumors in relation to hormone receptors. The immunohistochemical technique to estrogen receptors was negative in all meningiomas studied. Progesterone receptors were detected in 58.3% of typical, and in 48.2% of non-typical meningiomas. This difference was not statistically significant. However, individually considering the criteria used for selection of non-typical tumours, those that concurrently displayed brain invasion and increased mitotic activity or necrosis, as well as the summation of those three features, were predominantly negative for progesterone receptors (respectively p = 0.038; p = 0.001; and p = 0.044). The authors conclude that estrogen receptors were not present in meningiomas; that progresterone receptors in isolation are not enough to predict a higher tumoral malignancy but can be useful associated with other histological features.

[Meningiomas. Histopathological aspects and recurrence]. / Meningeomas. Aspectos histopatológicos e recidiva.

The authors assessed 246 cases of meningiomas that were classified as typical, atypical, anaplastic and papillary, according to previously defined criteria. Among the criteria used to define non-typical tumours, brain invasion was predominant in 62.3%. Meningiomas were typical in 75.22%, atypical in 19.1%, anaplastic in 5.68% of the cases. There was recurrence in 3.78% of typical, 42.55% of atypical and 45.45% of anaplastic. The authors conclusion was that the criteria used to define typical and non-typical were adequate to predict a higher chance to tumour recurrences

[Demographic change in Mecklenburg-Hither Pomerania: current trends and background]. / Demographischer Wandel in Mecklenburg-Vorpommern: aktuelle Prozesse und Hintergrunde.

PIP: This paper discusses the demographic situation in the north German state of Mecklenburg-Vorpommern. The authors argue that many of the theories and policies formulated for Germany as a whole and for this region in particular do not apply to Mecklenburg-Vorpommern, because of the unique characteristics of the state (extremely low population density, largely rural economy, pronounced demographic aging, skewed sex ratio, etc.). Strong regional variety within the state as regards demographic characteristics is noted.^ieng

[Neonatal encephalitis caused by herpes simplex: immunohistochemical diagnosis of a case]. / Encefalite neo-natal pelo vírus do herpes simplex: diagnóstico imuno-histoquímico de um caso.

The authors report the case of a female newborn infant, who had seizures and vesicles at the nose and inferior lip since the fifth day of life. CSF changes suggested an encephalitis. Signs of neurologic and respiratory deterioration were followed by death. Partial cranial autopsy showed a necrohemorrhagic temporal encephalitis without intranuclear inclusions. Immunohistochemical examination by the avidin-biotin-peroxidase technique with polyclonal antibodies against Herpes simplex type 1 and type 2 was positive to type 2 Herpes simplex virus.

[Cerebrovascular disorders: analysis of 190 autopsy cases]. / Acidente vascular cerebral: Análise de 190 casos autopsiados.

A retrospective study of 190 postmortem examinations of cerebrovascular disease from the Department of Pathology was carried out. We found 94 cases (49.47%) of hemorrhage, 67 (35.26%) of infarction and 29 patients (15.26%) with hemorrhage and infarction; both were more frequent in males. Among the hemorrhagic cerebral vascular disease the intracerebral hemorrhage was more frequent. The cerebral infarction was more frequent in the territory of the middle cerebral artery. Arterial hypertension was the most common cause of cerebral hemorrhage and the cause in the great majority of the cerebral infarction cases was atherosclerosis.

[Thrombosis of the basilar trunk caused by syphilis]. / Trombose do tronco basilar pela sífilis.

The authors describe a case of cerebrovascular accident by syphilis in a 37 years-old man. The clinical features were headache, right hemiparesis and ptosis of the left eyelid. Blood and spinal fluid tests for syphilis were positive. The angiography showed a basilar trunk occlusion with revascularization of the cerebellar culmen. The autopsy disclosed a sub-total occlusion of the basilar artery and a fresh left cerebellar infarct.

Circadian acrophases of powers and frequencies in the waking EEG.

Circadian changes in frequencies and powers of the close-eyed EEG were measured over six days in 12 healthy volunteers living in a regular rest-activity cycle. EEGs were recorded every two hours and the probands were awakened for the recordings during the period of rest. Circadian rhythms occurred in powers and frequencies with diurnal amplitudes differing between individuals and locally on the scalp. Acrophases of peak frequencies and beta-power coincide with those of body temperature between 5 and 7 p.m., however, the crests of the diurnal rhythms in delta-, theta- and alpha-power varied more between individuals and covered systematically different times of the day. Acrophases of delta- and theta-powers occurred during the second half of the rest period and during the first half of the waking period. Only powers in the alpha-band showed locally different acrophases on the scalp. This could be observed in single individuals, too. In the central and parietal leads, acrophases of alpha-power were found during rest, whereas in the occipital leads of some probands acrophases occurred in the second half of the waking period.