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1.
Environ Sci Technol ; 58(26): 11661-11674, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38874829

RESUMO

This study addresses existing gaps in understanding the specific involvement of dissolved organic matter (DOM) fractions in antibiotic photolysis, particularly under natural conditions and during DOM photobleaching. Employing fluorescent, chemical, and molecular analysis techniques, it explores the impact of extracellular and intracellular organic matter (EOM and IOM) on the photodissipation of multiclass antibiotics, coupled with DOM photobleaching under natural solar radiation. Key findings underscore the selective photobleaching of DOM fractions, propelled by distinct chemical profiles, influencing DOM-mediated antibiotic photolysis. Notably, lipid-like substances dominate in the IOM, while lignin-like substances prevail in the EOM, each uniquely responding to sunlight and exhibiting selective photobleaching. Sunlight primarily targets fulvic acid-like lignin components in EOM, contrasting the initial changes observed in tryptophan-like lipid substances in IOM. The lower photolability of EOM, attributed to its rich unsaturated compounds, contributes to an enhanced rate of indirect antibiotic photolysis (0.339-1.402 h-1) through reactive intermediates. Conversely, the abundance of aliphatic compounds in IOM, despite it being highly photolabile, exhibits a lower mediation of antibiotic photolysis (0.067-1.111 h-1). The triplet state excited 3DOM* plays a pivotal role in the phototransformation and toxicity decrease of antibiotics, highlighting microbial EOM's essential role as a natural aquatic photosensitizer for water self-purification. These findings enhance our understanding of DOM dynamics in aquatic systems, particularly in mitigating antibiotic risks, and introduce innovative strategies in environmental management and water treatment technologies.


Assuntos
Antibacterianos , Fotólise , Antibacterianos/química
2.
Eur Spine J ; 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38775820

RESUMO

OBJECTIVE: To report a "critical phase" (between osteotomy completion and correction beginning) that will frequently lead to the reversible intraoperative neurophysiological monitoring (IOM) change during posterior vertebral column resection (PVCR) surgery. METHODS: The study sample consisted of 120 patients with severe spine deformity who underwent PVCR and deformity correction surgeries. Those patients were recruited consecutively from 2010 to 2018 January in our spine center. The detailed IOM data (the amplitude of MEP & SEP) and its corresponding surgical points were collected prospectively. Early and long-term postoperative neurologic outcomes were assessed for the following functions: motor, sensory, and pain at immediate postoperative and 1-year post-operation in this cases series. RESULTS: A total of 105 (105/120) patients presented varying degrees of IOM reduction in the critical phase; the mean IOM amplitude retention vs rescue rate was 27% ± 11.2 versus 58% ± 16.9, P < 0.01 (MEP) & 34% ± 8.3 versus 66% ± 12.4 P < 0.01 (SEP). Patients with postoperative spinal deficits often had a significantly longer IOM-alerting duration than the patients without (p < 0.01, Mann-Whitney U-test), and IOM-alerting duration greater than 39.5 min was identified as an independent predictor of the risk of postoperative spinal deficits. CONCLUSIONS: The reversible IOM events probably often appear in the critical phase during PVCR surgery. The new postoperative spinal deficits are possible for patients without satisfied IOM recovery or alerting duration greater than 39.5 min. Timely and suitable surgical interventions are useful for rescuing the IOM alerts.

3.
BMC Public Health ; 23(1): 134, 2023 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-36658532

RESUMO

BACKGROUND: Appropriate gestational weight gain (GWG) is essential for maternal and fetal health. For twin pregnancies among Caucasian women, the Institute of Medicine (IOM) guidelines can be used to monitor and guide GWG. We aimed to externally validate and compare the IOM guidelines and the recently released guidelines for Chinese women with twin pregnancies regarding the applicability of their recommendations on total GWG (TGWG). METHOD: A retrospective cohort study of 1534 women who were aged 18-45 years and gave birth to twins at ≥ 26 gestational weeks between October 2016 and June 2020 was conducted in Guangzhou, China. Women's TGWG was categorized into inadequate, optimal, and excess per the IOM and the Chinese guidelines. Multivariable generalized estimating equations logistic regression was used to estimate the risk associations between TGWG categories and adverse neonatal outcomes. Cohen's Kappa coefficient was calculated to evaluate the agreement between the IOM and the Chinese guidelines. RESULTS: Defined by either the IOM or the Chinese guidelines, women with inadequate TGWG, compared with those with optimal TGWG, demonstrated higher risks of small-for-gestational-age birth and neonatal jaundice, while women with excess TGWG had a higher risk of delivering large-for-gestational-age infants. The agreement between the two guidelines was relatively high (Kappa coefficient = 0.721). Compared with those in the optimal TGWG group by both sets of the guidelines, women classified into the optimal group by the Chinese guidelines but into the inadequate group by the IOM guidelines (n = 214) demonstrated a statistically non-significant increase in the risk of all the adverse neonatal outcomes combined. CONCLUSIONS: The IOM and the Chinese guidelines are both applicable to Chinese women with twin pregnancies.


Assuntos
Ganho de Peso na Gestação , Complicações na Gravidez , Gravidez , Recém-Nascido , Feminino , Humanos , Gravidez de Gêmeos , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos , Índice de Massa Corporal
4.
Arch Gynecol Obstet ; 2023 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-37981602

RESUMO

PURPOSE: Gestational weight gain (GWG) is an important contributor to pregnancy outcomes in the general obstetric population and different subgroups. The corresponding information in women with thyroid conditions is limited. We aimed to evaluate the relationship between GWG according to institute of medicine (IOM) and pregnancy outcomes in women with thyroid disorders. METHODS: We performed a retrospective analysis of 620 pregnant women either treated with levothyroxine (N = 545) or attended because of hyperthyroidism during pregnancy (N = 75). RESULTS: The associations between GWG according to IOM and pregnancy outcomes were present both in women treated with thyroid hormone and women followed by hyperthyroidism, most of them related to the fetal outcomes. In women treated with levothyroxine, insufficient GWG was associated with gestational diabetes mellitus (GDM) (odds ratio (OR) 2.32, 95% confidence interval (CI) 1.18, 4.54), preterm birth (OR 2.31, 95% CI 1.22, 4.36), small-for-gestational age newborns (OR 2.38, 95% CI 1.09, 5.22) and respiratory distress (OR 6.89, 95% CI 1.46, 32.52). Excessive GWG was associated with cesarean delivery (OR 1.66, 95% CI 1.10, 2.51) and macrosomia (OR 2.75, 95% CI 1.38, 5.49). Large-for-gestational age newborns were associated with both insufficient GWG (OR 0.25, 95% CI 0.11, 0.58) and excessive GWG (OR 1.80, 95% CI 1.11, 2.92). In women followed by hyperthyroidism, excessive GWG was associated with large-for-gestational age newborns (OR 5.56, 95% CI 1.03, 29.96). CONCLUSION: GWG according to IOM is associated with pregnancy outcomes both in women treated with thyroid hormone and women followed by hyperthyroidism.

5.
Ecotoxicol Environ Saf ; 243: 113988, 2022 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-36029578

RESUMO

Dermal & inhalation exposure was examined and according to these results, risk assessment of agricultural workers to thiamethoxam was performed during pesticide mixing/loading and hand-held sprayer application (11 replicates, each of about 1000 L of spray suspension) in vineyards. For the whole body dosimetry (WBD), clothing (Outer and inner), gauze, and nitrile gloves were analyzed to determine dermal exposure using whole-body dosimetry exposure protocol. The inhalation exposure was measured using a glass fiber filter with an IOM sampler. Analytical method validation of exposure matrices was evaluated including the field recovery and breakthrough test. The dermal exposure amount during mixing/loading was 0.163 mg (0.0004% of the total mixed/loaded active ingredient [a.i.]), whereas there was no inhalation exposure. The gloves (0.154 mg, 94.5%) were the most exposed body parts followed by the chest and stomach (0.009 mg, 5.5%). During application, the dermal and inhalation exposure amounts were 32.3 mg (0.07% of the total applied a.i.) and 10.8 µg (2.4 × 10-6% of the total applied a.i), respectively. The shin (35.1%) had the highest exposure to pesticides, followed by the chest & stomach (15.6%) and pelvis (12.6%). In case of mixing/loading, the amounts of actual dermal exposure (ADE) and actual inhalation exposure (AIE) were 0.0 and 0.0 µg/day, while those of ADE and AIE were 4707.6 and 15.8 µg/day for application. In risk assessment of the two different scenarios, the risk index was much lower than 1 (mixing/loading:0.000, application:0.014), indicating that vineyard workers are at low risk of thiamethoxam exposure. To determine the validity of the risk assessment using WBD method, the urinary metabolite was analyzed. Comparison of biomonitoring data and WBD exposure data show a reliable correlation (r = 0.885, p = 0.0003), suggesting that these are suitable methods to estimate exposure.


Assuntos
Exposição Ocupacional , Praguicidas , Fazendeiros , Fazendas , Humanos , Exposição Ocupacional/análise , Medição de Risco , Tiametoxam
6.
Can J Neurol Sci ; 48(1): 25-30, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32811585

RESUMO

The COVID-19 pandemic has had a major impact on clinical practice. Safe standards of practice are essential to protect health care workers while still allowing them to provide good care. The Canadian Society of Clinical Neurophysiologists, the Canadian Association of Electroneurophysiology Technologists, the Association of Electromyography Technologists of Canada, the Board of Registration of Electromyography Technologists of Canada, and the Canadian Board of Registration of Electroencephalograph Technologists have combined to review current published literature about safe practices for neurophysiology laboratories. Herein, we present the results of our review and provide our expert opinion regarding the safe practice of neurophysiology during the COVID-19 pandemic in Canada.


Assuntos
COVID-19/prevenção & controle , Eletroencefalografia/métodos , Eletromiografia/métodos , Condução Nervosa , Canadá , Estimulação Encefálica Profunda , Técnicas de Diagnóstico Neurológico , Eletrodiagnóstico/métodos , Humanos , Controle de Infecções/métodos , Isoladores de Pacientes , Equipamento de Proteção Individual , Distanciamento Físico , SARS-CoV-2 , Triagem/métodos , Estimulação do Nervo Vago
7.
Surg Radiol Anat ; 43(10): 1609-1617, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34228179

RESUMO

PURPOSE: The anatomy of the ulna seems to have already been described exhaustively, particularly at its extremities, but very little in its middle third. We report the existence of an interosseous tuberosity on the interosseous border of the ulnar shaft that we have named the "tuberositas interossea ulnarii" (TIU). METHODS: First, we analyzed all side view X-rays of the forearm in neutral rotation, as well as forearm CT scans carried out during a 1-year period in our hospital. On these radiographic examinations, we evaluated the presence or absence of the TIU, its length, the thickness of the interosseous cortex at its level, above and below compared with anterior, posterior, and lateral bone cortices. In the second part of the study, we dissected cadaveric forearms to determine which ligaments and muscles were attached to it. RESULTS: A total of 91 standard forearm radiographs and 13 CT scans were analyzed. In all cases, the ulnar interosseous tuberosity was present. The mean tuberosity length was 107.5 mm (± 18.2), without any significant gender influence. It corresponded to a thickening (6.9 mm then 4.6 mm above and 3.9 mm below; p < 0.0001) of the ulnar interosseous cortex. Then, ten anatomic subjects (six females, four males) were dissected. We observed that this tuberosity served as an attachment for the central band of the interosseous membrane, for the deep flexor and extensor muscles for the long fingers, and for the abductor pollicis longus muscle's inner attachment. CONCLUSION: Tuberositas interossea ulnarii exists besides the tuberositas interossea radii, corresponds to thickening of the cortex and may play a role in the stability of the forearm and the function of the long fingers.


Assuntos
Radiografia/métodos , Ulna/anatomia & histologia , Cadáver , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos
8.
Surg Radiol Anat ; 43(5): 727-734, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33047194

RESUMO

PURPOSE: The radius is described with a single tuberosity: the radial tuberosity. However, we hypothesize that there is a second tuberosity on the interosseous border of the radius: which we propose to call the interosseous tuberosity - Tuberositas interossea radii - (IT). METHODS: First, we analyzed all anteroposterior radiographs of the forearm (48 females, 54 males; 62 lefts and 40 rights) as well as CT scans (6 females, 7 males; 5 lefts and 8 rights) carried out during one year in our hospital. We evaluated the presence of IT, its length, thickness of the interosseous cortex at IT level, above and below compared with anterior, posterior and lateral bone cortices. In the second part of the study, we dissected cadaveric forearms to determine which ligaments and muscles were attaches on the IT. RESULTS: A total of 102 standard forearm radiographs and 13 CT-scans were analyzed. In all cases, an IT was present. The mean tuberosity length was 93.9 mm (+ / - 15.8), which corresponds to 37% (+ / - 5) of total radial length. IT corresponds to a significant thickening (7.6 mm than 4.2 mm and 4.3 mm below; p < 0.0001) of radial interosseous cortex. A total of 10 forearms were dissected. In all cases, we observed that IT served as an attachment for central band of interosseous membrane and for all extrinsic muscles of the thumb with the exception of the extensor pollicis longus. CONCLUSION: Tuberositas interossea radii exists, corresponds to a cortex thickening and may play a role in the stability of the forearm and the function of the thumb.


Assuntos
Antebraço/anatomia & histologia , Ligamentos/anatomia & histologia , Músculo Esquelético/anatomia & histologia , Rádio (Anatomia)/anatomia & histologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cadáver , Dissecação , Feminino , Antebraço/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Rádio (Anatomia)/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto Jovem
9.
BMC Med Res Methodol ; 20(1): 105, 2020 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-32380945

RESUMO

BACKGROUND: The objective of this study was to assess the overall quality of study-level meta-analyses in high-ranking journals using commonly employed guidelines and standards for systematic reviews and meta-analyses. METHODS: 100 randomly selected study-level meta-analyses published in ten highest-ranking clinical journals in 2016-2017 were evaluated by medical librarians against 4 assessments using a scale of 0-100: the Peer Review of Electronic Search Strategies (PRESS), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Institute of Medicine's (IOM) Standards for Systematic Reviews, and quality items from the Cochrane Handbook. Multiple regression was performed to assess meta-analyses characteristics' associated with quality scores. RESULTS: The overall median (interquartile range) scores were: PRESS 62.5(45.8-75.0), PRISMA 92.6(88.9-96.3), IOM 81.3(76.6-85.9), and Cochrane 66.7(50.0-83.3). Involvement of librarians was associated with higher PRESS and IOM scores on multiple regression. Compliance with journal guidelines was associated with higher PRISMA and IOM scores. CONCLUSION: This study raises concerns regarding the reporting and methodological quality of published MAs in high impact journals Early involvement of information specialists, stipulation of detailed author guidelines, and strict adherence to them may improve quality of published meta-analyses.


Assuntos
Metanálise como Assunto , Relatório de Pesquisa , Humanos , Análise Multivariada
10.
BMC Neurol ; 20(1): 203, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-32438899

RESUMO

BACKGROUND: To our knowledge, the exposed nerve roots in thoracic spine are usually sacrificed to facilitate osteotomy during posterior vertebral column resection (PVCR) for severe spinal deformity. Currently we report a case with severe spine deformity in which intraoperative neurological monitoring (IOM) loss after interrupting T8 nerve root finally led to spinal cord injury during PVCR surgery. CASE PRESENTATION: The patient was a 14-year-old female with severe congenital kyphoscoliosis (CKS) without preoperative neurologic deficits. The IOM events (MEP loss and SSEP latency prolong) were showed when T8 nerve root at concave side was interrupted. And then we reduce the scope of osteotomy to control bleeding, raised blood pressure (MAP, 65-80) to increase blood supply for spinal cord, placed the bilateral rod to stabilized the spinal cord, used the methylprednisolone, explored the presence or absence of spinal cord compression, and prepared to change the surgical plan from PVCR to PSO. After that the IOM signals partial recovered from the lowest point. Postoperatively the patients showed transient motor function deficits of left lower limbs weak without somatosensory deficits, and come back to preoperative status 6 months later. CONCLUSIONS: Interrupting the thoracic spine nerve root is danger to trigger the spinal cord injury during PVCR procedure of severe CKS. That probably because the increasing tension of contralateral anterior horn area of spinal cord via the nerve root pulling.


Assuntos
Procedimentos Neurocirúrgicos/efeitos adversos , Traumatismos da Medula Espinal/etiologia , Raízes Nervosas Espinhais/cirurgia , Coluna Vertebral/cirurgia , Adolescente , Feminino , Humanos , Complicações Intraoperatórias/etiologia , Cifose/complicações , Cifose/cirurgia , Monitorização Intraoperatória , Osteotomia/métodos , Estudos Retrospectivos , Escoliose/complicações , Escoliose/cirurgia , Resultado do Tratamento
11.
Ethn Health ; 25(1): 110-125, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-29132221

RESUMO

Objective: To determine whether the Institute Of Medicine's (IOM) 2009 guidelines for weight-gain during pregnancy are predictive of maternal and infant outcomes in ethnic minority populations.Methods: We designed a population-based study using administrative data on 181,948 women who delivered live singleton births in Washington State between 2006-2008. We examined risks of gestational hypertension, preeclampsia/eclampsia, cesarean delivery, and extended hospital stay in White, Black, Native-American, East-Asian, Hispanic, South-Asian and Hawaiian/Pacific islander women according to whether they gained more or less weight during pregnancy than recommended by IOM guidelines. We also examined risks of neonatal outcomes including Apgar score <7 at 5 min, admission to NICU, requirement for ventilation, and a diagnosis of small or large for gestational age at birth.Results: Gaining too much weight was associated with increased odds for gestational hypertension (adjusted OR (aOR) ranged between 1.53-2.22), preeclampsia/eclampsia (aOR 1.44-1.81), cesarean delivery (aOR 1.07-1.38) and extended hospital stay (aOR 1.06-1.28) in all ethnic groups. Gaining too little weight was associated with decreased odds for gestational hypertension and delivery by cesarean section in Whites, Blacks and Hispanics. Gaining less weight or more weight than recommended was associated with increased odds for small for gestational age and large for gestational age infants respectively, in all ethnic groups.Conclusions: Adherence to the 2009 IOM guidelines for weight gain during pregnancy reduces risk for various adverse maternal outcomes in all ethnic groups studied. However, the guidelines were less predictive of infant outcomes with the exception of small and large for gestational age.Abbreviations: GWG: Gestational weight gain; IOM/NRC; Institute of Medicine and National Research Council; NICU: Neonatal intensive care need for ventilation; SGA: Small for gestational age; LGA: Large for gestational age; BERD: Birth Events Records Database; CHARS: Comprehensive Hospital Discharge Abstract Reporting System; ICD: International Classification of Disease; LMP: Last menstrual period; OR: Odds ratio.


Assuntos
Etnicidade/estatística & dados numéricos , Ganho de Peso na Gestação , Resultado da Gravidez , Adulto , Índice de Massa Corporal , Bases de Dados Factuais , Feminino , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Guias de Prática Clínica como Assunto , Gravidez , Estudos Retrospectivos , Washington
12.
Br J Nutr ; 121(4): 426-438, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30526692

RESUMO

Pregnant and lactating women and breastfed infants are at risk of vitamin D deficiency. The supplemental vitamin D dose that optimises maternal vitamin D status and breast milk antirachitic activity (ARA) is unclear. Healthy pregnant women were randomised to 10 (n 10), 35 (n 11), 60 (n 11) and 85 (n 11) µg vitamin D3/d from 20 gestational weeks (GW) to 4 weeks postpartum (PP). The participants also received increasing dosages of fish oil supplements and a multivitamin. Treatment allocation was not blinded. Parent vitamin D and 25-hydroxyvitamin D (25(OH)D) were measured in maternal plasma at 20 GW, 36 GW and 4 weeks PP, and in milk at 4 weeks PP. Median 25(OH)D and parent vitamin D at 20 GW were 85 (range 25-131) nmol/l and 'not detectable (nd)' (range nd-40) nmol/l. Both increased, seemingly dose dependent, from 20 to 36 GW and decreased from 36 GW to 4 weeks PP. In all, 35 µg vitamin D/d was needed to increase 25(OH)D to adequacy (80-249 nmol/l) in >97·5 % of participants at 36 GW, while >85 µg/d was needed to reach this criterion at 4 weeks PP. The 25(OH)D increments from 20 to 36 GW and from 20 GW to 4 weeks PP diminished with supplemental dose and related inversely to 25(OH)D at 20 GW. Milk ARA related to vitamin D3 dose, but the infant adequate intake of 513 IU/l was not reached. Vitamin D3 dosages of 35 and >85 µg/d were needed to reach adequate maternal vitamin D status at 36 GW and 4 weeks PP, respectively.


Assuntos
Suplementos Nutricionais , Lactação/efeitos dos fármacos , Leite Humano/química , Vitamina D/farmacologia , Vitaminas/farmacologia , Adulto , Aleitamento Materno , Colecalciferol/farmacologia , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Fenômenos Fisiológicos da Nutrição Materna , Estado Nutricional , Período Pós-Parto , Gravidez , Cuidado Pré-Natal/métodos , Vitamina D/análogos & derivados , Vitamina D/sangue
13.
Br J Nutr ; 121(1): 42-54, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30588902

RESUMO

This study aimed to evaluate the longitudinal association of vitamin D status with glycaemia, insulin, homoeostatic model assessment of insulin resistance, adiponectin and leptin. A prospective cohort with 181 healthy, pregnant Brazilian women was followed at the 5th-13th, 20th-26th and 30th-36th gestational weeks. In this cohort, 25-hydroxyvitamin D (25(OH)D) plasma concentrations were analysed using liquid chromatography-tandem MS. Vitamin D status was categorised as sufficient or insufficient using the Endocrine Society Practice Guidelines (≥75/<75 nmol/l) and the Institute of Medicine (≥50/<50 nmol/l) thresholds. Linear mixed-effect regression models were employed to evaluate the association between vitamin D status and each outcome, considering interaction terms between vitamin D status and gestational age (P<0·1). At baseline, 70·7 % of pregnant women had 25(OH)D levels <75 nmol/l and 16 % had levels <50 nmol/l. Women with sufficient vitamin D status at baseline, using both thresholds, presented lower glycaemia than those with insufficient 25(OH)D. Pregnant women with 25(OH)D concentrations <75 nmol/l showed lower insulin (ß=-0·12; 95 % CI -0·251, 0·009; P=0·069) and adiponectin (ß=-0·070; 95 % CI -0·150, 0·010; P=0·085) concentrations throughout pregnancy than those with 25(OH)D levels ≥75 nmol/l. Pregnant women with 25(OH)D <50 nmol/l at baseline presented significantly higher leptin concentrations than those with 25(OH)D levels ≥50 nmol/l (ß=-0·253; 95 % CI -0·044, 0·550; P=0·095). The baseline status of vitamin D influences the biomarkers involved in glucose metabolism. Vitamin D-sufficient women at baseline had higher increases in insulin and adiponectin changes throughout gestation than those who were insufficient.


Assuntos
Adipocinas/sangue , Glicemia/metabolismo , Vitamina D/análogos & derivados , Adiponectina/sangue , Adulto , Brasil , Estudos de Coortes , Diabetes Gestacional/sangue , Diabetes Gestacional/prevenção & controle , Dieta , Feminino , Idade Gestacional , Humanos , Insulina/sangue , Resistência à Insulina , Leptina/sangue , Gravidez , Complicações na Gravidez/sangue , Estudos Prospectivos , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações
14.
Br J Nutr ; 121(5): 538-548, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30843501

RESUMO

In India, there is a lack of information about the adequate daily dose of vitamin D3 supplementation in school children. Hence, we undertook this study to evaluate the adequacy and efficacy of different doses of vitamin D3 in schoolchildren. A total of 1008 vitamin D-deficient (VDD) children, aged 6-16 years with serum 25-hydroxyvitamin D (25(OH)D) levels <50nmol/l, were cluster randomised into three groups (A-344, B-341 and C-232) for supplementation (600, 1000 and 2000 IU daily) of vitamin D3 under supervision for 6 months. Of the 1008 subjects who completed the study, 938 (93 %) were compliant. Baseline and post-supplementation fasting blood and urine samples were evaluated for Ca, phosphates, alkaline phosphatase, 25(OH)D and parathormone and urine Ca:creatinine ratio. The mean age of the subjects was 11·7 (sd 2·4) years, and the overall mean baseline serum 25(OH)D level was 24·3 (SD 9·5)nmol/l. Post-supplementation rise in serum 25(OH)D in compliant group was maximum with 2000 IU (70·0 (SD 30·0)nmol/l), followed by 1000 IU (46·8 (SD 22·5)nmol/l) and 600 IU (36·5 (SD 18·5)nmol/l), and serum 25(OH)D levels of ≥50nmol/l were achieved in 71·5, 81·8 and 92·9 % by groups A, B and C, respectively. Secondary hyperparathyroidism decreased from 31·7 to 8·4 % post-supplementation. Two participants developed hypercalciuria, but none developed hypercalcaemia. Children with VDD benefit maximum with the daily supplementation of 2000 IU of vitamin D3. Whether recommendations of 400 IU/d by Indian Council of Medical Research or 600 IU by Indian Academy of Pediatrics or Institute of Medicine would suffice to achieve vitamin D sufficiency in children with VDD remains debatable.


Assuntos
Colecalciferol/administração & dosagem , Suplementos Nutricionais , Deficiência de Vitamina D/terapia , Vitaminas/administração & dosagem , Adolescente , Fosfatase Alcalina/sangue , Cálcio/sangue , Cálcio/urina , Criança , Creatinina/urina , Feminino , Humanos , Hiperparatireoidismo Secundário/sangue , Hiperparatireoidismo Secundário/etiologia , Hiperparatireoidismo Secundário/urina , Índia , Masculino , Hormônio Paratireóideo/sangue , Fosfatos/sangue , Estudos Prospectivos , Método Simples-Cego , Estudantes , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/urina
15.
J Occup Environ Hyg ; 16(1): 66-77, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30325716

RESUMO

Indium-tin oxide production has increased greatly in the last 20 years subsequent to increased global demand for touch screens and photovoltaics. Previous studies used measurements of indium in blood as an indicator of indium exposure and observed associations with adverse respiratory outcomes. However, correlations between measurements of blood indium and airborne respirable indium are inconsistent, in part because of the long half-life of indium in blood, but also because respirable indium measurements do not incorporate inhalable indium that can contribute to the observed biological burden. Information is lacking on relationships between respirable and inhalable indium exposure, which have implications for biological indicators like blood indium. The dual IOM sampler includes the foam disc insert and can simultaneously collect respirable and inhalable aerosol. Here, the field performance of the dual IOM sampler was evaluated by comparing performance with the respirable cyclone and traditional IOM for respirable and inhalable indium and dust exposure, respectively. Side-by-side area air samples were collected throughout an indium-tin oxide manufacturing facility. Cascade impactors were used to determine particle size distribution. Several statistical methods were used to evaluate the agreement between the pairs of samplers including calculating the concordance correlation coefficient and its accuracy and precision components. One-way ANOVA was used to evaluate the effect of dust concentration on sampler differences. Respirable indium measurements showed better agreement (concordance correlation coefficient: 0.932) compared to respirable dust measurements (concordance correlation coefficient: 0.777) with significant differences observed in respirable dust measurements. The dual IOM measurements had high agreement with the traditional IOM for inhalable indium (concordance correlation coefficient: 0.997) but lower agreement for inhalable dust (concordance correlation coefficient: 0.886 and accuracy: 0.896) with a significantly large mean bias (-146.9 µg/m3). Dust concentration significantly affected sampler measurements of inhalable dust and inhalable indium. Results from this study suggest that the dual IOM is a useful single sampler for simultaneous measurements of occupational exposure to respirable and inhalable indium.


Assuntos
Poluentes Ocupacionais do Ar/análise , Monitoramento Ambiental/instrumentação , Índio/análise , Exposição por Inalação/análise , Poeira/análise , Instalações Industriais e de Manufatura , Exposição Ocupacional/análise , Tamanho da Partícula , Compostos de Estanho
16.
J Occup Environ Hyg ; 16(3): 250-257, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30640589

RESUMO

This study evaluates the performance of the disposable inhalable aerosol sampler (DIAS), a new sampler developed to be more cost-effective than the traditional inhalable particle samplers and comparable to the inhalable particle sampling convention. Forty-eight pairs of the DIAS prototype and the IOM sampler were utilized to collect copper exposure measurements (23 personal and 25 area) at an electrorefinery facility. The geometric mean (GM) value of ratios of exposure data (DIAS/IOM) was 1.1, while the GM of ratios (DIAS/IOM) was 1.6 for the area exposure data, revealing 84% of the ratios were greater than one. For both personal and area exposure data, the concordance correlation coefficient tests revealed significant disagreements between the two types of samplers and suggested precision as the source of the disagreement. The estimated mean concentration was higher for the DIAS compared that for the IOM for the area exposure data (p < 0.05), while the results were comparable for the personal exposure data (p = 0.49). Overall, the DIAS generated higher exposure results compared to the IOM sampler for the area exposures. For the personal exposures, the findings were inconclusive due to inconsistent results of factors aforementioned. This study is limited to one metal component (copper) of the dust at a worksite. To date, this is the first field evaluation using personal exposure data to test the performance of the DIAS and the second evaluation using area exposure data. Thus, it will be necessary to conduct additional field evaluations with various elements to further evaluate the performance of the DIAS. In addition, particle migration to the internal walls of the cap was observed during the transportation of collected samples to a laboratory for both sampler types (6.4% for the DIAS and 7.4% for the IOM). Occupational health and safety professionals should be aware of potential errors caused from transferring samples from a field to a laboratory and should be careful not to exclude particles collected on the caps.


Assuntos
Aerossóis/análise , Poluentes Ocupacionais do Ar/análise , Cobre , Poeira/análise , Monitoramento Ambiental/instrumentação , Exposição por Inalação/análise , Exposição Ocupacional/análise , Equipamentos Descartáveis , Monitoramento Ambiental/métodos , Desenho de Equipamento , Humanos
17.
J Occup Environ Hyg ; 16(9): 634-642, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31298629

RESUMO

An ideal inhalable aerosol sampler for occupational exposure monitoring would have a sampling efficiency that perfectly matches the inhalable particulate matter (IPM) criterion. Two common aerosol samplers in use worldwide are the closed-face cassette (CFC) and the Institute of Occupational Medicine (IOM) sampler. However, the CFC is known to under-sample, with near zero sampling efficiency for particles >30 µm, whereas the IOM, considered by many to be the "gold standard" in inhalable samplers, has been shown to over-sample particles >60 µm. A new sampler in development incorporates characteristics of both the CFC and the IOM. Like the CFC, it would be disposable, have a simple design, and is intended to be oriented at a 45° downward angle. Like the IOM, the new sampler has a 15-mm inlet diameter and incorporates a 25-mm filter cassette with a protruding lip. The IOM is oriented at 0° to the horizontal, so it is hypothesized that orienting the new sampler at ∼45° downward angle will reduce oversampling of larger particles. In comparison, the CFC's inlet diameter is 4 mm; increasing the size of the inlet should allow the new sampler to have an increased efficiency relative to the CFC for all particles. A unique characteristic of the new sampler is the incorporation of a one-piece capsule-style filter that mimics the IOM's cassette but is made of disposable material. Seven different sizes of alumina particles (mean aerodynamic diameters from 4.9-62.4 µm) were tested (total = 124 samples collected). For each test, six samplers were placed on a manikin located inside a wind tunnel operated at 0.2 m/sec. Results indicated that the new sampler improved on the CFC for smaller particles, providing a larger range for which it matches the IPM criterion, up to 44.3 µm. However, the efficiency was significantly lower in comparison to the IPM criterion for particle sizes above 60 µm. Overall, the new sampler showed promise, but additional modifications may help improve sampling efficiency for larger particles.


Assuntos
Poluentes Ocupacionais do Ar/análise , Equipamentos Descartáveis , Monitoramento Ambiental/instrumentação , Exposição por Inalação/análise , Exposição Ocupacional/análise , Aerossóis , Desenho de Equipamento , Humanos , Tamanho da Partícula , Material Particulado/análise
18.
Br J Nutr ; 119(1): 57-65, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29355097

RESUMO

Inadequate nutrient intakes put children at risk for impaired growth and development. We described diet, usual intakes of energy and macro- and micronutrients and prevalence of nutrient intake adequacies among 4-8-year-old Zambian children. Children not yet in school and living in Mkushi District, Central Province, Zambia were enrolled into an efficacy trial of pro-vitamin A biofortified maize. Children in the non-intervened arm were included in this analysis (n 202). Dietary intake data were collected by tablet-based 24-h recall on a monthly basis over the 6-month trial. Observed nutrient intakes were derived from reported food quantities, standard recipes and food composition tables. Usual nutrient intake distributions were modelled based on observed intakes. Prevalence of inadequacy was estimated by comparing the usual nutrient intake distribution to the nutrient requirement distribution. Frequency and quantity of consumption of commonly reported foods were described and key sources of energy and nutrients were identified. Median usual energy intake was 6422 kJ/d (1535 kcal/d). Most childrens' macronutrient intakes fell within recommended ranges (74-98 %). Estimated prevalences of inadequate intakes of Fe, folate, vitamin B12 and Ca were 25, 57, 76 and >99 %, respectively. Estimated prevalences of inadequacy for other micronutrients were low (0·1-2·2 %). Commonly consumed foods included maize, vegetable oil, tomatoes, rape leaves and small fish (>0·6 servings/d), whereas meat, eggs or dairy were rarely eaten (<0·2 servings/d). These findings suggest that the heavily plant-based diet of rural Zambian children provides inadequate Ca, folate, vitamin B12 and Fe to meet recommended nutrient intakes.


Assuntos
Inquéritos sobre Dietas , Dieta , Alimentos Fortificados , Estado Nutricional , Zea mays/química , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Registros de Dieta , Ingestão de Energia , Comportamento Alimentar , Feminino , Humanos , Masculino , Micronutrientes , Necessidades Nutricionais , Prevalência , População Rural , Vitamina A/química , Zâmbia
19.
Br J Nutr ; 120(3): 335-344, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29875026

RESUMO

Our study compares adequacy of nutritional intakes among pregnant women with different prepregnancy BMI and explores associations between nutritional intakes during pregnancy and both prepregnancy BMI and gestational weight gain (GWG). We collected dietary information from a large cohort of pregnant Canadian women (n 861) using a 3-d food record. We estimated usual dietary intakes of energy (E), macronutrients and micronutrients using the National Cancer Institute method. We also performed Pearson's correlations between nutritional intakes and both prepregnancy BMI and GWG. In all BMI categories, intakes considered suboptimal (by comparison with estimated average requirements) were noted for Fe, vitamin D, folate, vitamin B6, Mg, Zn, Ca and vitamin A. Total fat intakes were above the acceptable macronutrient distribution range (AMDR) for 36 % of the women. A higher proportion of obese women had carbohydrate intakes (as %E) below the AMDR (v. normal-weight and overweight women; 19 v. 9 %) and Na intakes above the tolerable upper intake level (v. other BMI categories; 90 v. 77-78 %). In all BMI categories, median intakes of K and fibre were below adequate intake. Intakes of several nutrients (adjusted for energy) were correlated with BMI. Correlations were detected between energy-adjusted nutrient intakes and total GWG and were, for the most part, specific to certain BMI categories. Overweight and obese pregnant women appear to be the most nutritionally vulnerable. Nutrition interventions are needed to guide pregnant women toward their optimal GWG while also meeting their nutritional requirements.


Assuntos
Dieta , Fenômenos Fisiológicos da Nutrição Materna , Necessidades Nutricionais , Obesidade/sangue , Complicações na Gravidez/sangue , Adulto , Índice de Massa Corporal , Cálcio/sangue , Canadá , Estudos de Coortes , Registros de Dieta , Ingestão de Energia , Feminino , Ácido Fólico/sangue , Humanos , Ferro/análise , Magnésio/sangue , Micronutrientes , Nutrientes , Obesidade/complicações , Sobrepeso/complicações , Gravidez , Vitamina A/sangue , Vitamina B 6/sangue , Vitamina D/sangue , Vitaminas , Aumento de Peso , Adulto Jovem , Zinco/sangue
20.
Br J Nutr ; 119(8): 928-936, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29644951

RESUMO

Vitamin D deficiency (VDD) and insufficiency (VDI) are increasing at a global level, and they are associated with increased risk of various diseases. However, little information is available on the prevalence and predictors of VDD and VDI in a representative population of US adults. Serum 25-hydroxyvitamin D (25(OH)D) measurements were collected from 26 010 adults aged ≥18 years from the National Health and Nutrition Examination Survey (NHANES) 2001-2010. Using thresholds recommended by the Endocrine Society, VDD was defined as 25(OH)D<50 nmol/l and VDI as 50≤25(OH)D<75 nmol/l. Weighted multinomial log-binomial regression was conducted to estimate prevalence ratios of VDD and VDI. The prevalences of VDD and VDI in 2001-2010 were 28·9 and 41·4 %, respectively. Adults who were black, less educated, poor, obese, current smokers, physically inactive and infrequent milk consumers had a higher prevalence of VDD. After adjustment for other potential predictors, obese adults showed 3·09 times higher prevalence of VDD and 1·80 times higher prevalence of VDI than non-obese adults. Physically inactive adults had 2·00 and 1·36 times higher prevalence of VDD and VDI than active peers. Compared with frequent consumers, rare consumers of milk had 2·44 and 1·25 times higher prevalence of VDD and VDI, respectively. Current alcohol drinkers had 38 % lower prevalence of VDD than non-drinkers. Awareness of the high prevalence of VDD and VDI among US adults and related predictors could inform behavioural and dietary strategies for preventing VDD and monitoring VDI, especially in old, black, obese and inactive individuals who report rare consumption of milk.


Assuntos
Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adolescente , Adulto , Dieta/normas , Comportamento Alimentar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estações do Ano , Fatores Socioeconômicos , Luz Solar , Estados Unidos/epidemiologia , Vitamina D/sangue , Adulto Jovem
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