Eating behaviour, insulin resistance and cluster of metabolic risk factors in European adolescents. The HELENA study

The present study examined the associations of food behaviours and preferences with markers of insulin resistance and clustered metabolic risk factors score after controlling for potential confounders, including body fat in European adolescents. A cross-sectional study "Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study" of 3546 European adolescents aged 12.5-17.5 years was conducted, using a complete dataset on at least glucose, insulin and "Food Choice Questionnaire". Results indicated skipping breakfast, as well as the preference of some foods such as nuts, chocolate, burgers and pizzas, soft drinks or juices, explain part of homeostasis model assessment index variance. In addition, snacking regularly during school day is associated with higher metabolic risk score in females. In conclusion, the present findings suggest that intervention studies aimed to prevent insulin resistance and metabolic risk factors in youth should focus not only in influencing food and drink preferences, but also to ensure healthy food behaviour in adolescents. The harmful consequences in the choice of certain foods or drinks and food habits can be countered with proper planning and intervention programs to prevent insulin resistance and metabolic risk factors.     

Effects of a chlorhexidine-fluoride-strontium rinsing program on caries, gingivitis and some salivary bacteria among Finnish school children

Abstract – In order to find out if it is possible to prevent caries and gingivitis by periodical use of chlorhexidine-fluoride mouthrinses with or without strontium, and to find out what effects they have on salivary mutans streptococci and lactobacilli counts, a total of 243 schoolchildren aged 11 yr with high DMFS scores were randomly divided into four groups. One group (C) served as a basic control. Subjects in the second group (GXF) rinsed their mouths twice a day every third week with a rinsing solution containing 0.05% chlorhexidine gluconate and 0.04% NaF. In the third group (CXFS) the rinsing solution contained 500 ppm Sr during the first and second year and 15 ppm during the last 6 months, in addition to chlorhexidine and fluoride. In the fourth group (CX) the solution contained only 0.05% chlorhexidine gluconate. All the rinsing solutions had pH 5.8 buffered with succinic acid-NaOH buffer. After 2 yr and 9 months, the mean DMFS (SD) increments in the C, GXF, GXFS, and GX groups were 3.8 (5.7), 2.5 (3.2), 3.5 (4.8), and 3.4 (5.5), respectively. The percentage of subjects with bleeding gingival units had decreased from initial to final values as follows: C, 81–38; GXF, 88–42; GXFS, 89–56; GX, 89–37. The number of lactobacilli and mutans streptococci in saliva remained virtually unchanged throughout the study. For caries increment and gingival bleeding, the differences between groups were not statistically significant. The chlorhexidine-fluoride combination tended to prevent caries, but the effect on gingival bleeding and salivary counts of mutans streptococci and lactobacilli was negligible.     

Mucosa‐associated lymphoid‐tissue lymphoma. Should we perform a colonoscopy in multiorgan involvement?

Mucosa‐associated lymphoid tissue (MALT) lymphoma is the most frequent non‐Hodgkin lymphoma in the gastrointestinal tract, but colon involvement has only been reported in multiorgan lymphoma. We present a rare case of a woman with MALT involvement of eye conjunctiva, tonsils, stomach, duodenum and colon. In selected cases like this, with multiorgan involvement, we recommend performing colonoscopy, with biopsies for immunohistochemistry with CD10 and cyclin D1 for differential diagnosis with other entities with different prognosis, such as follicular lymphoma, and mantle cell lymphoma, respectively.     

MONOCYTE ADHESION TO FIBRONECTIN IN PSORIASIS

Background. After vascular extravasation, mononuclear cells (MNC) undergo chemotaxis and adhesion to extracellular matrix proteins, resulting in their differentiation into macrophages. Although endothelial adhesion and chemotaxis are altered in psoriasis, MNC adhesion to extracellular matrix proteins has not been previously studied in the disease. Since MNC adhesion to endothelial cells is abnormally regulated in psoriasis by TGF-beta, we tested they hypothesis that in psoriasis substance P also regulates the adhesion of monocytes to the extracellular matrix protein fibronectin. Methods. Monocytes from 16 normal controls and 11 psoriatic individuals were isolated and purified using a two-step gradient centrifugation procedure. Adhesion to fibronectin was studied by plating monocyte suspensions onto fibronectin-precoated microtiter plates. The number of adherent cells was quantified by measuring their hex-osaminidase activity. Results. Although statistically significant differences in the basal (unstimulated) adhesion or in the substance P-stimulated adhesion between normal control monocytes and those obtained from psoriatic individuals were not observed, a subpopulation of psoriatics was identified who responded to substance P. Furthermore, this in vitro response to substance P was correlated with the clinical status of the subpopulation which was characterized by unstable psoriasis triggered by stressful life events. Conclusions. The results of this study indicate that priming of monocytes by the extracellular matrix protein fibronectin or by elevated levels of substance P are not critical steps in the pathogenesis of stable, chronic psoriasis. Substance P may contribute to the appearance of new lesions in some individuals with unstable psoriasis.     

Stopping Insulin Treatment in Middle-aged Diabetic Patients with High Postglucagon Plasma C-Peptide

ABSTRACT We studied the successfulness of stopping insulin treatment in middle-aged diabetic patients aged 45–64 with a high postglucagon C-peptide level and the effects of this change on glycaemic control, serum lipids and lipoproteins. Insulin treatment was successfully stopped in 15 of our 22 patients who satisfied the inclusion criteria for the study and were selected on the basis of a computer file including practically all diabetic patients treated with insulin in the Kuopio University Central Hospital region (population base 250000 inhabitants). Insulin therapy was restarted in seven patients during the first 3 months after discharge. During the following 9 months insulin therapy was restarted in another three patients so that after a 1-year follow-up period half of the diabetic patients whose insulin therapy was stopped had been switched back to insulin. Insulin therapy was seldom successfully stopped if the postglucagon C-peptide value was under the limit of 1.0 nmol/l. Glycaemic control did not change during the follow-up, although there was a significant weight loss in diabetic patients. No changes were observed in serum lipids or lipoproteins with the exception of LDL cholesterol, which showed a significant reduction during the 3-month follow-up. In conclusion, insulin therapy can often be successfully stopped in patients with postglucagon C-peptide over the limit of 1.0 nmol/l without worsening of glycaemic control and without unfavourable changes in serum lipid and lipoprotein levels.     

Ultrastructure of a novel anaerobic Gram- positive nonsporing rod from dental root canal

Abstract — A novel anaerobic Gram-positive rod, strain ES4C, was isolated from a dental root canal infection. The isolate did not produce acids from carbohydrates and showed no glycosidase activity. Most biochemical reactions were identical to Clostridium malenominatum with the exception of the production of three aminopeptidases. In addition, no spores were detected. A tetragonally arranged surface layer was consistently found by electron microscopy. The ultrastructure of closely related Eubacterium spp. was also studied, but no crystalline surface structures were found. The physiologic and ultrastructural characteristics of ES4C did not allow identification as any known species. The periapical lesion responded to routine root canal therapy, but after 18 months observation the radiologic signs indicated partial healing only.     

Necrotizing sialometaplasia of the lip simulating squamous cell carcinoma

A case of necrotizing sialometaplasia of the lip in an 68-year-old pipe smoker is described. Necrotizing sialometaplasia is a self-healing non-neoplastic disease probably of ischaemic nature. Thirty-nine cases of sialometaplasia are described in the literature up to early 1979. These cases appeared in the palate, nasal cavity, gingiva, lip, hypopharynx and maxillary sinus. Six cases have also been reported from major salivary glands. Histologically there is necrosis of mucous cells with partial replacement by squamous epithelium. This entity has often been mistaken for squamous or mucoepidermoid carcinoma. One has to be familiar with the existence of necrotizing sialometaplasia in order to avoid subjecting the patient unnecessary and potentially mutilating surgery.