Circulating endothelial progenitor cells during pregnancy in multiple sclerosis.

BACKGROUND: Endothelial progenitor cells (EPCs) have been shown to increase during physiological pregnancy and are believed to play a fundamental role in the process of placentation. Reduced levels of EPCs during pregnancy have been associated with preeclampsia and miscarriage. Women with multiple sclerosis (MS) are not at increased risk of preeclampsia nor of general adverse obstetric outcome, in contrast with some other autoimmune diseases. OBJECTIVE: The aim of this study was to evaluate circulating EPCs levels in pregnant patients with MS. METHODS: CD34+ and CD133+ were longitudinally detected by flow cytometry in the maternal plasma of 29 healthy controls and 9 MS patients and in the cord blood of their newborns. RESULTS: EPCs were affected by pregnancy with the same trend in both groups (CD34+ p = 0.0342; CD133+ p = 0.0347). EPCs during pregnancy were increased in MS (mean ± SD: CD34+ cells 0.038 ± 0.010; CD133+ 0.024 ± 0.009) with respect to healthy controls (mean ± SD: CD34+ cells 0.022 ± 0.006; CD133+ 0.016 ± 0.004), CD34+ p = 0.0004; CD133+ p = 0.0109. EPCs levels of the cord blood of MS patients' newborns mild correlated with maternal EPC levels at delivery (CD34+: spearman's Rho 0.658, p = 0.054; CD133+: spearman's Rho 0.758, p = 0.018). CONCLUSIONS: This work identified increased circulating EPC levels during pregnancy, following the same trend both in MS patients and healthy controls. Despite the similar trend, the levels of circulating EPCs were significantly higher in MS patients with respect to the control population. A correlation was also found in MS patients between cord blood EPCs and circulating EPCs at delivery.

Avaliação do estado nutricional e da dieta de crianças e adolescentes com síndrome de down / Evaluación del estado nutricional y de la dieta de niños y adolescentes con síndrome de down / Evaluation of nutritional status and diet of children and adolescents with down syndrome

RESUMO Introdução: As crianças com síndrome de Down (SD) podem apresentar maior incidência de neofobia e de seletividade alimentar, sobrepeso e obesidade. A alimentação saudável e equilibrada é de suma importância para o crescimento adequado dessas crianças. Objetivo: Avaliar a adequação dos componentes da dieta e o estado nutricional de crianças e adolescentes com síndrome de Down em seguimento no ambulatório de pediatria genética do Hospital das Clínicas de Botucatu. Método: Estudo clínico descritivo transversal, com coleta de dados clínicos e avaliação nutricional, realizadopor meio de dados antropométricos e recordatório alimentar para avaliação da dieta. Análise estatística dos testes de Qui-quadrado e de Tukey. Resultados: Foram incluídos 35 crianças e dois adolescentes. Os diagnósticos nutricionais foram 2,7% de magreza, 81,1% de eutrofia, 8,1% de obesidade e 8,1% em risco ou sobrepeso. Houve excesso de ingestão de lipídeos naqueles com sobrepeso e obesidade, e a dieta deficiente em fibras foi prevalente a partir do primeiro ano de vida, bem como excesso de calorias e adequação de ferro e zinco. Entre os dois adolescentes, predominou a dieta com déficits em macro e micronutrientes, exceto em vitamina C e colesterol. Conclusões: A dieta com excesso de calorias, carboidratos e lipídios, como tambémcom déficit de fibras, aponta uma alimentação pouco balanceada entre crianças e adolescentes com SD, principalmente após o primeiro ano de vida, apesar do seu adequado estado nutricional.

RESUMEN Introducción: los niños consíndrome de Down (SD) pueden presentar mayor incidencia de neofobia yde selectividad alimentaria, sobrepeso y obesidad. La alimentación saludabley equilibradaes de gran importancia para el crecimiento adecuado de estos niños. Objetivo: la adecuación de los componentes de la dieta yel estado nutricional de niños y adolescentes con síndrome de Downasistidosen la clínica médica depediatría genética delHospital das Clínicas de Botucatu. Método: estudio clínico descriptivo transversal, con recolección de datos clínicos yevaluación nutricional, realizado medianteindicadores antropométricos y recordatorio alimentario para la evaluación de la dieta. Análisis estadísticode laspruebas de ji-cuadrado y de Tukey. Resultados: fueron incluidos 35niños ydos adolescentes. Los diagnósticos nutricionales fueron 2,7% de delgadez, 81,1% de eutrofia, 8,1% de obesidady8,1% en riesgo o sobrepeso. Hubo exceso de ingestión delípidosenaquellos con sobrepeso y obesidad, yla dieta deficiente en fibrasfueprevalentea partir del primer año de vida, así como exceso de calorías y adecuación de hierro y zinc. Entre los dos adolescentes, predominóla dieta con déficits en macro y micronutrientes, excepto en vitamina C y colesterol. Conclusiones: la dieta con exceso de calorías, carbohidratosylípidos, como tambiéncondéficit de fibras, señala una alimentación poco balanceada entre niños y adolescentes con SD, principalmente trasel primer año de vida, apesar de su adecuado estado nutricional.

ABSTRACT Introduction: Children with Down syndrome (DS) may have a prevalence of neophobia and food selectivity, overweight, and obesity. A healthy and balanced diet is of utmost importance for the proper growth of these children. Objective: To evaluate the adequacy of diet components and the nutritional status of children and adolescents with Down syndrome followed up at the outpatient care of genetic pediatrics, Hospital das Clínicas de Botucatu. Method: A cross-sectional descriptive clinical study, with a collection of clinical data and nutritional assessment, using anthropometric data and dietary records to evaluate the diet. Statistical analysis of the Chi-square and Tukey tests were performed. Results: A total of 35 children and two adolescents were included. Nutritional diagnoses were 2.7% lean, 81.1% eutrophic, 8.1% obese, and 8.1% at risk or overweight. There was an excess of lipid intake in overweight and obese children, and a fiber-deficient diet was prevalent since the first year of age, as well as extra calories and adequate iron and zinc intake. Among the two adolescents, a diet with deficits in macro and micronutrients, except for vitamin C and cholesterol, stood out. Conclusions: A diet with an excess of calories, carbohydrates, and lipids, as well as a fiber-deficient diet, indicates an unbalanced diet among children and adolescents with DS, especially after one year of age, despite their adequate nutritional status.