Under-reporting of the energy intake in patients with type 2 diabetes

BACKGROUND

In patients with type 2 diabetes mellitus (DM), an accurate assessment of food intake is essential for clinical nutritional management. Tools such as the food frequency questionnaire (FFQ) and 24-h food record (24HR) identify dietary habits in support of dietary planning. However, it is possible that these tools have reporting errors with respect to assessing food intake, particularly energy intake (EI).

METHODS

A cross-sectional study was conducted in patients with type 2 DM. EI was assessed by the FFQ and 24HR tools. Resting energy expenditure (REE) was measured by indirect calorimetry. Data were analysed using a kappa test, t-test and Spearman's correlation coefficients. Under-reporting was assessed using the EI/REE ratio. Patients with values <1.18 and <1.10 for FFQ and 24HR, respectively, were considered as under-reporting.

RESULTS

We evaluated 55 patients [mean (SD) 62.7 (5.3) years old, duration of diabetes 11.2 (7.3) years, 52.7% female]. The mean (SD) EI assessed by FFQ was 1797.7 (641.3) and as assessed by 24HR was 1624 (484.8) kcal day^-1 . The mean (SD) REE was 1641.3 (322.3) kcal day^-1 . The mean (SD) ratios FFQ/REE and 24HR/REE were 1.11 (0.38) and 1.01 (0.30), respectively. The tools showed a moderate agreement for under-reporting of EI (kappa = 0.404; P = 0.003). Moderate and positive correlations between REE were observed with FFQ (r = 0.321; P = 0.017) and 24HR (r = 0.364; P = 0.006). According to the tools, the under-reporting was observed in approximately 65% of patients.

CONCLUSIONS

The majority of patients with type 2 DM under-reported their calorie intake, as assessed by FFQ and 24HR. REE showed a positive correlation with both tools.

Cephalometric changes after headgear anchored to the deciduous second molars in the early mixed dentition

AIM

The present study aimed to evaluate the cephalometric effects of a headgear anchored to the deciduous second molars in the early mixed dentition.

MATERIALS AND METHODS

Study design: The study followed a retrospective longitudinal design and enrolled 31 consecutive patients (17 females and 14 males) treated with high pull (HP) headgear anchored to the deciduous second molars, average age 8y 5m± 5m at pre-treatment time (T0) and 9y 8m± 6m at post-treatment time (T1). All the patients wore the headgear for approximately 8-10 hours at night, with a force of 250 g per side. The active phase of treatment ended once patients obtained a distal step on permanent molars of at least 2 mm. Lateral cephalograms at T0 and T1 were taken; 10 angular measurements were chosen as variables of the study. The paired sample t-test was employed to assess the significance of the differences of each variable between T0 and T1.

RESULTS AND CONCLUSION

In this group of Class II patients, HP headgear anchored to the deciduous second molars in the early mixed dentition produced: significant reduction of SNA angle, significant increase of SN/NL angle with no significant change in SN/ML angle, significant labial flaring of upper incisors. As clinically evaluated, the correction of the Class II occlusal relationship and the anterior crowding of maxillary arch were also accomplished.

Are 6-8 year old Italian children moving away from the Mediterranean diet?

BACKGROUND

The Mediterranean diet (MD) is considered one of the healthiest dietary models, as it decreases the risk of chronic diseases and may modulate the organism's early response to environmental pollution. In recent decades, Mediterranean countries have been replacing their traditional diet with other less healthy eating habits, especially among children and teenagers.

OBJECTIVE

The aim of this study was to evaluate the MD and the level of adherence to it in 6-8 year old Italian children, in relation to residence, lifestyle, and social and family contexts.

METHODS

A questionnaire was administered to the children's parents in two seasons in 5 Italian towns. The diet section contained 116 questions investigating the frequency of consumption of different types of food. The Italian Mediterranean Index (IMI) was calculated according to the intake of 6 typical Mediterranean and 4 non-Mediterranean foods. On the basis of IMI score, MD adherence was classified as low (≤ 3 IMI score), medium (4-5) and high (≥ 6). Total energy load and diet composition in micro- and macronutrients were calculated from consumption frequency.

RESULTS

Diet analysis was computed on 1164 subjects with two complete questionnaires. Body mass index, calculated for each subject, showed that 28.9% of the children were overweight, the figure varying slightly with area of residence. Our findings showed that 59.0% of the children had a low score for MD adherence.

CONCLUSIONS

The results of this study showed that most Italian children did not follow the MD and socio-economic characteristics appeared not to be associated with type of diet.

Feasibility and reliability of a questionnaire for evaluation of the exposure to indoor and outdoor air pollutants, diet and physical activity in 6-8-year-old children

INTRODUCTION

The MAPEC-Life project aims to study the biological effects of early exposure to air pollutants on the oral mucosa cells of school-age children in five Italian cities. A questionnaire was created to evaluate the association between outdoor and indoor airborne pollutants, lifestyle, diet and biomarker effects. The feasibility and reliability of the questionnaire were evaluated.

METHODS

A questionnaire was drawn up to be filled in by the parents of 6-8-year-old children. It consisted of 148 questions on the children's health, physical activity, environmental exposures and the frequency of food consumption at the main meals. First we conducted a questionnaire feasibility study involving 53 volunteer parents. We then performed a reliability study by administering the questionnaire to a further 156 parents and again one month later (test/retest method). The correlations between answers at the first and second administration of the questionnaire were evaluated using the Kappa statistic and Spearman's coefficient.

RESULTS

After verifying the feasibility of the questionnaire, we conducted a reliability analysis on 132 completed questionnaires. The percentage of agreement between the first and the second responses given was over 70%, all K values being greater than 0.6. The analysis of calories and macronutrients also showed good agreement.

CONCLUSIONS

The questionnaire drawn up for the study proved to be sufficiently reliable for gathering information about the factors of interest in our study of the relationship between air pollution and early biological effects in children.

Profiling cancer gene mutations in longitudinal epithelial ovarian cancer biopsies by targeted next-generation sequencing: a retrospective study

BACKGROUND

The majority of patients with stage III-IV epithelial ovarian cancer (EOC) relapse after initially responding to platinum-based chemotherapy, and develop resistance. The genomic features involved in drug resistance are unknown. To unravel some of these features, we investigated the mutational profile of genes involved in pathways related to drug sensitivity in a cohort of matched tumors obtained at first surgery (Ft-S) and second surgery (Sd-S).

PATIENTS AND METHODS

Matched biopsies (33) taken at Ft-S and Sd-S were selected from the 'Pandora' tumor tissue collection. DNA libraries for 65 genes were generated using the TruSeq Custom Amplicon kit and sequenced on MiSeq (Illumina). Data were analyzed using a high-performance cluster computing platform (Cloud4CARE project) and independently validated.

RESULTS

A total of 2270 somatic mutations were identified (89.85% base substitutions 8.19% indels, and 1.92% unknown). Homologous recombination (HR) genes and TP53 were mutated in the majority of Ft-S, while ATM, ATR, TOP2A and TOP2B were mutated in the entire dataset. Only 2% of mutations were conserved between matched Ft-S and Sd-S. Mutations detected at second surgery clustered patients in two groups characterized by different mutational profiles in genes associated with HR, PI3K, miRNA biogenesis and signal transduction.

CONCLUSIONS

There was a low level of concordance between Ft-S and Sd-S in terms of mutations in genes involved in key processes of tumor growth and drug resistance. This result suggests the importance of future longitudinal analyses to improve the clinical management of relapsed EOC.

Monitoring air pollution effects on children for supporting public health policy: the protocol of the prospective cohort MAPEC study

INTRODUCTION

Genotoxic biomarkers have been studied largely in adult population, but few studies so far have investigated them in children exposed to air pollution. Children are a high-risk group as regards the health effects of air pollution and some studies suggest that early exposure during childhood can play an important role in the development of chronic diseases in adulthood. The objective of the project is to evaluate the associations between the concentration of urban air pollutants and biomarkers of early biological effect in children, and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children.

METHODS AND ANALYSIS

Two biomarkers of early biological effects, DNA damage by the comet assay and the micronuclei (MN) test, will be investigated in oral mucosa cells of 6-8-year-old children. Concurrently, some toxic airborne pollutants (polycyclic aromatic hydrocarbon (PAH) and nitro-PAH) and in vitro air mutagenicity and toxicity in ultra-fine air particulates (PM0.5) will be evaluated. Furthermore, demographic and socioeconomic variables, other sources of exposures to air pollutants and lifestyle variables will be assessed by a structured questionnaire. The associations between sociodemographic, environmental and other exposure variables and biomarkers of early biological effect using univariate and multivariate models will be analysed. A tentative model for calculating the global absolute risk of having early biological effects caused by air pollution and other variables will be proposed.

ETHICS AND DISSEMINATION

The project has been approved by the Ethics Committees of the local Health Authorities. The results will be communicated to local Public Health Agencies, for supporting educational programmes and health policy strategies. LIFE+2012 Environment Policy and Governance. LIFE12 ENV/IT/000614.

Identification of HEV in symptom-free migrants and environmental samples in Italy

Hepatitis E virus (HEV) is considered an emerging pathogen in industrialized countries. The occurrence of HEV genotypes in samples of faeces from asymptomatic migrants arriving on the coasts of South Italy and environmental samples was investigated. Analyses of sequences were used to compare human and environmental genotypes. A total of 40 stool specimens, 12 samples of untreated urban sewage, 12 samples of treated urban sewage and 12 samples of surface water were analysed. Viruses were concentrated from water samples by the tangential flow ultrafiltration technique. The presence of HEV RNA was detected by nested RT-PCR. Viral isolates were sequenced and phylogenetically characterized. Two (5%) of the 40 faecal samples tested were found to be positive for HEV RNA (G1 and G3 genotypes). The virus was detected in 25% (3/12) of the untreated sewage samples and 25% (3/12) of the surface water samples: all isolates belonged to G3 genotype. None of the treated sewage samples were found to be HEV RNA positive. The virus was detected in the faeces of two asymptomatic subjects, suggesting a potential role for symptom-free HEV carriers as a human reservoir. G3 HEV strains were detected in the untreated sewage, as observed in similar studies conducted in other European countries but differing from another study conducted in Italy recently. Moreover, our results show the first case of HEV isolated from fresh surface waters.

Sequence analysis of human rotavirus strains: comparison of clinical isolates from Northern and Southern Italy

The surveillance and monitoring of rotavirus (RV)-related diseases, preferably through the establishment of sentinel surveillance sites, are essential for assessing the need for vaccination and the projected results of the vaccine in terms of reducing the burden of disease. The objective of the present study was to compare RV strains isolated in Northern (Ferrara) and Southern (Galatina-LE) Italy. During 2007-2008, 115 RV-positive stool samples were collected from children with diarrhea admitted to the hospitals of Ferrara and Galatina. The specimens were genotyped for VP7 (G-type) and VP4 (P-type) gene by reverse transcription (RT) and multiplex polymerase chain reaction (PCR). A subset of 21 RV strains was randomly selected and characterized by sequence analysis of the VP7 genes. In total, seven G/P combinations (G1P[8], G2P[4], G4P[8], G9P[8], G2P[8], G1P[9], and G2P[10]) were identified. Phylogenetic comparison of the VP7 encoding gene of selected strains showed that there was similarity among RV strains circulating in Northern and Southern Italy. The observation of nucleotide sequence diversity contributes to a better understanding of RV spreading and helps to characterize the various antigenic shifts that could have an impact on vaccine effectiveness.

Microbial and nutritional aspects on the production of live feeds in a fish farming industry

Aquaculture is an enterprise in constant development, in particular relating to its effect on the environment and also the quality of its products. It represents a valid alternative to traditional fishing, facing the increasing demand for fish products. To guarantee to the consumer a product of high nutritional, organoleptic and hygienic quality, it is fundamental to monitor every phase of the fish farming industry, isolating the potential risk points. For this reason there has been a rapid evolution of productive technique, particularly in the technology, artificial reproduction and feed sectors. The aim of this research has been the monitoring of the evolution of certain microbial and nutritional quality indexes (total microbial counts and lipid analysis on suspensions of Rotifers and Artemia, used as live feed) in the larval phase of the productive cycle of the farm raised fish, in an intensive system. The study has shown an increment in the total microbial counts in the fish farming industry within the production of Rotifers and Artemia, more evident in the suspensions of Rotifers. In addition the study has demonstrated that the maintenance phase, in the enrichment protocol, can reduce the EPA and DHA content. The results confirm the importance of microbial and nutritional control of the live feeds before they get supplied to fish larvae.

G-genotyping of rotaviruses in stool samples in Salento, Italy

Rotaviruses are the most common agents of diarrhoeal illness in infants and young children. Gastroenteritis caused by rotaviruses is also more likely to be associated with severe dehydration compared to other viral gastroenteritis. We determined the G-genotype of rotaviruses circulating in the Salento. During 2004, 144 stool samples were collected from subjects with a positive screening test and stored at -20 degrees C until confirmation could take place using molecular biology techniques. A reverse transcription-polymerase chain reaction (RT-PCR) assay for the amplification of gene VP7 of rotavirus was developed and used; G-genotype was determined by sequencing and phylogenetic analysis. A total of 101 stool samples were detected positive by RT-PCR and 35 were sequence analyzed and classified into G1, G2, G4, G9 and G12 type. The overall relative incidence of G-types in Salento is different to that of other developed countries. The most prevalent genotype was G2 while genotype G1 was present at low levels. It is also interesting to note the presence of G9 rotavirus, which is now recognized as the fifth globally important rotavirus genotype. In this study, therefore, we demonstrate the usefulness of a simple method for correctly determining the G genotypes circulating in a geographic region.

Prevalence of obesity in dogs examined by Australian veterinary practices and the risk factors involved

A study was undertaken to determine the prevalence of obesity in dogs examined by veterinary practices across Australia, and to determine the risk factors involved; 1700 practices were asked to complete a veterinarian opinion survey, and of the 428 practices that responded, 178 were selected to complete an RSPCA Australia Pet Obesity Questionnaire, together with additional practices selected by Australian State and Territory RSPCA societies. This questionnaire was sent to a total of 209 practices which were asked to record details of eligible dogs, and the reason why they had been examined during the previous month. Fifty-two (24.9 per cent) of the practices responded and provided data on 2661 dogs, of which 892 (33.5 per cent) were overweight and 201 (7.6 per cent) were obese. A further 112 dogs (4.2 per cent) were classified as thin or very thin, but these were excluded from subsequent analyses. Of the remaining 2549 dogs, approximately half were female and 1905 (74.7 per cent) were neutered. The dogs' weight category was influenced by several factors. Breed influenced the importance of sex and neutering as risk factors. The prevalence of overweight and obese dogs combined was 41 per cent; the prevalence increased with age up to about 10 years old, and then declined. Rural and semirural dogs were more at risk of obesity than urban and suburban dogs.