Cardiovascular causes of sudden unexpected death in children and adolescents (0–17 years)

Background

Little is known about the causes of unexpected death in minors (0–17 years). In young adults an important cause is cardiovascular disease, with primary arrhythmogenic disorders, atherosclerotic events, cardiomyopathies and myocarditis as main contributors. The aim of this autopsy study was to determine the contribution of cardiovascular disease to unexpected death in minors.

Methods and results

In the Netherlands, systematic investigation of all cases of unexplained death in minors was compulsory in a nationwide governmental project during a 15-month period. Autopsies were performed according to a standardised protocol (autopsy rate 85%). A cardiovascular cause of death was found in 13/56 cases (23%). In the group <1 year, the main cardiovascular causes were various congenital defects (n?=?3) and myocarditis (n?=?2). In the 1–9 year group, no cardiovascular causes were found. In the 10–14 year group, hypertrophic cardiomyopathy (n?=?1) and ruptured ascending aortic aneurysm (n?=?1) were among the observed cardiovascular causes. In 14/56 (25%) cases autopsy revealed no structural abnormalities that could explain the sudden death, mostly in the group <1 year.

Conclusion

This national cohort with a high autopsy rate reveals a high incidence (23%) of cardiovascular diseases as the pathological substrate of sudden unexpected death in children. Another high percentage of minors (25%) showed no structural abnormalities, with the possibility of a genetic arrhythmia. These findings underline the importance of systematic autopsy in sudden death in minors, with implications for cardiogenetic screening of relatives.

     

Contribution of lead in soil to children’s lead burden,an update

Abstract

Blood lead levels in children in the USA have dropped dramatically since lead in food, air and drinking water was reduced. In inner cities and older residential areas, increased lead exposure may still be a problem because of dilapidated housing with high lead paint levels. In these areas, at mining sites and around smelters lead levels in soil may be very high. A review of many studies indicates that lead in soil or mine tailings does not make a meaningful contribution to lead absorption by children. The contribution of lead in soil to overall exposure, if any, lies within the variation of the analytical method for blood lead measurements. The results of exposure studies in the pediatric population reviewed in this article do not support exposure predictions for children under 6 years of age based on the US EPA Integrated Exposure Uptake Biokinetic Model (using default parameters or using results obtained with in vitro digestion models). They also do not support predictions based on the percent of solubility of lead in soil (accessibility studies).     

Oligogenic combinations associated with breast cancer risk in women under 53 years of age

Common, but weakly penetrant, functional polymorphisms probably account for most of the genetic risk for breast cancer in the general population. Current polygenic risk models assume that component genes act independently. To test for potential gene-gene interactions, single nucleotide polymorphisms in ten genes with known or predicted roles in breast carcinogenesis were examined in a case-control study of 631 Caucasian women diagnosed with breast cancer under the age of 53 years and 1,504 controls under the age of 53 years. Association of breast cancer risk with individual genes and with two- and three-gene combinations was analyzed. Sixty-nine oligogenotypes from 37 distinct two- and three-gene combinations met stringent criteria for significance. Significant odds ratios (ORs) covered a 12-fold range: 0.5-5.9. Of the observed ORs, 17% differed significantly from the ORs predicted by a model of independent gene action, suggesting epistasis, i.e., that these genes interact to affect breast cancer risk in a manner not predictable from single gene effects. Exploration of the biological basis for these oligogenic interactions might reveal etiologic or therapeutic insights into breast cancer and other cancers.     

Overproduction of an Arabidopsis aldo–keto reductase increases barley tolerance to oxidative and cadmium stress by an in vivo reactive aldehyde detoxification

In this work, we expressed an Arabidopsis thaliana-coded protein (AKR4C9) in transgenic barley to study its enzymatic activity and to enhance the reactive aldehyde neutralizing capacity (part of the oxidative stress tolerance) of transgenic plants. Total leaf protein was extracted from transgenic plants expressing either C or N-terminally His-tagged aldo–keto reductase (AKR) enzyme and purified by affinity chromatography. The Arabidopsis-coded enzyme showed moderate activity against the synthetic reactive aldehyde, glutaraldehyde, and low but detectable enzyme activity against fructose with a low Michaelis–Menten constant (K_m value). Activity of the C and the N-terminally His-tagged AKRs were found to be in the same range. Glutaraldehyde was also tested in vivo by spraying onto the leaves of the plants. The reactive aldehyde tolerance of both wild type and transgenic plants, as well as the general physiological effects of this reactive aldehyde treatment were evaluated. The growth rate was found to decrease in all (both wild type and transgenic) plants. The high AKR-expressing transgenic plants showed a lower respiratory rate, and they also showed higher fresh weight, higher chlorophyll content and photosynthetic activity, indicating a higher reactive aldehyde tolerance. Cadmium (Cd) treatment was also performed to validate this result. Cd caused strong lipid peroxidation; however, the Arabidopsis enzyme lowered the reactive aldehyde content as expected. This is the first report in which kinetic parameters of the fructose reduction by the stress inducible plant AKR enzyme are presented. Furthermore, data on the effects of a reactive aldehyde treatment on intact plants are also provided.     

Uptake and distribution of zinc,cadmium, lead and copper in Brassica napus var. oleífera and Helianthus annus grown in contaminated soils

Brassica napus var. oleifera and Helianthus annus were grown in artificially contaminated soils. Accumulation and translocation of the environmental pollutants zinc, cadmium, lead, and copper, was evaluated in different portions of the plants at two harvesting times. The distribution into the plants of these metal ions, as well as their capacity for contaminant phytoextraction and accumulation was assessed. For this purpose, an analytical method utilizing focused ultrasound employed for extraction and stripping voltammetry for measurement has been optimized and validated for the simultaneous measurement of Zn, Cd, Pb, and Cu in plant extracts.     

Exposure of children to residential magnetic fields in Norway: Is proximity to power lines an adequate predictor of exposure?

The aim of this work was to study the exposure to magnetic fields of children living at different distances from a power line and to evaluate how well theoretical calculations compared with actual exposure. Personal exposure instruments were carried for 24 h by 65 schoolchildren living 28–325 m from a 300 kV transmission line; the current load was 200–700 A. About half of the children attended a school far from the power line, whereas the other half attended a school located about 25 m from the line. Exposure to magnetic fields was analyzed for three categories of location: at home, at school, and at all other places. Time spent in bed was analyzed separately. The results indicated that children who lived close to a power line had a higher magnetic field exposure than other children. The power line was the most important source of exposure when the magnetic field due to the line was greater than about 0.2 μT. Exposure at school influenced the 24 h time-weighted average results considerably in those cases where the distance between home and power line was very different from the distance between school and power line. The calculated magnetic field, based on line configuration, current load, and distance between home and power line, corresponded reasonably well with the measured field. However, the correlation depends on whether home only or 24 h exposure is used in the analysis and on which school the children attended. The calculated magnetic field seems to be a reasonably good predictor of actual exposure and could be used in epidemiological studies, at least in Norway, where the electrical system normally results in less ground current than in most other countries. Bioelectromagnetics 18:47–57, 1997. © 1997 Wiley-Liss, Inc.     

Self-perception of self-regulatory skills in children with attention-deficit/hyperactivity disorder aged 8–10 years

Several studies have reported a characteristic "positive illusory bias" in the self-evaluation of children with ADHD. However, results are controversial. The aim of the present study was to investigate whether children with ADHD aged 8 to 10 years can rate their self-regulatory skills accurately when assessed with an age appropriate instrument. Twenty-seven children with ADHD and 27 matched normal control children completed the Self-rating Scale of Self-regulatory Function (SelfReg), a new rating scale that has been specifically designed for this age group. As expected, children with ADHD rated themselves significantly more dysfunctional than control children. In most domains, self-ratings of children with ADHD did not diverge from parent and teacher ratings to a greater extent than self-ratings of control children, although overall results indicated a moderate tendency toward a positive bias. When a cluster analysis based on discrepancies between children's and adults' evaluations was carried out, three groups with different self-rating patterns emerged: A "positive bias" group containing exclusively children with ADHD, a "negative bias" group containing both children with ADHD and control children, and the largest group of accurate self-raters which also included children from both diagnostic groups. It is concluded that overly positive self-judgments are not a ubiquitous finding in ADHD, but may be confined to a specific subgroup of children whose specific characteristics remain to be determined.     

Changes in and Patterns of Smoking Exposure in an Elderly Urban Population in Beijing: 2001–2010

Objective

The study aims to explore the patterns and changes of active and passive smoking in the elderly population.

Methods

Two cross-sectional surveys with representative samples of urban populations, aged between 60 and 95 years old, were conducted in 2001 and 2010 in Beijing. A current smoker was defined as a person who smoked a tobacco product at the time of the survey, and a passive smoker was defined as a person who had been exposed to smoke exhaled by a smoker for more than 15 minutes per day more than once per week.

Results

A total of 2,277 participants in 2001 and 2,102 participants in 2010 completed the survey. The current smoking prevalence changed slightly in males (24.7 vs. 21.2%, P = 0.081), while the prevalence in females decreased significantly from 8.8% (95% CI: 7.3–10.3%) in 2001 to 4.1% (95% CI: 3.0–5.2%) in 2010 (P<0.001). The prevalence of passive smoking was 30.5% (95% CI: 28.6–32.4%) in 2001 and 30.0% (95% CI: 28.1–32.0%) in 2010. The main source of secondhand smoke switched from a spouse in 2001 to offspring in 2010. This trend was observed in both sexes. Passive smoking in males from a smoking spouse decreased from 5.7% to 2.4% (P<0.001), while that from smoking offspring increased from 7.3 to 14.5% (P<0.001). Passive smoking in females from a spouse decreased from 30.6 to 17.6%, while that from offspring increased from 5.3 to 15.4% (P<0.001).

Conclusion

Offspring became the main source of secondhand smoke for the elderly. Our findings demonstrated the importance of implementing smoking prevention programs, to educate older adults who live with a smoking spouse and/or offspring.     

Mechanisms of plant and microbial adaptation to heavy metals in plant–microbial systems

The data on heavy metal (HM) accumulation and detoxification by plants and bacteria in plant–microbial systems (PMS) are reviewed. Bacteria are shown to be the labile component of the system, responsible for a considerable amelioration of HM stress impact on plants and for improved PMS adaptation to heavy metals. Simulation of plant–microbial interactions under conditions of soil contamination by HM revealed the protective role of bacterial migration from the rhizoplane to the rhizosphere.     

Disordered eating attitude and associated factors among high school adolescents aged 12–19 years in Addis Ababa,Ethiopia: a cross-sectional study

Background

Eating disorders are very complex, frequently developed and have a public health impact on adolescents. Different studies revealed that eating disorders is a pressing public health problem among adolescents. Eating disorders may also lead to mortality due to their physiological sequelae. There is no previous study regarding disordered of eating attitude in Ethiopian adolescents. Therefore, this study aimed to assess prevalence of disordered eating attitude and its associated factors among adolescents in Addis Ababa high schools.

Methods

A school-based cross sectional study was conducted. Data were collected among 836 high school adolescents aged 12–19 years from May to June, 2015 in Addis Ababa city. The data were collected by self-administered questionnaire containing eating attitudes test-26 items (EAT-26) and socio-demographic factors. Binary logistic regression analysis was carried out to identify factors associated with disordered eating attitude. Both crude odds ratio and adjusted odds ratio were calculated to show the strength of association. In multivariable analysis, variables with a P value of <0.05 were considered statistically significant.

Results

The prevalence of disordered eating attitude among adolescents was 8.6% [95% CI 4.9, 12.3]. Being female [AOR = 1.75, 95% CI 1.03, 3.00], Mother’s educational status (Primary [AOR = 0.28, 95% CI 0.11, 0.78], Certificate/diploma [AOR = 0.22, 95% CI 0.07, 0.58] and first degree and above [AOR = 0.16, 95% CI 0.07, 0.40]) were found to be significantly associated with disordered eating attitude.

Conclusion

The finding of this study revealed that a significant number of adolescents were susceptible to developing disordered eating attitude. Being female and Mothers’ education status were significantly associated with disordered eating attitude among adolescents. Provision of screening test for eating disorders focusing on female adolescents is highly recommended.

     

Predictive models and spatial variations of vital capacity in healthy people from 6 to 84 years old in China based on geographical factors

The aim of this study was to provide a scientific basic for a unified standard of the reference value of vital capacity (VC) of healthy subjects from 6 and 84 years old in China. The normal reference value of VC was correlated to seven geographical factors, including altitude (X ₁), annual duration of sunshine (X ₂), annual mean air temperature (X ₃), annual mean relative humidity (X ₄), annual precipitation amount (X ₅), annual air temperature range (X ₆) and annual mean wind speed (X ₇). Predictive models were established by five different linear and nonlinear methods. The best models were selected by t-test. The geographical distribution map of VC in different age groups can be interpolated by Kriging’s method using ArcGIS software. It was found that the correlation of VC and geographical factors in China was quite significant, especially for both males and females aged from 6 to 45. The best models were built for different age groups. The geographical distribution map shows the spatial variations of VC in China precisely. The VC of healthy subjects can be simulated by the best model or acquired from the geographical distribution map provided the geographical factors for that city or county of China are known.     

Temporal dynamics and resilience of fine litterfall in relation to typhoon disturbances over 14 years in an old-growth lucidophyllous forest in southwestern Japan

We examined fine litterfall fluctuations on a seasonal and annual scale for 14 years (1992–2005) in a 1.2-ha plot in an old-growth lucidophyllous (evergreen broad-leaved) forest within the Aya Research Site, southwestern Japan. The average total litterfall input was 6.32 Mg ha^–1, of which leaf litter accounted for 60% of the total. Two high-impact typhoons struck the study area in 1993 (T9313) and 2004 (T0416) during the observation period; however, the subsequent pattern of litterfall after disturbance was different between the two typhoons. T9313 disturbance caused a reduction of biomass (ca. 10% of basal area (BA)) and a sharp decrease in litterfall input following a massive input in 1993. On the other hand, T0416 caused a minor decline in litterfall input, accompanied by a relatively small reduction of BA (5.2% of the 2001 BA). In spite of large fluctuations, litterfall input increased year by year after the T9313 disturbance. In 2000, 7 years after T9313, leaf input showed no significant differences and recorded more than 90% of pre-T9313 levels. Re-leafing from typhoon survivors may play an important role in the recovery of litterfall input in this forest. This study demonstrated how one high-impact typhoon can alter the temporal fluctuations in fine litterfall in lucidophyllous forest ecosystems.     

Modulations of rabbit erythrocyte ATPase activities induced by in vitro and in vivo exposure to ethanol

Alcohol intake is associated with numerous degenerative disorders, and the detrimental effects of alcohol may be due to its influence on plasma membrane and cellular transport systems. The aim of the present study was to compare in vitro and in vivo effects of ethanol on rabbit erythrocyte ATPase activities and correlate them with ethanol-induced oxidative stress. Age-matched male rabbits were given 5% ethanol in 2% sucrose solution, for 6 weeks ad libitum; control animals were given tap water. Daily intake of ethanol was 5 g/kg body weight; this experimental regimen resulted in an average serum ethanol concentration of 16.77 ± 2.00 mM/l. After this period, blood was collected, serum ethanol concentration was determined and erythrocyte membranes were prepared according to the method of Post et al. Activities of Na⁺/K⁺- and Mg²⁺-ATPases were determined. Thiobarbituric acid-reactive substance (TBARS) assay was used to detect levels of lipid peroxidation, a major indicator of oxidative stress. In vitro ethanol inhibits both Na⁺/K⁺-ATPase and Mg²⁺-ATPase, but Na⁺/K⁺-ATPase is more sensitive to the ethanol-induced inhibition. Increasing concentration of ethanol increased TBARS production, but significant difference was attained only at 5 and 12.5 mM of ethanol. Chronic ethanol consumption induced significant increase in Na⁺/K⁺- and Mg²⁺-ATPase activity, and TBARS production. Our results suggest that increased ATPase activity induced by chronic ethanol consumption is due to oxidative, induced modification of membrane phospholipids and proteins, which are responsible for inhibition of ATPase activity. Increased production of TBARS induced by in vitro exposure to ethanol is not the only factor that influences ATPases activity. Further research is needed to elucidate this relationship.     

Improvement of Spatial Memory Disorder and Hippocampal Damage by Exposure to Electromagnetic Fields in an Alzheimer’s Disease Rat Model

Although some epidemiological investigations showed a potential association between long-term exposure of extremely low frequency electromagnetic fields (ELF-EMF) and Alzheimer’s disease (AD), no reasonable mechanism can explain this association, and the related animal experiments are rare. In this study, ELF-EMF exposure (50Hz 400µT 60d) combined with D-galactose intraperitoneal (50mg/kg, q.d., 42d) and Aβ_25–35 hippocampal (5μl/unilateral, bilateral, single-dose) injection was implemented to establish a complex rat model. Then the effects of ELF-EMF exposure on AD development was studied by using the Morris water maze, pathological analysis, and comparative proteomics. The results showed that ELF-EMF exposure delayed the weight gain of rats, and partially improved cognitive and clinicopathologic symptoms of AD rats. The differential proteomic analysis results suggest that synaptic transmission, oxidative stress, protein degradation, energy metabolism, Tau aggregation, and inflammation involved in the effects mentioned above. Therefore, our findings indicate that certain conditions of ELF-EMF exposure could delay the development of AD in rats.     

From sepiamelanin to chemical ecology of opisthobranchs and diatoms: an exciting 40 years game in the field of marine natural products

This paper reports the lecture delivered on the occasion of the “Ceremony of Professional Recognition” to the author at the 6th European Conference on Marine Natural Products (Porto, Portugal, 19–23 July 2009). The most recent results obtained studying opisthobranchs and diatoms at ICB are presented after a synthetic overview of the most significant moves played during this exciting 40 years game in the field of Marine Natural Products. In a symbolic manner this career is compared to a chess game. After the “romantic” opening dedicated to the study of natural black (melanin) and red-brown (phaeomelanins) pigments in the prestigious group of Rodolfo A. Nicolaus, the research on marine organisms started in 1969 and rapidly led to the characterization of an impressive number of new compounds exhibiting very unusual structures. Substantially, the “structure hunt” ended with the publication of a series of alkaloids with absolutely unprecedented structural features: the saraines. Slowly, the scientific interest shifted “from structure to function”. Opisthobranchs were selected as models to investigate. The majority of the protective allomones possessed by opisthobranch molluscs are sequestered through the food chain from algae and invertebrates. However, opisthobranchs were also able to biosynthesize many compounds structurally related to typical molecules possessed by their prey. These aspects “from function to ecology, to biosynthesis, to evolution” are discussed in detail.     

Forest crown density restoration and influencing factors in the burned area of northern Great Hing′an Mountains of China

Fire in the Great Hing′an Mountains in 1987 affected an area of more than 1.33×10⁶ hm², creating a mosaic of burn severities across the landscape, which strongly affected the postfire vegetation succession. In addition, undulate landform and anthropogenic disturbance inevitably influenced the postfire vegetation succession. In this paper, a typical area was selected for a case study, including two forest farms, covering more than 1.2×10⁵ hm². In order to reveal how the forest changed in 2000 (13 years after the fire) by comparing with 1987 (prefire) and to find out the relationship between the forest succession and the affecting factors, forest crown density was selected as the criterion, and forest type, fire severity, silviculture practice, elevation and topography gradients were designed as the affecting variables. With the support of GIS software, each variable was classified and entered into the multivariate regression model. The result showed that the forest crown density changed notably in 2000 compared with that of the prefire, and all the variables significantly affected the forest crown density. The most important affecting variable was elevation, which was positively correlated with the forest crown density. The next was fire severity, which was negatively related with the forest succession. The effects of topographic factors and silviculture practices on forest crown density were relatively small.     

Forest crown density restoration and influencing factors in the burned area of northern Great Hing′an Mountains of China

Fire in the Great Hing′an Mountains in 1987 affected an area of more than 1.33×10⁶ hm², creating a mosaic of burn severities across the landscape, which strongly affected the postfire vegetation succession. In addition, undulate landform and anthropogenic disturbance inevitably influenced the postfire vegetation succession. In this paper, a typical area was selected for a case study, including two forest farms, covering more than 1.2×10⁵ hm². In order to reveal how the forest changed in 2000 (13 years after the fire) by comparing with 1987 (prefire) and to find out the relationship between the forest succession and the affecting factors, forest crown density was selected as the criterion, and forest type, fire severity, silviculture practice, elevation and topography gradients were designed as the affecting variables. With the support of GIS software, each variable was classified and entered into the multivariate regression model. The result showed that the forest crown density changed notably in 2000 compared with that of the prefire, and all the variables significantly affected the forest crown density. The most important affecting variable was elevation, which was positively correlated with the forest crown density. The next was fire severity, which was negatively related with the forest succession. The effects of topographic factors and silviculture practices on forest crown density were relatively small.