BACKGROUND AND OBJECTIVES: Dietary variety and diversity are recommended in dietary guidelines, but their association with BMI in US preschool-aged children is unknown. This study examined predictors of dietary variety and diversity and their association with child BMI z score (BMIz).

Studies in Western nations have shown associations of certain dietary patterns with obesity and metabolic risk in youth. Little is known about these relations in newly industrialized countries where obesity prevalence is surpassing those of developed countries. We sought to characterize dietary patterns in a cross-sectional study in 224 adolescents aged 8-14 y in Mexico and to investigate associations of the dietary patterns with adiposity and metabolic risk. We used principal components analysis to derive dietary patterns from food-frequency questionnaire data. By using linear regression models that accounted for mother's marital status, education, and smoking habits and child's age and physical activity, we examined associations of the dietary patterns with adiposity [body mass index score, waist circumference, the sum and ratio of the subscapular and triceps skinfold thicknesses, blood pressure, serum fasting glucose and a C-peptide-based measure of insulin resistance (CP-IR), lipid profile, and a metabolic syndrome risk score (MetS score)]. We identified a "prudent" dietary pattern characterized by high intakes of vegetables, fruit, fish, chicken, and legumes and a "transitioning" dietary pattern, which comprises processed meats, Mexican foods, and sweetened beverages. Each unit increase in the prudent pattern factor score corresponded with 0.33 ng/mL (95% CI: 0.09, 0.57 ng/mL) lower C-peptide, 0.08 units (95% CI: 0.02, 0.13 units) lower CP-IR, and a 0.14 unit (0.00, 0.27 unit) lower MetS score in boys. In girls, the transitioning pattern corresponded with higher subscapular + triceps skinfold thickness (per 1-unit increase in the factor score: 2.46 mm; 95% CI: 0.10, 4.81 mm). These results did not change after accounting for pubertal status. A prudent dietary pattern was protective against metabolic risk in adolescent boys, whereas a transitioning dietary pattern corresponded with higher adiposity among adolescent girls. Given that adolescence is a key developmental period for long-term health, efforts to elucidate dietary determinants of metabolic risk during this life stage may have long-term benefits.

Selective eating in children is commonly measured by parental report questionnaires, yet it is unknown if parents accurately estimate their child's selective eating behavior. The objectives of this study were to test the validity and stability of two measures of selective eating using observed child behavior. Low-income mother-child dyads participated in a videotaped laboratory eating protocol at two time points (baseline: mean child age = 5.9 years; follow-up: mean child age = 8.6 years), during which they were presented with a familiar and an unfamiliar vegetable. Videos were reliably coded for child selective eating behaviors: amount consumed, child hedonic rating of vegetables, child compliance with maternal prompts to eat, latency to first bite, number of bites, and negative utterances. Mothers completed the Child Eating Behavior Questionnaire Food Fussiness (CEBQ FF) scale and the Food Neophobia Scale (FNS) at both time points. Questionnaire validity, stability of measured behaviors, and discriminant validity of questionnaires were examined in the full sample. CEBQ FF scores and FNS scores were both inversely correlated with the quantity consumed, child hedonic rating, and compliance with prompts to eat for both familiar and unfamiliar vegetables at baseline and at follow up. CEBQ FF and FNS scores were inversely correlated with number of bites (for both foods), positively correlated with latency to first bite (for both foods), and inversely correlated with child negative utterances (for the familiar food only). Notably, FNS scores correlated with observed behavior for both familiar and unfamiliar foods, rather than demonstrating a specific association with unfamiliar foods only. This study supports the validity of the CEBQ FF and FNS in low-income early school-aged children.

BACKGROUND AND OBJECTIVES: Picky eating is common, yet little is known about trajectories of picky eating in childhood. Our objectives were to examine trajectories of child picky eating in lowincome US children from ages 4 to 9 years and associations of those trajectories with participant characteristics, including child BMI z score (BMIz) and maternal feeding-behavior trajectories.METHODS: Mother-child dyads (N = 317) provided anthropometry and reported on picky eating and maternal feeding behaviors via questionnaires at child ages 4, 5, 6, 8, and 9 years. At baseline, mothers reported on demographics and child emotional regulation. Trajectories of picky eating and maternal feeding behaviors were identified by using latent class analysis. Bivariate analyses examined associations of picky-eating trajectory membership with baseline characteristics and maternal feeding-behavior trajectory memberships. A linear mixed model was used to examine the association of BMIz with picky-eating trajectories.RESULTS: Three trajectories of picky eating emerged: persistently low (n = 92; 29%), persistently medium (n = 181; 57%), and persistently high (n = 44; 14%). Membership in the high pickyeating trajectory was associated with higher child emotional lability and lower child emotional regulation. Picky eating was associated with restriction (P = .01) and demandingness (P , .001) trajectory memberships, such that low picky eating was associated with low restriction and high picky eating was associated with high demandingness. Medium and high picky-eating trajectories were associated with lower BMIz.CONCLUSIONS: Picky eating appears to be traitlike in childhood and may be protective against higher BMIz.WHAT'S KNOWN ON THIS SUBJECT: Picky eating is common during childhood. Certain child characteristics (eg, sex, birth order, and socioeconomic status) have been associated with persistence of picky eating. It remains unclear how picky eating is related to child weight and maternal feeding behaviors.WHAT THIS STUDY ADDS: Picky eating is a stable trait that is established in children by age 4 and may be protective against overweight and obesity. Picky eating is also associated with maternal feeding behaviors, such as restriction and demandingness.

Serum concentrations of neuroactive androgens decline in older men and, in some studies, low testosterone is associated with decreased cognitive function and incidence of depression. Existing studies evaluating the effect of testosterone administration on cognition in older men have been largely inconclusive, with some studies reporting minor to moderate cognitive benefit, while others indicate no cognitive effect. Our objective was to assess the cognitive effects of treating older hypogonadal men for 1 year with a supraphysiological dose of testosterone, either alone or in combination with finasteride (a type II 5α-reductase inhibitor), in order to determine whether testosterone produces cognitive benefit and whether suppressed dihydrotestosterone influences cognition. Sixty men aged ≥60 years with a serum testosterone concentration of ≤300 ng/dL or bioavailable testosterone ≤70 ng/dL and no evidence of cognitive impairment received testosterone-enanthate (125 mg/week) versus vehicle, paired with finasteride (5 mg/day) versus placebo using a 2×2 factorial design. Testosterone caused a small decrease in depressive symptoms as assessed by the Geriatric Depression Scale and a moderate increase in visuospatial memory as assessed by performance on a recall trial of the Rey-Osterrieth Complex Figure Test. Finasteride caused a small increase in performance on the Benton Judgment of Line Orientation test. In total, major improvements in cognition were not observed either with testosterone or finasteride. Further studies are warranted to determine if testosterone replacement may improve cognition in other domains.

We have investigated the effect of melatonin administration on the cytometric and endocrine functions of the ovary during aging. Young cyclic (3 months old), middle-aged pre-acyclic (13 months old), and old acyclic (22 months old) female Wistar rats were used for two months, in both control and melatonin-treated groups. Cell cycle by flow cytometry: the percentage of ovarian cells in the G0-G1 phase was the highest in both control and melatonin-treated rats. However, melatonin treatment significantly reduced (P< 0.05) the percentage of cells in the G0-G1 phase compared to control rats. This reduction of cells in the G0-G1 phase is derived to the S phase in cyclic and acyclic rats. The possibility that a tumoral process leads to a proliferative effect observed in young and acyclic melatonin-treated rats was ruled out because no significant differences were found for p53 and Ki67 expression levels between control and melatonin groups. Density of oocytes: the oocyte number per ovary unit volume was not affected by melatonin treatment in the three age ranges studied. Melatonin treatment in middle-aged (pre-acyclic) rats resulted in significantly higher (P< 0.05) ovarian volume; higher oocyte volume, without significant differences, and oocytes in circular form were significantly (P< 0.05) higher than in control rats. Melatonin treatment during pre-acyclic age range could resynchronize the estrous cycle periodicity. Melatonin treatment was able to maintain the same levels of estradiol in the pre-acyclic age groups studied as those observed in the young cyclic rats. The present results indicate that melatonin administration to middle-aged female rats produces beneficial effects that extend the reproductive function of the ovary.

Introduction: Acquired thrombotic thrombocytopenic purpura (aTTP) is a rare disease characterized by a severe deficiency of the enzymatic activity of ADAMTS13 caused by autoantibodies, with an incidence of 3-4 x106inhabitants per year according to the few published data available. Accurate estimates of the incidence of aTTP are important to assess the resources required for current treatments and to anticipate the need to develop new treatments. The aim of this study was to determine the actualincidence of aTTP in Spain, as well as its diagnosis, management, and associated complications. Material and methods:A cross-sectional surveywascarried out among hematologists working in Spanish hospitals by means of an email that was sent to all members of the three main hematological scientificsocieties of Spain. All participants were asked to report the number of patients over the age of 16 years with a de novodiagnosis and relapses examined between Jan 2015 and Dec 2017. They were also asked about the number of patients that were known and alive in each hospital without having experienced any episode during such period. The population area of each participating hospital was consideredto calculate the incidence and prevalence of the disease. We also estimated the hospitalization service, mean hospital stay, percentage of ADAMTS13 activity at diagnosis and during follow-up, initial management, refractory cases and exacerbations (as defined by Scully et al.), treatment-related complications, and sequelae of aTTP. The median, interquartile ranges, and percentages were used for the descriptive analysis. Given that no personal data were treated, this study did not require the approval of a Research Ethics Committee. Results:A response was received from 42 centers (Figure 1). All hospitals except a private one belonged to the Spanish public health system, which provides health coverage to the entire Spanish population.A total of 203 episodes were reported (138 new episodes). The calculated population of the participating centers was nearly 21 x 106inhabitants. The incidence was 2.25 x106inhabitants per year, and the prevalence 19 x106inhabitants. Six patients died before they could start treatment (all but one in first episodes) and five were sent to other hospitals; thus, a total of 192 episodes were eventually treated. Table 1 and 2 show the data of the enzymatic activity of ADAMTS13 and the ADAMTS13 inhibitor at diagnosis, as well asthe complications. Plasma exchange (PEX) was performed by the Hematology and Nephrology Departments of 29 (70.7%) and 12 (29.3%) hospitals, respectively. The median hospital stay was 14 days (IQR: 10-20). Seventy-five episodes (39.1%) required admission to the intensive care unit with a median stay of 4 days (IQR: 3-7). During first-time episodes, a median of 12 PEX procedures (IQR: 8-19) were performed per patient, whereas in the case of relapses, a median of 9 (7-10) PEX procedures were carried out per patient. One plasma volume (PV) was used in the PEX procedures performed in 34% of the episodes, while 1.5 PVs were used in 56% of the episodes, and other PVs were used in the remaining 9.8%. The median duration of the PEX procedures was 121 minutes (IQR: 118-180). PEX and corticosteroids were the initial treatments administered in 98.4% of the episodes. Rituximab was used as a first-line treatment for new episodes in 18 of the 127 patients (14.1%), as a second-line treatment in 34 patients (26.6%), and as a prophylactic treatment (followingremission) in 4 patients (3.5%). In addition to the 6 early deaths, 9 patients died despite receiving the treatment (15 of 203 episodes, accounting for a mortality rate of 7.3%). Refractoriness to the PEX + corticoids was observed in 31 episodes of the 192 ones treated (16.1%), and at least one exacerbation (26.5%) took place in 51 episodes. Conclusion.Wecalculated the incidence ofclinically diagnosed aTTP associated with a severe ADAMTS13 deficiency inalmost half of the Spanish population which provided a high accuracy to our findings. These data are concordant with those published previously in other countries. Despite the currently available therapies, considerable rates of refractoriness and mortality still persist.Our data will be very useful for estimating the budget invested in this pathology and proposing standards for the diagnosis and treatment of this disease in our region. Disclosures Pascual Izquierdo: Novartis: Consultancy; Sanofi: Consultancy. De La Rubia:AMGEN: Consultancy; Celgene Corporation: Consultancy; Takeda: Consultancy; AbbVie: Consultancy; Janssen: Consultancy. Mingot-Castellano:Novartis: Consultancy; Novonordisk: Consultancy; Roche: Consultancy; Takeda: Consultancy; Bayer: Consultancy; Amgen: Consultancy; CSL Behring: Consultancy; Sobi: Consultancy.

neoplasias diagnosticadas histopatológicamente. Se consideraron las variables sexo, edad, raza, origen celular y localización. De 4438 fichas en caninos, 1092 casos correspondieron a neoplasias (24.6%). En los grupos etáreos de 5 a <9 y 9 años se encontró la mayor frecuencia de neoplasias (37.1 y 35.6%, respectivamente). No se encontró diferencias entre sexos, pero los canes de raza Boxer fueron los más afectados (12.1%). Las neoplasias malignas fueron más frecuentes (64.9%) que las benignas, siendo el tumor venéreo transmisible la neoplasia más frecuente dentro los tumores benignos y el adenocarcinoma mamario el más frecuente dentro los tumores malignos. Las neoplasias de origen epitelial (39.5%) y a nivel de la glándula mamaria (16.7%) fueron las más frecuentes.