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No AccessJournal of Speech and Hearing DisordersResearch Article1 Nov 1959Preferred Method For Clinical Determination Of Pure-Tone Thresholds Raymond Carhart, and James F. Jerger Raymond Carhart Google Scholar and James F. Jerger Google Scholar https://doi.org/10.1044/jshd.2404.330 SectionsAboutPDF ToolsAdd to favoritesDownload CitationTrack Citations ShareFacebookTwitterLinked In Additional Resources FiguresReferencesRelatedDetailsCited by PLOS ONE18:3 (e0283519)28 Mar 2023Validation of web-based audiometry version of HEARZAPPandi Renganath P., Vidya Ramkumar and Annalisa Pace JAMA Network Open6:3 (e233061)15 Mar 2023Peripheral Auditory Function in Tanzanian Children Living With HIV With Clinically Normal HearingChristopher E. Niemczak, Christin Ealer, Abigail Fellows, Albert Magohe, Jiang Gui, Catherine Rieke, Trent Nicol, Enica R. Massawe, Nina Kraus and Jay C. Buckey International Journal of Audiology (1-6)27 Feb 2023Digits in noise testing in a multilingual sample of Asian adultsJeremy Chee, Robert H. Eikelboom, Cas Smits, De Wet Swanepoel, Shiou Liang Wee, Tze Pin Ng and Rebecca L. Heywood International Journal of Environmental Research and Public Health20:5 (3826)21 Feb 2023Prevalence of Hearing Loss and Perceptions of Hearing Health and Protection among Florida FirefightersBarbara Millet, Hillary A. Snapp, Suhrud M. Rajguru and Natasha Schaefer Solle Clinical Neurophysiology1 Feb 2023Onset-offset cortical auditory evoked potential amplitude differences indicate auditory cortical hyperactivity and reduced inhibition in people with tinnitusKenneth Morse and Kathy R. Vander Werff International Journal of Audiology (1-6)20 Jan 2023A Central Auditory Test reveals differences between drug treatment regimens in adults living with HIVChristopher E. Niemczak, Yi Zhan, Junkun Ren, Fengxiang Song, Hongzhou Lu, Guochao Chen, Abigail M. Fellows, Jiang Gui, Sigfrid D. Soli, Jay C. Buckey and Yuxin Shi Frontiers in Neuroscience1617 Jan 2023Spatial rehabilitation using virtual auditory space training paradigm in individuals with sensorineural hearing impairmentKavassery Venkateswaran Nisha, Ajith Kumar Uppunda and Rakesh Trinesh Kumar Environmental Health Perspectives131:3The Health Effects of 72 Hours of Simulated Wind Turbine Infrasound: A Double-Blind Randomized Crossover Study in Noise-Sensitive, Healthy AdultsNathaniel S. Marshall, Garry Cho, Brett G. Toelle, Renzo Tonin, Delwyn J. Bartlett, Angela L. D'Rozario, Carla A. Evans, Christine T. Cowie, Oliver Janev, Christopher R. Whitfeld, Nick Glozier, Bruce E. Walker, Roo Killick, Miriam S. Welgampola, Craig L. Phillips, Guy B. Marks and Ronald R. Grunstein Trends in Hearing27 (233121652311609)1 Jan 2023U.S. Population Data on Hearing Loss, Trouble Hearing, and Hearing-Device Use in Adults: National Health and Nutrition Examination Survey, 2011–12, 2015–16, and 2017–20Larry E. Humes Ear & HearingPublish Ahead of Print5 Apr 2023Asymmetric Hearing Loss in Adult Cochlear Implant Recipients: Results and Recommendations From a Multisite Prospective Clinical TrialJill B. Firszt, Laura K. Holden, Noël Y. Dwyer, Ruth M. Reeder and Michael J. Strube Indian Journal of Otolaryngology and Head & Neck Surgery30 Dec 2022Effect of Contralateral Acoustic Stimulation on Temporal Processing Abilities in Individuals with Normal HearingPraveen Prakash, Adithya Sreedhar, Abishek Umashankar and Prashanth Prabhu International Journal of Audiology (1-11)28 Dec 2022ABO blood group and cochlear function: evidence from a large sample size studyChanggeng Mo, Ting Fung Ma and Bradley McPherson Indian Journal of Otolaryngology and Head & Neck Surgery20 Dec 2022Effect of Age and Hearing Loss on Auditory Processing SkillsGeetha Chinnaraj, Chandni Jain, Keerthi Sringari Parameshwara and Rakesh Trinesh Frontiers in Neurology139 Dec 2022Associations of audiometric hearing and speech-in-noise performance with cognitive decline among older adults: The Baltimore Longitudinal Study of Aging (BLSA)Kening Jiang, Nicole M. Armstrong, Yuri Agrawal, Alden L. Gross, Jennifer A. Schrack, Frank R. Lin, Luigi Ferrucci, Susan M. Resnick, Jennifer A. Deal and Danielle S. Powell American Journal of Audiology31:4 (1098-1115)5 Dec 2022Effect of Occupational Noise Exposure on Cognition and Suprathreshold Auditory Skills in Normal-Hearing IndividualsSahana Vasudevamurthy and Ajith Kumar U. The Egyptian Journal of Otolaryngology38:11 Dec 2022Audio-vestibular manifestations in Kawasaki disease (KD): a rare atypical case presentationR. Mayuri Rao, E. R. Rajils Raveendran, K. Nidha, K. Namitha, P. Prashanth Prabhu and K. V. Nisha The Egyptian Journal of Otolaryngology38:11 Dec 2022High-frequency audiometry, speech perception in quiet and noise, and vestibular-evoked myogenic potential in women with polycystic ovary syndromeKumari Apeksha, Ananya Basappa and Darshan Devananda Indian Journal of Otolaryngology and Head & Neck Surgery74:S3 (4100-4105)1 Dec 2022Effect of Efferent Stimulation on the Differential Sensitivity in Individuals with Normal HearingAdithya Sreedhar, Praveen Prakash, Abishek Umashankar and Prashanth Prabhu Indian Journal of Otolaryngology and Head & Neck Surgery74:S3 (5492-5498)1 Dec 2022Changes in Auditory Working Memory Capacities During AdolescenceAbishek Umashankar, Chandana Shivaiah and Prashanth Prabhu Journal of the American Academy of Audiology29 Nov 2022Audiological Findings in Children with PLA2G6-Associated NeurodegenerationValiyaparambath Purushothaman Vandana, Jeevendra Kumar Darshini and Bindu Parayil Sankaran International Journal of Audiology (1-8)27 Oct 2022Measuring resonance frequency of the middle ear in school-aged children: potential applications for detecting middle ear dysfunctionCerys Downing, Joseph Kei and Carlie Driscoll International Journal of Audiology61:10 (818-825)3 Oct 2022The World Health Organization (WHO) hearing impairment guidelines and a speech recognition in noise (SRN) disorderAndrew J. Vermiglio and Xiangming Fang The Journal of the Acoustical Society of America152:4 (2419-2433)1 Oct 2022Supra-threshold deficits in normal hearing military recruits exposed to impulse noiseAlexis Pinsonnault-Skvarenina, William Soucy, Jonathan Noël, Félicia Doucet, Élise Lévesque, Adrian Fuente and Tony Leroux Journal of Otology17:4 (191-196)1 Oct 2022Effect of diurnal changes on dichotic listening in younger adults with normal hearingPraveen Prakash, K.P. Vismaya, Dhruvan S. Mahesh and Prashanth Prabhu Hearing Research424 (108594)1 Oct 2022Effects of unilateral eye closure on middle ear muscle contractionsStephen M. Tasko, Kristy K. Deiters, Gregory A. Flamme, Madeline V. Smith, William J. Murphy, Heath G. Jones, Nathaniel T. Greene and William A. Ahroon The Laryngoscope28 Sep 2022A Smartphone Application and Education Program for Hearing Health Promotion in High School TeenagersJolie L. Chang, Camille Huwyler, Norimasa Yoshida, Jennifer Henderson Sabes and Steven W. Cheung Frontiers in Psychology1326 Sep 2022Fear influences phantom sound percepts in an anechoic roomSam Denys, Rilana F. F. Cima, Thomas E. Fuller, An-Sofie Ceresa, Lauren Blockmans, Johan W. S. Vlaeyen and Nicolas Verhaert Revista de Investigación en Logopedia12:2 (e81057)23 Sep 2022Validez, precisión diagnóstica y fiabilidad del Test de Palabras Parónimas Susurradas para la detección rápida de la presbiacusiaJesús Valero-García and Josep María Vila-Rovira American Journal of Audiology31:3S (892-904)21 Sep 2022Feasibility and Assessment of a Hybrid Audiology Service Delivery Model for Older Adult Hearing Aid Users: A Pilot StudyMichelle L. Arnold, Breanne Schwartz, Haley Neil, Theresa H. Chisolm and Victoria A. Sanchez Biology of Sex Differences13:116 Sep 2022Sex differences in number of X chromosomes and X-chromosome inactivation in females promote greater variability in hearing among malesVan Summers BMC Geriatrics22:115 Sep 2022Sensory and motor correlates of frailty: dissociation between frailty phenotype and frailty indexFlorian Beier, Martin Löffler, Frauke Nees, Lucrezia Hausner, Lutz Frölich and Herta Flor International Journal of Environmental Research and Public Health19:17 (11028)3 Sep 2022Subclinical Hearing Deficits in Noise-Exposed FirefightersHillary A. Snapp, Natasha Schaefer Solle, Barbara Millet and Suhrud M. Rajguru Ear & Hearing43:5 (1526-1539)1 Sep 2022Characterizing Electrophysiological Response Properties of the Peripheral Auditory System Evoked by Phonemes in Normal and Hearing Impaired EarsWilliam J. Riggs, Meghan M. Hiss and Oliver F. Adunka American Journal of Audiology31:3 (737-745)1 Sep 2022Tinnitus Affects Endogenous But Not Exogenous Auditory Attention OrientingYichen Yuan, Yuexin Cai, Jiashuang Wu, Jiahong Li, Xiayin Huang, Guisheng Chen, Liping Lan, Hemei Huang, Hanwen Dong, Yiqing Zheng and Zhenzhu Yue International Journal of Audiology (1-17)29 Aug 2022Leisure noise exposure and hearing outcomes among Canadians aged 6 to 79 yearsKatya Feder, Leonora Marro and Cory Portnuff Behavior Research Methods12 Aug 2022Validation of a tablet-based assessment of auditory sensitivity for researchersKathryn Wiseman, Jerry Slotkin, Meredith Spratford, Amberlee Haggerty, Maggie Heusinkvelt, Sandra Weintraub, Richard Gershon and Ryan McCreery Frontiers in Neurology135 Aug 2022A randomized single-blind controlled trial of a prototype digital polytherapeutic for tinnitusGrant D. Searchfield and Philip J. Sanders Hearing Research421 (108491)1 Aug 2022Which threshold do we trust? A comparison of threshold measurements in adult bone-conduction device users and normal hearing adultsAlex Gascon, Amberley V. Ostevik, Truc Huynh and William E. Hodgetts Hearing Research421 (108379)1 Aug 2022Effects of extended high frequency bandwidth in osseointegrated bone conduction device usersHillary A. Snapp and Brianna Kuzbyt The Journal of the Acoustical Society of America152:1 (601-608)1 Jul 2022Reference equivalent threshold sound pressure levels for the Wireless Automated Hearing Test SystemOdile H. Clavier, James A. Norris, David W. Hinckley, William Hal Martin, Shi Yuan Lee, Sigfrid D. Soli, Douglas S. Brungart, Jaclyn R. Schurman, Erik Larsen, Golbarg Mehraei and Tera M. Quigley The Journal of the Acoustical Society of America152:1 (470-490)1 Jul 2022The audiogram: Detection of pure-tone stimuli in ototoxicity monitoring and assessments of investigational medicines for the inner earColleen G. Le Prell, Carmen C. Brewer and Kathleen C. M. Campbell Ear & Hearing43:4 (1245-1255)1 Jul 2022Wideband Tympanometry Findings in School-aged Children: Effects of Age, Gender, Ear Laterality, and EthnicityCerys Downing, Joseph Kei, Carlie Driscoll, Robyn Choi and Dion Scott Hearing Research (108568)1 Jul 2022Audiologic characterization using clinical physiological measures: Normative data from macaque monkeysAmy N. Stahl, Jane A. Mondul, Katy A. Alek, Troy A. Hackett and Ramnarayan Ramachandran American Journal of Audiology31:2 (403-410)2 Jun 2022Effect of Electrode Montage on 500-Hz Tone Burst Evoked Masseter Vestibular Evoked Myogenic PotentialVinayagar Pazhani Thirusangu and Sujeet Kumar Sinha International Journal of Pediatric Otorhinolaryngology (111212)1 Jun 2022Effect of modified programming parameters on sound field thresholds, speech perception and CAEP among children using CP802 processorMuthuselvi T, Ravikumar A, Madhuri Gore and AjithKumar U Aging and Health Research2:2 (100074)1 Jun 2022Inhibitory control and value-directed strategic attention in persons with mild age-related hearing lossShraddha A. Shende, Elizabeth A. Lydon, Fatima T. Husain and Raksha A. Mudar Speech Communication1 May 2022Learning transfer from singing to speech: Insights from vowel analyses in aging amateur singers and non-singersAnna Marczyk, Émilie Belley, Catherine Savard, Johanna-Pascale Roy, Josée Vaillancourt and Pascale Tremblay Journal of Otology17:2 (95-100)1 Apr 2022Evaluation of auditory working memory in Bharatanatyam dancersPraveen Prakash, Anjana M. Nath, Mereena Joy and Prashanth Prabhu The Journal of the Acoustical Society of America151:3 (1913-1921)1 Mar 2022Evaluation of hearing loss in young adults after exposure to 3.0T MRI with standard hearing protectionCarrie M Carr, John I Lane, Larry J Eckel, Felix E Diehn, Dave F Kallmes, Matthew L Carlson, Yunhong Shu, Matt A Bernstein, Tina M Gunderson and Gayla L Poling Otology & Neurotology43:3 (e348-e354)1 Mar 2022Does Vestibulo-Ocular Reflex (VOR) Gain Correlate With Radiological Findings in the Semi-Circular Canals in Patients Carrying the p.Pro51Ser (P51S) COCH Variant Causing DFNA9? Relationship Between the Three-Dimensional Video Head Impulse Test (vHIT) and MR/CT ImagingMahadi Salah, Julie Moyaert, Olivier Vanderveken, Steven Schepers, Bruno Termote, Vincent Van Rompaey and Sebastien Janssens de Varebeke World Journal of Clinical Cases10:6 (1815-1825)26 Feb 2022Early detection of noise-induced hearing lossZhao-Li Meng, Fei Chen, Fei Zhao, Hai-Ling Gu and Yun Zheng Hearing, Balance and Communication20:1 (15-20)2 Jan 2022Individuals practicing meditation have enhanced subcortical auditory processing of speechSujeet Kumar Sinha and Manisha Sahu Journal of International Society of Preventive and Community Dentistry12:5 (513)Should dentists mandatorily wear ear protection device to prevent occupational noise-induced hearing loss? A randomized case–control studyKishanM Mohan, Aditi Chopra, Vasudeva Guddattu, Shruti Singh and Kumari Upasana CoDAS34:1Comparison of performance with hearing aid programmed to NAL-NL1 first-fit and optimized-fitSreena Ediyarath Narayanan and Puttabasappa Manjula Trends in Hearing26 (233121652211397)1 Jan 2022Comparing Clinically Applicable Behavioral and Electrophysiological Measures of Speech Detection, Discrimination, and ComprehensionPushkar Deshpande, Christian Brandt, Stefan Debener and Tobias Neher ORL84:3 (238-246)Hearing Impairment and Audiological Alterations in Euthyroid Hashimoto's ThyroiditisÖmercan Topaloğlu and Bayram Şahin Ear & HearingPublish Ahead of Print20 Dec 2022Accelerated Cognitive Decline Associated With Hearing Loss and Bilateral Vestibulopathy: Insights From a Prospective Cross-Sectional Study Using the Repeatable Battery for the Assessment of Neuropsychological Status Adjusted for the Hearing Impaired in the DFNA9 PopulationHanne Gommeren, Joyce Bosmans, Julie Moyaert, Griet Mertens, Patrick Cras, Sebastiaan Engelborghs, Angelique Van Ombergen, Annick Gilles, Erik Fransen, Raymond van de Berg, Sebastien JanssensdeVarebeke and Vincent Van Rompaey Ear & Hearing43:3 (822-835)1 May 202212 Oct 2021Extended High-frequency Hearing Impairment Despite a Normal Audiogram: Relation to Early Aging, Speech-in-noise Perception, Cochlear Function, and Routine Earphone UseSrikanta K. Mishra, Udit Saxena and Hansapani Rodrigo Ear & Hearing43:3 (874-882)1 May 202220 Sep 2021Intraoperative Electrocochleography in Subjects Affected by Vestibular Schwannoma and Ménière's Disease: Comparison of ResultsEleonora M. C. Trecca, Oliver F. Adunka, Meghan M. Hiss, Jameson K. Mattingly, Aaron C. Moberly, Edward E. Dodson, Michele Cassano, Daniel M. Prevedello and William J. Riggs Ear & Hearing43:2 (495-506)1 Mar 202227 Jul 2021Evaluation of Remote Check: A Clinical Tool for Asynchronous Monitoring and Triage of Cochlear Implant RecipientsSaji Maruthurkkara, Sasha Case and Riaan Rottier Audiology Research11:4 (673-690)13 Dec 2021Verification of a Mobile Psychoacoustic Test SystemJordana C. Soares, Sangamanatha A. Veeranna, Vijay Parsa, Chris Allan, Winnie Ly, Minh Duong, Paula Folkeard, Sheila Moodie and Prudence Allen American Journal of Audiology30:4 (956-967)9 Dec 2021Perceived Listening Difficulty in the Classroom, Not Measured Noise Levels, Is Associated With Fatigue in Children With and Without Hearing LossSamantha J. Gustafson, Stephen Camarata, Benjamin W. Y. Hornsby and Fred H. BessAmerican Journal of Audiology30:4 (1037-1047)9 Dec 2021Relationship Between Peripheral and Central Auditory Abilities and Iron Deficiency Anemia in Adolescent GirlsChandni Jain, Vipin Ghosh Pushpoth Gangadharan, Chetak Kadabasal Basavaraja and Aishwarya LakshmiAmerican Journal of Audiology30:3S (825-833)11 Oct 2021Wideband Acoustic Reflex Growth in Adults With Cystic FibrosisMartha R. Westman, Daniel B. Putterman, Angela C. Garinis, Lisa L. Hunter and M. Patrick Feeney Scientific Reports11:11 Oct 2021Relationship between objective measures of hearing discrimination elicited by non-linguistic stimuli and speech perception in adultsHugo Sohier, Fabrice Bardy and Teresa Y. C. Ching An International Journal of Otorhinolaryngology Clinics13:1 (26-28)29 Sep 2021Noise through Bone Conduction—Differential Diagnosis for the Type of Hearing LossSindhu Parthasarathy and Hemanth N Shetty American Journal of Audiology30:3 (761-768)10 Sep 2021Hearing Aid Consumer Reviews: A Linguistic Analysis in Relation to Benefit and Satisfaction RatingsVinaya Manchaiah, De Wet Swanepoel, Abram Bailey, James W. Pennebaker and Rebecca J. BennettAmerican Journal of Audiology30:3 (709-716)10 Sep 2021Self-Reported Reasons for the Non-Use of Hearing Aids Among Hispanic Adults With Hearing LossJamie L. Desjardins and Loren R. SoteloAmerican Journal of Audiology30:3 (745-754)10 Sep 2021Experiences With Hearing Health Care Services: What Can We Learn From Online Consumer Reviews?Vinaya Manchaiah, Rebecca J. Bennett, Pierre Ratinaud and De Wet SwanepoelAmerican Journal of Audiology30:3 (518-523)10 Sep 2021Head Impulse Test Paradigm and Suppression Head Impulse Test Paradigm in Individuals With and Without Motion SicknessRakesh T. Kumar and Sujeet Kumar SinhaAmerican Journal of Audiology30:3 (790-795)10 Sep 2021An Objective Approach Toward Understanding Auditory Processing DisorderAkshay R. Maggu and Tobias OverathAmerican Journal of Audiology30:3 Sep the of a Hearing A Jonathan and Elizabeth A. Journal of Audiology30:3 Sep of During Vestibular Smith, and Journal of Audiology30:3 Sep for Hearing Aid Use and Care C. M. and A. Journal of Audiology30:3 Sep Consumer on Hearing Health Care Services: A Analysis Approach to Manchaiah, De Wet and Rebecca J. BennettAmerican Journal of Audiology30:3 Sep Cognitive Behavioral for in the A Pilot W. and Journal of Audiology30:3 Sep Approach to a K. J. and Barbara L. Journal of Audiology30:3 Sep Between the for Auditory Processing in Adults and Auditory Processing Test and Journal of Audiology30:3 Sep of a Smartphone for Cochlear Implant Patients With E. Richard S. Victoria and C. Journal of Audiology30:3 Sep and for in the Audiology of Audiology and J. Bennett, Lisa and C. Journal of Audiology30:3 Sep Understanding in Noise and Speech a Function of Cognitive Status in Older K. and S. Journal of Audiology30:3 Sep Implant Behavioral for Children With Auditory A and Journal of Audiology30:3 Sep Additional of Vestibular on for and Journal of Audiology30:3 Sep of Auditory Assessment in Clinical Using a C. S. J. and J. Journal of Audiology30:3 Sep Asynchronous Hearing Education and Research for and During the A Pilot Study on the and Journal of Audiology30:3 Sep Hearing Aid Battery Assessment of and of Michael and Kathleen M. Journal of Audiology30:3 Sep of Speech in and Older Adults With Cochlear C. and De Journal of Audiology30:3 Sep on and Tone in Can and Journal of Audiology30:3 Sep 2021Self-Reported Hearing Loss and Associated in Older Adults a Memory and de Journal of Audiology30:3 Sep Acoustic the of Children With Cochlear A Longitudinal Study and Cochlear Implant Christine and Journal of Audiology30:3 Sep Relationship Between and Auditory Abilities in Individuals With Jain, P. and Kumar of Otology and Sep of on Gain Kumar and Frontiers in Aug Pure-Tone and de The Journal of the Acoustical Society of Aug assessment of hearing loss military A. and C. J. Journal of and Hearing Jul in Healthy E. and M. 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International Journal of Audiology Feb listening device among Canadians and audiometric outcomes among Feder, James Leonora Marro and Cory Portnuff of Feb of diurnal changes on processing in and individuals with normal hearingPraveen Prakash, and Prashanth Prabhu Hearing, Balance and Jan 2021Hearing in individuals for a from a Indian Fatima and Jan of Acoustic of Using a Network J. G. G. K. and D. Searchfield of Indian Academy of Otorhinolaryngology Head and Neck of on the of Sahu and Trends in Jan Speech and With a Hearing Effects of Folkeard, Van Danielle and Susan Trends in Jan Wireless in Automated Pure-Tone and Ear & Sep Feb Noise Exposure and Longitudinal Hearing in During an of M. P. Kathleen F. Carlson, R. Jonathan M. Susan and James A. Ear & Mar Aug of Speech in to in Speech in Noise in Older R. G. E. Benjamin D. and Ear & Jan Aug of Auditory on and the C. Singh Chris Kei and D. Searchfield Philip and D. 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Thirty years ago, responding to the growing interest, rapid expansion, and increase in research in pediatric gastroenterology and nutrition, we established the Journal of Pediatric Gastroenterology and Nutrition (JPGN). The editorial of the first edition began, quo vadis? (1). Thirty years later, we are asking the same question. What should the vision of JPGN be? It seems mandatory to provide the pediatric gastroenterologist with research and knowledge of gastrointestinal ontogenic function and malfunction during early life. It was hoped that the Journal would serve as an intellectual stimulus and an international forum for the presentation and discussion of advances and controversies within the discipline. The findings of differential timing of the expression of the genes controlling various small intestinal disaccharidases, pancreatic exocrine enzymes, and so on, led to a new practical paradigm on gut development (2). The paradigm included interaction of genetic endowment, gene expression, intrinsic biological clocks, endogenous regulatory mechanisms of the hypothalamic-hypophysial-thyroid-adrenal axis, gastrointestinal receptors and mediators, and environmental influences. The environmental influences affecting gut ontogeny included intrauterine growth retardation and malnutrition early in life (2). Barker (3) hypothesized that the effect of intrauterine growth retardation increases the risk of later-onset disease, particularly cardiovascular disease, hypertension, and type 2 diabetes mellitus in adults (3). The ontogeny of gut enzymes in early infancy and the recognition of pancreatic amylase deficiency and the early appearance of intestinal α-glucosidases and salivary amylase led to another ontogenic paradigm of alternate pathways of digestion and absorption in early infancy. The pragmatic outcome of ontogenic research was to use α-glucosides, such as sucrose, maltose, maltodextrins, and short polymers of glucose, during the neonatal period and for the compromised infant. Studies focused on the investigation and clinical applications of gastrointestinal ontogeny exemplify the early emphasis of JPGN. The potential for new therapeutic modalities attributable to age-related changes in the gut can stimulate clinical and basic research. The human genome project, the availability of stem cell biology, advances in molecular mechanisms of growth and development, and discoveries of mucosal growth factors and receptors that occurred as a result of the inception of JPGN have led to dramatic expansion of the basic, translational, and clinical studies in the Journal. We aspired to be one of the journals that publish original articles on gut ontogeny. In addition, we decided to invite ontogenic review articles that provided a basis for understanding the importance of gut ontogeny. Conversely, we were successful publishing age-related clinical studies in pediatric gastroenterology, with an emphasis on early life. An example of clinical disorders that we began to address successfully is celiac disease (CD). Clinical studies in CD emerged in the Journal, including global prevalence and high prevalence of silent preschool- and school-aged children, association with autoimmune disorders, Down syndrome, type 1 diabetes mellitus, and atypical presentations. Mechanistic studies of the effect of several genetic factors together with an environmental trigger were published. The genetic predisposition to CD was studied as a complex of HLA-DQA1*05/DQB1*02 and HLA-DQA*0301/DQB*0302 genes as major factors. Two strategies of genetic research—linkage and association studies—led to the discovery of several susceptibility loci and genes such as a region on 5q, MYO9B, and CTLA4. In addition, a genomewide association study identified 8 new risk regions, 7 of which harbour genes controlling the immune response. Again, we solicited review articles on genetic molecular biology research and the pathogenesis of CD. Another example for specific age-related clinical presentation and therapeutic considerations is failure to gain weight and short stature associated with pediatric inflammatory bowel disease (IBD). Pediatric IBD is different in some major aspects from adult IBD. Early-onset IBD has a distinct phenotype with disease manifestations that are primarily colonic with severe perianal disease and extragastrointestinal manifestations. Furthermore, early-onset IBD is unique in its association with metabolic diseases, neutrophil defects, immunodeficiency states, chronic granulomatous disease, and leukocyte adhesion defects. IBD is thought to result from a complex interplay of multiple genes and environmental factors. Large-scale genotyping techniques have resulted in identification of >30 IBD-associated genes. Pediatric IBD management must consider lifelong disease and treatment. Twenty-five percent of patients with IBD develop the disease in childhood and adolescence. Clinicians need to weigh the risks and benefits of selected therapies, particularly the effects of medications, such as steroids, on growth and development and lifetime of exposure. For the last 30 years, the Journal has published a significant number of articles addressing issues specifically focused on pediatric IBD. We realized that the greatest challenge facing JPGN was reaching out to the world in general and developing countries in particular. We solicited articles from developing countries and found worthwhile clinical observations, but we were challenged by the flaws of study design, such as inclusion and exclusion criteria, sample size, and statistical analyses; data presentation; results; and conclusions. We were confronted with English and grammatical mistakes, leading us to correct and rewrite articles, provided they had a sound scientific message for the pediatric gastroenterology community. A new dimension of the Journal was added when the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition started to develop and update clinical practice guidelines and recommendations (4,5). Overall, it is apparent that JPGN has evolved to become an important cornerstone for the discipline and a reference journal for the societies of pediatric gastroenterology, hepatology, and nutrition. My suggestion for the future is that the clinical research emphasizes acute and chronic gut diseases, all the while continuing to consider the effect of the ontogeny of the gut. In the quest to improve the knowledge of pediatric gastroenterology and nutrition, we should develop new areas of focus and analysis, perspectives, policy forums, and technical comments, similar to the journal Science. Presentation of the basic science news on the ontogeny of the gut, including cell biology, genetics, and immunology, should be a stimulus for inquiry and research to advance the frontiers of pediatric gastroenterology.

For more than 50 years, many children with food protein allergies and other forms of dietary protein intolerance have been treated successfully with protein hydrolysates with highly reduced allergenicity and, more recently, also with products based on amino acid mixtures. Strategies for the prevention of allergy have been proposed, including the use of products with extensively reduced allergenicity. Products designed to have a moderately reduced allergenicity have also been proposed and marketed in Europe as hypoallergenic formulas. The European Society for Paediatric Allergology and Clinical Immunology (ESPACI) and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) have commented previously on these issues,1 2 and the Commission of the European Union has issued a regulation for the requirements of infant formulas with reduced allergenicity or reduced antigenicity.3 This paper comments on the current developments and unresolved issues in the dietary treatment and prevention of food allergy in infancy to help inform paediatricians and other health care professionals, as well as manufacturers of infant foods. Adverse reactions to foods are a problem, particularly in infancy and early childhood, and can present with a wide spectrum of clinical reactions such as cutaneous, gastrointestinal, respiratory, or other symptoms. Reproducible adverse reactions to food(s) can be the result of one or more immune mechanism(s) or they can be non-immunologically mediated. Immunologically mediated reactions, which are often immediate IgE mediated reactions, are defined as food protein allergy. Non-immunologically mediated reactions can be divided into enzymatic or transport defects (for example, lactase deficiency, or glucose/galactose malabsorption), pharmacological or other (undefined) reactions.2 4 The pattern and threshold of adverse reactions to foods varies. None of the symptoms related to immunologically or non- immunologically mediated adverse reactions to foods are pathognomonic, and no single laboratory test is diagnostic of food allergy. Therefore, the diagnosis …

Foodfortification is the process of adding micronutrients (essential trace elements and <br> vitamins) infood. As defined by the World Health Organization (WHO) and the Food and <br> Agricultural Organization of the United Nations(FAO), fortification refers to "the practice <br> of deliberately increasing the content of an essential micronutrient, i.e. vitamins and <br> minerals (including trace elements) in a food, so as to improve the nutritional quality of the <br> food supply and to provide a public health benefit with minimal risk to health", whereas <br> enrichment is defined as "synonymous with fortification and refers to the addition of <br> micronutrients to a food which are lost during processing". Foods based on fruits and <br> vegetables, such as its juices and pulp represent a new potential carrier and source of <br> probiotic microorganism. Yogurt, the best carrier of probiotics, traditionally is <br> manufactured streptococcus thermophiles and lactobacillus deldrueckii ssp. Bulgaricus (L. <br> bulgaricus) as starter cultures. Raw and fermented fruits represent an excellent vehicle for <br> probiotics due to their natural structure that allows the easy availability of usual nutrients <br> for microbial growth. Majority 70% of people in India do not consume enough <br> micronutrients such as vitamins and minerals in day to day life. Due to the high <br> consumption rate of dairy products such as probiotic yogurt, fortification of these products <br> will effectively reduce or prevent diseases associated with nutritional deficiencies. The aim <br> of this investigation is to study the technical aspects involved in production of different <br> types of fortified yogurts, firstly, fortification is defined and the main reasons behind <br> carrying out this process are presented and then yogurt production process and a variety of <br> minerals, vitamins, and functional ingredients which are used in the process are briefly

OBJECTIVES: Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment. METHODS: Thirty-one clinical questions addressing the diagnosis, treatment, and prognosis of common gastrointestinal and nutritional problems in neurological impaired children were formulated. Questions aimed to assess the nutritional management including nutritional status, identifying undernutrition, monitoring nutritional status, and defining nutritional requirements; to classify gastrointestinal issues including oropharyngeal dysfunctions, motor and sensory function, gastroesophageal reflux disease, and constipation; to evaluate the indications for nutritional rehabilitation including enteral feeding and percutaneous gastrostomy/jejunostomy; to define indications for surgical interventions (eg, Nissen Fundoplication, esophagogastric disconnection); and finally to consider ethical issues related to digestive and nutritional problems in the severely neurologically impaired children. A systematic literature search was performed from 1980 to October 2015 using MEDLINE. The approach of the Grading of Recommendations Assessment, Development, and Evaluation was applied to evaluate the outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation using the nominal voting technique. Expert opinion was applied to support the recommendations where no randomized controlled trials were available.

Anthropometry involves the external measurement of morphological traits of human beings. It has a widespread and important place in nutritional assessment, and while the literature on anthropometric measurement and its interpretation is enormous, the extent to which measurement error can influence both measurement and interpretation of nutritional status is little considered. In this article, different types of anthropometric measurement error are reviewed, ways of estimating measurement error are critically evaluated, guidelines for acceptable error presented, and ways in which measures of error can be used to improve the interpretation of anthropometric nutritional status discussed. Possible errors are of two sorts; those that are associated with: (1) repeated measures giving the same value (unreliability, imprecision, undependability); and (2) measurements departing from true values (inaccuracy, bias). Imprecision is due largely to observer error, and is the most commonly used measure of anthropometric measurement error. This can be estimated by carrying out repeated anthropometric measures on the same subjects and calculating one or more of the following: technical error of measurement (TEM); percentage TEM, coefficient of reliability (R), and intraclass correlation coefficient. The first three of these measures are mathematically interrelated. Targets for training in anthropometry are at present far from perfect, and further work is needed in developing appropriate protocols for nutritional anthropometry training. Acceptable levels of measurement error are difficult to ascertain because TEM is age dependent, and the value is also related to the anthropometric characteristics of the group of population under investigation. R > 0.95 should be sought where possible, and reference values of maximum acceptable TEM at set levels of R using published data from the combined National Health and Nutrition Examination Surveys I and II (Frisancho, 1990) are given. There is a clear hierarchy in the precision of different nutritional anthropometric measures, with weight and height being most precise. Waist and hip circumference show strong between-observer differences, and should, where possible, be carried out by one observer. Skinfolds can be associated with such large measurement error that interpretation is problematic. Ways are described in which measurement error can be used to assess the probability that differences in anthropometric measures across time within individuals are due to factors other than imprecision. Anthropometry is an important tool for nutritional assessment, and the techniques reported here should allow increased precision of measurement, and improved interpretation of anthropometric data.

Oral health is related to diet in many ways, for example, nutritional influences on craniofacial development, oral cancer and oral infectious diseases. Dental diseases impact considerably on self-esteem and quality of life and are expensive to treat. The objective of this paper is to review the evidence for an association between nutrition, diet and dental diseases and to present dietary recommendations for their prevention. Nutrition affects the teeth during development and malnutrition may exacerbate periodontal and oral infectious diseases. However, the most significant effect of nutrition on teeth is the local action of diet in the mouth on the development of dental caries and enamel erosion. Dental erosion is increasing and is associated with dietary acids, a major source of which is soft drinks. Despite improved trends in levels of dental caries in developed countries, dental caries remains prevalent and is increasing in some developing countries undergoing nutrition transition. There is convincing evidence, collectively from human intervention studies, epidemiological studies, animal studies and experimental studies, for an association between the amount and frequency of free sugars intake and dental caries. Although other fermentable carbohydrates may not be totally blameless, epidemiological studies show that consumption of starchy staple foods and fresh fruit are associated with low levels of dental caries. Fluoride reduces caries risk but has not eliminated dental caries and many countries do not have adequate exposure to fluoride. It is important that countries with a low intake of free sugars do not increase intake, as the available evidence shows that when free sugars consumption is <15-20 kg/yr ( approximately 6-10% energy intake), dental caries is low. For countries with high consumption levels it is recommended that national health authorities and decision-makers formulate country-specific and community-specific goals for reducing the amount of free sugars aiming towards the recommended maximum of no more than 10% of energy intake. In addition, the frequency of consumption of foods containing free sugars should be limited to a maximum of 4 times per day. It is the responsibility of national authorities to ensure implementation of feasible fluoride programmes for their country.

RATIONALE: This initiative is focused on building a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings. METHODS: In January 2016, the Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. GLIM appointed a core leadership committee and a supporting working group with representatives bringing additional global diversity and expertise. Empirical consensus was reached through a series of face-to-face meetings, telephone conferences, and e-mail communications. RESULTS: A two-step approach for the malnutrition diagnosis was selected, i.e., first screening to identify "at risk" status by the use of any validated screening tool, and second, assessment for diagnosis and grading the severity of malnutrition. The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment. Potential criteria were subjected to a ballot among the GLIM core and supporting working group members. The top five ranked criteria included three phenotypic criteria (weight loss, low body mass index, and reduced muscle mass) and two etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least one phenotypic criterion and one etiologic criterion should be present. Phenotypic metrics for grading severity as Stage 1 (moderate) and Stage 2 (severe) malnutrition are proposed. It is recommended that the etiologic criteria be used to guide intervention and anticipated outcomes. The recommended approach supports classification of malnutrition into four etiology-related diagnosis categories. CONCLUSION: A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure further collaboration and endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The diagnostic construct should be re-considered every 3-5 years.

BACKGROUND: Body weight and body mass index (BMI) are positively related to risk of colon cancer in men, whereas weak or no associations exist in women. This discrepancy may be related to differences in fat distribution between sexes or to the use of hormone replacement therapy (HRT) in women. METHODS: We used multivariable adjusted Cox proportional hazards models to examine the association between anthropometric measures and risks of colon and rectal cancer among 368 277 men and women who were free of cancer at baseline from nine countries of the European Prospective Investigation Into Cancer and Nutrition. All statistical tests were two-sided. RESULTS: During 6.1 years of follow-up, we identified 984 and 586 patients with colon and rectal cancer, respectively. Body weight and BMI were statistically significantly associated with colon cancer risk in men (highest versus lowest quintile of BMI, relative risk [RR] = 1.55, 95% confidence interval [CI] = 1.12 to 2.15; P(trend) = .006) but not in women. In contrast, comparisons of the highest to the lowest quintile showed that several anthropometric measures, including waist circumference (men, RR = 1.39, 95% CI = 1.01 to 1.93; P(trend) = .001; women, RR = 1.48, 95% CI = 1.08 to 2.03; P(trend) = .008), waist-to-hip ratio (WHR; men, RR = 1.51, 95% CI = 1.06 to 2.15; P(trend) = .006; women, RR = 1.52, 95% CI = 1.12 to 2.05; P(trend) = .002), and height (men, RR = 1.40, 95% CI = 0.99 to 1.98; P(trend) = .04; women, RR = 1.79, 95% CI = 1.30 to 2.46; P(trend)<.001) were related to colon cancer risk in both sexes. The estimated absolute risk of developing colon cancer within 5 years was 203 and 131 cases per 100,000 men and 129 and 86 cases per 100,000 women in the highest and lowest quintiles of WHR, respectively. Upon further stratification, no association of waist circumference and WHR with risk of colon cancer was observed among postmenopausal women who used HRT. None of the anthropometric measures was statistically significantly related to rectal cancer. CONCLUSIONS: Waist circumference and WHR, indicators of abdominal obesity, were strongly associated with colon cancer risk in men and women in this population. The association of abdominal obesity with colon cancer risk may vary depending on HRT use in postmenopausal women; however, these findings require confirmation in future studies.

OBJECTIVE: To explore published and unpublished research into consumer understanding and use of nutrition labelling which is culturally applicable in Europe. DESIGN: A systematic review undertaken between July 2002 and February 2003. RESULTS: One hundred and three papers were identified that reported on consumer understanding or use of nutrition labelling, most originating from North America or northern Europe. Only a few studies (9%) were judged to be of high or medium-high quality. We found that reported use of nutrition labels is high but more objective measures suggest that actual use of nutrition labelling during food purchase may be much lower. Whether or not consumers can understand and use nutrition labelling depends on the purpose of the task. Available evidence suggests that consumers who do look at nutrition labels can understand some of the terms used but are confused by other types of information. Most appear able to retrieve simple information and make simple calculations and comparisons between products using numerical information, but their ability to interpret the nutrition label accurately reduces as the complexity of the task increases. The addition of interpretational aids like verbal descriptors and recommended reference values helps in product comparison and in putting products into a total diet context. CONCLUSIONS: Improvements in nutrition labelling could make a small but important contribution towards making the existing point-of-purchase environment more conducive to the selection of healthy choices. In particular, interpretational aids can help consumers assess the nutrient contribution of specific foods to the overall diet.

Serum visceral proteins such as albumin and prealbumin have traditionally been used as markers of the nutritional status of patients. Prealbumin is nowadays often preferred over albumin due to its shorter half live, reflecting more rapid changes of the nutritional state. However, recent focus has been on an appropriate nutrition-focused physical examination and on the patient's history for diagnosing malnutrition, and the role of inflammation as a risk factor for malnutrition has been more and more recognized. Inflammatory signals are potent inhibitors of visceral protein synthesis, and the use of these proteins as biomarkers of the nutritional status has been debated since they are strongly influenced by inflammation and less so by protein energy stores. The current consensus is that laboratory markers could be used as a complement to a thorough physical examination. Other markers of the nutritional status such as urinary creatinine or 3-methylhistidine as indicators of muscle protein breakdown have not found widespread use. Serum IGF-1 is less influenced by inflammation and falls during malnutrition. However, its concentration changes are not sufficiently specific to be useful clinically as a marker of malnutrition, and serum IGF-1 has less been used in clinical trials. Nevertheless, biomarkers of malnutrition such as prealbumin may be of interest as easily measurable predictors of the prognosis for surgical outcomes and of mortality in severe illnesses.

The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their publication. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the ESC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and, where appropriate and/or necessary, the patient's caregiver. Nor do the ESC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.

BACKGROUND: Controversy exists about the timing of the initiation of parenteral nutrition in critically ill adults in whom caloric targets cannot be met by enteral nutrition alone. METHODS: In this randomized, multicenter trial, we compared early initiation of parenteral nutrition (European guidelines) with late initiation (American and Canadian guidelines) in adults in the intensive care unit (ICU) to supplement insufficient enteral nutrition. In 2312 patients, parenteral nutrition was initiated within 48 hours after ICU admission (early-initiation group), whereas in 2328 patients, parenteral nutrition was not initiated before day 8 (late-initiation group). A protocol for the early initiation of enteral nutrition was applied to both groups, and insulin was infused to achieve normoglycemia. RESULTS: Patients in the late-initiation group had a relative increase of 6.3% in the likelihood of being discharged alive earlier from the ICU (hazard ratio, 1.06; 95% confidence interval [CI], 1.00 to 1.13; P=0.04) and from the hospital (hazard ratio, 1.06; 95% CI, 1.00 to 1.13; P=0.04), without evidence of decreased functional status at hospital discharge. Rates of death in the ICU and in the hospital and rates of survival at 90 days were similar in the two groups. Patients in the late-initiation group, as compared with the early-initiation group, had fewer ICU infections (22.8% vs. 26.2%, P=0.008) and a lower incidence of cholestasis (P<0.001). The late-initiation group had a relative reduction of 9.7% in the proportion of patients requiring more than 2 days of mechanical ventilation (P=0.006), a median reduction of 3 days in the duration of renal-replacement therapy (P=0.008), and a mean reduction in health care costs of €1,110 (about $1,600) (P=0.04). CONCLUSIONS: Late initiation of parenteral nutrition was associated with faster recovery and fewer complications, as compared with early initiation. (Funded by the Methusalem program of the Flemish government and others; EPaNIC ClinicalTrials.gov number, NCT00512122.).

Cardiovascular disease (CVD) due to atherosclerosis of the arterial vessel wall and to thrombosis is the foremost cause of premature mortality and of disability-adjusted life years (DALYs) in Europe, and is also increasingly common in developing countries.1 In the European Union, the economic cost of CVD represents annually E192 billion1 in direct and indirect healthcare costs. The main clinical entities are coronary artery disease (CAD), ischaemic stroke, and peripheral arterial disease (PAD). The causes of these CVDs are multifactorial. Some of these factors relate to lifestyles, such as tobacco smoking, lack of physical activity, and dietary habits, and are thus modifiable. Other risk factors are also modifiable, such as elevated blood pressure, type 2 diabetes, and dyslipidaemias, or non-modifiable, such as age and male gender. These guidelines deal with the management of dyslipidaemias as an essential and integral part of CVD prevention. Prevention and treatment of dyslipidaemias should always be considered within the broader framework of CVD prevention, which is addressed in guidelines of the Joint European Societies’ Task forces on CVD prevention in clinical practice.2 – 5 The latest version of these guidelines was published in 20075; an update will become available in 2012. These Joint ESC/European Atherosclerosis Society (EAS) guidelines on the management of dyslipidaemias are complementary to the guidelines on CVD prevention in clinical practice and address not only physicians [e.g. general practitioners (GPs) and cardiologists] interested in CVD prevention, but also specialists from lipid clinics or metabolic units who are dealing with dyslipidaemias that are more difficult to classify and treat.

Purpose To explore the associations between type of milk feeding (the "nutrients") and mode of breast milk feeding (the "nursing") with child cognition. Methods Healthy children from the GUSTO (Growing Up in Singapore Toward healthy Outcomes) cohort participated in repeated neurodevelopmental assessments between 6 and 54 months. For "nutrients", we compared children exclusively bottle-fed according to type of milk received: formula only (n = 296) vs some/all breast milk (n = 73). For "nursing", we included only children who were fully fed breast milk, comparing those fed directly at the breast (n = 59) vs those fed partially/completely by bottle (n = 63). Results Compared to infants fed formula only, those who were bottle-fed breast milk demonstrated significantly better cognitive performance on both the Bayley Scales of Infant and Toddler Development (Third Edition) at 2 years [adjusted mean difference (95% CI) 1.36 (0.32, 2.40)], and on the Kaufman Brief Intelligence Test (Second Edition) at 4.5 years [7.59 (1.20, 13.99)]. Children bottle-fed breast milk also demonstrated better gross motor skills at 2 years than those fed formula [1.60 (0.09, 3.10)]. Among infants fully fed breast milk, those fed directly at the breast scored higher on several memory tasks compared to children bottle-fed breast milk, including the deferred imitation task at 6 months [0.67 (0.02, 1.32)] and relational binding tasks at 6 [0.41 (0.07, 0.74)], 41 [0.67 (0.04, 1.29)] and 54 [0.12 (0.01, 0.22)] months. Conclusions Our findings suggest that nutrients in breast milk may improve general child cognition, while nursing infants directly at the breast may influence memory.

International Journal of Pharmaceutical Sciences and Research (IJPSR) is an official publication of Society of Pharmaceutical Sciences & Research. It is an open access online and print International Journal published monthly. Website: www.ijpsr.com Projected Impact Factor (2012): 2.44, ICV 2012: 5.50, 2011: 5.07, 2010: 4.57 DOI: 10.13040/IJPSR.0975-8232 SJ Impact Factor (2012): 3.226 Global Impact Factor (2013): 0.533, (2012): 0.452 Indexing - EMBASE- Elsevier's

The overproduction of reactive oxygen species (ROS) has been implicated in the development of various chronic and degenerative diseases such as cancer, respiratory, neurodegenerative, and digestive diseases. Under physiological conditions, the concentrations of ROS are subtlety regulated by antioxidants, which can be either generated endogenously or externally supplemented. A combination of antioxidant-deficiency and malnutrition may render individuals more vulnerable to oxidative stress, thereby increasing the risk of cancer occurrence. In addition, antioxidant defense can be overwhelmed during sustained inflammation such as in chronic obstructive pulmonary diseases, inflammatory bowel disease, and neurodegenerative disorders, cardiovascular diseases, and aging. Certain antioxidant vitamins, such as vitamin D, are essential in regulating biochemical pathways that lead to the proper functioning of the organs. Antioxidant supplementation has been shown to attenuate endogenous antioxidant depletion thus alleviating associated oxidative damage in some clinical research. However, some results indicate that antioxidants exert no favorable effects on disease control. Thus, more studies are warranted to investigate the complicated interactions between ROS and different types of antioxidants for restoration of the redox balance under pathologic conditions. This review highlights the potential roles of ROS and nutritional antioxidants in the pathogenesis of several redox imbalance-related diseases and the attenuation of oxidative stress-induced damages.

Considerable experimental and epidemiological evidence suggests that elevated endogenous sex steroids - notably androgens and oestrogens - promote breast tumour development. In spite of this evidence, postmenopausal androgen replacement therapy with dehydroepiandrosterone (DHEA) or testosterone has been advocated for the prevention of osteoporosis and improved sexual well-being. We have conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition. Levels of DHEA sulphate (DHEAS), (Delta4-androstenedione), testosterone, oestrone, oestradiol and sex-hormone binding globulin (SHBG) were measured in prediagnostic serum samples of 677 postmenopausal women who subsequently developed breast cancer and 1309 matched control subjects. Levels of free testosterone and free oestradiol were calculated from absolute concentrations of testosterone, oestradiol and SHBG. Logistic regression models were used to estimate relative risks of breast cancer by quintiles of hormone concentrations. For all sex steroids -the androgens as well as the oestrogens - elevated serum levels were positively associated with breast cancer risk, while SHBG levels were inversely related to risk. For the androgens, relative risk estimates (95% confidence intervals) between the top and bottom quintiles of the exposure distribution were: DHEAS 1.69 (1.23-2.33), androstenedione 1.94 (1.40-2.69), testosterone 1.85 (1.33-2.57) and free testosterone 2.50 (1.76-3.55). For the oestrogens, relative risk estimates were: oestrone 2.07 (1.42-3.02), oestradiol 2.28 (1.61-3.23) and free oestradiol (odds ratios 2.13 (1.52-2.98)). Adjustments for body mass index or other potential confounding factors did not substantially alter any of these relative risk estimates. Our results have shown that, among postmenopausal women, not only elevated serum oestrogens but also serum androgens are associated with increased breast cancer risk. Since DHEAS and androstenedione are largely of adrenal origin in postmenopausal women, our results indicated that elevated adrenal androgen synthesis is a risk factor for breast cancer. The results from this study caution against the use of DHEA(S), or other androgens, for postmenopausal androgen replacement therapy.