Seasonal variation in the composition and melting behavior of milk fat.

Dairy bulk tank milk was sampled during 1yr from 2 conventional (C1 and C2) and 1 organic dairy (O1) for studying the seasonal variation as well as the variation between dairies in the composition and properties of milk fat. The composition of fatty acids (FA) as well as triglycerides (TAG) in milk fat was analyzed, and the melting properties of milk fat were analyzed by use of differential scanning calorimetry. The main differences in fat content and composition of FA in milk fat between dairies included a higher fat content, greater proportion of C18:0, and smaller proportion of C16:0 in milk from dairy C2, which could be associated with a higher frequency of Jersey herds supplying milk to this dairy. The organic milk was characterized by a higher proportion of C18:3n-3, C18:2 cis-9,trans-11, C6 to C14, a lower proportion of C18:1 cis-9, and a higher melting point of the low-melting fraction. The TAG composition showed a greater proportion of C24 to C38 TAG in milk fat from dairy O1 and a greater proportion of C52 to C54 TAG in milk fat from dairy C2, which was in accordance with the differences in FA composition. Melting point of the low-melting fraction was higher for milk fat from dairy O1 compared with dairies C1 and C2, whereas no differences between dairies were observed with respect to melting points of the medium- and high-melting fractions. The seasonal variation in FA composition was most pronounced for dairy O1 although similar patterns were observed for all dairies. During the summer, the content of C18:0 and C18:1 cis-9 in milk fat was greater, whereas the content of C14:0 and C16:0 was lower. In addition, the content of C18:2 cis-9,trans-11 and C18:1 trans-11 increased in late summer for dairy O1. The differential scanning calorimetry thermograms of individual milk fat samples could be divided into 3 groups by principal component analysis. For dairy O1, summer samples belonged to group 1, spring and autumn samples to group 2, and winter samples to group 3. For dairy C1 winter samples (group 2), were separated from other samples (group 1), and for dairy C2 all samples were in group 1. Individual melting points were related to FA composition, and the melting point of the low-melting fraction was positively correlated to the content of C14:0 and C16:0 in milk fat and negatively correlated to the content of C18:1 cis-9 and C18:0.

The Impact of COVID-19 on Interventional Radiology Practice Worldwide: Results from a Global Survey.

BACKGROUND: The COVID-19 pandemic had an unprecedented impact on clinical practice and healthcare professionals. We aimed to assess how interventional radiology services (IR services) were impacted by the pandemic and describe adaptations to services and working patterns across the first two waves. METHODS: An anonymous six-part survey created using an online service was distributed as a single-use web link to 7125 members of the Cardiovascular and Interventional Radiological Society of Europe via email. Out of 450 respondents, 327 who completed the survey at least partially including 278 who completed the full survey were included into the analysis. RESULTS: Interventional radiologists (IRs) reported that the overall workload decreased a lot (18%) or mildly (36%) or remained stable (29%), and research activities were often delayed (30% in most/all projects, 33% in some projects). Extreme concerns about the health of families, patients and general public were reported by 43%, 34% and 40%, respectively, and 29% reported having experienced significant stress (25% quite a bit; 23% somewhat). Compared to the first wave, significant differences were seen regarding changes to working patterns, effect on emergency work, outpatient and day-case services in the second wave. A total of 59% of respondents felt that their organisation was better prepared for a third wave. A total of 19% and 39% reported that the changes implemented would be continued or potentially continued on a long-term basis. CONCLUSION: While the COVID-19 pandemic has negatively affected IR services in terms of workload, research activity and emotional burden, IRs seem to have improved the own perception of adaptation and preparation for further waves of the pandemic.

Coronary heart disease risk factors among religious groupings in a Jewish population sample in Jerusalem.

The hypothesis that plasma lipids, blood pressure, smoking and dietary intake differed according to degree of religiosity was examined in a sample of Jewish residents of Jerusalem. Religiosity was classified according to the subject's self-ranking of his perceived degree of religiosity. Prevalence of smoking, and plasma levels of cholesterol, triglycerides, and low-density lipoprotein cholesterol were higher in secular participants than in the orthodox group. No differences in blood pressure and in high-density lipoprotein cholesterol were observed. Secular subjects consumed more total fat, more saturated fatty acids and less carbohydrate than religious subjects. These differences in nutrient intake among the religious groups reflected differences in their food selection, notably consumption of dairy products. These findings of parallel differences in plasma lipids and in dietary intake are consistent with the differing incidence of myocardial infarction in the religious groups which has been shown in the Israeli population.

Effects of diets rich in monounsaturated fatty acids on plasma lipoproteins--the Jerusalem Nutrition Study: high MUFAs vs high PUFAs.

Twenty-six Yeshiva students were randomly assigned to a 24-wk crossover study of monounsaturated fatty acid (MUFA) vs polyunsaturated fatty acid (PUFA) diets (50% carbohydrate, 32% fat, 18% protein) fed alternately during two 12-wk periods. Total plasma cholesterol (TC) decreased significantly by approximately 10% and approximately 16% on the MUFA and PUFA diets, respectively. Plasma triglyceride response was variable. Low-density-lipoprotein cholesterol (LDL-C) decreased in both groups with an additional significant effect between periods. Concentrations of high-density-lipoprotein cholesterol did not change significantly. LDL-receptor status in fresh monocytes, affinity of LDL towards the LDL receptor in cultured fibroblasts, zonal-centrifugation profiles, and lipoprotein composition were not significantly different between the diets. There was a significantly higher tendency toward lipid peroxidation on the PUFA diet, as ascertained by more thiobarbituric acid-reactive-substances formation on that diet. Dietary PUFA results in somewhat lower TC and LDL-C concentrations whereas with MUFA the susceptibility of LDL to oxidative stress is lower.

Comparison of nutrient intakes of selected populations in the United States and Israel: the Lipid Research Clinics prevalence study.

Nutrient intakes of 2,772 US and 2,680 Jerusalem participants of the Lipid Research Clinics Program were assessed by 24-h dietary recall in men aged 15-19 and 40-59 yr and women aged 15-19 and 35-59 yr. Energy intake was higher in the US than in Jerusalem. In Jerusalem intake of total fat ranged between 32.2-33.7% of kcal, of saturated fatty acids (SFA) between 9.8-10.9%, of polyunsaturated fatty acids (PFA) between 7.9-8.6%, of carbohydrates between 50.5-53.9%, and of starch between 24.0-30.5%. The P:S ratio ranged between 0.80 and 1.01. The corresponding ranges for the US were 38.8-40.8% for fat, 14.3-15.9% for SFA, 5.9-6.8% for PFA, 38.9-46.2% for carbohydrates, 17.0-17.9% for starch, and 0.40-0.53 for the P:S ratio. Intake of cholesterol (mg/1000 kcal) was higher in Jerusalem than in the US. These data address the feasibility of reducing fat in diets of free-living, Western populations.

Effects of diets rich in monounsaturated fatty acids on plasma lipoproteins--the Jerusalem Nutrition Study. II. Monounsaturated fatty acids vs carbohydrates.

Seventeen male Yeshiva students were randomly allocated to a crossover study with two 12-wk dietary periods of monounsaturated fatty acids (MUFAs) vs a carbohydrate (CHO)-rich diet while concentrations of saturated (SFAs) and polyunsaturated (PUFAs) fatty acids were kept similar. Total plasma cholesterol (TC) decreased significantly by approximately 7.7% and low-density-lipoprotein cholesterol (LDL-C) by 14.4% on the MUFA diet, whereas on the CHO diet no significant change in cholesterol concentrations occurred, in contrast to that predicted by the equations of Keys and Hegsted. Concentrations of high-density-lipoprotein cholesterol (HDL-C) did not change significantly on either diet. On the MUFA diet there was a significantly lower proneness to peroxidation of plasma and LDL lipids and less extensive metabolism of conditioned LDL by peritoneal macrophages. We conclude that dietary MUFAs lower TC and LDL-C concentrations, independently of other dietary fatty acids and in addition may reduce the susceptibility of LDL to oxidative stress.

The role of XbaI polymorphism of the apolipoprotein B gene in determining levels and covariability of lipid and lipoprotein variables in a sample of Israeli offspring with family history of myocardial infarction.

We have determined the frequency of DNA polymorphism of the gene for human apolipoprotein B detected with XbaI in 525 Israeli offspring whose parents experienced a myocardial infarction. The relative frequencies of the X1 (8.6 kb) and X2 (5.0 kb) alleles were 0.67 and 0.33, respectively, with no significant differences between males and females and across the different origin groups. Significant variation in sex, age and body mass adjusted plasma levels of cholesterol (P = 0.02), LDL-C (P = 0.02) and apo B (P = 0.03) were associated with the XbaI polymorphism. An interaction with age was demonstrated. For young individuals a simple codominant association of the XbaI site with cholesterol and LDL-C was evident and the differences between the two homozygote groups ranged between 22 and 25 mg/dl. For individuals above age 25 these differences were about 12 mg/dl with no significant difference between the X1X2 and the X2X2 genotype groups. In our study sample the apo B XbaI polymorphism accounted for 1% of the variability of plasma cholesterol, LDL-C and apo B levels. The XbaI polymorphism also had an effect on the associations among lipid and lipoprotein variables. In conclusion, we have demonstrated an association of the apo B XbaI polymorphism with the metabolism of the apo B-containing lipoprotein particles in a sample of Israeli offspring with a family history of myocardial infarction.

Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study.

PURPOSE: To test the hypothesis that long-term furosemide therapy in patients with congestive heart failure (CHF) is associated with clinically significant thiamine deficiency via urinary loss. DESIGN: (1) Biochemical evaluation of thiamine status in hospitalized patients with CHF treated with long-term furosemide and in age-matched control patients. (2) Uncontrolled trial of the effect of intravenous thiamine on cardiac performance in a subset of six patients with CHF. SETTING: General medical ward of a teaching community hospital. PATIENTS: Twenty-three patients with chronic CHF receiving furosemide, and 16 age-matched control patients without heart failure and not taking diuretics. Daily furosemide doses were 80 to 240 mg, and duration of furosemide therapy was 3 to 14 months. Patients with identifiable causes of inadequate thiamine intake, absorption, or utilization or increased metabolic requirements were excluded. INTERVENTION: A 7-day course of intravenous thiamine, 100 mg twice daily, in six consenting patients with CHF. RESULTS: A high thiamine pyrophosphate effect (TPPE), indicating thiamine deficiency, was found in 21 of 23 furosemide-treated patients and in two of 16 controls (p less than 0.001). The mean (+/- SE) TPPE (normal: 0% to 15%) in furosemide-treated and control patients was 27.7 +/- 2.5% and 7.1 +/- 1.6%, respectively (p less than 0.001). Despite the high TPPE, the mean (+/- SE) urinary thiamine excretion in the furosemide-treated patients (n = 18) was inappropriately high (defined as greater than 130 micrograms/g creatinine), 410 +/- 95 micrograms/g creatinine, even in comparison with that in the controls (n = 14): 236 +/- 69 micrograms/g creatinine. In six patients treated with intravenous thiamine, the elevated TPPE decreased to normal, from a mean (+/- SE) of 27.0 +/- 3.8% to 4.5 +/- 1.3% (p less than 0.001), indicating normal thiamine utilization capacity. Left ventricular ejection fraction increased in four of five of these patients studied by echocardiography. CONCLUSIONS: These preliminary findings suggest that long-term furosemide therapy may be associated with clinically significant thiamine deficiency due to urinary loss and contribute to impaired cardiac performance in patients with CHF. This deficit may be prevented or corrected by appropriate thiamine supplements.

Biochemical parameters of vitamin D nutriture in old people in Jerusalem.

Serum 25-hydroxycholecalciferol (25[OH]D3) levels and other parameters of vitamin D nutriture were examined in 58 subjects aged 70 or more, living in Jerusalem. They were compared with those of 54 young adults living in the same neighbourhood. No evidence was obtained of a lower level of vitamin D nutriture in the elderly compared to younger adults. Serum 25 (OH)D3 of the elderly adults was 18.4 (SEM: 1.4) ng/ml and in the younger adults, 17.8 (1.0) ng/ml. There was no seasonal variation in serum 25(OH)D3, nor could a strong association be found between reported vitamin D intake nor with exposure to sunshine. There was a negative correlation between serum alkaline phosphatase and the calcium-phosphorus product in serum. High values of alkaline phosphatase were associated with reported low exposure to sunlight and, in elderly persons, with a reported low consumption of vitamin D.

Eating habits and opinions of teen-agers on nutrition and obesity.

Opinions about good nutrition, causes of obesity and its prevention, as well as certain eating habits, were studied in 482 Israeli children (251 boys and 231 girls), thirteen to fourteen years old. Height, weight, and triceps skinfolds were measured. Mean relative weight and relative logarithmic skinfold thickness were close to standard, although 8 per cent of the boys and 9 per cent of the girls weighed more than 120 per cent of standard weight for their age and sex. Weight was closely associated with skinfold thickness. Over two-thirds of both boys and girls believed that daily consumption of milk, bread, fruits, eggs, cheese, meat, and tomatoes is desirable, and about two-thirds stated that overeating is a cause of obesity. More overweight than thin and normal-weight children indicated that, to prevent obesity, all kinds of food are permissible, but only in limited amounts. Most children believed in the fattening value of cakes, sweets, fried and fatty food, potatoes, bread, and nuts. The belief in the fattening value of potatoes, bread, and nuts was shared by a higher percentage of overweight than of under- and normal-weight children. Overweight children, particularly girls, reported eating less bread, cake, and cream, adding less sugar to beverages, and eating sweets and ice cream less frequently than thin and normal-weight children. A higher percentage of the obese group reported skipping one meal and eating no snack at school. Overweight teen-agers appear to be more conscious of their food intake than under- and normal-weight children.

Prognostic significance of hyperechogenic lesions in the basal ganglia and thalamus in neonates.

Neonatal cranial ultrasonography at times reveals hyperechogenic lesions in the basal ganglia and thalamus. These lesions have been attributed to a wide variety of pathologic states, among them toxoplasmosis, rubella, cytomegalovirus, and herpes simplex (TORCH) infections, chromosomal abnormalities, and asphyxia. The clinical significance in terms of the neurodevelopmental outcome of this radiologic abnormality is unknown. We performed a developmental evaluation on 16 children aged 2 to 6 years in whom neonatal cranial ultrasonography had demonstrated hyperechogenic lesions in the basal ganglia or thalamus and had no other neurodevelopmental risk factors. There was no significant difference between the average Developmental Quotient of the target population and the normal population in regard to developmental status. We conclude that in our population, an isolated finding of hyperechogenic lesions in the basal ganglia is probably not a predictor of poor neurodevelopmental outcome.

Evaluating intraoperative radiation therapy (IORT) and external beam radiation therapy (EBRT) in non-small cell lung cancer (NSCLC). Five years experience.

A pilot study on intraoperative radiation therapy (IORT) combined with external beam radiation therapy (EBRT) in nonresectable non-small cell lung cancer (NSCLC) was performed in 31 patients (mean age: 66.2 years, range: 51-80; 10 anatomically and functionally, 21 functionally, nonresectable; 20 squamous-cell, 11 adenocarcinoma). The tumor was exposed by lateral thoracotomy and a staging lymph node dissection was performed (final staging 7 T1, 16 T2, 8 T3; 11 nodal positive). Ten to 20 Gy IORT (energy: 7-20 MeV electrons) were delivered to the tumor. Unilateral continuous positive airway pressure ventilation of the diseased lung was used to reduce the amount of healthy lung tissue in the IORT port and to minimize the ventilatory movement. Secondary collimation and direct shielding of radio-sensitive structures within the IORT port by aluminium sheets were used to further reduce collateral damage. Four weeks after IORT, 46 Gy EBRT (2 Gy/day 5 times a week; 8-23 MeV photons) were administered to the mediastinum and to the tumor-bearing area on an outpatient basis. In nodal positive cases the mediastinal dose was increased to 56 Gy. Twenty-three patients were evaluable. In 13 complete, in 8 partial (50-97% regression) and in 2 minor response has been achieved. Five patients experienced a recurrence (local only: 2; local and distant: 1; distant only: 2). Twelve patients died of underlying cardio-respiratory disorders within 6 to 25 months after IORT; 7 died of cancer. The overall 5-year survival rate including the incidental deaths is 14.7%. The recurrence-free survival rate is 53.2%.

Blood glucose self-monitoring from abdominal skin: a precise and virtually pain-free method.

For many diabetic patients, years of blood glucose self-monitoring (SM) with readings taken several times daily is an inevitable aspect of insulin therapy. We investigated whether SM from abdominal skin might be an alternative to the established fingertip method. A total of 63 diabetic patients and 16 nondiabetic volunteers determined their blood glucose in parallel in capillary blood from the tip of the finger and from abdominal skin 5 times daily on 5 successive days. The blood samples were collected from the two test regions using lancing devices, and the SM determinations were all done with a meter. Consecutive specific enzymatic glucose determinations in blood from the fingertip served as the reference method. The results of the SM from abdominal skin, a method perceived as virtually painless, were in close correlation with the control laboratory determinations and with SM from the finger (Pearson's r, 0.94 and 0.95). The comparison of SM method for abdomen vs. finger laboratory control gave a linear regression equation of y=8.35+0.94x (r=0.94). Error grid analysis revealed: range A, 93.6%; range B, 5.4%; range C, 0.05%; range D, 1.0%; and range E, 0%. Bland and Altman analysis yielded the mean of the differences, 0.2 mg/dl; 2 SD, 32 mg/dl; minimum, -162 mg/dl; maximum, 148 mg/dl. Laboratory glucose determinations in capillary blood from the fingertip and from abdominal skin led in 99.7% of the cases to concordant therapeutic decisions in the diabetics; the sample material was therefore equivalent. The practical aspects (afterbleeding, number of punctures, test strip consumption) of SM from the two regions showed no essential differences. However, only 22% of the diabetic patients investigated continued to perform SM from abdominal skin on a longer basis. In a further 5 adipose diabetic patients (BMI, 32 kg/M2), SM from abdominal skin was not practicable, as there was insufficient blood to collect. SM from abdomal skin is a simple, virtually pain-free and precise method. It provides certain diabetic patients with an alternative to the established method of SM from the fingertip.

[Fluoroscopically guided percutaneous fine-needle biopsy of the lung using the ROTEX needle: results in 890 patients with focal lung lesions]. / Durchleuchtungsgezielte perkutane Feinnadelbiopsie der Lunge mit der ROTEX-Nadel. Ergebnisse bei 890 Patienten mit fokalen Lungenläsionen.

Fluoroscopically guided transthoracic fine needle biopsies were performed in 890 patients (380 female, 582 male, mean age: 56 years). In 795 patients (89.4%) the first biopsy was successful. The success rate of biopsy correlated closely with the size of the lesion and increased with larger size. Sensitivity in the diagnosis of malignant lesions was 94.6%, specificity 99.5%. Due to cytological, histological, and clinical confirmation of benign lung lesions in 300 patients (33.7% of all patients), the number of unnecessary diagnostic thoracotomies for benign disease could be reduced significantly. In 9 of 113 cases (8%) histological reclassification of the cytologic results was necessary. Reclassification was not necessary in the differentiation between benign and malignant lesions and between small cell and non-small cell carcinomas. The overall complication rate was 24.7% (220 patients). Only 36 patients (4% of all patients) required chest-tube insertion. There were no fatal complications. Percutaneous fluoroscopically guided transthoracic fine needle biopsy of the lung, performed with the Rotex needle, is a time-effective, safe, and efficient method for diagnosing focal pulmonary lesions.

Recommended micronutrient supplementation for institutionalized elderly.

A committee nominated by the Israel Ministry of Health examined the relevant literature and the local recommendations as well as the recommendations from other countries and suggested a daily micronutrient supplementation for institutionalized elderly living in institutions supervised by the Ministry of Health. The micronutrient preparatory, tailored for this population, is designed to contain about half the RDA for most of the vitamins and some microelements. Biotin and vitamins C, D and B12 as well as zinc, copper, chromium and molybdenum are suggested at a level higher than half the RDA, whereas fluorine, at a lower level. Major elements (calcium, magnesium and phosphorus) are excluded and should be supplied separately. Vitamin K and iron are also excluded. Fat-soluble vitamins should be microencapsulated. Micronutrient supplementation for institutionalized elderly is part of the Ministry of Health s balanced nutrition policy. The committee s recommendations are also applicable to the free-living elderly population.

The validity of biochemical assessment of thiamine, riboflavin and folacin nutriture.

Nutriture of thiamine, riboflavin and folacin was assessed by two tests: thiamine (109 subjects) by the TPP effect of erythrocyte transketolase activity and urinary excretion of thiamine (mug/g creatinine); riboflavin (81 subjects) by the activation coefficient of erythrocyte glutathione reductase and excretion of riboflavin in urine (mug/g creatinine); and folacin (91 subjects) by estimation of folacin in red blood cells and in serum (ng/ml). The following correlation coefficients (r) were obtained: transketolase activity vs thiamine excretion: -0.33; glutathione reductase vs riboflavin excretion: -33; and red blood cell folacin vs serum folacin: 0.77. When "deficient" and "low" values were defined as "not acceptable" and compared with "acceptable" values, sensitivity of thiamine excretion was 54%, of riboflavin excretion 33% and of serum folacin level 90%. The respective value of specificity were 75%, 83% and 37%. Sensitivity of thiamine excretion and of serum folacin level, respectively, increased when stricter criteria of insufficiency were applied and assessment of "deficiency" of these vitamins rather than of "non-acceptability" was attempted.

[Micronutrient (vitamins and minerals) supplementation for the elderly, suggested by a special committee nominated by Ministry of Health].

The elderly tend to be at a higher risk for nutritional deficiencies and in particular for micronutrient deficiencies. A committee nominated by Ministry of Health examined the relevant literature and the local recommendations as well as the recommendations from other countries and suggested a daily special micronutrient supplementation for institutionalized elderly. The preparatory will contain about half the RDA for most of the micronutrients, except for fluorine that is recommended at a lower level and biotin, vitamins D, C, B12 as well as zinc, copper and molybdenum at a level higher than half the RDA. Major elements such as calcium, are not included in the preparatory and would be supplied separately when needed. Vitamin K and iron are excluded as well. The suggested preparatory composition, mg: vitamin A, 0.450; vitamin D, 0.015; vitamin E, 10; thiamin, 0.6 Pound riboflavin, 0.7; biotin, 0.030; pantothenic acid, 3; niacin, 8; vitamin C, 60; vitamin B6, 0.8; folic acid, 0.120; vitamin B12, 0.0024; choline up to 275; zinc, 8; copper, 0.9; fluorine, 0.5; manganese, 1.2; chromium 0.020; molybdenum, 0.045; selenium, 0.030; and iodine, 0.075. Fat-soluble vitamins should be microencapsulated. Micronutrient supplementation is part of Ministry of Health balanced nutrition policy. The committees recommendations are also applicable for the free-living elderly.