Associations between vitamin D status in infants and blood lipids, body mass index and waist circumference.

AIM: To study the relationships between 25-hydroxyvitamin D status and blood lipids, insulin, glucose, body mass index and waist circumference in infants. METHODS: In a cross-sectional study, 255 infants aged 9 months with a blood sample for 25-hydroxyvitamin D were examined. Plasma 25-hydroxyvitamin D concentrations were analysed by chemiluminescent immunoassay. Associations between plasma 25-hydroxyvitamin D and high-density lipoprotein (HDL), low-density lipoprotein, total cholesterol, triglycerides, insulin, glucose, body mass index and waist circumference were analysed. RESULTS: Mean plasma 25-hydroxyvitamin D was 77.2 ± 22.7 nM. At the time of examination, 97% received vitamin D supplementation. 25-Hydroxyvitamin D was negatively associated with HDL (p = 0.003), cholesterol (p = 0.002) and triglycerides (p = 0.010) in multivariate analysis controlled for gender, season, body mass index, length, birth weight and breastfeeding. There were no associations between 25-hydroxyvitamin D and glucose or insulin (all p > 0.05). 25-hydroxyvitamin D was negatively associated with body mass index (p = 0.005) and waist circumference (p = 0.002) controlled for gender, season, breastfeeding, birth weight and length. CONCLUSION: Vitamin D status is negatively associated with blood lipids, body mass index and waist circumference in infants where nearly all received vitamin D supplements. Whether this has long-term health effects remains to be elucidated.

Determinants of blood glucose and insulin in healthy 9-month-old term Danish infants; the SKOT cohort.

AIMS: Insulin secretion is important for early regulation of growth, but high insulin concentration is also a risk factor for insulin resistance later in life. It is therefore important to better understand how insulin and glucose are associated with early diet and growth. The aim of this study was to examine blood glucose and insulin concentration in relation to anthropometric measurements, growth, breastfeeding practice and complementary feeding in 9-month-old infants. METHODS: This was a cross-sectional study (SKOT cohort), examining 312 healthy term infants from the age of 9 months. Of these, 265 infants had data on insulin and glucose and were included in this study. Measurements include weight, length, skinfold thickness, waist circumference, 7-day food records, 2-h fasting venous glucose and insulin analysis, and questionnaire. RESULTS: At 9 months of age there was a strong negative association between number of breastfeedings per day and insulin concentration (P=0.0015). Insulin concentration was positively associated to waist circumference (P=0.042) and change in Z-score for weight-for-age between 5 and 9 months (P=0.004). Glucose concentration was positively associated to subscapular skinfold (P=0.002) and sum of skinfolds thicknesses (P=0.006). CONCLUSION: At 9 months, breastfeeding still had a strong negative effect on insulin concentrations, which were positively associated with weight gain and current waist circumference, while glucose concentrations were associated with subcutaneous fat. These results are of interest in disentangling the association between early growth and later risk of disease.

Chromosome number distribution and cellular DNA content in colorectal adenomas from polyposis and nonpolyposis patients.

Ploidy analyses of colorectal adenomas were performed by combined flow cytometric DNA analysis of unfixed isolated nuclei and direct chromosome preparation after Colcemid incubation for 9-20 hours. Ten of 18 adenomas from nonpolyposis patients and 4 of 13 adenomas from patients with familial adenomatous polyposis yielded a mean of 25 countable metaphases (range 7-44) per tumor. Of 343 metaphases, only 38% had 46 chromosomes, and 62% were nondiploid. All but one adenoma had diploid or peridiploid modes in the range of 46-50 chromosomes. One adenoma was hyperploid, with a mode of 74 chromosomes and a correspondingly increased nuclear DNA content. In another two adenomas, the DNA analyses showed small hyperploid populations constituting 6% and 2% of the cells. The most striking difference between the DNA analyses and chromosome number distributions was that 13% of all metaphases were hyperploid with chromosome numbers outside the perimodal range but, except in one adenoma, without indication in the DNA histogram of corresponding hyperploid cell populations. We propose that these aberrant metaphases indicate an early acquired genetic instability of the neoplastic epithelium, which may be instrumental in generation of hyperploid, invasive clones, which constitute most colorectal carcinomas.

Maximal prime subgraph decomposition of Bayesian networks.

The authors present a method for decomposition of Bayesian networks into their maximal prime subgraphs. The correctness of the method is proven and results relating the maximal prime subgraph decomposition (MPD) to the maximal complete subgraphs of the moral graph of the original Bayesian network are presented. The maximal prime subgraphs of a Bayesian network can be organized as a tree which can be used as the computational structure for LAZY propagation. We also identify a number of tasks performed on Bayesian networks that can benefit from MPD. These tasks are: divide and conquer triangulation, hybrid propagation algorithms combining exact and approximative inference techniques, and incremental construction of junction trees. We compare the proposed algorithm with standard algorithms for decomposition of undirected graphs into their maximal prime subgraphs. The discussion shows that the proposed algorithm is simpler, more easy to comprehend, and it has the same complexity as the standard algorithms.

Practical modeling of Bayesian decision problems - exploiting deterministic relations.

The widespread use of influence diagrams to represent and solve Bayesian decision problems is still limited by the inflexibility and rather restrictive semantics of influence diagrams. We propose a number of extensions and adjustments to the definition of influence diagrams in order to make the practical use of influence diagrams more flexible and less restrictive. In particular, we describe how deterministic relations can be exploited to increase the flexibility and efficiency of representing and solving Bayesian decision problems. The issues addressed in the paper were motivated by the construction of a decision support system for mission management of unmanned underwater vehicles (UUVs).

[Akathisia. A frequent adverse effect in treatment with neuroleptics]. / Akatisi. En hyppig bivirkning ved behandling med neuroleptika.

Neuroleptics are employed in the treatment of psychotic states but also in the treatment of anxiety states, as anti-emetics, in the treatment of pain and for anaesthesia. In approximately 20% of the patients, side effect in the form of akathisia are observed. Akathisia caused by neuroleptics may be difficult to diagnose as the symptoms are non-specific with anxiety, restlessness and agitation. Treatment consisted previously of anticholinergics but investigations have been published which demonstrate good effects of non-specifically acting beta-receptor blocking agents. On the basis of a review of the literature, the development of akathisia caused by neuroleptics is described, the symptoms and differential diagnoses involved and the therapeutic possibilities, are described.

[Balint's syndrome--visual disorientation]. / Balint-syndrom--visuel desorientering.

The three major components of the Balint's syndrome are described: 1) visual disorientation or simultanagnosia, i.e. the inability to perceive the visual field as a whole, 2) ocular apraxia, a deficit of visual scanning and 3) optic ataxia, an impairment of pointing and reaching under visual guidance. Our description of the syndrome is illustrated by three case histories. The complete syndrome is rare, and partial syndromes have been reported more frequently. Sudden and severe hypotension resulting in bilateral borderzone infarction in the occipito-parietal region is reported to be the most frequent cause of complete Balint's syndrome. Lack of awareness of the syndrome may lead to misdiagnosis such as blindness, psychosis, or dementia.

[Serious criminality among adolescents. I. Twenty years of mental observations of 15-17 years old delinquents in greater Copenhagen]. / Alvorlig kriminalitet hos ganske unge. I. Tyve års mentalobservationer af 15-17-årige i det storkøbenhavnske område.

The purpose of the study was to enlighten the background, psychopathology and criminality of young delinquents. Twenty years of reports for the court regarding young delinquents were analysed and information as to background, educational level, psychiatric diagnoses, criminal records and sentence was registered. Among 91 delinquents aged 15-17 years, 65% had not completed primary school and 50% were unemployed. Eighty percent had committed violent acts (homicide or attempted homicide, robbery, violence, rape). Twenty-two percent were sentenced to psychiatric treatment, and more than 50% were imprisoned. In conclusion young delinquents have severe social problems and a disproportionally high number suffer from psychiatric illness. The main part of the adolescents are convicted to prison, in spite of young age, and at present no institutions in Denmark are suitable for the treatment of young delinquents with severe criminal records.

[Serious criminality among adolescents. II. Criminality, psychiatric morbidity and mortality 15-20 years after the first mental observation]. / Alvorlig kriminalitet hos ganske unge. II. Kriminalitet, psykiatrisk morbiditet og mortalitet 15-20 år efter mentalobservation.

The purpose of the present study was to enlighten the prognosis for young delinquents, who had been subject to a mental report for the court, regarding later psychiatric illness, mortality and criminal relapse. The study was retrospective based on register information about psychiatric admissions, death courses and later criminal commitments. After less than 20 years, 11% were found psychotic, 22% had died and 90% of the survivors had committed a total of 831 criminal offences from drunk driving to homicide. We conclude, that at present no institutions in Denmark are suitable for the treatment of young delinquents with severe criminal records. Most of the young delinquents have psychological and behavioural disturbances from childhood, and early intervention is needed followed by careful documentation and follow-up studies in order to improve the prognosis for these young people.

[Compulsory procedures in the treatment of somatic diseases in mentally ill patients]. / Tvangsforanstaltninger ved behandlingskraevende somatisk sygdom hos sindssyge.

The Danish law concerning commitment and compulsory procedures in psychiatry was reformed in October 1989, and for the first time laid down regulations for compulsory treatment of somatic disease in psychotic patients. The aim of the study was to evaluate whether the law is useful in clinical practice. The course of 28 psychotic patients who were committed and/or compulsorily treated due to severe somatic disease is described. We conclude that the law is a useful tool in the acute treatment of life-endangering somatic disease in psychotic patients.

[Somatic illness in psychiatric patients]. / Fysisk helbred hos psykisk syge.

Psychiatric patients are a vulnerable group in society and have been shown to suffer from a wide range of somatic diseases when admitted to the psychiatric department. During a three month period we examined 174 newly admitted psychiatric patients with the purpose of investigating 1) the frequency of somatic illness, 2) the value of routine blood tests as a screening tool for somatic illness and 3) a possible causality between somatic disease and psychiatric illness. Fifty percent of the patients suffered from a somatic disease and 31% of the patients had a previously undiagnosed disease. The somatic disease was found to be the main cause of admission in 16% of the patients. Older patients and patients with alcohol abuse were found to have the highest prevalence of somatic disease. In conclusion, we found no indication for a screening programme of blood tests, but recommend that selected blood tests based on the clinical examination and history of the individual patient should be taken. Psychiatric patients have a high prevalence of somatic disease, and it is important to direct clinical attention towards this when giving care to psychiatric patients.

Vitamin D status in infants: relation to nutrition and season.

In a cross-sectional study, the primary objective was to assess the plasma concentration of 25-hydroxyvitamin D (25(OH)D) in healthy 9-month-old infants (n=255). The secondary objective was to evaluate nutritional variables and season in relation to 25(OH)D. The concentration of 25(OH)D was 77.2 ± 22.7 nmol/l (mean ± s.d.), ranging from 12 to 151 nmol/l. During the first 9 months, 97% received vitamin D supplementation (10 µg/day) and 89% had sufficient levels of 25(OH)D (50-250 nmol/l). In multiple regression analysis, controlled for body mass index (BMI) and intake of infant formula, a longer period of exclusive breastfeeding (P=0.026) and breastfeeding at 9 months (P=0.001) were both associated with lower levels. Dietary vitamin D intake was 4.4 ± 3.1 µg/day and in multiple regression analysis, controlled for BMI, intake of infant formula and mean energy intake, it was positively associated with 25(OH)D (P=0.001). There was a significant seasonal difference in 25(OH)D, with higher levels during summer-autumn compared with winter-spring (P=0.021) after control for BMI.

Neurological abnormalities in schizophrenic patients: a prospective follow-up study 5 years after first admission.

OBJECTIVE: The aim of this study was to examine the temporal stability of neurological abnormalities in first-episode schizophrenic patients, and to clarify the relationships between such abnormalities and psychopathology. METHOD: A total of 18 schizophrenic patients, 11 non-schizophrenic patients and 10 healthy volunteers were examined neurologically at first admission and 5 years later. RESULTS: A significant increase in the number of neurological abnormalities was seen in schizophrenic patients with genetic predisposition and in patients with a non-remitting course of disease. Birth complications had an impact on the occurrence of neurological abnormalities at first admission. CONCLUSION: The association between a deteriorating course of disease and neurological impairment supports the theory that any possible impairment of the brain in schizophrenia is aggravated during the first 5 years of disease.

Progressive atrophy of the frontal lobes in first-episode schizophrenia: interaction with clinical course and neuroleptic treatment.

OBJECTIVE: This prospective study examined the interaction of clinical course of disease and brain structure with time in schizophrenic patients. METHOD: A total of 21 first-episode schizophrenic patients, 10 patients with other psychiatric disorders and a control group of 9 healthy volunteers had CT at first admission and at reinvestigation 5 years later. RESULTS: At first admission all of the patients had enlarged cortical fissures and sulci compared to controls, and the duration of untreated psychosis was significantly correlated with sulcal enlargement. At reinvestigation, frontal and central brain atrophy had progressed in schizophrenic patients. CONCLUSION: The study indicated that ongoing psychosis and lifetime dose of classical antipsychotics were the main candidates accounting for the finding of progressively disturbed brain structure during the first 5 years of schizophrenia.