Oral glutamine supplementation during preoperative radiochemotherapy in patients with rectal cancer: a randomised double blinded, placebo controlled pilot study

Background & aims

Enteral glutamine may have protective effects on gut function and reduce metabolic stress in patients receiving radiochemotherapy. The aim of our study was to evaluate its influence in patients with rectal cancer undergoing preoperative radiochemotherapy.

Methods

We performed a randomized double blind, placebo controlled pilot study in 33 patients. 30 g of glutamine, average dose 0.41 g/kg (SD = 0.07) g/kg/day was administered orally in three doses per day for five weeks during preoperative radiochemotherapy of rectal cancer. 30 g of maltodextrin was given as placebo. Body weight was measured and NRS 2002 screening was performed before and after treatment. Bowel function was evaluated by stool consistency and frequency. Plasma levels of inflammatory parameters and hormones were measured.

Results

There was no difference between groups in frequency and severity of diarrhoea during radiochemotherapy (p = 0.5 and p = 0.39 respectively), insulin levels significantly increased in both groups, IL-6 only in glutamine group.

Conclusion

Results of this small pilot study in rectal cancer patients receiving preoperative radiochemotherapy, showed that ingestion of larger quantities of glutamine given more often as previously reported did not diminish the incidence and severity of diarrhoea and did not affect inflammatory and metabolic activity compared to the placebo treatment with maltodextrin.     

Rapeseed and milk protein exhibit a similar overall nutritional value but marked difference in postprandial regional nitrogen utilization in rats

Background

Rapeseed is an emerging and promising source of dietary protein for human nutrition and health. We previously found that rapeseed protein displayed atypical nutritional properties in humans, characterized by low bioavailability and a high postprandial biological value. The objective of the present study was to investigate the metabolic fate of rapeseed protein isolate (RPI) and its effect on protein fractional synthesis rates (FSR) in various tissues when compared to a milk protein isolate (MPI).

Methods

Rats (n = 48) were given a RPI or MPI meal, either for the first time or after 2-week adaptation to a MPI or RPI-based diet. They were divided in two groups for measuring the fed-state tissue FSR 2 h after the meal (using a flooding dose of ¹³C-valine) and the dietary N postprandial distribution at 5 h (using ¹⁵N-labeled meals).

Results

RPI and MPI led to similar FSR and dietary nitrogen (N) losses (ileal and deamination losses of 4% and 12% of the meal, respectively). By contrast, the dietary N incorporation was significantly higher in the intestinal mucosa and liver (+36% and +16%, respectively) and lower in skin (-24%) after RPI than MPI.

Conclusions

Although RPI and MPI led to the same overall level of postprandial dietary N retention in rats (in line with our findings in humans), this global response conceals marked qualitative differences at the tissue level regarding dietary N accretion. The fact that FSR did not however differed between groups suggest a differential modulation of proteolysis after RPI or MPI ingestion, or other mechanisms that warrant further study.     

Oral citrulline does not affect whole body protein metabolism in healthy human volunteers: results of a prospective, randomized, double-blind, cross-over study

Background & aims

Citrulline increases protein synthesis during refeeding in rodents with short bowel syndrome, aging and malnutrition, and improves nitrogen balance in fed healthy humans. The aim of the current study therefore was to determine whether citrulline had affected protein metabolism in healthy volunteers.

Methods

In a randomized, double-blind, cross-over study, 12 healthy adults received a 5-h intravenous infusion of L-[1-¹³C]-leucine in the post-absorptive state, after a 7-day oral supplementation with 0.18 g/kg/day citrulline, or an iso-nitrogenous placebo. Treatment order was randomized, treatment periods were separated by 13-day wash out. Leucine appearance rate (Ra) was determined from plasma [1-¹³C]-keto-iso-caproate enrichment and leucine oxidation from expired ¹³CO₂, and nitrogen balance was estimated from 6-h urinary urea excretion.

Results

Compared with placebo, oral citrulline supplementation increased plasma citrulline, arginine and ornithine concentrations, but failed to affect albumin, transthyretin, free insulin and insulin-like growth factor (IGF)-1 plasma concentrations, urinary nitrate excretion, or nitrogen balance. Citrulline supplementation did not alter leucine Ra, leucine oxidation, nor whole-body protein synthesis.

Conclusion

In healthy, well nourished volunteers, oral citrulline increases plasma citrulline and arginine availability but does not affect whole-body protein kinetics in the post-absorptive state.     

Postprandial protein metabolism but not a fecal test reveals protein malabsorption in patients with pancreatic exocrine insufficiency

Background & aims

Pancreatic exocrine insufficiency (PEI) impairs fat absorption, but few data are available on protein absorption. We investigated this question in patients with chronic pancreatitis, both in the absence and presence of enzyme therapy, using a stable isotope sensitive method.

Methods

Eleven patients with sustained PEI and regular enzyme substitution were investigated at hospital, after a washout period without enzyme substitution, and later after reintroduction of substitution. The digestibility and postprandial metabolism of dietary protein were characterized after the ingestion of a semi-synthetic single meal containing 20 g ¹⁵N-labeled casein.

Results

At baseline, 20 ± 8% of dietary nitrogen was transferred to the metabolic pools vs. 24.5 ± 7% under enzyme treatment (P = 0.04). After treatment, the transfer of dietary nitrogen tended to increase in plasma amino acids, and increased significantly in plasma proteins and the deamination pool. In contrast, the fecal excretion of dietary nitrogen did not demonstrate any treatment effect. In patients not receiving insulin for diabetes, the treatment stimulated insulin secretion.

Conclusions

Protein malabsorption was mostly undetectable using standard fecal tests. The study of the postprandial fate of dietary protein revealed a moderate increase of its transfer to metabolic pools after enzyme substitution.     

Oral sensitivity to oleic acid is associated with fat intake and body mass index

Background & aims

Taste sensitivity to fatty acids influences food ingestion and may regulate fat intake and body weight status. Fatty acids are detected via homologous receptors within the mouth and gastrointestinal (GI) tract, where attenuated sensitivity may be associated with greater fat intake and BMI. This study aimed to extend observations surrounding fatty acid taste, specifically the types of foods consumed and dietary behaviours that may be associated with fatty acid taste sensitivity.

Methods

51 subjects (41 female; BMI, 21.4 ± 0.46 kg/m², age, 20 ± 0.52 yrs, 10 male; BMI, 23.6 ± 1.4 kg/m², age, 22 ± 1 yrs) were screened for oral sensitivity to oleic acid (3.8 mM) using triplicate sensory evaluations, and classified as hypersensitive; (3/3 correct identifications), or hyposensitive, (<3/3). Fat-taste perception (using sensory-matched custards made with 0, 2, 6, 10% oil), recent diet (4-day diet record) and food habits and behaviours (food habits and behaviours questionnaire) were also established.

Results

75% (n = 38) of subjects were classified as hyposensitive to oleic acid and these subjects differed from those who were classified as hypersensitive. Hyposensitive subjects consumed significantly more energy, fat, saturated fat, fatty foods (butter, meat, dairy), had greater BMI and were less perceptive of small changes in the fat content of custard (all P < 0.05), compared to hypersensitive subjects.

Conclusion

An inability to perceive low concentrations of fatty acids in foods was associated with greater consumption of fatty foods, specifically butter, meat, dairy, and increasing BMI.     

Aging does not impair the anabolic response to a protein-rich meal

BACKGROUND: Sarcopenia is a debilitating condition afflicting the elderly that may be facilitated by insufficient or ineffectual intake of dietary protein. We previously showed that free-form essential amino acids acutely stimulate muscle protein synthesis in both the young and the elderly. However, the ability of an actual protein-rich food to stimulate anabolism in the young and the elderly has not been explored. OBJECTIVE: We aimed to characterize changes in plasma amino acid concentrations and to quantify muscle protein synthesis in healthy young (41 +/- 8 y old; n = 10) and elderly (70 +/- 5 y old; n = 10) persons after ingestion of a 113-g (4-oz) serving of lean beef. DESIGN: Venous blood samples and vastus lateralis muscle biopsy samples were obtained during a primed (2.0 mumol/kg) constant infusion (0.08 mumol.kg(-1).min(-1)) of l-[ring-(13)C(6)] phenylalanine. Plasma amino acid concentrations were measured and a mixed-muscle fractional synthesis rate (FSR) was calculated during the premeal period and for 5 h after beef ingestion. RESULTS: Mixed-muscle FSR increased by approximately 51% in both the elderly (mean +/- SE measurements: 0.072 +/- 0.004%/h and 0.108 +/- 0.006%/h before and after the meal, respectively) and the young (0.074 +/- 0.005%/h and 0.113 +/- 0.005%/h before and after the meal, respectively) after beef ingestion (P < 0.001). Plasma amino acid concentrations peaked at approximately 100 min after beef ingestion in both age groups but were substantially higher in the elderly (2185 +/- 134 nmol/mL compared with 1403 +/- 96 nmol/mL; P < 0.001). CONCLUSION: Despite differences in the concentration of amino acids in the plasma precursor pool, aging does not impair the ability to acutely synthesize muscle protein after ingestion of a common protein-rich food.     

Effect of essential amino acid supplementation on quality of life, amino acid profile and strength in institutionalized elderly patients

Background & aims

This study assessed the efficacy of supplemented essential amino acids on depressive symptoms, nutrition, muscle function, daily physical activity, and health-related quality of life (HRQoL) of institutionalized elderly patients.

Methods

Forty-one patients (58.5% women; mean age 79.8 yrs) with sequelae of coronary artery disease (73%), femoral fracture (34%), were randomly assigned to receive oral essential amino acids 4 gr 2 times a day for 8 weeks or isocaloric placebo. Before randomization and 8 weeks after the protocol started, the following variables were measured: depressive symptoms (Geriatric Depression Scale, GDS), nutritional panel (Mini Nutritional Assessment, MNA; serum albumin and prealbumin levels), muscle strength (Hand Grip, HG), Activity Daily Life (ADL), Quality of Life (SF-36, HRQoL) and amino acid profile.

Results

Compared with the placebo group, EAA patients improved nutrition (MNA score 22.6 ± 1.5 post vs 21.8 ± 1.6 pre; p < 0. 04, albumin g/dl 4.04 ± 0.35 post vs 3.88 ± 0.3 pre; p < 0.01), GDS(score 10.3 ± 1.75 post vs 13.85 ± 3.37 pre; p < 0.001), HG (Kg 19.75 ± 1.7 post vs 18.68 ± 1.36 pre; p = 0.001), ADL (p < 0.04) and both physical and mental components of SF-36 (p < 0.002).

Conclusions

Oral supplementation with essential amino acids improved several determinants of quality of life in institutionalized elderly patients, including depressive symptoms, nutrition, muscle function and daily life activity.     

Development and validation of a nutrition screening tool for hospitalized cancer patients

Background & aims

Although various nutrition screening tools are used, they are not specific for the screening of malnourished cancer patients. The objective of this study was to develop a nutrition screening tool that could be used to identify cancer patients at risk for malnutrition.

Methods

Of 3010 cancer patients admitted to the National Cancer Center of Korea between April 1 and June 2, 2008, the nutritional status of 1057 patients was assessed by the Scored Patient-Generated Subjective Global Assessment (PG-SGA). Variables used in current nutrition screening tools were analyzed to select indices for a developing malnutrition screening tool for cancer patients (MSTC). The equation for the MSTC was established using receiver operating characteristics curves. Sensitivities and specificities of the MSTC were calculated using the PG-SGA as gold standard.

Results

The MSTC was calculated as follows: [MSTC = −0.116 + (1.777 × intake change) + (1.304 × Eastern Cooperative Oncology Group performance status) + (1.568 × weight loss) + (−0.187 × body mass index)]. The MSTC had a sensitivity of 94.0%, a specificity of 84.2%, and high agreement (κ = 0.70, P < 0.0001) with the PG-SGA.

Conclusions

The MSTC appears to be a valid nutrition screening tool for determining nutritional risk in hospitalized cancer patients.     

Underreporting of Energy Intake in Brazilian Women Varies According to Dietary Assessment: A Cross-Sectional Study Using Doubly Labeled Water

Objective

Underreporting of energy intake is prevalent in food surveys, but there is controversy about which dietary assessment method provides greater underreporting rates. Our objective is to compare validity of self-reported energy intake obtained by three dietary assessment methods with total energy expenditure (TEE) obtained by doubly labeled water (DLW) among Brazilian women.

Design

We used a cross-sectional study.

Subjects/setting

Sixty-five females aged 18 to 57 years (28 normal-weight, 10 overweight, and 27 obese) were recruited from two universities to participate.

Main outcome measures

TEE determined by DLW, energy intake estimated by three 24-hour recalls, 3-day food record, and a food frequency questionnaire (FFQ).

Statistical analyses performed

Regression and analysis of variance with repeated measures compared TEE and energy intake values, and energy intake-to-TEE ratios and energy intake−TEE values between dietary assessment methods. Bland and Altman plots were provided for each method. χ² test compared proportion of underreporters between the methods.

Results

Mean TEE was 2,622 kcal (standard deviation [SD]=490 kcal), while mean energy intake was 2,078 kcal (SD=430 kcal) for the diet recalls; 2,044 kcal (SD=479 kcal) for the food record and 1,984 kcal (SD=832 kcal) for the FFQ (all energy intake values significantly differed from TEE; P<0.0001). Bland and Altman plots indicated great dispersion, negative mean differences between measurements, and wide limits of agreement. Obese subjects underreported more than normal-weight subjects in the diet recalls and in the food records, but not in the FFQ. Years of education, income and ethnicity were associated with reporting accuracy.

Conclusions

The FFQ produced greater under- and overestimation of energy intake. Underreporting of energy intake is a serious and prevalent error in dietary self-reports provided by Brazilian women, as has been described in studies conducted in developed countries.     

Public awareness of colorectal cancer and screening in a Spanish population

Objectives

To investigate screening intentions and previous uptake of colorectal cancer (CRC) screening tests in a general population in Spain; and to determine knowledge about CRC, risk perceptions, major barriers to screening and perceived benefits of screening.

Study design

Cross-sectional study.

Methods

Six hundred consecutive Spanish individuals over 50 years of age completed a questionnaire to determine their screening intentions, previous CRC diagnostic procedures, and knowledge about screening procedures, risk factors for CRC, 5-year prognosis, warning signs and symptoms, incidence, age-related risk and perceived barriers to screening.

Results

Although 78.8% of subjects reported that they were willing to participate in CRC screening, only 12% had ever undergone a screening test, and none with screening intention. Awareness of a breast cancer screening test [odds ratio (OR) 1.67, 95% confidence interval (CI) 1.04–2.70; P = 0.035], visiting a general practitioner in the preceding year (OR 3.08, 95% CI 1.86–5.08; P < 0.0001), awareness of risk factors (OR 2.32, 95% CI 1.49–3.61; P < 0.001), awareness of CRC signs or symptoms (OR 1.65, 95% CI 1.03–2.64; P = 0.04) and belief in the efficacy of CRC screening (OR 8.85, 95% CI 1.53–51.3; P = 0.01) were independent predictors for intention to participate in CRC screening. The most common reasons given for refusing screening were ‘CRC tests might be dangerous’ (28.2%), ‘CRC tests might be painful’ (17.9%) and ‘feeling healthy’ (16.2%).

Conclusion

Although reported willingness to undergo CRC screening was high, CRC knowledge and actual uptake of CRC screening were low. An educational intervention to reduce barriers and increase awareness could improve uptake of CRC screening.     

Protein Redistribution From Skeletal Muscle to Splanchnic Tissue on Fasting and Refeeding in Young and Older Healthy Individuals

BackgroundDuring aging, a shift of protein metabolism from muscle to splanchnic tissue contributes to increased muscle protein loss after a period of metabolic stress (eg, fasting).ObjectiveTo study the adaptation of protein metabolism in the whole body and tissue (ie, skeletal muscle and splanchnic area) to metabolic stress, such as short-term fasting and refeeding, in aged people.Design and participantsWe studied splanchnic and muscle protein metabolism after 38 hours of fasting and refeeding in 7 young (5 men/2 women, 24.4 ± 2.0 years) and 8 elderly individuals (6 men/2 women, 70.6 ± 3.1 years).MeasurementsWe used intravenous (IV) L-[¹³C₆]phenylalanine, IV L-[²H₃]leucine, and oral L-[¹³C₁]leucine to obtain (1) whole-body protein kinetics, (2) muscle and albumin fractional synthesis rate (FSR, %/d; ¹³C₆-Phe, and ¹³C₁-Leu), and (3) splanchnic extraction during fasting and refeeding (%, ²H₃- and ¹³C₁-Leu).ResultsWhole-body protein breakdown was activated during fasting in young and older individuals (P < .01 vs fasted state). Muscle FSR remained unchanged in both groups and not stimulated by refeeding in either group with either IV ¹³C Phe or oral ¹³C Leu, probably because of high plasma levels of essential amino acids (EAAs) and branched-chain amino acids (BCAAs). Splanchnic extraction of leucine was 42% higher in the elderly individuals (P = .03 vs young) and was associated with an increased albumin synthesis rate in elderly individuals in the fed state (P < .05 vs young).ConclusionSplanchnic protein metabolism is modified by age, but this metabolic change is not associated with a lower synthesis rate of muscle protein, provided high plasma levels of essential EAAs are maintained. Our data also suggest that splanchnic protein synthesis is a metabolic priority during recovery after metabolic stress in healthy elderly persons and that it might be even more affected in polymedicated older individuals having chronic diseases.     

Reducing glucose infusion safely prevents hyperglycemia in post-surgical children

Background & aims

To investigate the effects of two different glucose infusions on glucose homeostasis and amino acid metabolism in post-surgical children.

Methods

This randomized crossover study evaluated glucose and amino acid metabolism in eight children (age 9.8 ± 1.9 months, weight 9.5 ± 1.1 kg) admitted to a pediatric intensive care unit in a tertiary university hospital after surgical correction for non-syndromal craniosynostosis. Patients were randomized to receive low (LG; 2.5 mg kg⁻¹ min⁻¹) and standard (SG; 5.0 mg kg⁻¹ min⁻¹) glucose infusion in a crossover setting. After a bolus (4 g kg⁻¹) of deuterium oxide, we conducted a primed, constant, 8 h tracer infusion with [6,6-²H₂]Glucose, [1-¹³C]Leucine, [ring-²H₅]Phenylalanine and [3,3-²H₂]Tyrosine.

Results

SG resulted in hyperglycemia (defined as > 6.1 mmol L⁻¹), while during LG plasma glucose levels were normoglycemic (5.9 ± 0.6 vs. 7.5 ± 1.7 mmol L⁻¹; LG vs. SG respectively, p = 0.02). Hypoglycemia did not occur during LG infusion. Endogenous glucose production was not fully suppressed during the hyperglycemic state under SG and increased with reduced glucose infusion (2.6 ± 1.5 vs. 1.1 ± 1.4 mg kg⁻¹ min⁻¹; LG vs. SG; p = 0.05). Whole body protein balance derived from leucine and phenylalanine kinetics was slightly negative but not further affected with a decrease in glucose infusion.

Conclusions

The current recommended glucose infusion induces hyperglycemia in post-surgical children. A reduced glucose infusion safely reduced high glucose levels, while children were capable to sustain normoglycemia with increased endogenous glucose production. The reduced glucose infusion did not exacerbate the mild catabolic state in which the patients were.     

Associations between the macronutrient composition of the evening meal and average daily sleep duration in early childhood

Background & aims

Short sleep duration in early childhood may increase the risk for chronic diseases in later life. Strategies to improve sleep duration are thus of interest. We investigated whether the nutritional composition of the evening meal is associated with children’s sleep duration in the 2nd year of life.

Methods

Multivariable regression models included 594 participants of the DONALD Study with 3-days weighed dietary records and average daily sleep duration at age 1.5 and 2 years.

Results

Higher energy intakes with the evening meal were associated with a longer sleep duration (1 min/10 kcal, p = 0,01). With respect to absolute intakes, carbohydrates (0.8 min/g, p < 0.0001), especially from high GI foods (1.3 min/g, p < 0.01), and a higher GL (1.5 min/g GL, p < 0.01) were accompanied by longer sleeping time. A qualitative exchange of energy from protein by energy from carbohydrates from high GI foods was only associated with increased sleep duration in toddlers without (1.9 min/%E, p < 0.05), but not with nightly eating occasions (p > 0.4).

Conclusions

The observed associations are in line with suggested sleep-improving effects of carbohydrates. Effect sizes suggest that the clinical relevance of nutritional composition for sleep duration is limited in healthy young toddlers. These observations and their possible importance for more vulnerable groups need to be confirmed in clinical trials.     

Evaluation of the knowledge of primary healthcare patients in Poland on the prevention of hypertension: a community study

Objectives

To investigate the knowledge of Poles on the prevention of arterial hypertension (HT) and identify the main souces of knowledge in order to make health promotion activities more effective, and thus increase the efficiency and efficacy of the Polish healthcare system.

Study design

Community study.

Methods

This questionnaire study included 180 subjects (120 primary healthcare patients without a history of diagnosed HT and 60 primary care physicians).

Results

The knowledge of most surveyed patients was insufficient (43%, n = 52) or sufficient (40%, n = 48) for the effective prevention of HT; 17% (n = 20) of the respondents had knowledge that was definitely sufficient, and none of the respondents had knowledge that was definitely insufficient. The patients reported that primary care physicians were the most common source of health information (67%, n = 80). Primary care physicians were also the most trusted source of information.

Conclusions

Patients’ knowledge on smoking, diet and exercise is sufficient for the effective prevention of HT. The areas of insufficient knowledge for the development of HT and possible organ complications are drinking alcohol, stress, genetic factors and diabetes.     

Effects of Modified Adeli Suit Therapy on Improvement of Gross Motor Function in Children With Cerebral Palsy

Objective

This study aimed to investigate the effects of the Modified Adeli suit therapy (MAST) on improvement of gross motor function in children with cerebral palsy (CP).

Methods

Thirty-six children with CP assigned by match pairs to three equal groups such as the MAST, the AST, and the Neurodevelopmental Treatment. They were treated for 4 weeks, 2 hr/d, 5 d/wk. All children were tested by the Gross Motor Function Measure (GMFM) at baseline, immediately before and 16 weeks after treatments.

Results

All groups had improvement in the GMFM after treatment (p < .01) and there were significant differences among groups (p < .01). In the follow-up study, no significant improvement in the GMFM was seen within groups (p > .05), but again there were significant differences among groups (p < .01).

Conclusion

The MAST was more effective than using either the AST or the Neurodevelopmental treatment on improvement of gross motor function in children with CP after treatment and at follow-up.     

Plasma Amino Acid Concentrations Are Associated with Muscle Function in Older Japanese Women

Background

Although several previous studies have found benefits for amino acid supplementation in terms of muscle function, the role of plasma amino acid concentrations on sarcopenia are not well addressed yet.

Objective

The aim of this study was to compare the amino acid concentrations at each stage of sarcopenia (normal, pre-sarcopenia, dynapenia, and sarcopenia) in community-dwelling older Japanese adults. Setting and Subjects: Community-dwelling older Japanese women (n=232, 79.4±7.0 years) participated in this study.

Measurements

We measured plasma amino acid concentrations, 5-m walking speed, grip strength, and skeletal muscle mass using a bioelectrical impedance data acquisition system and compared them among participants at each stage of sarcopenia.

Results

The proportions of normal, pre-sarcopenia, dynapenia, and sarcopenia patients were 40.5% (n=94), 12.1% (n=28), 26.3% (n=61), and 21.1% (n=49), respectively. Significant differences were observed for concentrations of leucine, branched-chain amino acid (BCAAs), and essential amino acid (EAAs) among the four groups (p<0.05), and the dynapenia and sarcopenia groups showed significantly lower concentrations of leucine than the normal group (p<0.05).

Conclusions

This study indicated a positive relationship between plasma leucine, BCAA and EAA concentrations and muscle function. A longitudinal study is needed to determine the causal relationship between leucine/BCAA concentrations and muscle function.

     

Rural and urban differences in the associations between characteristics of the community food environment and fruit and vegetable intake

Objective

To examine the relationship between measures of the household and retail food environments and fruit and vegetable (FV) intake in both urban and rural environmental contexts.

Design

A cross-sectional design was used. Data for FV intake and other characteristics were collected via survey instrument and geocoded to the objective food environment based on a ground-truthed (windshield audit) survey of the retail food environment.

Setting

One urban and 6 contiguous rural counties.

Participants

This study involved 2,556 residents of the Brazos Valley, Texas, who were selected through random-digit dialing.

Main Outcome Measure

Two-item scale of FV intake.

Analysis

Data were analyzed using chi-square analysis, 2-sample t tests, and linear regression.

Results

Distance to supermarket or supercenter was insignificant in the urban model, but significant in the rural model (β = -.014, P < .010, confidence interval = -.024, -.003).

Conclusions and Implications

Retail food environments have different impacts on FV intake in urban and rural settings. Interventions to improve FV intake in these settings should account for the importance of distance to the retail food environment in rural settings.     

Teignes du nourrisson en Tunisie

Objective

The aim of the study was to specify the epidemiological, clinical, and mycological particularities of tinea capitis in infants.

Design

We retrospectively collected data from the files of 245 infants presenting with tinea capitis, followed in the Hedi-Chaker hospital dermatology department and in two mycology laboratories of the Sfax hospital, between January 1995 and December 2006. We collected the epidemiological, clinical, and mycological data for each patient.

Results

We included 137 boys and 108 girls with trichophytic tinea in 62 % of cases and microsporic tinea in 34 % of cases. Trichophyton violaceum and Microsporum canis were identified by culture respectively in 51 and 37 % of cases.

Conclusion

Tinea capitis is frequent observed in our region, Trichophyton violaceum and Microsporum canis are the most frequent mycological agents.