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After controlling for socioeconomic indicators, longer healthy life is enjoyed by populations of countries with greater dietary diversity.

Myxoid adrenocortical tumors are extremely rare neoplasms with only nine adenomas and eleven carcinomas reported in the literature. They occasionally have a pseudoglandular component resembling metastatic mucinous adenocarcinoma in the adrenal gland. However the cytological features of this unusual tumor have not been previously described. We report here the first cytopathological study of a myxoid adrenocortical adenoma with a pseudoglandular component, contributing especially to the differential diagnosis from metastatic mucinous adenocarcinoma. Two major cytopathological features distinguishing myxoid adrenocortical adenoma from metastatic mucinous adenocarcinoma in the adrenal gland are: (1) the myxoid material is found only in the extracellular space, and not in the cytoplasm; and (2) nuclei are usually located in the central portion of the cytoplasm, and not compressed to the periphery. Careful observation of these cytological features and positive immunoreactivity to Melan A, alpha-inhibin and synaptophysin can lead to the correct diagnosis.

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ObjectiveThe aim of the present study was to clarify the global relationship between Mediterranean diet score (MDS) and the incidence of IHD by country using international statistics.DesignThe incidence of IHD by country was derived from the Global Burden of Disease (GBD) database. Average supplies of food (g/d per capita) and energy (kcal/d per capita) by country, excluding loss between production and household, were obtained from the FAOSTAT database. MDS was evaluated based on the total score of nine food items that characterize the Mediterranean diet. The association between MDS and the incidence of IHD was examined in countries with a population of 1 million or greater using a general linear model controlled for socio-economic and lifestyle variables.SettingPopulation data from global international databases.ParticipantsOne hundred and thirty-two countries with a population of over 1 million.ResultsMDS was inversely correlated with obesity rate, ageing rate, years of education and IHD incidence; however, no associations were found with gross domestic product, life expectancy, smoking rate, energy supply or health expenditure. In the general linear model of IHD incidence by MDS controlled for socio-economic and lifestyle variables, the β of the MDS was –26·4 (se 8·6; P<0·01).ConclusionsThe results of this global international comparative study confirmed that the Mediterranean diet is inversely associated with the incidence of IHD.