Is body mass index a useful measure of excess body fatness in adolescents and young adults with Down syndrome?

BACKGROUND: To determine the validity of body mass index (BMI) to identify excess fatness in youth with Down syndrome (DS). METHODS: Using the Centers for Disease Control and Prevention (CDC) growth reference, we defined overweight ( \u3e = 85th percentile) and obesity ( \u3e = 95th percentile) based on participants\u27 age- and sex-specific BMI z-scores, calculated from measured height and weight. Percentage body fat was measured by dual-energy X-ray absorptiometry. We determined sensitivity, specificity, positive predictive value, negative predictive value and efficiency of BMI percentiles to identify excess adiposity relative to elevated percentage body fat cut-offs developed from the Pediatric Rosetta Body Composition project in 32 youth (20 boys/12 girls), ages 13-21 years with Down syndrome. RESULTS: For adolescents with Down syndrome using the cut-off points of 95th percentile for BMI (obesity), sensitivity and specificity were 71% and 96% respectively. Positive predictive value was 83% and negative predictive value was 92%. Overall efficiency was 91%. Sensitivity and specificity for BMI cut-offs above the 85th percentile (overweight) were 100% and 60% respectively. The positive predictive value was 41% and negative predictive value was 100%. Overall efficiency was 69%. CONCLUSION: On the whole, the obesity ( \u3e = 95th percentile) cut-off performs better than the overweight cut-off (85th-94th percentile) in identifying elevated fatness in youth with DS. Wiley and Sons Ltd, MENCAP and IASSID

Flow cytometry analysis of lymphocyte subsets in bronchoalveolar lavage: comparison between lung non-Hodgkin lymphomas and reactive diseases

Deepened flow cytometry (FCM) analysis of bronchoalveolar lavage fluid (BALF) cells can disclose clonal B and abnormal T lymphocytes in case of lung involvement in non Hodgkin lymphoma (NHL). The possible role of routine FCM BALF analysis in diagnosing NHL involving the lungs is largely undetermined. To evaluate whether differences exist, within FCM screening of lymphocyte subsets, between BALFs from lung NHL and BALFs from reactive diseases. We compared alveolar leukocyte and lymphocyte data obtained using flow cytometry in 17 lung NHL cases with the median corresponding data detected in 208 controls, matched with cases for computed tomography findings. Absolute leukocyte counts did not differ significantly between cases and controls. As calculated within leukocytes, percentages of total, B, T, CD4+ and CD8+ T lymphocytes, respectively, were significantly higher in B cell NHL cases than in their controls (P = .003, .023, .009, .004, and .020, respectively). Similarly, percentages of total, and CD8+ T lymphocytes, respectively, were significantly higher in T cell NHL cases than in their controls (P = .046 and .027, respectively). Huger BALF lymphocytosis occurs in pulmonary NHLs than in other lung diseases. Possible lymphocyte cutoffs, that could indicate lung NHL and the subsequent need of a second-step BALF staining shortly following the initial screening, should be prospectively attempted

Community-based interventions for enhancing access to or consumption of fruit and vegetables among five to 18-year olds: a scoping review

<p>Abstract</p> <p>Background</p> <p>Low fruit and vegetable ( FV) consumption is a key risk factor for morbidity and mortality. Consumption of FV is limited by a lack of access to FV. Enhanced understanding of interventions and their impact on both access to and consumption of FV can provide guidance to public health decision-makers. The purpose of this scoping review is to identify and map literature that has evaluated effects of community-based interventions designed to increase FV access or consumption among five to 18-year olds.</p> <p>Methods</p> <p>The search included 21 electronic bibliographic databases, grey literature, targeted organization websites, and 15 key journals for relevant studies published up to May 2011. Retrieved citations were screened in duplicate for relevance. Data extracted from included studies covered: year, country, study design, target audience, intervention setting, intervention strategies, interventionists, and reported outcomes.</p> <p>Results</p> <p>The search located 19,607 unique citations. Full text relevance screening was conducted on 1,908 studies. The final 289 unique studies included 30 knowledge syntheses, 27 randomized controlled trials, 55 quasi-experimental studies, 113 cluster controlled studies, 60 before-after studies, one mixed method study, and three controlled time series studies. Of these studies, 46 included access outcomes and 278 included consumption outcomes. In terms of target population, 110 studies focused on five to seven year olds, 175 targeted eight to 10 year olds, 192 targeted 11 to 14 year olds, 73 targeted 15 to 18 year olds, 55 targeted parents, and 30 targeted teachers, other service providers, or the general public. The most common intervention locations included schools, communities or community centres, and homes. Most studies implemented multi-faceted intervention strategies to increase FV access or consumption.</p> <p>Conclusions</p> <p>While consumption measures were commonly reported, this review identified a small yet important subset of literature examining access to FV. This is a critically important issue since consumption is contingent upon access. Future research should examine the impact of interventions on direct outcome measures of FV access and a focused systematic review that examines these interventions is also needed. In addition, research on interventions in low- and middle-income countries is warranted based on a limited existing knowledge base.</p