Cohort profile: the Spanish Early-onset Colorectal Cancer (SECOC) cohort: a multicentre cohort study on the molecular basis of colorectal cancer among young individuals in Spain

Purpose

The Spanish Early-onset Colorectal Cancer (SECOC) study is a multicentre prospective cohort established in Spain to investigate the molecular basis of early-onset colorectal cancer (EOCRC), including metabolic alterations.

Participants

220 patients with EOCRC have been enrolled since January 2019 through 18 centres across Spain. Individual-level data were collected by questionnaire, including lifestyle and other colorectal cancer-related factors. Medical record review was performed to capture clinical, histopathological and familial cancer history data. Biospecimen collection (blood, stool, tissue) at diagnosis and at various time points across treatment, as applicable, is also completed.

Findings to date

Participants had a median age of 44 years (range 14–49), and the majority are men (60%), with individuals age 40–49 years at EOCRC diagnosis being over-represented. Forty-three per cent of participants were diagnosed with a tumour in the rectosigmoid junction/rectum. Nearly two-thirds of EOCRC cases (64%) were diagnosed with advanced stage (III–IV) disease, and 28% of cases had no reported familial history of cancer.

Future plans

We are actively recruiting and observing participants; we plan to administer follow-up questionnaires and perform additional biospecimen collection. This prospective cohort offers a unique, rich resource for research on EOCRC aetiologies and will contribute to larger international efforts to disentangle the rising disease burden.

Effect of tolerance induction to immunodominant T-cell epitopes of Sendai virus on gene expression following repeat administration to lung

Sendai virus (SeV) is able to transfect airway epithelial cells efficiently in vivo. However, as with other viral vectors, repeated administration leads to reduced gene expression. We have investigated the impact of inducing immunological tolerance to immunodominant T-cell epitopes on gene expression following repeated administration. Immunodominant CD4 and CD8 T-cell peptide epitopes of SeV were administered to C57BL/6 mice intranasally 10 days before the first virus administration with transmission-incompetent F-protein-deleted DeltaF/SeV-GFP. At 21 days after the first virus administration, mice were again transfected with DeltaF/SeV. To avoid interference of anti-GFP antibodies, the second transfection was carried out with DeltaF/SeV-lacZ. At 2 days after the final transfection lung beta-galactosidase expression, T-cell proliferation and antibody responses were measured. A state of 'split tolerance' was achieved with reduced T-cell proliferation, but no impact on antiviral antibody production. There was no enhancement of expression on repeat administration; instead, T-cell tolerance was, paradoxically, associated with a more profound extinction of viral expression. Multiple immune mechanisms operate to eradicate viruses from the lung, and these findings indicate that impeding the adaptive T-cell response to the immunodominant viral epitope is not sufficient to prevent the process.

Complementary and alternative medicine use in children

OBJECTIVE

Adults frequently use complementary and alternative medicines (CAM). Few studies have reported how often CAM therapies are used to treat children. The purpose of this study is to describe the use of alternative therapies by children visiting an emergency department (ED) and to identify sociodemographic factors that may influence the decision to use such therapies.

DESIGN

Survey of families using a self-administered questionnaire.

SETTING

An urban, tertiary care pediatric emergency department.

PARTICIPANTS

Convenience sample of families presenting to the ED for acute care.

MAIN OUTCOME MEASURE

Use of CAM therapies to treat children. Secondary measures include the type of therapies used, types of medical problems the therapies were used for, reasons for using such therapies, use of such therapies by the child's caretakers, and sociodemographic characteristics of the children and families.

RESULTS

A review of 525 completed surveys identified 63 caretakers (12%) who acknowledged that they had used at least one form of CAM therapy to treat any of their children. Homeopathic and naturopathic remedies were the most common therapies used. Parents most often used CAM therapies to treat respiratory problems in their children and were most influenced by word-of-mouth. Children who were treated with CAM therapies were more likely to have a caretaker who used such therapies. Twelve (40%) of 30 families who reported using either an herbal or homeopathic remedy, also used a prescription or over-the-counter medication at the same time to treat their child. Thirty-nine of 55 families (70.9%) reported informing their child's physician of their use of CAM therapies.

CONCLUSION

CAM therapies are frequently used to treat children. Most parents who use CAM therapies to treat their children use such therapies themselves. Large proportions of children who are taking herbal supplements are also taking prescription or over-the-counter medications concurrently.

Protein quality of enteral nutrition products is consistent with label claims during shelf life and beyond expiration date

OBJECTIVE

Eternal formulas were monitored during their shelf life and beyond expiration date to examine protein quality.

DESIGN

Protein quality was determined by protein efficiency ratio (PER) bioassays and amino acid analyses.

SETTING

A certified laboratory performed the PER tests according to procedures established by the Association of Official Analytical Chemists and recognized by the US Food and Drug Administration (FDA). The amino acid analyses were performed in our laboratory using validated methods.

SAMPLES

Commercially available formulas (Ensure, Osmolite HN, TwoCal HN) that contained protein blends of caseinates or caseinates with soybean protein isolate were studied.

MAIN OUTCOME MEASURES

Achievement of protein-quality values greater than or equal to 70% of the fresh reference casein value as determined by the PER method would be consistent with adequate protein quality as described by the FDA. Levels of indispensable amino acids that meet or exceed the standards established by the National Research Council of the National Academy of Sciences are considered high-quality proteins. Levels of amino acids throughout shelf life were compared with published label claims.

RESULTS

Amino acid analyses, which included measurement of tryptophan and total sulfur amino acids, revealed that both fresh and outdated products met or exceeded standards for proteins of high biologic value and were consistent with label claims. The PER values ranged from 90% to 96% of the control diet for fresh product and 82% to 87% for products evaluated after expiration.

CONCLUSION

The enteral products studied provide high-quality protein throughout the shelf life of the product.

The relationship of eating frequency and caloric density to energy intake among rural Mexican preschool children

The energy intake of children in a population characterized by chronic malnutrition was measured in order to examine the effects of eating frequency and caloric density. Forty-five children aged 33-60 months were each observed continuously throughout one day. Food intake was determined by weighing and all aspects of food-related behavior were recorded. The children ate on average 13.5 +/- 4 times each day. Children who ate more frequently had significantly higher energy intake than children who ate fewer than 13 times [1655 vs. 1395 kcal (6928 vs. 5839 kJ)], and the excess was consumed during snacks. The caloric density of all foods consumed averaged 121 kcal (507 kJ) per 100 g. While children served meals of low caloric density [less than 100 kcal (419 kJ) per 100 g] consumed less energy at meals than did other children [709 vs. 900 kcal (2968 vs. 3767 kJ)], they consumed more energy from snacks [917 vs. 617 kcal (3839 vs. 2583 kJ]. Thus, total energy intake did not differ significantly between children served meals of lower vs. higher caloric density.

Self-regulation of food intake among rural Mexican preschool children

Access to food and the amount consumed were investigated within a group of 45 children aged 33 to 60 months, among whom growth stunting was common. Children were observed throughout 1 day; all foods offered and consumed were weighed, and food-related behaviors noted. Children ate frequently, at least 2 meals and an average of 7.4 +/- 2.6 snacks daily. Children had access to 2029 +/- 575 kcal (8493 +/- 2407 kJ) yet only consumed 1528 +/- 343 kcal (6396 +/- 1436 kJ) daily; thus food availability was not restricting intake. A higher proportion of snacks than meals (85 per cent vs. 71 per cent) was consumed. Children requested foods frequently (x = 9.2 +/- 4.3) and 76 per cent of requests were fulfilled. Neither amount of accessible food nor amount consumed differed by age, gender, or socioeconomic status. The importance of the child's role in determining food intake, and of snacking to overall food consumption, was demonstrated.