Combined influence of healthy diet and active lifestyle on cardiovascular disease risk factors in adolescents

To investigate the combined influence of diet quality and physical activity on cardiovascular disease (CVD) risk factors in adolescents, adolescents (n = 1513; 12.5–17.5 years) participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence study were studied. Dietary intake was registered using a 24‐h recall and a diet quality index was calculated. Physical activity was assessed by accelerometry. Lifestyle groups were computed as: healthy diet and active, unhealthy diet but active, healthy diet but inactive, and unhealthy diet and inactive. CVD risk factor measurements included cardiorespiratory fitness, adiposity indicators, blood lipid profile, blood pressure, and insulin resistance. A CVD risk score was computed. The healthy diet and active group had a healthier cardiorespiratory profile, fat mass index (FMI), triglycerides, and high‐density lipoprotein cholesterol (HDL‐C) levels and total cholesterol (TC)/HDL‐C ratio (all P ≤ 0.05). Overall, active adolescents showed higher cardiorespiratory fitness, lower FMI, TC/HDL‐C ratio, and homeostasis model assessment index and healthier blood pressure than their inactive peers with either healthy or unhealthy diet (all P ≤ 0.05). Healthy diet and active group had healthier CVD risk score compared with the inactive groups (all P ≤ 0.02). Thus, a combination of healthy diet and active lifestyle is associated with decreased CVD risk in adolescents. Moreover, an active lifestyle may reduce the adverse consequences of an unhealthy diet.     

Semen quality changes among 2343 healthy Slovenian men included in an IVF-ET programme from 1983 to 1996

To determine whether semen quality in Slovenians has changed over 14 years (1983-96), we analysed retrospectively the semen of 2343 healthy men with a normal spermiogram, who were partners of women with tubal infertility included in the IVF-ET programme. Age at semen collection, duration of sexual abstinence, semen volume, sperm concentration, total sperm count, percentage of spermatozoa with progressive motility, and normal morphology were determined. Multiple regression analysis was used to assess the changes in sperm characteristics according to the year of semen collection, year of the man's birth and the duration of sexual abstinence. Semen volume, sperm concentration, sperm count and total sperm motility did not change between 1983 and 1996, whereas between 1988 and 1996 rapid progressive sperm motility decreased by 0.95% per year (p < 0.0001). Semen volume, sperm concentration, and sperm count increased with duration of sexual abstinence. After adjustment for the year of semen collection and duration of sexual abstinence, multiple regression analysis showed that sperm concentration decreased by 0.67% per each successive year of birth (p = 0.03). Thus the sperm concentration decreased from 87.6 x 10(6)/mL in men born in the 1940s to 77.3 x 10(6)/mL in those born between 1956 and 1960. After 1960, sperm concentration was found to increase. In 2343 healthy men, no decline in semen quality, except in rapid progressive motility, was observed in the study period. Lower sperm concentration was found among men born between 1950 and 1960. This could be related to worse socio-economic status, stress or negative environmental factors in this time period.     

Breastfeeding in infancy is not associated with inflammatory status in healthy adolescents

It has been suggested that breast-feeding (BF) may be associated with a decreased risk of cardiovascular disease in adulthood. A low-grade inflammation is associated with an increased risk of cardiovascular disease, even in apparently healthy children. The objective of this study was to assess the potential modulating effect of BF on the inflammatory status of healthy adolescents. Information on BF (duration) was obtained from parental records in 484 of 1040 healthy European urban adolescents (56.4% females) that had a blood sample obtained as part of the Healthy Lifestyle in Europe by Nutrition and Adolescence study. Blood serum inflammatory markers were measured, including high sensitivity C-reactive protein, complement factors 3 and 4, ceruloplasmin, adhesion molecules (L-selectin and soluble endothelial selectin, soluble vascular cell adhesion molecule 1, and intercellular adhesion molecule 1), cytokines, TGFβ1, and white blood cells. After univariate analysis, a propensity score, including the potential confounding factors, was computed and used to assess the association between BF and selected inflammatory markers. BF was not significantly associated with any of the selected inflammatory markers after adjustment for gender and propensity score. In our study, BF was not associated with low-grade inflammatory status in healthy adolescents, suggesting that the potential cardiovascular benefits of BF are related to other mechanisms than modulation of inflammation or might become relevant at a later age. Groups at high risk for cardiovascular disease should be a target for further research concerning the effects of BF.     

Breakpoint: Left Main Stent Fracture—Review of the Literature

The incidence and morbidity associated with stent fracture are unknown. Recommendations and evidence-based treatment are lacking. We report a case of symptomatic fracture of a sirolimus-eluting stent advancing from the left main into the circumflex coronary artery, forming an acute angle with calcifications at the hinge point; the literature is reviewed and treatment options are discussed.     

Analysis of Transferrin and α1-Fetoprotein in Amniotic Fluid and Neonatal Serum: a Possible Means for Indirect Prenatal Diagnosis of the Carbohydrate-deficient Glycoprotein Syndrome

A new type of inborn error of glycoprotein metabolism has recently been identified (CDG syndrome). The disease has systemic manifestations but mainly involves the nervous system. The most striking biochemical abnormality is the presence of secretory glycoproteins that are partially deficient in their carbohydrate moieties, the most pronounced of which is seen in serum transferrin. The basic genetic defect of the syndrome has not yet been identified. This study was carried out in order to provide a basis for indirect prenatal diagnosis by qualitative and quantitative analyses of a corresponding carbohydrate-deficiency in transferrin and also in α¹-fetoprotein in amniotic fluid. On isoelectric focusing both glycoproteins normally showed a carbohydrate (sialic acid (-dependent microheterogeneity in amniotic fluid as well as in neonatal serum which in transferrin differed from adult serum. Reference values of total transferrin (TT) and carbohydrate-deficient isotransferrins (CDT) during gestation were determined. Analysis of the microheterogenity of these glycoproteins by isoelectric focusing or determination of the CDT/TT ratio in amniotic fluid might provide a possibility for prenatal diagnosis of this syndrome. It was also shown that neonatal diagnosis is possible by analysis of serum transferrin.     

Hepatic Sarcoidosis with Portal Hypertension. A Report of Seven Cases with a Review of the Literature

We have reviewed the clinical, histological and hemodynamicfeatures of sarcoidosis complicated by portal hypertension inseven patients and in 40 previously reported cases. Young blackpatients of either sex and white females over 40 years wereselectively affected. In 12 of these 47 patients, portal hypertensionappeared to be a consequence of cirrhosis due to longstandingintrahepatric cholestasis; in white patients, this conditionwas clinically, histologically, and serologically indistinguishablefrom primary biliary cirrhosis. In most of the other patients,portal hypertension was the predominant and often the presentingsymptom of hepatic sarcoidosis; in these patients portal hypertensionwas due to a presinusoidal block probably determined by portalgranulomas, with or without superimposed sinusoidal block determinedby fibrosis. Corticosteroids did not prevent the developmentof portal hypertension.