RESUMO
Colorectal cancer (CRC) is a major global health concern, and the development of effective treatment strategies is crucial. Enzyme prodrug therapy (EPT) shows promise in combating tumors but faces challenges in achieving sustained expression of therapeutic enzymes and optimal biological distribution. To address these issues, a fungi-triggered in situ chemotherapeutics generator (named as SC@CS@5-FC) was constructed via oral delivery of a prodrug (5-fluorocytosine, 5-FC) for the treatment of orthotopic colorectal tumor. When SC@CS@5-FC targets the tumor through tropism by Saccharomyces cerevisiae (SC), the chemotherapeutic generator could be degraded under abundant hyaluronidase (HAase) in the tumor microenvironment by an enzyme-responsive gate to release prodrug (5-FC). And nontoxic 5-FC was catalyzed to toxic chemotherapy drug 5-fluorouracil (5-FU) by cytosine deaminase (CD) of SC. Meanwhile, SC and zinc-coordinated chitosan nanoparticles could be used as immune adjuvants to activate antigen-presenting cells and further enhance the therapeutic effect. Our results demonstrated that SC@CS@5-FC could effectively inhibit tumor growth and prolong mouse survival in an orthotopic colorectal cancer model. This work utilizes living SC as a dynamotor and positioning system for the chemotherapeutic generator SC@CS@5-FC, providing a strategy for oral enzyme prodrug therapy for the treatment of orthotopic colorectal.
RESUMO
BACKGROUND AND OBJECTIVE: Malnutrition is prevalent among elderly patients with COPD, who also experience a high rate of readmission. Therefore, it is imperative to investigate the nutrition status of these patients, identify risk factors for readmission, and offer insights for clinical management. To achieve this, a cross-sectional study was conducted to investigate factors influencing nutrition status using GLIM criteria and explore the 180-day readmission factors among hospitalized elderly COPD patients. METHORDS AND RESULTS: The data were collected from a hospital in Southwest China, encompassing a cohort of 319 eligible patients. Among elderly hospitalized COPD patients, the prevalence of malnutrition was 49.53% (158/319). Multivariate logistic regression revealed malnutrition (OR = 3.184), very severe airway obstruction (OR = 3.735), and Number of comorbidities ≥ 3 (OR = 5.754) as significant risk factors for 180-day readmission. CONCLUSIONS: These findings suggest that malnutrition is a prevalent issue among elderly hospitalized patients with COPD and constitutes one of the risk factors contributing to the 180-day readmission rate. Therefore, timely identification and treatment for malnourished patients are crucial.
Assuntos
Desnutrição , Estado Nutricional , Readmissão do Paciente , Doença Pulmonar Obstrutiva Crônica , Humanos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Idoso , Masculino , Feminino , Readmissão do Paciente/estatística & dados numéricos , Desnutrição/epidemiologia , Estudos Transversais , Fatores de Risco , Idoso de 80 Anos ou mais , Hospitalização/estatística & dados numéricos , Prevalência , China/epidemiologia , ComorbidadeRESUMO
The effects of xylo-oligosaccharides (XOS) on broiler growth performance, immune function, and intestinal health were investigated. A total of 540 one-d-old Arbor Acres Plus broilers were randomly divided into 5 groups with 6 replicates per group and 18 chickens per replicate. Broilers in the control (CON) group received a corn-soybean meal based basal diet, those in the antibiotics (ANT) group received the basal diet plus 500 mg/kg oxytetracycline, and those in XOS groups received the basal diet plus 150, 300, or 450 mg/kg XOS. Compared with CON, the body weight at 42 d and average daily gain from 1 to 42 d were significantly increased in the 150, 450 mg/kg XOS-added and ANT groups (P = 0.018), and the relative expression of claudin-1 and ZO-1 mRNA in the ileum was significantly higher in the 300 and 450 mg/kg XOS-added groups (P < 0.001). The feed conversion ratios (P < 0.001) and abdominal fat rates (P = 0.012) of broilers from 1 to 42 d of age were significantly lower in all XOS-added groups than in the control group. Splenic index (P = 0.036) and bursa of Fabricius index (P = 0.009) were significantly better in the ANT group and each XOS-added group than in the control group. Compared to CON and ANT, serum IgA (P = 0.007) and IgG (P = 0.002) levels were significantly higher in the 300 mg/kg XOS-added group, and the relative abundance of short-chain fatty acid-producing genera (Alistipes) was also significantly higher (P < 0.001). Meanwhile, ileal villus height (P < 0.001) and ratio of villus height to crypt depth (V:C) (P = 0.001) were significantly increased in XOS-added broilers. In analysis of relationships between cecal microbes and the physical barrier of the gut, [Ruminococcus]_torques_group was positively correlated with mRNA expression of ileal ZO-1 and claudin-1 (P < 0.05), and Bacteroides was positively correlated with increased ileal villus height and V:C (P < 0.05). Overall, XOS addition to broiler diets improved growth performance, promoted intestinal health by enhancing intestinal barrier function and regulating cecal microbiota diversity, and had positive effects on immunity.
RESUMO
Curcumin (CUR) is a compound extracted from turmeric that has a variety of functions including antioxidant and anti-inflammatory. As an estrogen-like mycotoxin, zearalenone (ZEN) not only attacks the reproductive system, but also has toxic effects on the liver. However, whether CUR can alleviate ZEN-induced liver injury remains unclear. This paper aims to investigate the protective effect of CUR against ZEN-induced liver injury in mice and explore the molecular mechanism involved. BALB/c mice were randomly divided into control (CON) group, CUR group (200â¯mg/kg b. w. CUR), ZEN group (40â¯mg/kg b. w. ZEN) and CUR+ZEN group (200â¯mg/kg b. w. CUR+40â¯mg/kg b. w. ZEN). 28 d after ZEN exposure and CUR treatment, blood and liver samples were collected for subsequent testing. The results showed that CUR reversed ZEN-induced hepatocyte swelling and necrosis in mice. It significantly reduced the serum alkaline phosphatase (ALP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in mice (p < 0.05). In addition, CUR significantly reduced hepatic ROS, malondialdehyde, hydrogen peroxide and apoptosis levels in mice (p < 0.05). Quantitative RT-PCR and Western blot results showed that CUR significantly reduced the expression of Bax and Caspase3, and reversed the increase of Nrf2, HO-1 and NQO1 expression in the liver of mice induced by ZEN (p < 0.05). In conclusion, CUR alleviated ZEN-induced liver injury in mice by scavenging ROS and inhibiting the mitochondrial apoptotic pathway.
Assuntos
Apoptose , Doença Hepática Induzida por Substâncias e Drogas , Curcumina , Camundongos Endogâmicos BALB C , Espécies Reativas de Oxigênio , Zearalenona , Animais , Zearalenona/toxicidade , Curcumina/farmacologia , Apoptose/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo , Camundongos , Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Doença Hepática Induzida por Substâncias e Drogas/patologia , Doença Hepática Induzida por Substâncias e Drogas/tratamento farmacológico , Mitocôndrias/efeitos dos fármacos , Fígado/efeitos dos fármacos , Fígado/patologia , Fígado/metabolismo , Masculino , Estresse Oxidativo/efeitos dos fármacos , Antioxidantes/farmacologiaRESUMO
The effectiveness of various cancer therapies for solid tumors is substantially limited by the highly hypoxic tumor microenvironment (TME). Here, a microalgae-integrated living hydrogel (ACG gel) is developed to concurrently enhance hypoxia-constrained tumor starvation therapy and immunotherapy. The ACG gel is formed in situ following intratumoral injection of a biohybrid fluid composed of alginate, Chlorella sorokiniana, and glucose oxidase, facilitated by the crossing-linking between divalent ions within tumors and alginate. The microalgae Chlorella sorokiniana embedded in ACG gel generate abundant oxygen through photosynthesis, enhancing glucose oxidase-catalyzed glucose consumption and shifting the TME from immunosuppressive to immunopermissive status, thus reducing the tumor cell energy supply and boosting antitumor immunity. In murine 4T1 tumor models, the ACG gel significantly suppresses tumor growth and effectively prevents postoperative tumor recurrence. This study, leveraging microalgae as natural oxygenerators, provides a versatile and universal strategy for the development of oxygen-dependent tumor therapies.
Assuntos
Chlorella , Microalgas , Neoplasias , Animais , Camundongos , Hidrogéis , Glucose Oxidase , Fotossíntese , Hipóxia , Oxigênio , Imunoterapia , Alginatos , Microambiente TumoralRESUMO
Background: Monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) have been reported to combat saturated fatty acid (SFA)-induced cellular damage, however, their clinical effects on patients with metabolic diseases such as diabetes and hyperlipidemia are still controversial. Since comparative studies of the effects of these two types of unsaturated fatty acids (UFAs) are still limited. In this study, we aimed to compare the protective effects of various UFAs on pancreatic islets under the stress of SFA-induced metabolic disorder and lipotoxicity. Methods: Rat insulinoma cell line INS-1E were treated with palmitic acid (PA) with or without UFAs including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and oleic acid (OA) to determine cell viability, apoptosis, endoplasmic reticulum (ER) stress, and inflammatory. In vivo, male C57BL/6 mice were fed a 60% high-fat diet (HFD) for 12 w. Then the lard in HFD was partially replaced with fish oil (FO) and olive oil (OO) at low or high proportions of energy (5% or 20%) to observe the ameliorative effects of the UFA supplement. Results: All UFAs significantly improved PA-induced cell viability impairment in INS-1E cells, and their alleviation on PA induced apoptosis, ER stress and inflammation were confirmed. Particularly, OA had better effects than EPA, DHA, and AA on attenuating cellular ER stress. In vivo, the diets with a low proportion of UFAs (5% of energy) had limited effects on HFD induced metabolic disorder, except for a slight improved intraperitoneal glucose tolerance in obese mice. However, when fed diets containing a high proportion of UFAs (20% of energy), both the FO and OO groups exhibited substantially improved glucose and lipid metabolism, such as decrease in total cholesterol (TC), low-density lipoprotein (LDL), fasting blood glucose (FBG), and fasting blood insulin (FBI)) and improvement of insulin sensitivity evidenced by intraperitoneal glucose tolerance test (IPGTT) and intraperitoneal insulin tolerance test (IPITT). Unexpectedly, FO resulted in abnormal elevation of the liver function index aspartate aminotransferase (AST) in serum. Pathologically, OO attenuated HFD-induced compensatory hyperplasia of pancreatic islets, while this effect was not obvious in the FO group. Conclusions: Both MUFAs and PUFAs can effectively protect islet ß cells from SFA-induced cellular lipotoxicity. In particular, both OA in vitro and OO in vivo showed superior activities on protecting islets function and enhance insulin sensitivity, suggesting that MUFAs might have greater potential for nutritional intervention on diabetes.
Assuntos
Diabetes Mellitus , Resistência à Insulina , Insulinas , Humanos , Ratos , Camundongos , Animais , Masculino , Ácidos Graxos Monoinsaturados , Camundongos Endogâmicos C57BL , Ácidos Graxos Insaturados/farmacologia , Ácidos Graxos , Ácido Palmítico , Ácido Eicosapentaenoico/farmacologia , GlucoseRESUMO
Obesity is a recognized epidemic worldwide, and the accumulation of excess free saturated fatty acids (SFAs) in cells induces cellular lipotoxic damage and increases the risk of a wide spectrum of metabolic diseases including type 2 diabetes (T2D) and nonalcoholic fatty liver disease (NAFLD). Monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) have been reported to combat SFA-induced cellular damage. However, the comparative studies of the two types of unsaturated fatty acids (UFAs) are still limited. We investigated the effects of different MUFAs and PUFAs in the human hepatocyte line L-02 cells in vitro, and in high-fat-diet (HFD)-induced obese C57BL/6 mice in vivo. The results of the in vitro study showed that SFAs induced significant cellular lipotoxic damage, but the combination of MUFAs/PUFAs with SFAs significantly improved the impaired cell viability. Particularly, oleic acid (OA) was superior to eicosapentaenoic acid (EPA), Docosahexaenoic acid (DHA), and arachidonic acid (AA) in terms of its anti-apoptotic effect and inhibition of endoplasmic reticulum (ER) stress. In vivo, both olive-oil-enriched (HFD + OO) and fish-oil-enriched high-fat diets (HFD + FO) reduced hepatic steatosis and improved insulin sensitivity in obese mice. However, FO induced an abnormal increase in serum aspartate aminotransferase (AST) and an increase in the oxidative stress indicator Malondialdehyde (MDA). Liver-targeted lipidomic analysis showed that liver lipid metabolites under the two types of UFA dietary interventions differed from the HFD group, modulating the abundance of some lipid metabolites such as triglycerides (TGs) and glycerophospholipids. Furthermore, the FO diet significantly increased the abundance of the associated FA 20:5 long-chain lipid metabolites, whereas the OO diet regulated the unsaturation of all fatty acids in general and increased the abundance of FA 18:1 in the overall lipid metabolites, especially TGs, which may primarily contribute to the FO, and OO drove protection in NAFLD.
Assuntos
Diabetes Mellitus Tipo 2 , Hepatopatia Gordurosa não Alcoólica , Camundongos , Animais , Humanos , Ácidos Graxos Monoinsaturados/farmacologia , Ácidos Graxos Monoinsaturados/metabolismo , Camundongos Obesos , Hepatopatia Gordurosa não Alcoólica/etiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Camundongos Endogâmicos C57BL , Fígado/metabolismo , Ácidos Graxos Insaturados/metabolismo , Ácidos Graxos/metabolismo , Triglicerídeos/metabolismo , Dieta Hiperlipídica/efeitos adversos , Obesidade/metabolismoRESUMO
Glioblastomas (GBMs) are aggressive primary brain tumors with fatal outcome. Traditional chemo-radiotherapy has poor therapeutic effect and significant side effects, due to the drug and radiotherapy (RT) resistance, natural blood-brain barrier, and high-dose RT damage. Even more, tumor-associated monocytes (macrophages and microglia, TAMs) constitute up to 30%-50% of the GBM cellular content, and the tumor microenvironment (TME) in GBM is extremely immunosuppressive. Here, we synthesized nanoparticles (D@MLL) that hitchhike on circulating monocytes to target intracranial GBMs with the assistance of low-dose RT. The chemical construction of D@MLL was DOX·HCl loaded MMP-2 peptide-liposome, which could target monocytes by the surface modified lipoteichoic acid. First, low-dose RT at the tumor site increases monocyte chemotaxis and induces M1 type polarization of TAMs. Subsequently, the intravenous injected D@MLL targets circulating monocytes and hitchhikes with them to the central site of the GBM area. DOX·HCl was then released by the MMP-2 response, inducing immunogenic cell death, releasing calreticulin and high-mobility group box 1. This further contributed to TAMs M1-type polarization, dendritic cell maturation, and T cell activation. This study demonstrates the therapeutic advantages of D@MLL delivered by endogenous monocytes to GBM sites after low-dose RT, and it provides a high-precision treatment for GBMs.
Assuntos
Neoplasias Encefálicas , Glioblastoma , Nanopartículas , Humanos , Monócitos/metabolismo , Glioblastoma/tratamento farmacológico , Metaloproteinase 2 da Matriz/metabolismo , Macrófagos/metabolismo , Neoplasias Encefálicas/tratamento farmacológico , Microambiente Tumoral , Linhagem Celular TumoralRESUMO
BACKGROUND AND OBJECTIVES: To investigate the capacity of clinical nutrition services in secondary and tertiary hospitals in the Sichuan Province, China. METHODS AND STUDY DESIGN: Convenience sampling was used. E-questionnaires were distributed to all eligible medical institutions in Sichuan through the official network of provincial and municipal clinical nutrition quality control centers. The data obtained were sorted in Microsoft Excel and analyzed by SPSS. RESULTS: A total of 519 questionnaires were returned, of which 455 were valid. Only 228 hospitals were accessible to clinical nutrition services, of which 127 hospitals had independently set up clinical nutrition departments (CNDs). The ratio of clinical nutritionists to beds was 1:214. During the last decade, the rate of constructing new CNDs was maintained at approximately 5 units/year. A total of 72.4% of hospitals managed their clinical nutrition units as part of their medical technology departments. The specialist number ratio of senior, associate, intermediate and junior is approximately 1:4:8:10. There were 5 common charges for clinical nutrition. CONCLUSIONS: The sample representation was limited, and the capacity of clinical nutrition services may have been overestimated. Secondary and tertiary hospitals in Sichuan are currently in the second high tide of department establishment, with a positive trend of departmental affiliation standardization and a basic formation of a talent echelon.
Assuntos
Estado Nutricional , Projetos de Pesquisa , Humanos , Centros de Atenção Terciária , ChinaRESUMO
Despite the recognition that the gut microbiota acts a clinically significant role in cancer chemotherapy, both mechanistic understanding and translational research are still limited. Maximizing drug efficacy requires an in-depth understanding of how the microbiota contributes to therapeutic responses, while microbiota modulation is hindered by the complexity of the human body. To address this issue, a 3D experimental model named engineered microbiota (EM) is reported for bridging microbiota-drug interaction research and therapeutic decision-making. EM can be manipulated in vitro and faithfully recapitulate the human gut microbiota at the genus/species level while allowing co-culture with cells, organoids, and isolated tissues for testing drug responses. Examination of various clinical and experimental drugs by EM reveales that the gut microbiota affects drug efficacy through three pathways: immunological effects, bioaccumulation, and drug metabolism. Guided by discovered mechanisms, custom-tailored strategies are adopted to maximize the therapeutic efficacy of drugs on orthotopic tumor models with patient-derived gut microbiota. These strategies include immune synergy, nanoparticle encapsulation, and host-guest complex formation, respectively. Given the important role of the gut microbiota in influencing drug efficacy, EM will likely become an indispensable tool to guide drug translation and clinical decision-making.
Assuntos
Microbioma Gastrointestinal , Microbiota , Humanos , Hidrogéis/farmacologia , Interações Medicamentosas , Modelos TeóricosRESUMO
Objective: There is a lack of evidence regarding the outcomes of oral nutrition supplementation (ONS) in patients with esophageal cancer (EC) who received chemotherapy treatment. The aim of this study was to perform a retrospective cohort study by comparing an adequate ONS group with a control group. Materials and methods: The study was performed in the Oncology Department of West China Hospital of Sichuan University. Patients at nutritional risk were identified from March 2016 to June 2019, and divided into an ONS group and a control group. To control for potential confounding variables, the propensity score method with matching was carried out. The main outcomes were length of stay (LOS) and hospitalization cost. Secondary outcomes included the incidence of pulmonary infection and myelosuppression. Results: Out of 5,316 hospitalizations, a one-to-one matched sample was created (N = 229). The pathological tumor, node, metastasis (pTNM) stage of patients ranged from II to IV. A total of 69 patients received ONS, and 160 patients did not receive ONS. The incidence of myelosuppression in the ONS group and the control group was 4.3 vs. 17.4% (P = 0.014), respectively. However, ONS was associated with a 2 days increase in LOS, from 7 to 9 days (P < 0.000) and a hospitalization cost increase of $731, from $1134 to $1865 (P = 0.005). No statistical differences were observed in the incidence of pulmonary infection between the two groups. Further subgroup analysis based on body mass index (BMI) showed that at BMI ≤ 18.5 kg/m2, the incidence of myelosuppression in the ONS group was lower than that in the control group (3.0 vs. 20.8%, P = 0.022). At BMI > 18.5 kg/m2, no statistical differences were observed in the incidence of myelosuppression between the two groups. Conclusion: Although ONS increases hospitalization cost and LOS, it may be associated with reduced myelosuppression incidence, especially for patients with a BMI ≤ 18.5 kg/m2.
RESUMO
Objective: From the perspective of economics, this study discusses the value of establishing a standardized clinical nutrition diagnosis and treatment pathway in the diagnosis and treatment of pulmonary infection and provides a reference for optimizing the diagnosis and treatment pathway of pulmonary infection. Methods: The patients who received the nutrition diagnosis and treatment pathway intervention in 2017 were counted as the routine group and were subdivided into the conventional intervention group (C1) and conventional control group (C2) according to whether the standardized nutrition therapy was applied or not. The patients who received the nutrition diagnosis and treatment pathway intervention in 2020 were counted as the experimental group and were subdivided into the experimental intervention group (T1) and the experimental control group (T2) according to whether standardized intervention was applied or not. The total hospitalization expenses, average daily hospitalization cost, nutrition support expenses, plasma albumin before and after nutrition support, readmission, and other indicators of all patients were recorded and compared. The cost-effectiveness ratio (CER), incremental cost-effectiveness ratio (ICER), and cost-effectiveness threshold for cost-effectiveness analysis were adopted. Results: Compared with the C2 group, the C1 group had higher total hospitalization expenses, average daily hospitalization expenses, nutritional support expenses, and plasma albumin improvement rate and lower readmission rate (P < 0.001). Compared with the T2 group, the T1 group had higher total hospitalization cost, average daily hospitalization expenses, nutritional support expenses, and plasma albumin improvement rate and lower readmission rate (P < 0.001). Taking the improvement rate of plasma albumin as the effect index, compared with the C1 group, the T1 group has less investment cost and better effect, and the ICER is negative (below the cost-effect threshold). And taking the readmission rate as the effective index, compared with the C1 group, the T1 group invested less cost and had a better effect, and the ICER was negative (below the cost-effect threshold). Conclusion: For the patients with pulmonary infection, whether the improvement rate of plasma albumin or the readmission rate is used as the impact index, the standardized nutrition diagnosis and treatment pathway in 2020 is more economical than the nonstandardized nutrition diagnosis and treatment pathway.
Assuntos
Estado Nutricional , Pneumonia , Análise Custo-Benefício , Hospitalização , Humanos , Albumina SéricaRESUMO
Background: Radiotherapy and chemotherapy in patients with lung cancer can lead to a series of problems such as malnutrition and inflammatory reaction. Some studies have shown that ω-3 polyunsaturated fatty acids (PUFAs) could improve malnutrition and regulate inflammatory reaction in these patients, but no relevant meta-analysis exists. Methods: We systematically searched randomized controlled trials of ω-3 PUFAs in the adjuvant treatment of lung cancer in the PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang databases. Relevant outcomes were extracted, and we pooled standardized mean differences (SMDs) using a random or fixed-effects model. The risk of bias was evaluated according to the Cochrane Handbook (version 15.1). The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: A total of 7 studies were included. The SMDs (95% CI) of body weight change, albumin change, energy intake, and protein intake at the end of intervention were 1.15 (0.50, 1.80), 0.60 (0.11, 1.09), 0.39 (-0.10, 0.89), and 0.27 (-0.04, 0.58), respectively. The SMDs (95% CI) of CRP change and TNF-α change were -3.44 (-6.15, -0.73) and -1.63 (-2.53, -0.73), respectively. Conclusions: ω-3 PUFAs can improve nutritional status and regulate indicators of inflammation in patients with lung cancer undergoing radiotherapy and chemotherapy. This study was registered in the PROSPERO (registration number: CRD42022307699).
Assuntos
Ácidos Graxos Ômega-3 , Neoplasias Pulmonares , Desnutrição , China , Ácidos Graxos Ômega-3/uso terapêutico , Humanos , Inflamação , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/radioterapiaRESUMO
Isothiocyanates, bioactive phytochemicals of cruciferous vegetables, have chemopreventative efficacy. To clarify evidence of associations between cruciferous vegetable and isothiocyanate intake and various health outcomes, we conducted an umbrella review of meta-analyses and systematic reviews in humans. A total of 413 articles were identified, and 57 articles with 24 health outcomes were included. Consumption of cruciferous vegetables was associated with a reduced risk of all-cause mortality, cancers, and depression. Dose-response analyses revealed that a per 100 g/d increment was associated with a 10% decrease in the risk of all-cause mortality. Warfarin resistance caused by vitamin K-rich broccoli was reported. Caution was warranted for those allergies/hypersensitivities to the Brassica genus. The intake of cruciferous vegetables is generally safe and beneficial in humans. However the quality of the majority (68%) of evidence was low.
Assuntos
Brassica , Verduras , Dieta , Humanos , Isotiocianatos , Metanálise como Assunto , Avaliação de Resultados em Cuidados de Saúde , Revisões Sistemáticas como AssuntoRESUMO
BACKGROUND AND OBJECTIVES: An adequate iodine status during pregnancy is very important for maternal and infant health. The aim of this study was to characterize the iodine nutritional status of healthy pregnant women in Chengdu by measuring urinary iodine (UI) and analyzing dietary iodine intake. METHODS AND STUDY DESIGN: Pregnant women who underwent regular antenatal examinations were invited to participate in this study. Each woman underwent UI determination and urinary creatinine (Cr) measurement and recorded the details of her diet and salt intake at the beginning and end of one week. RESULTS: In total, 139 healthy pregnant women underwent UI determination in this study; among them, 116 participants completed the diet survey. The median urine iodine/ creatinine (UI/Cr) of the 139 patients was 216 µg/g, and the median dietary iodine level of 104 patients who completed the 7-day dietary record was 230 µg/d. The dietary iodine sources of the pregnant women were mainly seafood (11%), iodized salt (51%), iodized multivitamins (17%) and daily food (21%). CONCLUSIONS: We concluded that healthy pregnant women in Chengdu showed appropriate iodine nutritional status. The 7-day dietary record can be a nice way to evaluate dietary iodine nutritional status, and there is a strong correlation between dietary iodine intake and UI concentration.
Assuntos
Iodo , Complicações na Gravidez , China , Dieta , Feminino , Humanos , Estado Nutricional , Gravidez , Cloreto de Sódio na Dieta/análiseRESUMO
Green leafy vegetables (GLVs) are a key element of healthy eating patterns and are an important source of lutein. To clarify the evidence for associations between GLVs and lutein intake and multiple health outcomes, we performed a review. A total of 24 meta-analyses with 29 health outcomes were identified by eligibility criteria. Dose-response analyses revealed that, per 100 g/d GLV intake was associated with a decreased risk (ca. 25%) of all-cause mortality, coronary heart disease and stroke. Beneficial effects of GLV intake were found for cardiovascular disease and bladder and oral cancer. Dietary lutein intake was inversely associated with age-related macular degeneration, age-related cataracts, coronary heart disease, stroke, oesophageal cancer, non-Hodgkin lymphoma, metabolic syndrome, and amyotrophic lateral sclerosis. Caution was warranted for contamination with potentially pathogenic organisms, specifically Escherichia coli. GLV consumption and lutein intake therein are generally safe and beneficial for multiple health outcomes in humans.
Assuntos
Dieta , Luteína/metabolismo , Verduras/metabolismo , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/patologia , Humanos , Luteína/química , Neoplasias/mortalidade , Neoplasias/patologia , Avaliação de Resultados em Cuidados de Saúde , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/patologia , Verduras/químicaRESUMO
Lycopene is a potent lipophilic antioxidant in tomato. We aim to clarify the evidence for associations between tomato and lycopene and multiple health outcomes. Umbrella review of meta-analyses and systematic reviews was performed in humans. A total of 174 articles were searched, 17 articles with 20 health outcomes were identified by eligibility criteria. Tomato intake was inversely associated with all-cause mortality, coronary heart disease mortality, cerebrovascular disease mortality, prostate cancer, and gastric cancer. Dietary lycopene intake or serum lycopene was inversely associated with all-cause mortality, prostate cancer, stroke, cardiovascular disease, metabolic syndrome, and male infertility. Caution was warranted for potential allergy and pollution. The quality of the vast majority of evidence by GRADE was low or very low with the remaining six as moderate. The intake of tomato or lycopene was generally safe and beneficial for multiple health outcomes in humans. But the quality of the evidence was not high.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Licopeno/administração & dosagem , Neoplasias da Próstata/prevenção & controle , Solanum lycopersicum/química , Neoplasias Gástricas/prevenção & controle , Antioxidantes/química , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/patologia , Humanos , Licopeno/química , Solanum lycopersicum/metabolismo , Masculino , Neoplasias da Próstata/patologia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Análise de SobrevidaRESUMO
BACKGROUND: Chylothorax is caused by thoracic lymphatic system injuries that leads to the lymph extravasating into the thoracic cavity. There are few reports comparing the therapeutic effects of enteral nutrition with medium-chain triglyceride and total parenteral nutrition, and the results are inconsistent. Our study aimed to research the optimum nutrition support method for chylothorax. STUDY DESIGN: We retrospectively reviewed 35 chylothorax patients after heart and chest surgery from 2014 to 2018, at West China Hospital of Sichuan University, among them there were 27 post-heart surgery patients. We analyzed the therapeutic effects and costs of enteral nutrition with medium-chain triglyceride (E group) and total parenteral nutrition (T group) for chylothorax. RESULTS: The results were similar in patients with all surgeries and patients with only post heart surgery. The total cost during hospitalization in E group was higher than T group (P < 0.01), whereas the nutrition support cost was lower (P < 0.001). The length of hospital stay was longer in E group than T group (P > 0.05). Time from admission to surgery was shorter and from surgery to chylothorax diagnosis was longer in E group compared with T group. Time to resolution and removal of drainage was shorter in E group than T group but the differences were not significant. CONCLUSION: The therapeutic effects in enteral nutrition with medium-chain triglyceride and total parenteral nutrition had no obvious differences. Moreover, enteral nutrition with medium-chain triglyceride is safer and more economical. Therefore, we suggest that enteral nutrition with medium-chain triglyceride could be the first choice to treat postoperative chylothorax when the gastrointestinal tract function is allowed, and this result could be considered for postoperative chylous ascites.
RESUMO
BACKGROUND: Chylothorax is caused by thoracic lymphatic system injury that leads to lymph extravasates in the thoracic cavity. Cardiac surgery was the most common cause. Reports comparing therapeutic effects between enteral nutrition (EN) with medium-chain triglycerides (MCT) and total parenteral nutrition (TPN) are few and inconsistent. Our study aimed to analyze the incidence of chylothorax in children in our hospital and optimum nutritional management modalities. METHODS: We retrospectively reviewed the medical records of children admitted to our hospital with a diagnosis of chylothorax from 2014 to 2018. We analyzed the incidence of chylothorax, therapeutic effectiveness, and cost effectiveness of EN with MCT or TPN. RESULTS: 136 patients with chylothorax after surgery for congenital heart disease (CHD) were identified from 172 patients with chylothorax (79.07%); chylothorax occurred in 5.62% of all 2420 congenital heart disease surgeries that were performed during that period. Tetralogy of Fallot (TOF), ventricular septal defect (VSD), and double-outlet right ventricle (DORV) were the most common primary diagnoses. Fontan surgery, TOF repair, and VSD repair were the most common primary procedures. We enrolled 45 patients with cured chylothorax. Nutrition support costs in the EN with MCT group (n = 28) were significantly lower than in the TPN group (n = 17) (P = .000). Time to resolution and time to removal of the drainage tube were shorter in EN with MCT versus TPN (P = .003), and the length of hospital stay was shorter (P = .032). There were no significant differences between the 2 groups in time from admission to surgery, postoperative days before diagnosing chylothorax, or length of PICU stay (P > .05). CONCLUSIONS: The therapeutic effects of EN with MCT were significantly better than those of TPN, with lower costs. Therefore, we suggest that EN with MCT be chosen first to treat chylothorax caused by surgery with mild chest drainage volume when gastrointestinal tract function is allowed.
Assuntos
Quilotórax/terapia , Nutrição Enteral/métodos , Técnica de Fontan/efeitos adversos , Cardiopatias Congênitas/cirurgia , Complicações Pós-Operatórias/terapia , Criança , Pré-Escolar , China/epidemiologia , Quilotórax/epidemiologia , Quilotórax/etiologia , Feminino , Humanos , Incidência , Lactente , Masculino , Complicações Pós-Operatórias/etiologia , Estudos RetrospectivosRESUMO
BACKGROUND: The association between coffee and colorectal adenoma risk remains controversial. We conducted a meta-analysis of cohort and case-control studies to sum up the existing proof about this matter. METHODS: We searched Pubmed, Medline, and Embase for studies published before 1 September 2018 on coffee consumption and colorectal adenoma in any language. The different ORs were calculated for cohort and case-control studies in this study, and we use a random-effects model to aggregate the relative risks of individual studies and conduct dose response, heterogeneity, and publication bias. RESULTS: A total of 8 studies (6 case-control studies, 2 cohort studies) were identified, including 7090 subjects. In a summary analysis of all studies, high coffee intake (compared the highest with the lowest categories) was associated with a reduced risk of colorectal adenoma (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.55-0.90). The results of subgroup analysis of adenoma location were similar with the pooled analysis, except for rectal adenoma. In the dose-response meta-analysis study, the estimated total odds ratio for increasing coffee consumption by 150 ml per day (about one cup) was 0.91 (95% CI = 0.87-0.95). CONCLUSIONS: The meta-analysis demonstrates possible evidence that increased coffee intake is related to a reduced risk of colon adenoma. However, because of latent confusion and different exposure classification, this finding should be carefully considered.