bluuebunny/crossref_metadata_2025 huggingface dataset:
Attentional Correlates of Illness Anxiety in a Non-Clinical Sample
Authors: Vervaeke Geert A.C. , Bouman Theo K. , Valmaggia Lucia R.
Published: April 2003

Background: Attentional processes are assumed to play an important role in the maintenance of illness anxiety, although empirical support is relatively scarce. Methods: The present study explores the relationship between selective attention (i.e. private body consciousness and symptom reporting), intensive concentration (i.e. attentional control and sustained attention), and illness anxiety in 57 non-clinical subjects. Results: Zero-order and multiple correlations suggest that illness anxiety is significantly related to cognitive failures in everyday life and private body consciousness and to a lesser extent to symptom reporting. Conclusion: It is concluded that illness anxiety can be partly predicted from specific attentional variables. However, specific operationalizations of attentional parameters seems to determine the existence and magnitude of these relations.
Sense of Coherence – A Mediator between Disability and Handicap?
Authors: Schnyder Ulrich , Büchi Stefan , Mörgeli Hanspeter , Sensky Tom , Klaghofer Richard
Published: April 2003

Background: The aim of this study was first to analyze the associations between disability and handicap and Antonovsky’s concept of sense of coherence (SOC); secondly, to find out how the SOC concept could be integrated in the WHO model of impairments, disabilities, and handicaps (ICIDH). Methods: Data from two studies were used: one on patients with rheumatoid arthritis, one on severely injured accident victims. Objective measures of the illness or the injury were conceptualized as indicator variables for disability, whereas variables related to the patients’ subjective judgement were conceptualized as indicator variables for handicap. Correlations were calculated between both sets of variables and the SOC scale total score. Results: SOC showed no significant correlation with ‘disability variables’ (rheumatoid arthritis: HAQ, SF36 physical functioning; accidental injuries: ISS, GCS). However, significant correlations were found between SOC and all ‘handicap variables’ (rheumatoid arthritis: HAD, SF36 social functioning; accidental injuries: CAPS-2, IES, SCL-90-R depression subscale). Conclusions: SOC is related to the psychosocial effects of health problems. It may be understood as a mediator between disability and handicap. Prospective studies are needed to clarify whether the SOC scale can be used as an outcome predictor with regard to psychosocial adaptation, in acute as well as in chronic health problems.
Combined Treatment for Patients with Double Depression
Authors: Miller Ivan W. , Norman William H. , Keitner Gabor I.
Published: April 2003

Background: Patients with double depression (major depression + dysthymia) have a particularly chronic course of illness, yet few studies have investigated treatments for these patients. Methods: 26 inpatients with double depression were assigned to two types of treatment: (1) pharmacotherapy and (2) combined treatment (pharmacotherapy + cognitive-behavioral psychotherapy). Treatment began while the patients were in the hospital and continued for 20 weeks after discharge. Comprehensive assessments were conducted at the end of treatment as well as at 6- and 12-month follow-up assessments. Results: The results indicated that double-depressed patients who received the combined treatment had significantly lower levels of depression and higher social functioning at the end of treatment. However, no significant differences between groups were found at the follow-up assessments. Conclusions: These results suggest that the addition of cognitive-behavioral psychotherapy may produce an improved short-term outcome for patients with double depression.
High-Density Exposure Therapy for Obsessive-Compulsive Inpatients: A 1-Year Follow-Up1
Authors: Wetzel Claudia , Bents Hinrich , Florin Irmela
Published: April 2003

Background: This study evaluates the effects of individual high-density exposure (2–3 weeks, all day) plus response prevention therapy on 85 unselected inpatients suffering from obsessive-compulsive disorder (OCD). Methods: Twenty-eight therapist practitioners performed treatment. Results: At 1-year follow-up, self-ratings indicated that patients on average felt much improved. Impairment by both obsessions and compulsions was significantly reduced (p < 0.001 in each case), and OCD symptoms as assessed by two OCD questionnaires had also decreased significantly, as had depressiveness and overall symptomatology (all p < 0.001). Defining improvements as >30% successes, as done in other OCD treatment outcome studies, success rates were 68 and 69%, respectively, for the two OCD questionnaire scores, 75% for self-rated impairment by obsessions and 84.5% for compulsions, 85.6% for overall psychopathology (General Symptom Index), and 75% for depressiveness (Beck Depression Inventory). Effect sizes were >1 SD for all of the measures included. Conclusions: We conclude that long-term effects for high-density treatment of unselected OCD patients bring about as good results as treatments with exposure and response prevention performed with selected patient samples in a research context.
Facilitating Adjustment to Inflammatory Bowel Disease: A Model of Psychosocial Intervention in Non-Psychiatric Patients
Authors: Maunder Robert , Esplen Mary Jane
Published: April 2003

Background: There is no consensus about the most appropriate psychosocial interventions for people with inflammatory bowel disease (IBD) or the most appropriate criteria by which to select which patients might benefit from the available interventions. Nonetheless the perception that stress and other subjective factors contribute to suffering in IBD is persistent and professionals are often called upon to offer appropriate support. A model of normal psychosocial adjustment to IBD and the interventions which can improve difficulties with adjustment will facilitate rational therapeutic intervention and needed research in this area. Methods: A model of normal adjustment to IBD is developed from a synthesis of the empirical literature and clinical experience in a tertiary care medical/surgical IBD centre and is used to identify potential points of psychosocial intervention. Results: Normal adjustment to IBD can be understood as a process involving the interaction of a triad of adaptive challenges: illness uncertainty, loss and change, and suffering. Each of these challenges requires different criteria of psychosocial assessment and may lead to different interventions. Conclusions: Although the interventions available for improving adjustment to IBD have not been exhaustively investigated, the existing data support the value of further study. The model of psychosocial adjustment presented here provides a synthesis of the existing data and a starting point for further research.
Impact of Management Change and an Intervention Program on Health Care Personnel
Authors: Lökk C.T. Johan , Arnetz Bengt B.
Published: April 2003

Background: There has been a major shift in the organization and responsibility for the provision of geriatric care in Sweden. This was believed to be stressful. We therefore decided to launch a controlled intervention program on health care personnel aimed at enhancing their adaptation and ability to cope. The purpose of this study was to assess the impact of management change on psychosocial parameters of health care personnel and the effects, if any, of a structured intervention program. Methods: Two separate wards were randomly allocated to be either intervention (I) or control (C) ward. The I-ward personnel were subjected to a psychologist’s structured 10-session intervention program for 20 weeks. The program consisted of an initial educational part followed by a practical problem-solving discussion part. A structured questionnaire on psychosocial issues was answered by the participants before (0 weeks), immediately after (20 weeks), and 10 weeks after the intervention (30 weeks). Results: There were no significant changes in the psychosocial parameters of the C-ward personnel. In the I-ward, however, there was a significant increase in work demand as well as in positive feelings about work, as compared to the C-ward at the 30-week follow-up. There was also significantly better work comfort in the I-ward. Conclusions: We did not find any anticipated negative psychosocial effects on health care personnel undergoing an organizational change. However, by offering a structured intervention program to one group of health care personnel, we found some positive psychosocial effects. Future research is needed to pinpoint which factor or factors in the intervention program were the most crucial for the effects to occur.
The Relationship between Semantic Organization and Memory in Obsessive-Compulsive Disorder
Authors: Deckersbach Thilo , Otto Michael W. , Savage Cary R. , Baer Lee , Jenike Michael A.
Published: April 2003

Background: A variety of evidence suggests that frontostriatal dysfunction is involved in obsessive-compulsive disorder (OCD). This evidence includes both neuroimaging findings and results from studies using neuropsychological assessments. Previous studies have documented nonverbal memory deficits in individuals with OCD, whereas verbal learning and memory were less affected. Methods: The present study examined both verbal and nonverbal memory in a sample of 17 untreated outpatients with OCD. We also evaluated the effects of encoding strategies which are believed to be mediated by frontostriatal system functioning. Results: OCD patients were significantly impaired in both verbal and nonverbal memory performance. This deficit was correlated with impairments in organizational and semantic clustering strategies at the time of encoding. Conclusions: Deficits in organizational strategies are consistent with frontostriatal dysfunction models in OCD.
Female Depression before and after Menopause
Authors: Benazzi Franco
Published: April 2003

Background: There is no clear association between menopause and depression. Aim of the study was to compare female depression with onset before menopause with female depression with onset after menopause, to find out if endocrinological changes had an impact on depression. Methods: Five hundred and twelve consecutive unipolar and bipolar I/II depressed outpatients were interviewed with the Structured Clinical Interview for DSM-IV, the Montgomery-Asberg Depression Rating Scale and the Global Assessment of Functioning scale. Patients were divided into patients with depression/mania onset before 40 and after 40. Results: Female depression with onset after 40 had a significantly shorter duration of illness, fewer recurrences, fewer patients with atypical features, fewer bipolar II patients and more unipolar patients than female depression with onset before 40. Male depression with onset after 40 had a significantly shorter duration of illness and fewer patients with atypical features than male depression with onset before 40. Conclusions: Some features were common to both female and male depression with onset after 40. Female depression with onset after 40 had significantly more unipolar and fewer bipolar II patients, than female depression with onset before 40. Different frequency of unipolar and bipolar II patients suggests that the biology of depression in menopause women may be different from that of women not in menopause, and from that of male depression with onset after 40. Differences may be related to menopause.
Sexual Dysfunction in Male Posttraumatic Stress Disorder Patients
Authors: Kotler Moshe , Cohen Hagit , Aizenberg Dov , Matar Mike , Loewenthal Uri , Kaplan Zeev , Miodownik Hanoch , Zemishlany Zvi
Published: April 2003

Background: Previous studies have suggested that sexual dysfunction may be associated with posttraumatic stress disorder (PTSD). Yet such studies have not examined a full range of sexual functioning and have not accounted for the possibility that medication used to treat PTSD may contribute to sexual dysfunction. Objective: The current study compares the various components of sexual functioning among three groups of males: (1) untreated PTSD patients (n = 15), (2) PTSD patients currently treated with selective serotonin reuptake inhibitor (SSRI) agents (n = 27) and (3) a group of normal controls (n = 49). Methods: All participants completed an 18-item questionnaire for assessment of sexual functioning. Those with PTSD also completed the Impact of Events Scale and the Symptom Check List-90 (SCL-90). Results: Untreated and treated PTSD patients had significantly poorer sexual functioning in all domains (desire, arousal, orgasm, activity and satisfaction) as compared to normal controls. Those treated with SSRI had greater impairment in desire, arousal and frequency of sexual activity with a partner. There was a high correlation between sexual dysfunction among the PTSD group and the anger-hostility subscale of the SCL-90. Conclusions: PTSD appears to be associated with pervasive sexual dysfunction that is exacerbated by treatment with SSRIs. PTSD may represent a heterogeneous syndrome. Patients with PTSD have a high rate of comorbid panic disorder, major depression and anxiety, and it could thus be argued that these comorbid disorders, rather than PTSD, accounted for the observed result. Future research aimed at understanding comorbidity and heterogeneity should help to illuminate the psychobiology of PTSD and eventually guide both medication and psychosocial treatments.
Personality and Psychopathology in Patients with Temporomandibular Joint Pain-Dysfunction Syndrome
Authors: Meldolesi G.N. , Picardi A. , Accivile E. , Toraldo di Francia R. , Biondi M.
Published: April 2003

Objective: Our aim was to deepen the understanding of the psychosomatic aspects of temporomandibular joint (TMJ) pain dysfunction syndrome. Patients affected by this syndrome were compared with both healthy subjects and psychiatric patients, using both self-report and physician-scored psychological measures. Methods: Three sex- and age-matched groups were recruited: a TMJ group (n = 32), a healthy group (n = 22) and a psychiatric group (n = 22). The psychiatric group consisted of outpatients diagnosed as having a DSM-IV anxiety or depressive disorder of mild to moderate severity. Psychometric assessment included the Minnesota Multiphasic Personality Inventory (MMPI) and the Hamilton Anxiety Rating Scale (HARS). Results: Psychiatric patients scored higher than both the comparison groups on all but one of the MMPI scales; the majority of the differences were significant or approached significance. TMJ patients scored higher than healthy controls on the Hs (hypochondriasis; p ≤ 0.01), Hy (hysteria; p ≤ 0.01) and D (depression; p ≤ 0.05) scales. Psychiatric patients scored higher than TMJ patients on the HARS psychic anxiety subscale (p ≤ 0.05), while TMJ patients scored higher than psychiatric patients on the somatic anxiety subscale (p ≤ 0.05). Conclusions: Certain personality characteristics were associated with TMJ dysfunction. However, further longitudinal studies should be performed to properly assess causal relationships. Despite signs of neuroticism, anxiety and depression, patients with TMJ dysfunction differed from anxious and depressed patients. While the latter displayed a higher level of psychopathology, each group was characterised by a distinct pattern of anxiety symptoms. In addition, a substantial proportion of TMJ patients had little awareness of their inner states and emotions.
Energy Intake and Growth of 3- to 36-Month-Old German Infants and Children
Authors: Alexy Ute , Kersting Mathilde , Sichert-Hellert Wolfgang , Manz Friedrich , Schöch Gerhard
Published: April 2003

Recently, new estimations of the energy requirements of infants and children were proposed as a basis of new FAO/WHO energy requirements. We have compared the energy intake of 354 healthy, well-nourished infants taking part in the Dortmund Nutritional and Anthropometric Longitudinal Designed Study (3-day-weighted diet records) with these new estimated energy requirements. The energy intake of breast-fed and formula-fed infants and the energy intake of the 1- to 3-year-old children in the study population corresponded well with the new estimated energy requirements, although these were considerably lower than the 1985 FAO/WHO energy requirements. Breast-feeding rates were lower and the introduction of beikost was earlier than the current recommendations. Height and weight, which were taken as global indicators of the adequacy of the energy intake, were in good accordance with The Netherlands’ third nationwide survey. Our data indicate that the new estimations of energy requirement seem to be more appropriate than the 1985 FAO/WHO energy requirements.
Effects of Dietary Long-Chain Polyunsaturated Fatty Acids on Plasma Amino Acids and Indices of Protein Metabolism in Infants: Results from a Randomized Clinical Trial
Authors: Decsi T. , Burus I. , Koletzko B.
Published: April 2003

Background/Aim: Previous studies in vitro and in animals in vivo found that α-linolenic acid (C18:3ω3) may enhance oxidative damage of essential amino acids. We investigated whether the addition of the long-chain polyunsaturated fatty acids (LCPUFA) arachidonate (C20:4ω-6; AA) and docosahexaenoate (C22:6-ω3; DHA) in the form of egg phospholipids to infant formula affects plasma amino acid concentrations and indices of protein metabolism in term infants. Methods: In a double-blind, randomized clinical trial, healthy infants were fed from day 5 of life formula with or without preformed LCPUFA (n = 10 and 12, respectively). At the age of 5 days and 1, 2, 3 and 4 months, blood samples were obtained and analyzed for plasma amino acids by high-performance liquid chromatography and for plasma phospholipid fatty acid composition by gas chromatography. Results: At the age of 3 months, plasma threonine concentrations were significantly lower in infants receiving dietary LCPUFA than in controls (124 ± 16 vs. 216 ± 28 µmol/l, p < 0.05). Values of other plasma essential amino acids, total protein, albumin, creatinine and urea nitrogen did not differ between the two feeding groups throughout the study. At the age of 5 days, plasma phospholipid AA and DHA concentrations were inversely correlated with histidine concentrations (AA: r = –0.60, p = 0.01; DHA: r = –0.53, p < 0.05). At the age of 3 months, DHA concentrations were inversely related to plasma histidine, methionine and threonine concentrations (r = –0.66, –0.62, and –0.64, respectively, p < 0.05). Conclusions: The dietary LCPUFA supplementation of infant formula used in this study has no adverse effects on infant plasma amino acid concentrations and indicators of protein metabolism. Nonetheless, the apparent interaction of LCPUFA with some amino acids in formula-fed infants warrants further investigation.
A Linoleic Acid Enriched Diet Increases Serum Cholesterol Esterification by Lecithin:Cholesterol Acyltransferase in Meal-Fed Rats
Authors: Romijn D. , Wiseman S.A. , Scheek L.M. , de Fouw N.J. , van Tol A.
Published: April 2003

Dietary fats are known to influence the fatty acid profile of plasma lipids, including phospholipids which are substrates of lecithin:cholesterol acyltransferase (LCAT; EC 2.3.1.43), an important enzyme in lipoprotein metabolism. We tested whether the dietary fatty acid profile has an effect on LCAT activity in an animal model. Rats were conditioned to eat two meals per day, which were enriched in either palmitic, oleic or linoleic acids, for 10 weeks. Serum was isolated from blood samples taken prior to the meal. The LCAT activity was determined in two ways: (1) by measuring serum cholesterol esterification rates, which are an estimate of LCAT action on endogenous lipoproteins, and (2) by measuring serum LCAT activity levels with excess exogenous substrates, an estimate of LCAT mass. Animals receiving the linoleic acid diet had lower serum concentrations of unesterified cholesterol and triglycerides, if compared with animals fed oleic acid or palmitic acid diets (p < 0.05). Serum LCAT activity levels (measured with excess exogenous substrates) were not different, but both the absolute and fractional rates of cholesterol esterification were highest on the linoleic acid rich diet (p < 0.01), showing that LCAT action on endogenous lipoproteins is improved. No differences were found in serum apolipoprotein B and A-IV concentrations between the dietary groups. Apolipoprotein A-I levels were lowest in the palmitic acid group (oleic and linoleic > palmitic; p < 0.05), and apolipoprotein E levels were highest in the palmitic acid group (palmitic > oleic and linoleic; p < 0.05). It is concluded that a linoleic acid rich diet may cause increased metabolism of serum cholesterol by LCAT in rats. This effect is not due to elevated serum concentrations of LCAT or of its apolipoprotein activators, but most likely to changes in the chemical composition of endogenous lipoprotein substrates. It remains to be established whether the serum cholesterol esterification rates measured in vitro are related to in vivo rates of reverse cholesterol transport.
Comparison between Extra Virgin Olive Oil and Oleic Acid Rich Sunflower Oil: Effects on Postprandial Lipemia and LDL Susceptibility to Oxidation
Authors: Nicolaïew Nathalie , Lemort Nicole , Adorni Laura , Berra Bruno , Montorfano Gigliola , Rapelli Silvana , Cortesi Nicoletta , Jacotot Bernard
Published: April 2003

The aim of our study was to determine whether the minor polar components of virgin olive oil could have favorable effects (1) on fasting and postprandial lipid profile and (2) on low-density lipoprotein (LDL) composition and susceptibility to oxidation in vitro. Ten normolipidic subjects were included in a crossover study (two diet periods of 3 weeks) and received either virgin olive oil (OO diet) or oleic acid rich sunflower oil. An oral fat load was performed at the end of each period. The plasma lipid levels were not significantly different after both diets in the fasting and postprandial states. A few minor variations of the LDL composition were observed only in the postprandial lipemia, and they were different after both diets. The LDL oxidation susceptibility was evaluated by the formation of conjugated dienes. With LDL isolated in the fasting state, the diene production decreased (p = 0.0573) only after the OO diet. The dienes determined at time 0 and the maximal dienes obtained during the oxidation reaction decreased (p = 0.0145 and p = 0.0184, respectively) only after the OO fat load. Nevertheless, the diene production decrease was not significant (p = 0.0848). Our results suggest a mild effect of minor components of virgin olive oil related to a decrease of LDL susceptibility to oxidation; further analyses are necessary to give clear conclusions about their role.
Lymphocyte T Subset Counts in Children with Hypercholesterolemia Receiving Dietary Therapy
Authors: Moreno Luis A. , Sarría Antonio , Lázaro Aurora , Lasierra María Pilar , Larrad Luis , Bueno Manuel
Published: April 2003

Background: In children with hypercholesterolemia, dietary therapy is indicated; however, we do not know if a low-fat diet can modify some organic functions, i.e. immune function. Methods: 42 children with hypercholesterolemia received a low-fat, low-cholesterol diet during 6 months. At baseline and after the treatment period, we determined a lipoprotein profile and some immune characteristics: immunoglobulins G, A and M; complement components (C3, C4 and factor B), and blood lymphocyte subsets (CD3, CD4 and CD8). Results: Total cholesterol serum concentrations showed a significant reduction after 6 months of dietary therapy (p = 0.008). After 6 months on a low-fat diet, lymphocyte T subset counts (CD3, CD4 and CD8) showed significant decreases (p < 0.01 to p < 0.003), but lymphocyte counts were always within normal ranges. There was also a significant correlation between changes in some lymphocyte T subset counts (CD3 and CD8) and changes in triglyceride serum concentrations (p < 0.05). Conclusions: A low-fat, low-cholesterol diet diminished CD3, CD4 and CD8 lymphocyte subset counts that are elevated in children with hypercholesterolemia. Dietary therapy, with emphasis on the intake of n–3 fatty acids, could be useful in the modulation of the immune response at the atheromatous plaque level.
Does Dietary α-Linolenic Acid Promote Liver Metastases in Pancreatic Carcinoma Initiated by BOP in Syrian Hamster?
Authors: Wenger F.A. , Jacobi C.A. , Kilian M. , Zieren J. , Zieren H.U. , Müller J.M.
Published: April 2003

Background: α-Linolenic acid (ALA) has been shown to have a promoting effect on pancreatic carcinogenesis. The purpose of this study was to evaluate the influence of ALA on liver metastases in a model of BOP-induced pancreatic ductular carcinoma in the Syrian golden hamster. Methods: While the control group (group V) received a standard diet low in fat (soya oil, 3 w/v) without ALA, groups I–IV were fed a diet high in fat (soya oil 25 w/v) with increasing percentages of ALA (2.5, 5, 7.5 and 10%) for 16 weeks. Results: No significant differences in mean body weight and pancreas weight were found between the groups. But significant differences (p = 0.0001) were observed in the mean weight of the resected liver. Treatment with BOP alone resulted in the induction of well-differentiated ductal pancreatic adenocarcinoma in 91%, while all groups treated with different amounts of ALA had induction of 100%. The incidence of liver metastases differed significantly between the groups. The incidence of liver metastases in group I (2.5% ALA) was 18%, in group II (5% ALA) 27%, in group III (7.5% ALA) 50%, and in group IV (10% ALA) 91%. Moreover, the diameter of liver metastases increased significantly according to ALA supplementation (p = 0.001). Conclusion: The results indicate that dietary ALA increases liver metastases in BOP-initiated pancreatic cancer.
Resting Metabolic Rate and Thermogenic Effect of Food in Vegetarian Diets Compared with Mediterranean Diets
Authors: Bissoli Luisa , Armellini Fabio , Zamboni Mauro , Mandragona Roberta , Ballarin Antonia , Bosello Ottavio
Published: April 2003

The purpose of our work is to compare the resting metabolic rate (RMR) and thermogenic effect of food (TEF) in a group of vegetarians and a group of subjects consuming a Mediterranean diet. The composition of the diets was similar. Thirty-two subjects were studied: 16 vegetarians (age 34 ± 9 years, BMI 21 ± 2) and 16 omnivors (age 30 ± 5 years, BMI 22 ± 3). All were in excellent general health. Each subject consumed a dish of pasta (100 g) and bread (30 g) after RMR had been measured. TEF was measured over the next 3 h and calculated as the incremental area above RMR. Energy (vegetarians and omnivors 7,727 ± 3,516 vs 8,970 ± 2,273 kJ/day, respectively) and carbohydrate (vegetarians and omnivors 285.1 ± 141.3 vs. 300.1 ± 74 g/day, respectively) intakes of the 2 groups were similar. The vegetarian group consumed a higher quantity of fiber (30.5 ± 16.7 vs. 16.5 ± 7.9) and a lower amount of protein (44.9 ± 18.3 vs. 70.1 ± 14.9) than the omnivorous group. No significant differences were observed in RMR (4.23 ± 0.96 vs. 4.06 ± 0.54 kJ/min) and TEF (0.50 ± 0.25 vs. 0.38 ± 0.25 ΔkJ/min) between the groups. Results did not change after correcting for weight, age and gender. Our study failed to show any significant differences in RMR and TEF between vegetarians and subjects consuming a Mediterranean diet. We conclude that vegetarianism per se is not accompanied by a difference in RMR and TEF when the carbohydrate content of the diet is similar to a control group of nonvegetarians.
Measures of Quality Control in the German Component of the EPIC Study
Authors: Kroke A. , Bergmann M.M. , Lotze G. , Jeckel A. , Klipstein-Grobusch K. , Boeing H.
Published: April 2003

Quality control is an indispensable part of quality assurance in any study, intending to ensure high standards during data acquisition. The aim of this paper is to describe the measures of quality control undertaken in the German EPIC study centers and to present selected results of these procedures (EPIC = European Prospective Investigation into Cancer and Nutrition). For all data assessment tools applied in the German EPIC study, procedures were developed to monitor both the personnel as well as the technical instruments. These procedures combined quantitative and qualitative measurements of quality control. Interviewer performance was evaluated through direct observation and rated according to an evaluation score. Blood pressure and anthropometric measurements were both controlled through direct observation of measurement procedures as well as through periodical technical control of measurement devices. Blood sampling procedures were directly monitored and subsequent handling of the probes tightly recorded, including information on time sequence of work-up and room temperature. With these diverse control measurements and the obtained rating of assessment procedures a broad pool of information has been made available to support a critical evaluation of the data obtained in the EPIC study centers in Heidelberg and Potsdam.
Effects of Dietary Fish Oil Supplementation on the Phospholipid Composition and Fluidity of Cell Membranes from Human Volunteers
Authors: Lund Elizabeth K. , Harvey Linda J. , Ladha Shabirali , Clark David C. , Johnson Ian T.
Published: April 2003

Background: Membrane fluidity is an important aspect of cellular physiology which may be manipulated by diet. Methods: We studied the effect of dietary fish oil on the membrane composition of erythrocytes and cheek cells, and on membrane fluidity of erythrocytes as assessed by fluorescence recovery after photobleaching (FRAP). Healthy volunteers received a daily supplement of fish oil (930 mg EPA, 630 mg DHA) for 42 days. Results: The intervention reduced the ratio of n-6 to total fatty acid in the phospholipid fraction of erythroctye membranes but the n-3 fraction remained stable and the ratio of cholesterol to phospholipid increased. The level of EPA and DHA in cheek cells increased significantly during the intervention period. The mean diffusion coefficient of the fluorescent probe in erythrocyte membranes increased from 7.2 ± 0.7 × 10–9 cm2/s at the start to 9.8 ± 0.5 × 10–9 cm2/s after 21 days. Membrane fluidity remained higher than the initial value 42 days after withdrawal of the supplement. Fish oil also reduced platelet aggregation in response to ADP but there was no effect on plasma lipid profiles. Conclusion: We conclude that n-3 fatty acids influence erythrocyte membrane composition at relatively low levels of supplementation by a mechanism which does not necessarily involve an increase in the level of EPA or DHA present in the membrane.
Effect of Dietary Hydrogenated Fish Oil on the Plasma Lipoprotein Profile and on the Fatty Acid Composition of Different Tissues of the Rat
Authors: Morgado Nora , Sanhueza Julio , Galleguillos Angélica , Garrido Argelia , Nieto Susana , Valenzuela Alfonso
Published: April 2003

Dietary fatty acids are actively incorporated into membrane lipids, and fat intake can modify the composition and the biochemical activity of cellular membranes and the pattern of plasma lipoproteins. Industrial hydrogenation of polyunsaturated oils leads to the formation of isomeric trans fatty acids which are incorporated into cellular membranes when they are present in the diet. The trans fatty acid amount present in hydrogenated oils depends on the degree of hydrogenation, being high for partially hydrogenated oils and low for highly hydrogenated oils. Hydrogenated fish oil is widely used in some countries for the production of margarine and industrial fats. This study compares the fatty acid composition of plasma, erythrocytes, subcutaneous adipose tissue, and hepatic microsomal membranes and the plasma lipoprotein profile after feeding rats with a synthetic diet containing either fish oil, partially hydrogenated fish oil, or highly hydrogenated fish oil. It is observed that the tissue content of monounsaturated fatty acids increases and that the content of polyunsaturated fatty acids decreases after an increase of the degree of hydrogenation of the dietary fat. Tissues from animals fed partially hydrogenated fish oil show significant amounts of trans fatty acids only. The plasma triacylglyceride composition and the lipoprotein profile are also altered by the degree of hydrogenation of the dietary fat. Triacylglycerides decrease after highly hydrogenated fat feeding only. Total cholesterol and low-density lipoprotein cholesterol are significantly increased after partially hydrogenated fat feeding. Although no direct evidence is presented, this effect may be attributable to the high content of trans isomers of this dietary fat which nutritionally may behave as saturated fatty acids.
Protective Efficacy of Trypsin Inhibitor on the Gut following Rotavirus Infection in Malnourished Infant Mice
Authors: Katyal R. , Ojha S. , Rana S.V. , Vaiphie K. , Singh K. , Singh V.
Published: April 2003

Epidemiologic data suggest a close relationship between protein energy malnutrition (or protein energy malnourished) (PEM) and development of infectious diarrheal diseases. In the present studies, the impact of trypsin inhibitor (TI) on the gut following rotavirus (RV) infection was investigated in PEM young growing inbred balb/c mice. The animals were divided into four groups: (1) control; (2) PEM; (3) PEM+RV and (4) PEM+ RV+TI. Control and PEM animals were orally inoculated with normal saline, PEM+RV animals were given 50 μl RV (100 ID50) and PEM+RV+TI animals were inoculated with 0.6 mg TI/g body weight + 50 μl RV. The body weight of each animal was recorded. Six animals from each group were sacrificed on days 0, 1, 3, 5, 7 and 10 post inoculation by cervical dislocation. The intestines were removed, everted and homogenized in ice-cold saline. Leucine aminopeptidase (LAP), glutathione (GSH) levels and L-leucine uptake were determined in the jejunum and ileum. Body weight was decreased in PEM and PEM+RV groups compared to the controls. LAP and leucine uptake levels were elevated in the PEM group but decreased in the PEM+RV group. GSH levels were decreased in the PEM+RV group. Enzyme activity, GSH and LAP uptake levels were restored in the PEM+RV+TI group. The study shows the protective role of soybean TI against RV infection in malnourished mice.
Home Parenteral Nutrition: Clinical and Laboratory Analysis of Initial Experience (1994–1997)
Authors: Reimund Jean-Marie , Duclos Bernard , Cuby Catherine , Malzac Denis , Zimmermann Françoise , Dietemann Jean-Louis , Beretz Laurence , Baumann René
Published: April 2003

Background/Aim and Method: Severe malabsorption often necessitates prolonged parenteral nutrition. Home parenteral nutrition (HPN) offers the opportunity for treatment at home. We report clinical and laboratory data of initial 27 HPN patients of one center since its opening in 1994. Results: Clinical and biological markers of nutritional status were normalized and well maintained in most patients. Except for vitamin E and selenium (lower in HPN patients), the other vitamin and micronutrient levels were normal. There was no obvious essential fatty acid deficiency. Cholestasis was usual, but only 1 patient had a severe hepatic disease. Catheter infection occurred 18 times in 13 patients, but the frequency decreased with time (from 4.2 to 1.7 infections/1,000 days on HPN). No patient died from HPN complications. Social rehabilitation and, in some patients, full professional rehabilitation were constant. Conclusions: These data confirm that HPN performed in centers with expertise allowed patients to overcome gut failure and to recover subnormal or normal nutritional status. Satisfactory social rehabilitation was obtained in all patients. HPN complications were rarely life-threatening, and their frequency decreased with experience.
Oxidation of an Oil Rich in Docosahexaenoic Acid Compared to Linoleic Acid in Lactating Women
Authors: Fidler N. , Sauerwald T. , Demmelmair H. , Pohl A. , Koletzko B.
Published: April 2003

Background: We studied the oxidation of an oil rich in docosahexaenoic acid (DHA; DHASCO®) in lactating mothers receiving a dietary DHA supplement or a placebo. The results were compared with the oxidation of linoleic acid. Methods: Breast-feeding mothers received a dietary supplement (DHASCO; 200 mg DHA/day, n = 5) or a placebo (n = 5) for 14 days. Six weeks post partum all 10 mothers received a single dose of 2 mg/kg body weight uniformly 13C-labeled DHASCO. In a previously reported study 6 mothers received 1 mg/kg body weight uniformly 13C-labeled linoleic acid. Breath samples were collected over 48 h after tracer application. The total CO2 production was measured by indirect calorimetry and the 13C isotopic enrichment of labeled CO2 by isotopic ratio mass spectrometry. Results: The oxidation of 13C-labeled DHASCO in the supplemented and placebo groups was similar. Maximal 13C enrichment was reached earlier in the group receiving 13C-DHASCO (median 1.0 vs. 3.0 h in the linoleic acid group). The cumulative 13C recovery in breath was higher in the DHASCO versus the linoleic acid group until 10 h after tracer application and comparable thereafter. Conclusions: The difference in oxidation of DHASCO versus linoleic acid after tracer ingestion might be partly due to a faster absorption and oxidation of shorter chain saturated fatty acids contained in DHASCO. The cumulative oxidation of DHASCO and linoleic acid 24 and 48 h after tracer ingestion is similar.
Post-Natal Modulation of Heart and Liver Phosphoglyceride Fatty Acids in Pups
Authors: Ghebremeskel K. , Bitsanis D. , Koukkou E. , Lowy C. , Poston L. , Crawford M.A.
Published: April 2003

Background: Maternal dietary fats alter tissue fatty acids of the fetus and suckling pups. However, the possible change in tissue composition in response to the high oxygen tension extrauterine milieu independent of diet is not well understood. Methods: We have compared the fatty acids of heart and liver choline (CPG) and ethanolamine (EPG) phosphoglycerides of rat offspring at birth and post-natal day 15. Sprague-Dawley rats were fed a breeding diet prior to mating, pregnancy and lactation. A proportion of each litter was sacrificed and the liver and heart were obtained for analysis. Changes in fatty acid composition specific to tissue (heart and liver) and phosphoglyceride (CPG and EPG) occurred post-natally. Results: Relative levels of palmitate and oleate decreased and those of stearate increased in both the heart and liver phosphoglycerides of the suckling pups. There was a reduction in arachidonate/linoleate ratio primarily due to the increase in linoleic acid. With the exception in the heart EPG, the levels of arachidonic acid did not decrease concomitantly. Although the fatty acid composition of the diet did not change between pregnancy and lactation, docosahexaenoic and total n–3 increased in heart CPG and EPG and liver CPG of the suckling pups. Evidently, membrane fatty acid modulation, independent of maternal dietary fat, occurs in the extrauterine environment. It seems to favour the accretion of linoleic, arachidonic, docosahexaenoic and total n–3 fatty acids. Conclusion: Since there appears to be some parallel between the very preterm human neonate and rat pups with regard to nutrient store at birth and the neonatal developmental time window, our results may have relevance for the understanding of fatty acid metabolism and turnover in the human neonate.
Long-Term Oral β-Carotene Supplementation in Patients with Cystic Fibrosis – Effects on Antioxidative Status and Pulmonary Function
Authors: Rust Petra , Eichler Irmgard , Renner Sabine , Elmadfa Ibrahim
Published: April 2003

To investigate the efficacy of long-term oral β-carotene supplementation for optimizing the antioxidant status and pulmonary function in patients with cystic fibrosis (CF), 24 patients (aged 12.8 ± 6.3 years) were randomized to a CF supplementation or to a CF placebo group. As controls 14 healthy age-matched subjects (aged 14.7 ± 6.2 years) were studied. Patients of the CF supplementation group received 1 mg β-carotene/kg body weight (BW)/day (maximally 50 mg β-carotene/day) for the first 12 weeks; during the following 12 weeks, dosage was reduced to 10 mg β-carotene/day. At study entry, plasma β-carotene concentrations were significantly lower in CF patients than in controls (p < 0.001). In the CF supplementation group, plasma β-carotene concentrations were significantly increased (baseline: 0.08 ± 0.04 μmol/l) at the end of high-dose treatment (12th week; 0.6 ± 0.4 μmol/l; p < 0.001), but decreased again during supplementation with 10 mg β-carotene/day to 0.3 ± 0.2 μmol/l at the end of the study (p < 0.001). β-Carotene supplementation did not affect plasma concentrations of other carotenoids and retinol, but an increase in plasma α- and γ-tocopherol concentrations was noticed. During high-dose treatment, a significant decrease in TBA-MDA complexes and a correction of total antioxidative capacity was observed. During the treatment, pulmonary exacerbation could be corrected significantly (p < 0.05). We conclude that CF patients can be efficiently supplemented with 1 mg β-carotene/kg BW/day (maximally 50 mg β-carotene/day) to achieve plasma concentrations of healthy control subjects and to minimize oxidative stress, improving the quality of life of CF patients.
Concentrations of Trace Elements in Extensively Hydrolysed Infant Formulae and Their Estimated Daily Intakes
Authors: Krachler M. , Rossipal E.
Published: April 2003

The 18 trace elements Ba, Be, Bi, Cd, Co, Cs, Cu, La, Li, Mn, Mo, Pb, Rb, Sb, Sn, Sr, Tl, and Zn were determined in three extensively hydrolysed formulae by inductively coupled plasma mass spectrometry. Two formulae were whey hydrolysates, whereas one was based on soy-bovine collagen hydrolysate. Two skim milk powder reference materials, analyzed to ensure the analytical precision and accuracy of the applied procedure, showed good agreement with the certified values. Most of the elemental concentrations in this three formulae were comparable to each other. However, concentrations of Cs in one formula were approximately 20 times higher than in the other two formulae. Another formulae had much higher concentrations of La and Mn compared to the other two formulae. As regards Rb, all three formulae had distinctly lower concentrations than the four pre- and nine follow-up formulae investigated in a previous study. For the essential trace element Sn, much higher concentrations were found in the three extensively hydrolysed formulae (≈8 μg/kg) when compared to pre- and follow-up formulae (most of them <0.44 μg/kg). The concentrations of the toxic trace elements Cd, Pb, Sb, and Tl in extensively hydrolysed formulae did not exceed the concentrations in cow-milk-based formulae. Daily intakes provided by the investigated formulae differ by a factor of 1.6 for Co, of 3.2 for Cu, of 8.7 for Mn, of 4.8 for Mo, and of 1.5 for Zn. Adequate daily intakes for Cu, Mo, and Zn are guaranteed by the use of most formulae, whereas only one hydrolysed formula fulfilled these requirements for manganese. Two hydrolysed formulae provide only approximately 50% of the recommended intakes for Mo.
Inappropriate Antidiuresis and Hyponatremia with Suppressible Vasopressin in Guillain-Barré Syndrome
Authors: Cooke C. Robert , Latif Kashif A. , Huch Kim M. , Wall Barry M.
Published: April 2003

Studies in which plasma osmolality was altered acutely by oral water loading and hypertonic sodium chloride infusion were performed to further identify the mechanisms involved in the pathogenesis of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in a patient with Guillain-Barré syndrome. Although resetting of the osmotic threshold for vasopressin release was demonstrated in these studies, this does not seem to have been a primary factor in the development of SIADH in this patient. Downward resetting of the osmotic threshold by sustained hypoosmolality has been previously demonstrated, and it is possible that this may account for the initially low osmotic threshold identified by our studies. These studies suggest that inappropriate antidiuresis, as shown by the absence of a diuretic response to low threshold suppression of the plasma arginine vasopressin concentration was due either to a vasopressin-independent mechanism or to markedly increased renal tubular sensitivity to vasopressin.
Monoclonal Antibody Analysis of Crescentic Membranous Glomerulonephropathy
Authors: Arrizabalaga Pilar , Sans Boix Antonia , Rabassa Alberto Torras , Tey Alejandro Darnell , Torrellas Luis Revert
Published: April 2003

Idiopathic membranous glomerulonephropathy (MG) has a rather benign prognosis. Acute renal failure with cellular crescents superimposed on MG is unusual and its pathogenesis is not fully understood. We report 3 patients with crescentic MG who showed strong glomerular and interstitial infiltration of leukocytes (CD45), T lymphocytes (CD3), helper/inducer T cells (CD4), cytotoxic/suppressor T cells (CD8), and monocyte-macrophages (CD14). A similar number of CD4+ and CD8+ cells contributed to T cellularity within the glomerular tuft, whereas CD4+ cells were predominant over CD8+ cells in the crescents. Intercellular adhesion molecule-1 (ICAM-1) antigens (CD54) were found on renal vascular endothelium, interstitial cellular aggregates and proximal tubular epithelial cells. The case reports illustrate the contribution of macrophages and T cells bearing predominantly CD4+ phenotype to cellular crescents, and the abnormal expression of ICAM-1 antigens on proximal tubular epithelial cells. Both features suggest that cell-mediated immunity may play a role in the transformation of crescentic MG.
Atherogenic Lipoproteins Enhance Murine Cortical Epithelial Cell Fibronectin Protein Synthesis and Gene Expression
Authors: Roh Daeyoung D. , Kamanna Vaijinath S. , Kirschenbaum Michael A.
Published: April 2003

Tubulointerstitial changes, characterized by the accumulation of extracellular matrix proteins (ECM) and fibrosis, are often associated with primary glomerular injury. Furthermore, these changes may be better prognostic indicators for decline in renal function than the anatomical changes seen within the glomerulus itself. Although hyperlipidemia and the increased renal accumulation of atherogenic lipoproteins are commonly seen in both human and experimental models of renal disease, the possible role that atherogenic lipoproteins may play in the cellular and molecular events associated with the development of tubulointerstitial injury remains unclear. Since atherogenic lipoproteins have been shown to be mediators of renal injury, we examined the effects of native LDL and oxidatively-modified LDL (ox-LDL, a more atherogenic form of LDL) on fibronectin protein synthesis and gene expression in proximal tubular epithelial cells (TEC). Human LDL was freshly isolated and ox-LDL prepared by incubation of LDL with 100 µM CuSO4. Incubation of TEC with LDL or ox-LDL (25–50 µg/ml) for 24 h increased the steady-state mRNA expression of fibronectin by 16–135% over control as measured by Northern blot analysis and the effect was greater with ox-LDL than native LDL. Additional studies were done to examine whether the increased fibronectin message in response to lipoprotein activation was translated into TEC protein synthesis. The activation of TEC by LDL or ox-LDL stimulated the synthesis and secretion of fibronectin (52–150%, over control) as measured by Western blot analysis. The data show that LDL and ox-LDL stimulate TEC fibronectin gene message and protein synthesis supporting a pathobiological role for these atherogenic lipoproteins in tubulointerstitial fibrosis.