L’évolution des achats alimentaires: 30 ans d’enquêtes auprès des ménages en France

We describe the evolution of the French food consumption in the last thirty years from representative household data. Such microeconomic data can be found in the French food survey (Insee) and in SECODIP panel data. On 1969-2001, the analysis of these data sources allows to have a picture of French food consumption before the implementation of any nutritional prevention program. We observe decreasing purchases in the majority of food groups. Within this trend, we note decreasing purchases of traditional products and at the same time the development of manufactured products. An increasing share of industrial products can be observed for every food group through substitutions between products. The transformation of the structure of food purchases is discussed along with the evolution of the economic environment, changes in lifestyles and in cultural habits in France.     

Abdominal cystic lymphangiomas in children: presurgical evaluation with imaging.

Cystic lymphangiomas are benign vascular tumors which are most often seen in young children. They are considered to be congenital malformations stemming from sequestration of lymphatic tissue. The authors report 15 cases of abdominal location and detail the findings of imaging in the etiologic and topographic diagnosis of these lesions. The initial incidents were essentially the discovery of a palpable abdominal mass, and more rarely, an acute gastrointestinal complication. There was also one case of prenatal diagnosis. Plain films provide only indirect signs related to the displacement of neighboring organs. Ultrasonography permits the etiologic diagnosis by showing an often voluminous, septated cyst. The intra- or retroperitoneal location of the lesion is sometimes difficult to determine by sonography, in which case CT scanning is usually adequate. For abdominal locations, percutaneous sclerosis is not available, and surgical removal is the only treatment for this disorder. The topography of the lesion and the involvement of retroperitoneal structures is important to determine.     

Sequential cytopunctures during preoperative chemotherapy for primary breast carcinoma. II. DNA flow cytometry changes during chemotherapy, tumor regression, and short-term follow-up.

Between May 1986 and May 1987, 35 primary noninflammatory breast carcinomas (T3N0-N1M0) were studied by means of DNA flow cytometry (FCM-DNA) before and after each of three courses of preoperative chemotherapy (doxorubicin, vincristine, cyclophosphamide, methotrexate, and 5-fluorouracil) to assess initial nuclear DNA content, initial S-phase fraction (SPF), and the impact of chemotherapy on these parameters. Correlations were sought with objective regression and short-term follow-up. Four sequential cytopunctures were performed for cytologic examination and FCM-DNA analyses. Ten tumors were diploid and 25 aneuploid. No significant changes in FCM-DNA parameters during chemotherapy were observed in diploid tumors, and no regression was seen in nine of the ten cases. Among the 25 aneuploid tumors, 10 showed changes in DNA content and/or kinetic parameters. A significant correlation was observed between objective regression and initial FCM-DNA content (P = 0.008), initial SPF (P = 0.004), and changes in FCM-DNA patterns observed during chemotherapy (P = 0.00005). During the follow-up period (range, 27 to 41 months), 13 patients had relapses. Patients with aneuploid tumors were more likely to have relapses (n = 11) than patients with diploid tumors (n = 2), and patients with high SPF were more likely to have relapses than patients with low SPF, but the differences were not significant. Similarly, changes in FCM-DNA parameters were observed more often in patients who had relapses, but, again, the difference was not significant. In 5 of the 13 patients who had relapses, FCM-DNA analyses were performed on cytopunctures of the recurrences: patterns were identical to those observed before treatment even when the primary tumor regressed or showed changes in FCM-DNA parameters during chemotherapy.     

IANA (International Academy on Nutrition and Aging) Expert Group: weight loss and Alzheimer's disease

Weight loss, together with psychological and behavioural symptoms and problems of mobility, is one of the principal manifestations of Alzheimer's disease (AD). Weight loss may be associated with protein and energy malnutrition leading to severe complications (alteration of the immune system, muscular atrophy, loss of independence). Various explanations have been proposed such as atrophy of the mesial temporal cortex, biological disturbances, or feeding behaviours; however, none has been proven. Prevention of weight loss in AD is a major issue. It requires regular follow-up and must be an integral part of the care plan. The aim of this article is to review the present state of scientific knowledge on weight loss associated with AD. We will consider four points: the natural history of weight loss, its known etiological factors, its consequences and the various management options.     

IANA task force on nutrition and cognitive decline with aging

Cognitive impairment can be influenced by a number of factors. The potential effect of nutrition has become a topic of increasing scientific and public interest. In particular, there are arguments that nutrients (food and/or supplements) such as vitamins, trace minerals, lipids, can affect the risk of cognitive decline and dementia, especially in frail elderly people at risk of deficiencies. Our objective in this paper is to review data relating diet to risk of cognitive decline and dementia, especially Alzheimer's disease (AD). We chose to focus our statements on homocysteine-related vitamins (B-vitamins), antioxidant nutrients (vitamins E and C, carotenoids, flavonoids, enzymatic cofactors) and dietary lipids. Results of epidemiological studies may sometimes appeared conflicting; however, certain associations are frequently found. High intake of saturated and trans-unsaturated (hydrogenated) fats were positively associated with increased risk of AD, whereas intake of polyunsaturated and monounsaturated fats were protective against cognitive decline in the elderly in prospective studies. Fish consumption has been associated with lower risk of AD in longitudinal cohort studies. Moreover, epidemiologic data suggest a protective role of the B-vitamins, especially vitamins B9 and B12, on cognitive decline and dementia. Finally, the results on antioxidant nutrients may suggest the importance of having a balanced combination of several antioxidant nutrients to exert a significant effect on the prevention of cognitive decline and dementia, while taking into account the potential adverse effects of these nutrients. There is no lack of attractive hypotheses to support research on the relationships between nutrition and cognitive decline. It is important to stress the need to develop further prospective studies of sufficiently long duration, including subjects whose diet is monitored at a sufficiently early stage or at least before disease or cognitive decline exist. Meta analyses should be developed, and on the basis of their results the most appropriate interventional studies can be planned. These studies must control for the greatest number of known confounding factors and take into account the impact of the standard social determinants of food habits, such as the regional cultures, social status, and educational level.     

HIV protease inhibitors restore impaired T-cell proliferative response in vivo and in vitro: a viral-suppression-independent mechanism

In 99 adults infected with human immunodeficiency virus type 1 (HIV-1) who received highly active antiretroviral therapy (HAART) (including 2 nucleoside analogues and 1 or 2 protease inhibitors) for 1 year, CD4(+) and CD8(+) T cells (including memory and naive subsets) increased similarly among patients with sustained plasma viral load decrease, transient decrease, or no decrease. A linear correlation was observed between the decrease in serum beta(2)-microglobulin concentration (an independent surrogate marker of HIV disease) and the increase in peripheral blood T-cells (CD4(+) and CD8(+)) counts. In vitro, HIV protease inhibitors indinavir and saquinavir (but not nucleoside analogues) enhanced the survival of patients' peripheral blood T cells at doses that are at least 30-fold lower than those required for achieving 90% viral inhibition in the same cultures. This enhanced T-cell survival (which is similar for CD4 and CD8 cells) was associated with a restoration of T-cell proliferative response to immune stimuli. However, neither TCR/CD3-ligation- nor Fas-ligation-triggered apoptosis was affected by either of the 2 protease inhibitors. A reduction in apoptosis observed after prolonged culture of patient T cells in the presence of the protease inhibitors could result from restored T-cell proliferation. These findings explain the discrepancies between virologic and immunologic responses that are increasingly reported in patients receiving HAART, and may provide insights into the pathogenesis of HIV infection.     

Next-Generation Sequencing and Immunohistochemistry as Future Gold Standard of ALK Testing in Lung Cancer?

A recent study examined the use of fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), and next-generation sequencing (NGS) for the detection of EML4-ALK rearrangement in lung cancer. This letter suggests that although NGS offers an opportunity to obtain additional data concerning the molecular mechanisms of cancer and to target oncogenic pathways, it should be considered a supplementary test associated with FISH and IHC combined ALK testing rather than as the new gold standard method.We read with much interest the study by Pekar-Zlotin et al. [1] concerning the use of fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), and next-generation sequencing (NGS) for the detection of EML4-ALK rearrangement in lung cancer. We would like to comment on some issues.First, this study of 51 patients reported a high percentage of ALK-positive/rearranged tumors with a global rate upgraded from 7.8% with FISH alone to 13.7% with the combination of FISH, IHC, and NGS. No multistep oncogenic screening algorithm (i.e., ALK testing in only KRAS and EGFR wild-type tumors for example) leading to a higher ALK rearrangement frequency among the tested samples was reported in the methods. Furthermore, the KRAS and EGFR mutational status of these tumors was not mentioned. This frequency of 13.7% is surprisingly far superior to the 2%–7% reported in lung cancer and, although the authors assume that their cohort may not be representative of their lung cancer population, it remains impressively high [2, 3]. Second, many studies have pointed out a valuable substitution of ALK FISH testing by ALK IHC testing in lung cancer, although some other studies noted discrepancies not only between FISH and IHC but also in the clinical response to crizotinib in both FISH⁺IHC⁻ and FISH⁻IHC⁺ tumors [4, 5].Clinical response to crizotinib therapy was reported in only two of the five discordant cases, that is, in an IHC⁺FISH⁻NGS⁺ patient and in an IHC⁺FISH⁻NGS⁻ patient, without data concerning a third patient who was FISH⁺IHC⁻NGS⁻ [1]. In fact, replacing FISH with IHC would lead to misdiagnosis and inappropriate therapeutic strategy in FISH⁺IHC⁻ patients. Furthermore, the percentages of FISH ALK-rearranged cells were not mentioned, raising questions about true ALK-negative FISH tumors versus ALK FISH borderline tumors (i.e., with a percentage of rearranged cells around the cutoff of 15%).The authors considered NGS the gold standard in ALK testing instead of the U.S. Food and Drug Administration-approved FISH test and reported a high rate of false negativity with FISH. Nevertheless, when looking at the few available data concerning the clinical response of FISH⁻NGS⁺ ALK patients to crizotinib, the superiority of NGS compared with FISH is not evident. Pekar-Zlotin et al. [1] reported a IHC⁺FISH⁻NGS⁻ patient with partial clinical response to crizotinib. Two FISH⁻NGS⁺ ALK patients with no response to crizotinib were reported by Ali et al. [6]. These cases are examples of actual limitations to consider NGS as a new gold standard in ALK testing.To conclude, we agree that NGS offers a great opportunity to obtain additional data concerning the molecular mechanisms of cancer and to target oncogenic pathways in lung cancer. Nevertheless, we think that it should be considered more as a supplementary test associated with FISH and IHC combined ALK testing rather than as the new gold standard method. Faced with technique drawbacks and challenging biopsy samples, this combination of the three methods appears a more effective screening tool in an intent-to-treat strategy.