General Dietary Recommendations for People with Down Syndrome.

Down syndrome (DS) is caused by trisomy of chromosome 21 and is associated with characteristic features of appearance, intellectual impairment to varying degrees, organ defects, and health problems typical of this syndrome. Studies on the frequency of consumption of food products in this group show many irregularities, in particular too low consumption of vegetables and fruits, wholegrain cereal products and dairy products, and excessive consumption of meat products and sweets. It is necessary to correct eating habits. The diets of people with trisomy 21 should be consistent with the recommendations of rational nutrition for the general population and take into account specific dietary modifications related to the occurrence of diseases and health problems characteristic of this syndrome.

Initial laboratory validation of temperature development models for Necrodes littoralis L. (Staphylinidae: Silphinae).

Development models of necrophagous insects are applied in forensic entomology for post-mortem interval estimation. Such estimates may be used as scientific evidence in legal investigations. For this reason, it is important that the models are valid and that the expert witness is aware of their limitations. Necrodes littoralis L. (Staphylinidae: Silphinae) is a necrophagous beetle species that frequently colonizes human cadavers. Temperature models of development for the Central European population of these beetles were recently published. In this article, we present results of the laboratory validation study for these models. Errors of beetle age estimation differed significantly between the models. Thermal summation models yielded the most accurate estimates, and the isomegalen diagram least accurate estimates. Errors of the beetle age estimation varied across beetle developmental stages and rearing temperatures. In general, most development models of N. littoralis were satisfactorily accurate in estimating beetle age under laboratory conditions; therefore, the study provides initial evidence to support their validity in forensic cases.

Temperature models of development for Necrodes littoralis L. (Coleoptera: Silphidae), a carrion beetle of forensic importance in the Palearctic region.

Analysis of insects can provide evidence in death cases, for example, by answering the question about the time of death. Apart from flies, beetles are the second most useful insect group in forensic entomology. To elucidate the time of death based on insect evidence, developmental models of a given species are necessary. In this study, we developed such models for Necrodes littoralis, a necrophagous beetle, which is common in the Palearctic region and has great potential in forensic entomology. We monitored the development at 10 constant temperatures (14-30 °C). Larvae were reared in aggregations. Thermal summation models, isomorphen and isomegalen diagrams and growth curves were derived using the data. Depending on the temperature, development lasted between about 23 and 89 days. Mortality was high at the extremes of the temperature range. The thermal summation constant for the total development was 434.7 ± 28.86 accumulated degree-days above a developmental threshold of 9.04 ± 0.55 °C. This is the first comprehensive dataset on the development of N. littoralis. Implications for its use in forensic casework are discussed.

Insect rearing protocols in forensic entomology: Benefits from collective rearing of larvae in a carrion beetle Necrodes littoralis L. (Silphidae).

Forensic entomologists frequently use a developmental method to estimate a post-mortem interval (PMI). Such estimates are based usually on the blow fly larvae or puparia. Data on their development is obtained by rearing them in colonies. In the case of beetles, which can be also useful for PMI estimation, development data is frequently collected by rearing them individually. However, some carrion beetles are gregarious, for instance, Necrodes littoralis (Linnaeus, 1758) (Silphidae). We compared mortality, rate of development and body size of emerged adult beetles reared individually and in aggregations. Mortality was much higher for beetles reared individually, particularly at low temperatures. The rearing protocol affected the time of immature development and the size of adult insects. Individually reared specimens developed much longer at 16°C, whereas at 20°C and 26°C development times of individually reared beetles were slightly shorter. Significant differences in the body size were observed only at 16°C; beetles that developed in aggregations were larger at this temperature. These findings demonstrate that aggregating is particularly beneficial for larvae of N. littoralis at low temperatures, where it largely reduces mortality and facilitates growth. Moreover, these results indicate that in forensic entomology the protocol of individual rearing is unsuitable for gregarious beetles, as it produces reference developmental data of low quality.

Estimation of physiological age at emergence based on traits of the forensically useful adult carrion beetle Necrodes littoralis L. (Silphidae).

The main entomological method for post-mortem interval involves estimation of age for immature insects found on a cadaver. Forensic entomologists frequently use the thermal summation value for the total immature development (K), which is a measure of physiological time needed to complete development of a species (age at emergence). K is highly variable within the species. Its true value for an adult insect may be estimated based on insect traits such as size and sex at maturity. Here, we have tested, if size and sex of adult beetles of Necrodes littoralis may be useful for the estimation of the true K. Necrodes littoralis is a Palearctic carrion beetle that frequently colonizes human cadavers in forest and agricultural environments. General and sex-specific thermal summation models for the emergence and models for the relationship between size of adult beetles and their age at emergence were developed for N. littoralis. The models were subsequently tested in the validation study. The general K for N. littoralis was about 469 (+/-25 SE) accumulated degree-days above the developmental threshold of about 8.5 (+/-0.45 SE) °C. Thermal summation parameters of the sex-specific models revealed minor differences compared to the general model. A true K was negatively related to the beetle size. Methods for the estimation of K represented its true value with different accuracy. The highest accuracy was obtained when K was estimated using beetle weight as a predictor variable and the sex-specific models for the relationship between K and size, although sex contributed slightly to this improvement. Using this method the estimated K represented the true K with the error of 6.3%, while the error for K from the general thermal summation model was about 9.7%. In conclusion, the findings demonstrate that physiological age at emergence of N. littoralis may be accurately predicted based on the adult beetle size. Necrodes littoralis is a second beetle species in which the age at maturity was more accurately represented by size-based estimates of K than K from the general thermal summation model. Therefore, we encourage testing the relationship between K and size in all insect species that are used in forensic entomology; particularly blow flies and flesh flies.

Assessment of Synvisc treatment in osteoarthritis.

Background. Viscosupplementation is a relatively new method for the treatment of osteoarthritis (OA). The main goal of this project was to assess the safety and clinical utility of Hylan G-F20 (Synvisc(R)) in the treatment of pain associated with osteoarthritis of the knee. The type and frequency of additional therapies used during Synvisc(R) treatment were also assessed. It was a prospective project designed for monitoring Synvisc(R)-prescribing habits in usual medical care.
Material and method. One hundred ninety knee joints in 187 patients were studied (OA symptoms were bilateral in 3 women). Synvisc(R) was indicated for the local treatment of pain in osteoarthritis of the knee. After the diagnosis, Synvisc(R) therapy was started at the recommended dose of 2 ml per intra-articular injection once
a week (at 1-week intervals), three injections in total. The data collected, including medical history, physical examination, radiographic examination and treatment efficacy (overall assessment performed at each visit), were recorded on case report forms designed to facilitate statistical analysis. The physicians completed visual Analogue Scale (VAS) for overall assessment of OA pain at each visit. The clinical outcome was recorded after the end of therapy. The patient data were collected by physicians taking part in this project only.
Results. In 156 cases (82.1%) either a substantial improvement or subsidence of symptoms was observed. In 34 cases (17.9%) the improvement was small or there was no change in the patient's condition. There were local adverse reactions in 2 patients (1.07%). There was no need to cease the treatment, to hospitalise a patient or to start any additional treatment. In 167 patients (89.3%) there was no need to start any non-pharmacological concomitant treatment.
Conclusions. In summary, Synvisc(R) viscosupplementation should be rated among the safest and most effective methods for the treatment of OA, for it alleviates OA-related pain, thus reducing the need for NSAIDs and steroid injections. The use of Synvisc(R) in OA patients alleviates pain regardless of sex and age, the effect being the most pronounced in patients with low- and medium-grade radiographic changes.