Large Population Sample Research Articles

Vitamin D concentrations from neonatal dried blood spots and the risk of early-onset type 2 diabetes in the Danish D-tect case-cohort study.

The aim of this study was to examine the influence of neonatal vitamin D concentration on the development of early-onset type 2 diabetes in a large population sample. We conducted a case-cohort study utilising data from the Danish biobank and registers. Neonatal vitamin D was assessed measuring 25-hydroxyvitamin D3 [25(OH)D3] concentrations on the dried blood spot samples from the Biological Specimen Bank for Neonatal Screening. Cases of type 2 diabetes (n = 731) were retrieved from the Danish National Patient Register for all individuals born in Denmark between 1 May 1981 and 31 December 1992. The sub-cohort (n = 1765) was randomly selected from all children born in the same period. We used a weighted Cox proportional hazard model assessing the hazard of first type 2 diabetes diagnoses by quintiles of 25(OH)D3 and restricted cubic spline. The median 25(OH)D3 concentration (IQR) among cases was 21.3nmol/l (13.3-34.1) and 23.9nmol/l (13.7-35.7) in the sub-cohort. There was no indication of a potential lower risk of early-onset type 2 diabetes among individuals in the higher quintile of vitamin D concentration compared with the lowest (HRcrude 0.97 [95% CI 0.71, 1.33] p = 0.85; HRadjusted 1.29 [95% CI 0.92, 1.83] p = 0.14). The results of this study do not support the hypothesis that higher neonatal vitamin D concentrations are associated with a lower risk of early-onset type 2 diabetes in adulthood.

Hospital Presentation for Self-Harm in Youth as a Risk Marker for Later Psychotic and Bipolar Disorders: A Cohort Study of 59 476 Finns.

Expanding clinical strategies to identify high risk groups for psychotic and bipolar disorders is a research priority. Considering that individuals diagnosed with psychotic and bipolar disorder are at high risk of self-harm, we hypothesised the reverse order relationship would also be true (ie, self-harm would predict psychotic/bipolar disorder). Specifically, we hypothesised that hospital presentation for self-harm would be a marker of high risk for subsequent development of psychotic/bipolar disorder and sought to test this hypothesis in a large population sample. This prospective register-based study included everyone born in Finland in 1987, followed until age 28 years (N = 59 476). We identified all hospital records of self-harm presentations, as well as all ICD-10 healthcare registrations of first diagnoses of psychotic and bipolar disorders. Cox proportional hazards models were used to assess the relationship between self-harm and psychotic/bipolar disorders. Of all individuals who presented to hospital with self-harm (n = 481), 12.8% went on to receive a diagnosis of psychosis (hazard ratio [HR] = 6.03, 95% confidence interval [CI] 4.56–7.98) and 9.4% a diagnosis of bipolar disorder (HR = 7.85, 95% CI 5.73–10.76) by age 28 years. Younger age of first self-harm presentation was associated with higher risk—for individuals who presented before age 18 years, 29.1% developed a psychotic or bipolar disorder by age 28 years. Young people who present to hospital with self-harm are at high risk of future psychotic and bipolar disorders. They represent an important cohort for the prevention of serious mental illness.

Health Conditions, Lifestyle Factors and Depression in Adults in Qingdao, China: A Cross-Sectional Study.

Background: Depression is a common mental illness. Previous studies suggested that health conditions and lifestyle factors were associated with depression. However, only few studies have explored the risk factors of depression in a large representative sample of the general population in the world.Methods: A population-based cross-sectional survey was conducted in the 2006 survey and 2009 survey in Qingdao, China. The participants with insufficient information were excluded: Zung score, body mass index (BMI), diabetes items, physical activity, smoking, or drinking. Finally, a total of 3,300 participants were included in this analysis. The category of depression was used in the Zung self-rating depression scale (ZSDS). The associations between different indicators of health conditions (diabetic status, BMI), lifestyle factors (physical activity, smoking, and alcohol consumption), and depression were assessed by the logistic regression model.Results: The mean Zung scores for all participants, male participants, and female participants were 29.73 ± 7.57, 28.89 ± 7.30, 30.30 ± 7.70, respectively. In all participants, those who were pre-diabetes status (OR: 1.53, 95% CI: 1.04–2.27), and irregular physical activity (OR: 0.39, 95% CI: 0.17–0.89) had an increased risk of depression. In man, the analysis showed an increased risk of depression those with pre-diabetes (OR: 2.49, 95% CI: 1.25–4.97), previously diagnosed diabetes (OR: 4.44, 95% CI: 1.58, 12.48), and in those irregular activities (OR: 0.07, 95% CI: 0.01–0.61). In women, those who were underweight (OR: 5.66, 95% CI: 1.04–30.71) had a greater risk of depression.Conclusions: These results suggested that health conditions and lifestyle factors were the potential risk factors for depression. Men with pre-diabetes, previously diagnosed diabetes, and irregular activity had an increased risk for depression; women with underweight status had a higher risk for depression.

Addressing COVID-19 vaccine hesitancy: is official communication the key?

Daniel Freeman and colleagues' study published in The Lancet Public Health1 provides insight on possible means to reduce COVID-19 vaccine hesitancy in the general population. In their randomised controlled trial among a large sample (n=18 855) of the UK general population surveyed from Jan 19 to Feb 18, 2021, the authors assessed whether brief written statements about COVID-19 vaccination that addressed personal benefits, collective benefits, safety concerns, or the seriousness of the pandemic could reduce vaccine hesitancy, when added to the National Health Service's official statement on vaccine safety and effectiveness.

The association between total volatile basic nitrogen (TVB-N) concentration and other biomarkers of quality and spoilage for vacuum packaged beef

Beef longissimus lumborum muscles (24) were each portioned into 6 steaks, and these were held at ~0.5 °C for up to 14 weeks. Total volatile basic nitrogen (TVB-N) data was compared against other measures of quality and freshness: total viable microbial count (TVC), ultimate pH, drip loss, purge, moisture content, cook loss, shear force, particle size, vitamin E, intramuscular fat content (IMF) and colour parameters. There was an association between TVB-N and colour parameters; and between TVB-N and several parameters for microbial load, tenderness and moisture. IMF and vitamin E were not correlated to TVB-N. TVB-N of 5.1 mg/100 g (95% confidence intervals: 4.6–5.5 mg/100 g) was estimated as equivalent to a TVC of log 7 cfu/g. When beef samples were categorised as either spoilt or fresh using this TVC recommendation, TVB-N was correct in 77.9% of its assignments. Additional investigation is necessary to confirm this result against a larger sample population with a broader range of TVB-N values.

High-Resolution Characterization of KIR Genes in a Large North American Cohort Reveals Novel Details of Structural and Sequence Diversity.

The KIR (killer-cell immunoglobulin-like receptor) region is characterized by structural variation and high sequence similarity among genes, imposing technical difficulties for analysis. We undertook the most comprehensive study to date of KIR genetic diversity in a large population sample, applying next-generation sequencing in 2,130 United States European-descendant individuals. Data were analyzed using our custom bioinformatics pipeline specifically designed to address technical obstacles in determining KIR genotypes. Precise gene copy number determination allowed us to identify a set of uncommon gene-content KIR haplotypes accounting for 5.2% of structural variation. In this cohort, KIR2DL4 is the framework gene that most varies in copy number (6.5% of all individuals). We identified phased high-resolution alleles in large multi-locus insertions and also likely founder haplotypes from which they were deleted. Additionally, we observed 250 alleles at 5-digit resolution, of which 90 have frequencies ≥1%. We found sequence patterns that were consistent with the presence of novel alleles in 398 (18.7%) individuals and contextualized multiple orphan dbSNPs within the KIR complex. We also identified a novel KIR2DL1 variant, Pro151Arg, and demonstrated by molecular dynamics that this substitution is predicted to affect interaction with HLA-C. No previous studies have fully explored the full range of structural and sequence variation of KIR as we present here. We demonstrate that pairing high-throughput sequencing with state-of-art computational tools in a large cohort permits exploration of all aspects of KIR variation including determination of population-level haplotype diversity, improving understanding of the KIR system, and providing an important reference for future studies.

Sexual Orientation and Functional Limitations: Cross-sectional Analyses From the Adult Psychiatric Morbidity Survey

ObjectiveTo assess the association between sexual orientation and functional limitations in a large representative sample of the English population. DesignCross-sectional. SettingData were from the 2007 Adult Psychiatric Morbidity Survey. ParticipantsA total of 7403 adults aged 16-95 years (51.4% female; mean age, 46.3±18.6y) were included in the present study. InterventionsNot applicable. Main Outcome MeasuresSexual orientation was assessed using 2 items adapted from the Kinsey scale and was dichotomized into heterosexual and sexual minority orientation. Functional limitations were assessed using 7 activities of daily living (ADL) and instrumental activities of daily living (IADL). Functional limitations were defined as at least 1 difficulty in 1 of 7 ADL and IADL. Adjusted logistic regression analyses were conducted to investigate the association between sexual orientation (independent variable) and functional limitations (dependent variable). ResultsThe level of sexual minority orientation and prevalence of functional limitations in the sample was 7.1% and 32.9%, respectively. After adjusting for several potential confounders, sexual minority orientation was positively and significantly associated with functional limitations (odds ratio, 1.51; 95% confidence interval, 1.18-1.95; reference group: heterosexual orientation). ConclusionsBased on the findings of this study, interventions aiming to prevent against and/or manage/reduce functional limitations in sexual minorities are needed. More research is also warranted to better understand mediators (eg, obesity, cognitive complaints, psychiatric disorders) involved in the sexual orientation–functional limitation relationship.

Multiple dimensions of stress vs. genetic effects on depression

Many psychiatric disorders including depression involve complex interactions of genetics and environmental stressors. Environmental influence is challenging to measure objectively and account for in genetic studies because the necessary large population samples in these studies involve individuals with varying cultures and life experiences, clouding genetic findings. In a unique population with relative sociocultural homogeneity and a narrower range of types of stress experiences, we quantitatively assessed multiple stress dimensions and measured their potential influence in biasing the heritability estimate of depression. We quantified depressive symptoms, major lifetime stressors, current perceived stress, and a culturally specific community stress measure in individuals with depression-related diagnoses and community controls in Old Order Amish and Mennonite populations. Results showed that lifetime stressors measured by lifetime stressor inventory (R2 = 0.06, p = 2 × 10−5) and current stress measured by Perceived Stress Scale (R2 = 0.13, p < 1 × 10−6) were both associated with current depressive symptoms quantified by Beck Depression Inventory in community controls, but current stress was the only measure associated with current depressive symptoms in individuals with a depression diagnosis, and to a greater degree (R2 = 0.41, p < 1 × 10−6). A novel, culturally specific community stress measure demonstrated internal reliability and was associated with current stress but was not significantly related to depression. Heritability (h2) for depression diagnosis (0.46 ± 0.14) and quantitative depression severity as measured by Beck Depression Inventory (0.45 ± 0.12) were significant, but h2 for depression diagnosis decreased to 0.25 ± 0.14 once stressors were accounted for in the model. This quantifies and demonstrates the importance of accounting for environmental influence in reducing phenotypic heterogeneity of depression and improving the power and replicability of genetic association findings that can be better translated to patient groups.

Exploring Dietary Behavior Changes Due to the COVID-19 Confinement in Colombia: A National and Regional Survey Study.

The aim of this study was to evaluate the impact of coronavirus SARS-Cov2 (COVID-19) confinement measures in Colombia on the dietary behaviors of a large population sample, at national and regional levels. A survey was conducted to assess dietary behaviors during the COVID-19 confinement. The survey involved 2,745 participants, aged 18 years or older, from six regions of the country (Atlántica, Bogotá, Central, Oriental, Orinoquía and Amazonía, and Pacífica). Dietary intake of foods and foods groups in grams per day before and during the confinement was estimated by considering standard serving sizes of foods. One-way ANOVA was used to analyze differences between the regions with regard to dietary behavior changes during the confinement. Differences were deemed significant at p-value < 0.05. Dietary patterns (DPs) before and during the confinement were derived from principal component analysis. Certain dietary habits were adopted by the study population during the confinement (e.g., higher frequency of snacking and home cooking), with significant differences by regions with regard to these habits, as well as regarding culinary processes. The levels of consumption of several foods also changed during the confinement, nationally and regionally. We identified three DPs before the confinement (protein-rich, carbohydrate-rich, and sugar foods patterns) and four DPs during the confinement (westernized, carbohydrate-rich, protein-rich, fish and fruits-vegetable patterns), with an explained total variance of 33 and 45%, respectively. The profile of these DPs varied to some extent between the regions; their adherence to each DP also varied (p-value < 0.001). Our results show that there were marked differences by regions in the dietary behaviors of this population during the confinement, with an overall trend toward unhealthier DPs. These results may help to shape public health nutrition interventions in Colombia during the COVID-19 pandemic and in a post-COVID stage.

Fragmented sleep relates to hallucinations across perceptual modalities in the general population

Although previous studies reported a link between sleep problems and the occurrence of hallucinations, more detailed information is needed to translate this association into clinical practice. This study investigates sleep quality and its relation to prevalence, type, content, and phenomenology of hallucinations, using an online survey in a large population sample (n = 10,299). Based on community-based cluster analysis, four groups could be distinguished that differed in terms of sleep quality. Our results confirm previous studies in showing that poor sleep is associated with the occurrence of hallucinations, and extend previous results on a number of aspects. First, we show that particularly fragmented sleep relates to the occurrence of hallucinations. Second, we show that this is the case for hallucinations across the auditory, visual, olfactory, and tactile domains. Third, our results show that fragmented sleep not only relates to the occurrence, but also to the content, frequency, duration, and associated distress of hallucinations. Finally, compared to poor sleep, good sleep quality is associated with hallucinations that are less negative and disruptive. We conclude that sleep hygiene measures could have a large positive impact on individuals whose fragmented sleep underlies the occurrence of bothersome hallucinations.

The effect of language on performance: do gendered languages fail women in maths?

Research suggests that gendered languages are associated with gender inequality. However, as languages are embedded in cultures, evidence for causal effects are harder to provide. We contribute to this ongoing debate by exploring the relationship between gendered languages and the gender gap in mathematics achievements. We provide evidence for causality by exploiting the prominent (but not exclusive) practice in gendered languages of using masculine generics to address women. In an experiment on a large representative sample of the Hebrew-speaking adult population in Israel, we show that addressing women in the feminine, compared to addressing them in the masculine, reduces the gender gap in mathematics achievements by a third. These effects are stronger among participants who acquired the Hebrew language early in childhood rather than later in life, suggesting that it is the extent of language proficiency that generates one’s sensitivity to being addressed in the masculine or in the feminine. Moreover, when women are addressed in the masculine, their efforts (in terms of time spent on the maths test) decrease and they report feeling that “science is for men” more than when addressed in the feminine. We supplement the analysis with two experiments that explore the roles of general and task-specific stereotypes in generating these effects.

HYPERTENSION, AUTONOMIC DYSFUNCTION AND SUDDEN DEATH RISK IN CADASIL DISEASE: NOVEL DATA

Objective: Sudden death (SD) is the first cause of mortality in CADASIL disease (CD)(Cerebral Autosomic Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy). An early development of cardiac autonomic neuropathy (CAN) in the pathogenesis of CD was demonstrated by others. As we detected hypertension in members of 4 families of this rare condition we decided to explore the imbalance of the autonomic nervous system as a potential tool for the prediction of SD risk. Aims: to explore the relationship between hypertension and CAN in CD. Design and method: We included 10 hypertensive (officce and 24 hs ABPM) patients with CD. Autonomic function was evaluated by the study of heart rate variability (HRV) and Ewing test (handgrip, inspiration/espiration, valsalva manouver and orthostatism). CAN stages were determined as as subclinical, early and advanced. Results: CD patients were classified as hypertensives (n:5), or normotensives. Table 1 showed hypertensives subjects characteristics and the distribution of CAN. The control group was constituted with patients with CD and arterial normotension (n:5), the study of HRV and Ewing Test being normal in them. No association was observed between the number and extent of brain lessions, location, impact of white matter with the presence of hypertension. The prevalence of CVRF was similar between both groups. Conclusions: Autonomous alterationwas identified in 80% of hypertensive patients with CADASIL disease in our population sample. This association would be independent of traditional CVRF, and the evolutionary characteristics of brain lesions. Although hypertension has not been reported elsewhere as associated with CD, its identification could indicate the risk of autonomic nervous system involvement in these patients. The relevance of their suspicion would reside in the risk re-stratification of cardiovascular events with a focus on the risk of sudden death, linked to the NAC. The limitation of the reduced number of subjects requires the analysis of this hypothesis in a larger population sample, the present being a proof of concept that could justify the development of a survey work in other centers that report cases of this rare disease.

Prevalence of hypercementosis and frequency of possible etiological factors in a Turkish subpopulation.

The aim of this study was to investigate the prevalence and types of hypercementosis and the frequency of possible etiological factors in a large sample of Turkish central Anatolian population. A cross-sectional study was performed using panoramic radiographs of 1176 randomly selected adult patients with an age range of 18-96 years, who presented to the Department of Oral and Maxillofacial Radiology of the Faculty of Dentistry, Cumhuriyet University (Sivas, Turkey) for dental care. Patients were questioned about the presence of systemic diseases. Panoramic radiographs of the patients were examined for the presence and types of hypercementosis (diffuse, focal and shirt sleeve cuff) and the frequency of local factors that may be associated with hypercementosis. Chi-square and t-tests were used for statistical analysis. Hypercementosis was detected in 128 of 1176 patients. In total, 85.6% of the teeth with hypercementosis had a diffuse, 7.5% had a focal, and 6.8% had a shirt sleeve cuff type. Hypercementosis was observed most frequently in the mandibular (P < 0.05) and the premolar region. Gender-related differences were nonsignificant (P > 0.05). Atherosclerosis, osteoporosis, and multiple diseases were reported more frequently in individuals with hypercementosed teeth (P < 0.05). While idiopathic origin (39.3%), bruxism (30%), and inflammation (24.37%) were the most prevalent local etiological factors, impacted teeth (1.25%) and history of trauma (0.62%) were less common. The prevalence of hypercementosis was 10.8% in the study population. The lesions were more common in the mandibule. Idiopathic origin was the most common factor associated with hypercementosis.

Altruism and efficient allocations in three-generation households

In this paper we test the efficiency of family resource allocation in three-generation households. Understanding how the so-called “squeezed middle” generation allocates resources towards the children and grandparents in the household will be increasingly important as populations age, and more elderly people become dependent upon their relations for financial support. Despite a large literature on household resource allocation in two-generation households (parents and children), to the best of our knowledge ours is the first study that includes the third generation. We present a theoretical model and conduct a discrete choice experiment in the context of reductions in the lifetime risk of developing coronary artery disease to verify the efficient resource allocation hypothesis. The data is obtained from a large sample of the Polish population. The sample consists of the middle generation members of three-generation households and hence WTP represents household value from the perspective of the “squeezed middle” parent. The results imply that household resource allocation is efficient. This has implications for understanding the likely response to government financial support aimed at supporting elderly people and their families.

Rivermead assessment of somatosensory performance: Italian normative data

The Rivermead assessment of somatosensory performance (RASP) provides a quantitative assessment of somatosensory processing, suitable for brain-damaged patients suffering from stroke. It consists of seven subcomponents: Subtest 1 (sharp/dull discrimination), Subtest 2 (surface pressure touch), Subtest 3 (surface localization), Subtest 4 (sensory extinction), Subtest 5 (2-point discrimination), Subtest 6 (temperature discrimination), and Subtest 7 (proprioception). Overall, the RASP assesses 5 bilateral body regions: face (cheek), hand (palm and back), and foot (sole and back). This study aimed at providing normative data and cut-off scores for RASP subtests, for each body region, in a large Italian population sample. We present results from 300 healthy Italian individuals aged 19 to 98 years. Data represent a comprehensive set of norms that cover each subtest and each body region tested. Performance in Subtests 1, 5, and 6 decreased, for some body regions, with increasing age. Based on these results, norms were stratified for age (seven groups), with the pathological/non-pathological cut-off coinciding with the 5th percentile. Conversely, other results were not influenced by age; in such cases, a single error, in each body region, has to be considered indicative of pathological performance. This independent investigation of all subcomponents of the somatosensory system, for each body region, further confirms RASP’s potential in clinical practice, for neurological assessment, as well as in research settings.

Assessment of Sleep Hygiene Practices and Sleep Quality among Nursing Officers of Selected Hospital in Delhi

Introduction: Nurses play a vital role in patient care and health sector. In order to meet the needs of the patients around the clock, in the nursing profession, 24 hours of the day are usually covered by three 8-hour shifts. Nurses are one subgroup of the population who appear to be especially vulnerable to poor sleep. The aim of the study was to assess sleep hygiene practices and sleep quality among nursing officers. Methodology: A quantitative (non-experimental) research approach was adopted for the study with a descriptive survey design. The sample of the present study comprised of 100 nursing officers working in a selected hospital of Delhi. A Structured Rating Scale was used to assess the sleep hygiene practices and Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality of nursing officers. The data gathered were analysed and interpreted using descriptive and inferential statistics. Results: The result of the study showed that majority of the nursing officers have poor sleep quality. Sleep hygiene practices of nursing officers were almost divided equally in fairly good and fairly poor categories. As sleep hygiene improved, sleep quality also was seen to improve. A negative correlation was seen between sleep quality and sleep hygiene practice. Conclusion: Finding of study will act as a catalyst to carry out more extensive research on a large population sample in various settings and also a reference material for researchers who are willing to conduct research in assessing sleep quality and sleep hygiene practice.

The role of sour and bitter perception in liking, familiarity and choice for phenol-rich plant-based foods

Among factors influencing food preferences and choices, individual differences in taste perception play a key role in defining eating behaviour. In particular, sour and bitter responsiveness could be associated with the acceptance and the consumption of phenol-rich plant-based foods recommended for a healthy diet. The aim of this study was to investigate, in a large population sample, the associations among sour and bitter responsiveness and liking, familiarity and choice for plant-based foods characterized by these target tastes. Adults aged 18 to 60 years (n = 1198; 58% women) were tested for their sour and bitter responsiveness both in water solutions and in food models (pear juice-based beverages modified in citric acid content to induce different levels of sourness: 0.5, 2.0, 4.0 and 8.0 g/kg; chocolate pudding samples modified in sucrose content to induce different levels of bitterness: 38, 83, 119, 233 g/kg). Familiarity, stated liking and choice for fruit juices and vegetables varying for sour/bitter taste (high in bitter/sour taste: e.g. grapefruit juice and cauliflower; low in bitter/sour taste: e.g. zucchini and pineapple juice) were measured. Results showed a significant positive correlation between bitter and sour taste perception in water solutions and model foods, as well as a positive correlation between the perceived intensity of the two taste stimuli. Subjects characterized by high responsiveness to the two target stimuli were found to give lower liking scores to foods characterized by sour/bitter tastes and tended to choose less sour/bitter foods compared to less responsive subjects.Thus, food choice for phenol rich plant-based products could be associated with a reduced responsiveness to bitter and sour tastes and a consequent higher acceptance of food products characterized by these taste qualities.

The Impact of the COVID-19 Pandemic on Vulnerable People Suffering from Depression: Two Studies on Adults in France.

This study investigated the difficulties experienced by people suffering from depression in coping with the stressful context of the COVID-19 pandemic and the lockdown. Two large samples of the French population were classified on the basis of their depressive symptoms and completed an online questionnaire on their emotions and their behaviors during the lockdown. Results showed that, compared to participants with no or mild mental health-related symptoms, participants with moderate to severe depressive symptoms suffered from greater psychological effects of the pandemic and the lockdown (fear, anxiety, sadness, sleep quality, loss of daily routine). However, health risk behaviors (smoking, drinking, non-compliance with lockdown and barrier gestures) and perceived vulnerability did not differ between the participant groups, although more severely depressed participants tended to be less respectful of health guidelines. In addition, the most heightened effects on the depressed participants were boredom and the feeling of social isolation, which was not compensated by the search for social affiliation. Supporting people with depression should be a public health priority because they suffer psychologically more than others from the pandemic and the lockdown.

Modern approaches to the prevention and rehydration therapy of antibiotic-associated diarrhea affected by ARI in children

The use of antibiotic drugs (ABDs) has significantly reduced the number of severe bacterial infectious diseases and mortality in children, especially in infants. But the widespread and unnecessary use of ABDs, including reserve antibiotics (the use of carbapenems increased by 45%, polymyxins – by 13%), to treat uncomplicated acute respiratory infections is open to many hazards, such as increased antibiotic resistance of pathogens. Antibiotic-associated diarrhea is one of the common complications of antibiotic therapy. According to various authors, the incidence of antibiotic-associated diarrhea is 6–80% among patients treated with antibiotics, on average 35% of patients (approximately every third patient) receiving antibiotics report symptoms of antibiotic-associated diarrhea. Disruptive changes in the qualitative and quantitative composition of the intestinal microbiota are accompanied by a decrease in the protective functions of the intestinal mucosa and contribute to the growth of pathogenic and opportunistic microorganisms (Clostridium spp., Candida spp., Salmonella spp., Staphyloccus aureus). The findings of most studies obtained on a large sample of paediatric population, as well as the clinical guidelines of the World Association of Gastroenterologists recommend the use of L. rhamnosus GGprobiotic strain (level of evidence 1) to prevent antibiotic-associated diarrhea in children. L. rhamnosus GGpresents chromosomal resistance to a range of antibiotics, which varies with species and strain. They do not contain plasmid DNA, which is dangerous for the spread of antibiotic resistance among other bacteria, which enables their wide therapeutic and prophylactic use. Clinical case studies of the course of antibiotic-associated diarrhea in children are presented to demonstrate the variability of clinical symptoms. Fever in children with ARI, particularly in tender-age infants, requires special attention from parents and doctors, as its main risk lies with a dehydration due to significant water loss during breathing, and especially increased sweating (including sweating induced by antipyretics). Therefore, oral rehydration therapy is an important method for treating infectious diseases in children. Complications that develop in patients, especially in children, after administration of antibiotics, diseases that can lead to water and electrolyte imbalance are life-threatening conditions that require immediate medical attention. Correction of water and electrolyte balance, timely restoration of intestinal microflora improve prognosis in such patients and promote faster recovery.

Application of the Sampson equation to estimate LDL-C in children: Comparison with LDL direct measurement and Friedewald equation in the BLIP study

Background and aimsIn epidemiological trials and in clinical practices, it is relevant to have affordable and reliable methods to measure the main lipid cardiovascular risk factors, and in particular low-density lipoprotein cholesterol (LDL-C) plasma level. In this context, we aimed to compare the reliability of the Friedewald's (LDL-Cf) and Sampson's (LDL-Cs) equations with the LDL-value dosed by a validated dosage method (LDL-Cd) in a large cohort of children. Methods and resultsWe considered the lipid values of 145 infants, 278 preschoolers, 810 scholar children, and 1372 adolescents (Total N. 2605, 1291 males, 1314 females), with mean total cholesterol (TC) = 169.8 ± 39.7 mg/dL, HDL-Cholesterol = 50.8 ± 12.7 mg/dL, non HDL-Cholesterol = 118.9 ± 35.9 mg/dL, Triglycerides (TG) = 90.3 ± 77.9 mg/dL, LDL-Cd = 106.2 ± 29.9 mg/dL, LDL-Cf = 100.9 ± 33.8 mg/dL, and LDL-Cs = 102.2 ± 33.4 mg/dL. Comparing the distance to the LDL-Cd, Friedewald's equation mildly but significantly underestimated in infants (3.4 ± 5.3 mg/dL), preschoolers (1.5 ± 7.1 mg/dL). Children (1.2 ± 2.2 mg/dL) and adolescents (1.1 ± 5.9 mg/dL) compared to Sampson's equation (all comparisons, p < 0.001). ConclusionsOur analysis, being carried out on a large population sample, shows that Sampson's equation is more reliable than Friedewald's one at each considered age class and even for extreme TG values.