Obesity is associated with insulin resistance and components of the metabolic syndrome in Lebanese adolescents

adolescents has been reported to range between 18–42%, depending on country of origin, thus suggesting an ethnicbased association between obesity and MS. Aim: This study aims to investigate the magnitude of the association between obesity, insulin resistance and components of MS among adolescents in Lebanon. Subjects and methods: The sample included 263 adolescents at 4 th and 5 th Tanner stages of puberty (104 obese; 78 overweight; 81 normal weight). Anthropometric, biochemical and blood pressure measurements were performed. Body fat was assessed using dual-energy X-ray absorptiometry. Results: According to International Diabetes Federation criteria, MS was identified in 21.2 % of obese, 3.8 % of overweight and 1.2 % of normal weight subjects. The most common metabolic abnormalities among subjects having MS were elevated waist circumference (96.2%), low HDL (96.2%) and hypertriglyceridemia (73.1%). Insulin resistance was identified in all subjects having MS. Regression analyses showed that percentage body fat, waist circumference and BMI were similar in their ability to predict the MS in this age group. Conclusions: MSwas identified in asubstantial proportion of Lebanese obese adolescents, thus highlighting the importance of early screening for obesity-associated metabolic abnormalities and of developing successful multi-component interventions addressing adolescent obesity

Ciguatera fish poisoning in the Pacific Islands (1998 - 2008)

Background: Ciguatera is a type of fish poisoning that occurs throughout the tropics, particularly in vulnerable island communities such as the developing Pacific Island Countries and Territories (PICTs). After consuming ciguatoxin-contaminated fish, people report a range of acute neurologic, gastrointestinal, and cardiac symptoms, with some experiencing chronic neurologic symptoms lasting weeks to months. Unfortunately, the true extent of illness and its impact on human communities and ecosystem health are still poorly understood

First ciguatera outbreak in Germany in 2012

Im November 2012 traten in Deutschland nach dem Verzehr von importiertem Tropenfisch (Lutjanus spp.) 23 Vergiftungen mit der für Ciguatera typischen Kombination gastrointestinaler und neurologischer Symptome auf. Anhand eines Fragebogens wurden der Krankheitsverlauf und Informationen zum Fischverzehr erfasst. Alle Patienten litten an der pathognomonischen Kaltallodynie. Zwei Patienten hatten schwere Symptome, die anderen Fälle verliefen mittelschwer. Im Rahmen des 3‑Jahres-Follow-up berichteten sieben Patienten von länger als ein Jahr anhaltenden Parästhesien. Bei zwei Patienten konnten fast drei Jahre anhaltende Neuropathien detailliert dokumentiert werden. Die Patienten können acht Clustern in sieben deutschen Städten zugeordnet werden. Ein weiteres potenzielles Cluster wurde durch den geglückten Rückruf bereits verkaufter, Ciguatoxin-haltiger Ware verhindert. Drei Cluster wurden durch den Nachweis von Ciguatoxin in Rückruf- und Verdachtsproben objektiviert. Eine Hochrechnung auf der Basis Ciguatoxin-haltiger Proben ergab etwa 20 verhinderte Erkrankungsfälle. Im Rahmen der Ausbruchsaufklärung wurden irrtümlich widersprüchliche Kennzeichnungen auf den Lieferpapieren hinsichtlich der an den Einzelhandel gelieferten Fischart sowie deren Fanggebiet bekannt. Durch die uneinheitliche Vorgehensweise bei den Meldungen an Giftinformationszentren, Veterinär- und Gesundheitsämter erwiesen sich die Erfassung der Fälle und die Aufklärung des Ciguatera-Ausbruchs als schwierig. Vielen Ärzten in Deutschland ist das durch Tropenfisch verursachte Krankheitsbild bislang unzureichend bekannt. Das Auftreten weiterer Ausbrüche in den Folgejahren unterstreicht die zunehmende Bedeutung von Ciguatera in Deutschland.In November 2012, 23 cases of ciguatera with typical combinations of gastrointestinal and neurological symptoms occurred in Germany after consumption of imported tropical fish (Lutjanus spp.). A questionnaire was used to gather information on the disease course and fish consumption. All patients suffered from pathognomonic cold allodynia. Aside from two severe courses of illness, all other cases showed symptoms of moderate intensity. During a three-year follow-up, seven patients reported prolonged paresthesia for more than one year. Two of them reported further neuropathies over almost three years. This is the first time that long-term persistence of symptoms has been documented in detail. Outbreak cases were allocated to eight clusters in seven German cities. A further cluster was prevented by the successful recall of ciguatoxic fish. Three clusters were confirmed by the detection of ciguatoxin in samples of suspicious and recalled fish. An extrapolation on the basis of ciguatoxic samples revealed twenty prevented cases of ciguatera. Further officially unknown cases should be assumed. During the outbreak investigations, inadvertently falsely labelled fish species and fishing capture areas on import and retail level documents were observed. The ascertainment of cases and the outbreak investigations proved to be difficult due to inconsistent case reports to poisons centers, local health and veterinary authorities. In Germany, many physicians are unaware of the disease pattern of ciguatera and the risks caused by tropical fish. The occurrence of further outbreaks during the following years emphasizes the increasing significance of ciguatera in Germany