RESUMO
A paradox of so-called developed countries is that, as the major historical causes of human mortality are eliminated or mitigated by medical progress, lifestyle-related diseases have become major killers. Furthermore, as lifespan is extended by the combined effects of modern medicine, health span is struggling to keep apace because of the burden of noncommunicable diseases linked to diet and sedentary lifestyle. The gut microbiome is now recognized as a plastic environmental risk factor for many of these diseases, the microbiome being defined as the complex community of co-evolved commensal microbes that breaks down components of a complex diet, modulates innate immunity, and produces signalling molecules and metabolites that can impact on diverse regulatory systems in mammals. Aspects of the so-called 'Western' lifestyle linked to disease risk such as energy dense diet and antibiotic treatment are known to affect the composition and function of the microbiome. Here, we review the detailed mechanisms whereby the gut microbiome may modulate risk of diseases linked to sedentary lifestyle and ageing-related health loss. We focus on the comparative value of natural animal models such as hibernation for studying metabolic regulation and the challenge of extrapolating from animal models to processes that occur in human ageing.
Assuntos
Envelhecimento/fisiologia , Doença Crônica/mortalidade , Doença Crônica/prevenção & controle , Metabolismo Energético/fisiologia , Microbiota , Comportamento Sedentário , Animais , Hibernação/fisiologia , Humanos , Estilo de Vida , Longevidade , Modelos AnimaisRESUMO
Studies have shown associations between reduced vitamin K status and poor cognitive function. However, despite this apparent link, direct studies measuring cognitive function, vitamin K status and inflammation are lacking. In the current study, The ELDERMET cohort was investigated to identify associations between cognition, vitamin K status and inflammation. The primary aim of the ELDERMET study was to investigate the relationship between gut bacteria, diet, lifestyle and health in 500 older Irish adults. Significant differences in serum phylloquinone, dietary phylloquinone and inflammatory markers were found across varying levels of cognitive function, after controlling for sex, age, body mass index (BMI), triglycerides and blood pressure. In addition, significantly higher levels of dietary phylloquinone were found in those with better cognition compared to those with the poorest function. Higher levels of inflammatory were also associated with poor cognition. Furthermore, both dietary and serum phylloquinone were significant independent predictors of good cognitive function, after controlling for confounders. This study highlights the importance of dietary vitamin K as a potentially protective cognitive factor; it also provides evidence for the correlation between cognition and inflammation. Strategies should be devised by which elderly populations can access rich dietary sources of phylloquinone to maintain cognition.
Assuntos
Cognição , Disfunção Cognitiva/epidemiologia , Dieta , Inflamação/epidemiologia , Estado Nutricional , Vitamina K 1/sangue , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/sangue , Estudos de Coortes , Feminino , Humanos , Inflamação/fisiopatologia , Mediadores da Inflamação/sangue , Irlanda , MasculinoRESUMO
AIM: Organ-preserving local excision by transanal endoscopic microsurgery (TEM) for early rectal cancer offers significantly lower morbidity as compared to formal rectal cancer resection with acceptable outcomes. This study presents our 6-year experience of TEM for rectal lesions referred to a specialist early rectal cancer centre in the UK. METHOD: Data were collected for all patients referred for TEM of suspected early rectal cancer to a regional specialist early rectal cancer multidisciplinary team (MDT) over a 6-year period. RESULTS: One hundred and forty-one patients who underwent full-thickness TEM for suspected or confirmed early rectal cancer were included. Thirty patients were referred for TEM following incomplete endoscopic polypectomy. Final pathology was benign in 77 (54.6%) cases and malignant in 64 (45.4%). Of the 61 confirmed adenocarcinomas, TEM resections were pT0 in 17 (27.9%), pT1 in 32 (51.7%), pT2 in 11 (18.0%) and pT3 in 1 (1.6%). Thirty-eight of 61 patients (62.3%) had one or more poor histological prognostic features and these patients were offered further treatment. Twenty-three of 61 (37.7%) patients with rectal adenocarcinoma required no further treatment following TEM. Forty-three cases of rectal adenocarcinoma were available for establishing recurrence rates. Two of 43 patients (4.7%) developed a recurrence at a median follow-up of 28.7 months (12.1-66.5 months). The overall estimated 5-year overall survival rate was 87.9% and the disease-free survival rate was 82.9%. CONCLUSION: Acceptable outcomes are possible for TEM surgery with appropriate patient selection, effective technique, expert histopathology, appropriate referral for adjuvant treatment and meticulous follow-up. This can be achieved through an early rectal cancer MDT in a dedicated specialist regional centre.
Assuntos
Protectomia/estatística & dados numéricos , Neoplasias Retais/cirurgia , Especialidades Cirúrgicas/estatística & dados numéricos , Microcirurgia Endoscópica Transanal/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Seleção de Pacientes , Protectomia/métodos , Neoplasias Retais/patologia , Encaminhamento e Consulta , Programas Médicos Regionais , Resultado do Tratamento , Reino Unido , Adulto JovemRESUMO
Imaging and characterization of engineered nanoparticles (ENPs) in water, soils, sediment and food matrices is very important for research into the risks of ENPs to consumers and the environment. However, these analyses pose a significant challenge as most existing techniques require some form of sample manipulation prior to imaging and characterization, which can result in changes in the ENPs in a sample and in the introduction of analytical artefacts. This study therefore explored the application of a newly designed instrument, the atmospheric scanning electron microscope (ASEM), which allows the direct characterization of ENPs in liquid matrices and which therefore overcomes some of the limitations associated with existing imaging methods. ASEM was used to characterize the size distribution of a range of ENPs in a selection of environmental and food matrices, including supernatant of natural sediment, test medium used in ecotoxicology studies, bovine serum albumin and tomato soup under atmospheric conditions. The obtained imaging results were compared to results obtained using conventional imaging by transmission electron microscope (TEM) and SEM as well as to size distribution data derived from nanoparticle tracking analysis (NTA). ASEM analysis was found to be a complementary technique to existing methods that is able to visualize ENPs in complex liquid matrices and to provide ENP size information without extensive sample preparation. ASEM images can detect ENPs in liquids down to 30 nm and to a level of 1 mg L(-1) (9×10(8) particles mL(-1) , 50 nm Au ENPs). The results indicate ASEM is a highly complementary method to existing approaches for analyzing ENPs in complex media and that its use will allow those studying to study ENP behavior in situ, something that is currently extremely challenging to do.
Assuntos
Análise de Alimentos , Sedimentos Geológicos/química , Microscopia Eletrônica de Varredura/métodos , Nanopartículas/análise , Soro/química , Animais , Bovinos , Solanum lycopersicum , Nanopartículas/ultraestruturaRESUMO
AIMS: To isolate and characterize bacteriocins produced by predominant species of lactic acid bacteria from faeces of elderly subjects. METHODS AND RESULTS: Screening over 70,000 colonies, from faecal samples collected from 266 subjects, using the indicator organisms Lactobacillus bulgaricus LMG 6901 and Listeria innocua DPC 3572, identified 55 antimicrobial-producing bacteria. Genomic fingerprinting following ApaI digestion revealed 15 distinct strains. The antimicrobial activities associated with 13 of the 15 strains were sensitive to protease treatment. The predominant antimicrobial-producing species were identified as Lactobacillus salivarius, Lactobacillus gasseri, Lactobacillus acidophilus, Lactobacillus crispatus and Enterococcus spp. A number of previously characterized bacteriocins, including ABP-118 and salivaricin B (from Lact. salivarius), enterocin B (Enterococcus faecium), lactacin B (Lact. acidophilus), gassericin T and a variant of gassericin A (Lact. gasseri), were identified. Interestingly, two antimicrobial-producing species, not generally associated with intestinally derived microorganisms were also isolated: Lactococcus lactis producing nisin Z and Streptococcus mutans producing mutacin II. CONCLUSION: These data suggest that bacteriocin production by intestinal isolates against our chosen targets under the screening conditions used was not frequent (0.08%). SIGNIFICANCE AND IMPACT OF THE STUDY: The results presented are important due to growing evidence indicating bacteriocin production as a potential probiotic trait by virtue of strain dominance and/or pathogen inhibition in the mammalian intestine.
Assuntos
Bacteriocinas/isolamento & purificação , Enterococcus/isolamento & purificação , Intestinos/microbiologia , Lactobacillus/isolamento & purificação , Microbiota , Idoso , Proteínas de Bactérias/isolamento & purificação , Bacteriocinas/biossíntese , Impressões Digitais de DNA , DNA Bacteriano/genética , Enterococcus/genética , Enterococcus/metabolismo , Fezes/microbiologia , Humanos , Irlanda , Lactobacillus/genética , Lactobacillus/metabolismo , Probióticos , RNA Ribossômico 16S/genéticaRESUMO
UNLABELLED: In this study, we characterized the gut microbiota in six healthy Irish thoroughbred racehorses and showed it to be dominated by the phyla Firmicutes, Bacteroidetes, Proteobacteria, Verrucomicrobia, Actinobacteria, Euryarchaeota, Fibrobacteres and Spirochaetes. Moreover, all the horses harboured Clostridium, Fibrobacter, Faecalibacterium, Ruminococcus, Eubacterium, Oscillospira, Blautia Anaerotruncus, Coprococcus, Treponema and Lactobacillus spp. Notwithstanding the sample size, it was noteworthy that the core microbiota species assignments identified Fibrobacter succinogenes, Eubacterium coprostanoligenes, Eubacterium hallii, Eubacterium ruminantium, Oscillospira guillermondii, Sporobacter termiditis, Lactobacillus equicursoris, Treponema parvum and Treponema porcinum in all the horses. This is the first study of the faecal microbiota in the Irish thoroughbred racehorse, a significant competitor in the global bloodstock industry. The information gathered in this pilot study provides a foundation for veterinarians and other equine health-associated professionals to begin to analyse the microbiome of performance of racehorses. This study and subsequent work may lead to alternate dietary approaches aimed at minimizing the risk of microbiota-related dysbiosis in these performance animals. SIGNIFICANCE AND IMPACT OF THE STUDY: Although Irish thoroughbreds are used nationally and internationally as performance animals, very little is known about the core faecal microbiota of these animals. This is the first study to characterize the bacterial microbiota present in the Irish thoroughbred racehorse faeces and elucidate a core microbiome irrespective of diet, animal management and geographical location.
Assuntos
Bactérias/classificação , Bactérias/isolamento & purificação , Fezes/microbiologia , Trato Gastrointestinal/microbiologia , Cavalos/microbiologia , Microbiota , Animais , Bactérias/genética , Feminino , Masculino , MetagenomaRESUMO
AIMS: To assess the ability of human intestinally derived strains of Lactobacillus and Bifidobacterium to produce γ-aminobutyric acid (GABA). METHODS AND RESULTS: Strains of Lactobacillus and Bifidobacterium were grown in medium containing monosodium glutamate (MSG). Growth of the bacteria and conversion of MSG to GABA were measured. Of 91 intestinally derived bacteria assessed, one Lactobacillus strain and four strains of Bifidobacterium produced GABA. Lactobacillus brevis DPC6108 was the most efficient of the strains tested, converting up to 90% [corrected] of MSG to GABA. The ability of the cultured intestinal strains to produce GABA was investigated using a simple pH-controlled anaerobic faeces-based fermentation, supplemented with 30 mg ml⻹ MSG. The addition of Lact. brevis DPC6108 to a faeces-based fermentation significantly increased the GABA concentration (P < 0·001), supporting the notion that this biosynthesis could occur in vivo. CONCLUSIONS: The production of GABA by bifidobacteria exhibited considerable interspecies variation. Lactobacillus brevis and Bifidobacterium dentium were the most efficient GABA producers among the range of strains tested. The addition of Lact. brevis DPC6108 to the culturable gut microbiota increased the GABA concentration in fermented faecal slurry at physiological pH. SIGNIFICANCE AND IMPACT OF THE STUDY: Identification of optimal MSG conversion to GABA by particular cultured elements of the commensal intestinal microbiota and the demonstration that this can occur under simulated in vivo conditions offer new prospects for microbiota modulation to promote health.
Assuntos
Bifidobacterium/metabolismo , Fermentação , Levilactobacillus brevis/metabolismo , Ácido gama-Aminobutírico/biossíntese , Bifidobacterium/crescimento & desenvolvimento , Meios de Cultura/metabolismo , Fezes , Humanos , Concentração de Íons de Hidrogênio , Intestinos/microbiologia , Levilactobacillus brevis/crescimento & desenvolvimento , Glutamato de Sódio/metabolismoRESUMO
AIMS: The aim of this investigation was to establish the degree of correlation between measurements from culture-dependent microbiological techniques and from next generation sequencing technologies. METHODS AND RESULTS: Data generated by both techniques were collected from faecal samples from 185 elderly Irish people involved in the ongoing ELDERMET study (http://eldermet.ucc.ie). The results for three groups of intestinal bacteria were compared. Bifidobacterium sp., Lactobacillus sp. and Enterobacteriaceae were enumerated on selective media through culture-dependent techniques, whereas proportions of these bacteria were determined through sequencing technology against the background of other bacteria. The Spearman's rank correlation coefficient determined a good correlation between results from culture-dependent microbiology and culture-independent techniques for all three bacterial groups assessed (correlation coefficients for Bifidobacterium sp., Lactobacillus sp. and Enterobacteriaceae were 0·380, 0·366 and 0·437, respectively). CONCLUSION: Correlation between the two methods implies that a single method is capable of profiling intestinal Bifidobacterium, Lactobacillus and Enterobacteriaceae populations. However, both methods have advantages that justify their use in tandem. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first extensive study to compare bacterial counts from culture-dependent microbiological techniques and from next generation sequencing technologies.
Assuntos
Bifidobacterium/isolamento & purificação , Enterobacteriaceae/isolamento & purificação , Fezes/microbiologia , Intestinos/microbiologia , Lactobacillus/isolamento & purificação , Adulto , Idoso , Bifidobacterium/genética , Contagem de Colônia Microbiana , Biologia Computacional , Meios de Cultura , DNA Bacteriano/genética , Enterobacteriaceae/genética , Genes de RNAr , Humanos , Lactobacillus/genética , Análise de Sequência de DNARESUMO
BACKGROUND AND AIMS: Increased efficiency of energy harvest, due to alterations in the gut microbiota (increased Firmicutes and decreased Bacteroidetes), has been implicated in obesity in mice and humans. However, a causal relationship is unproven and contributory variables include diet, genetics and age. Therefore, we explored the effect of a high-fat (HF) diet and genetically determined obesity (ob/ob) for changes in microbiota and energy harvesting capacity over time. METHODS: Seven-week-old male ob/ob mice were fed a low-fat diet and wild-type mice were fed either a low-fat diet or a HF-diet for 8 weeks (n=8/group). They were assessed at 7, 11 and 15 weeks of age for: fat and lean body mass (by NMR); faecal and caecal short-chain fatty acids (SCFA, by gas chromatography); faecal energy content (by bomb calorimetry) and microbial composition (by metagenomic pyrosequencing). RESULTS: A progressive increase in Firmicutes was confirmed in both HF-fed and ob/ob mice reaching statistical significance in the former, but this phylum was unchanged over time in the lean controls. Reductions in Bacteroidetes were also found in ob/ob mice. However, changes in the microbiota were dissociated from markers of energy harvest. Thus, although the faecal energy in the ob/ob mice was significantly decreased at 7 weeks, and caecal SCFA increased, these did not persist and faecal acetate diminished over time in both ob/ob and HF-fed mice, but not in lean controls. Furthermore, the proportion of the major phyla did not correlate with energy harvest markers. CONCLUSION: The relationship between the microbial composition and energy harvesting capacity is more complex than previously considered. While compositional changes in the faecal microbiota were confirmed, this was primarily a feature of high-fat feeding rather than genetically induced obesity. In addition, changes in the proportions of the major phyla were unrelated to markers of energy harvest which changed over time. The possibility of microbial adaptation to diet and time should be considered in future studies.
Assuntos
Dieta , Metabolismo Energético/fisiologia , Trato Gastrointestinal/microbiologia , Metagenoma/fisiologia , Obesidade/microbiologia , Envelhecimento/fisiologia , Animais , Bactérias/classificação , Bactérias/isolamento & purificação , Composição Corporal/fisiologia , Criopreservação , Gorduras na Dieta/administração & dosagem , Modelos Animais de Doenças , Fezes/microbiologia , Trato Gastrointestinal/metabolismo , Camundongos , Camundongos Knockout , Obesidade/metabolismo , Obesidade/fisiopatologia , Aumento de Peso/fisiologiaRESUMO
Alterations of the gut microbiota have been reported in various gastrointestinal disorders, but knowledge of the mycobiome is limited. We investigated the gut mycobiome of 80 patients with Irritable Bowel Syndrome (IBS) in comparison with 64 control subjects. The fungal-specific internal transcribed spacer 1 (ITS-1) amplicon was sequenced, and mycobiome zero-radius operational taxonomic units (zOTUs) were defined representing known and unknown species and strains. The fungal community was sparse and individual-specific in all (both IBS and control) subjects. Although beta-diversity differed significantly between IBS and controls, no difference was found among clinical subtypes of IBS or in comparison with the mycobiome of subjects with bile acid malabsorption (BAM), a condition which may overlap with IBS with diarrhoea. The mycobiome alterations co-varied significantly with the bacteriome and metabolome but were not linked with dietary habits. As a putative biomarker of IBS, the predictive power of the fecal mycobiome in machine learning models was significantly better than random but insufficient for clinical diagnosis. The mycobiome presents limited therapeutic and diagnostic potential for IBS, despite co-variation with bacterial components which do offer such potential.
Assuntos
Bactérias/isolamento & purificação , Fezes/microbiologia , Fungos/isolamento & purificação , Microbioma Gastrointestinal , Síndrome do Intestino Irritável/microbiologia , Adulto , Idoso , Bactérias/classificação , Bactérias/genética , Feminino , Fungos/classificação , Fungos/genética , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Irritable Bowel Syndrome (IBS), the most common gastrointestinal disorder, is diagnosed solely on symptoms. Potentially diagnostic alterations in the bacterial component of the gut microbiome (the bacteriome) are associated with IBS, but despite the known role of the virome (particularly bacteriophages), in shaping the gut bacteriome, few studies have investigated the virome in IBS. We performed metagenomic sequencing of fecal Virus-Like Particles (VLPs) from 55 patients with IBS and 51 control individuals. We detected significantly lower alpha diversity of viral clusters comprising both known and novel viruses (viral 'dark matter') in IBS and a significant difference in beta diversity compared to controls, but not between IBS symptom subtypes. The three most abundant bacteriophage clusters belonged to the Siphoviridae, Myoviridae, and Podoviridae families (Order Caudovirales). A core virome (defined as a cluster present in at least 50% of samples) of 5 and 12 viral clusters was identified in IBS and control subjects, respectively. We also identified a subset of viral clusters that showed differential abundance between IBS and controls. The virome did not co-vary significantly with the bacteriome, with IBS clinical subtype, or with Bile Acid Malabsorption status. However, differences in the virome could be related back to the bacteriome as analysis of CRISPR spacers indicated that the virome alterations were at least partially related to the alterations in the bacteriome. We found no evidence for a shift from lytic to lysogenic replication of core viral clusters, a phenomenon reported for the gut virome of patients with Inflammatory Bowel Disease. Collectively, our data show alterations in the virome of patients with IBS, regardless of clinical subtype, which may facilitate development of new microbiome-based therapeutics.
Assuntos
Microbioma Gastrointestinal , Síndrome do Intestino Irritável/virologia , Viroma , Adolescente , Adulto , Idoso , Bacteriófagos/classificação , Bacteriófagos/genética , Bacteriófagos/isolamento & purificação , Fezes/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vírus/classificação , Vírus/genética , Vírus/isolamento & purificação , Adulto JovemRESUMO
OBJECTIVE: A 24-hour day is made up of time spent in a range of physical activity (PA) behaviours, including sleep, sedentary time, standing, light-intensity PA (LIPA) and moderate-to-vigorous PA (MVPA), all of which may have the potential to alter an individual's health through various different pathways and mechanisms. This study aimed to explore the relationship between PA behaviours and the gut microbiome in older adults. DESIGN: Cross-sectional study. SETTINGS AND PARTICIPANTS: Participants (n=100; age 69.0 [3.0] years; 44% female) from the Mitchelstown Cohort Rescreen (MCR) Study (2015-2017). METHODS: Participants provided measures of gut microbiome composition (profiled by sequencing 16S rRNA gene amplicons), and objective measures of PA behaviours (by a 7-day wear protocol using an activPAL3 Micro). RESULTS: Standing time was positively correlated with the abundance of butyrate-producing and anti-inflammatory bacteria, including Ruminococcaceae, Lachnospiraceae and Bifidobacterium, MVPA was positively associated with the abundance of Lachnospiraceae bacteria, while sedentary time was associated with lower abundance of Ruminococcaceae and higher abundance of Streptococcus spp. CONCLUSION: Physical activity behaviours appear to influence gut microbiota composition in older adults, with different PA behaviours having diverging effects on gut microbiota composition.
Assuntos
Envelhecimento/fisiologia , Exercício Físico , Microbioma Gastrointestinal , Idoso , Estudos Transversais , Feminino , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , RNA Ribossômico 16S , Comportamento SedentárioRESUMO
The technique of single-particle fluorescence imaging was used to investigate the oligomeric state of MHC class II molecules on the surface of living cells. Cells transfected with human leukocyte antigen (HLA)-DR A and B genes were labeled at saturation with a univalent probe consisting of Fab coupled to R-phycoerythrin. Analysis of the intensities of fluorescent spots on the cell surface revealed the presence of single and double particles consistent with the simultaneous presence of HLA-DR heterodimers and dimers of dimers. The proportion of double particles was lower at 37 degrees C than at 22 degrees C, suggesting that the heterodimers and dimers of dimers exist in a temperature-dependent equilibrium. These results are discussed in the context of a possible role for HLA-DR dimers of dimers in T cell receptor-MHC interactions. The technique is validated by demonstrating that fluorescence imaging can distinguish between dimers and tetramers of human erythrocyte spectrin deposited from solution onto a solid substrate. The methodology will have broad applicability to investigation of the oligomeric state of immunological and other membrane-bound receptors in living cells.
Assuntos
Antígenos HLA-DR/biossíntese , Linhagem Celular , Membrana Celular/imunologia , Dimerização , Citometria de Fluxo , Antígenos HLA-DR/análise , Antígenos HLA-DR/química , Cadeias alfa de HLA-DR , Humanos , Fragmentos Fab das Imunoglobulinas , Leucócitos/imunologia , Substâncias Macromoleculares , Microscopia de Fluorescência , Proteínas Recombinantes/análise , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/química , TransfecçãoRESUMO
Biofilms are an important element of the natural ecosystems but can be detrimental in health care and industrial settings. To improve our ability to combat biofilms, we need to understand the processes that facilitate their formation and dispersal. One approach that has proven to be invaluable is to image biofilms as they grow. Here we describe tools and protocols to visualize biofilms with multiphoton laser scanning microscopy, compare this with single photon laser scanning confocal microscopy and highlight best working procedures. Furthermore, we describe how with multiphoton laser scanning microscopy the laser can be used to manipulate the biofilm, specifically to achieve localized bleaching, killing or ablation within the biofilm biomass. These applications open novel ways to study the dynamics of biofilm formation, regeneration and dispersal.
Assuntos
Biofilmes/crescimento & desenvolvimento , Escherichia coli/fisiologia , Microscopia Confocal/métodos , Escherichia coli/crescimento & desenvolvimento , Escherichia coli/metabolismoRESUMO
BACKGROUND & AIMS: Malnutrition in older adults results in significant personal, social, and economic burden. To combat this complex, multifactorial issue, evidence-based knowledge is needed on the modifiable determinants of malnutrition. Systematic reviews of prospective studies are lacking in this area; therefore, the aim of this systematic review was to investigate the modifiable determinants of malnutrition in older adults. METHODS: A systematic approach was taken to conduct this review. Eight databases were searched. Prospective cohort studies with participants of a mean age of 65 years or over were included. Studies were required to measure at least one determinant at baseline and malnutrition as outcome at follow-up. Study quality was assessed using a modified version of the Quality in Prognosis Studies (QUIPS) tool. Pooling of data in a meta-analysis was not possible therefore the findings of each study were synthesized narratively. A descriptive synthesis of studies was used to present results due the heterogeneity of population source and setting, definitions of determinants and outcomes. Consistency of findings was assessed using the schema: strong evidence, moderate evidence, low evidence, and conflicting evidence. RESULTS: Twenty-three studies were included in the final review. Thirty potentially modifiable determinants across seven domains (oral, psychosocial, medication and care, health, physical function, lifestyle, eating) were included. The majority of studies had a high risk of bias and were of a low quality. There is moderate evidence that hospitalisation, eating dependency, poor self-perceived health, poor physical function and poor appetite are determinants of malnutrition. Moderate evidence suggests that chewing difficulties, mouth pain, gum issues co-morbidity, visual and hearing impairments, smoking status, alcohol consumption and physical activity levels, complaints about taste of food and specific nutrient intake are not determinants of malnutrition. There is low evidence that loss of interest in life, access to meals and wheels, and modified texture diets are determinants of malnutrition. Furthermore, there is low evidence that psychological distress, anxiety, loneliness, access to transport and wellbeing, hunger and thirst are not determinants of malnutrition. There appears to be conflicting evidence that dental status, swallowing, cognitive function, depression, residential status, medication intake and/or polypharmacy, constipation, periodontal disease are determinants of malnutrition. CONCLUSION: There are multiple potentially modifiable determinants of malnutrition however strong robust evidence is lacking for the majority of determinants. Better prospective cohort studies are required. With an increasingly ageing population, targeting modifiable factors will be crucial to the effective treatment and prevention of malnutrition.
Assuntos
Desnutrição , Idoso , Idoso de 80 Anos ou mais , Cognição , Exercício Físico , Feminino , Hospitalização , Humanos , Masculino , Desnutrição/epidemiologia , Desnutrição/fisiopatologia , Desnutrição/psicologia , Fatores de RiscoRESUMO
Electroporation is a long-established technique used to deliver molecules to cells. Most in vivo electroporation protocols entail applying square-wave, or monotonically-decreasing pulses but relatively few have explored the use of pulsed ac fields. This study measures the efficiency of electroporation in human kidney embryonal cells, using pulsed ac electric fields of peak amplitude 30-200 kV m(-1). The results indicate that optimum electroporation efficiencies of up to 70% can be achieved using pulses at frequencies of 20-160 kHz. Increasing the field strength results in higher electroporation efficiency, but also increases cell kill. This study confirms that efficient electroporation may be achieved using pulsed ac fields. This finding raises the possibility of a wider range of clinical and laboratory applications based on ac technology and avoiding the use of invasive needle electrodes.
Assuntos
Membrana Celular/patologia , Eletroporação/métodos , Rim/embriologia , Caspases/metabolismo , Membrana Celular/metabolismo , Permeabilidade da Membrana Celular , Sobrevivência Celular , Eletricidade , Eletrodos , Campos Eletromagnéticos , Desenho de Equipamento , Citometria de Fluxo/métodos , Fluoresceínas/química , Humanos , Rim/patologia , Modelos Teóricos , Fatores de TempoRESUMO
Knowledge of the number and type of injuries attending the paediatric orthopaedic outpatients is crucial in the future planning of any new paediatric hospital. We prospectively collected data on all new patients attending two paediatric orthopaedic out-patients departments, over a four month period. There were a total of 1,791 completed questionnaires. Sporting and recreational injuries represented 270% and 28% of the total attending, respectively. The new use of heelies represented 11% of the recreational injuries. The upper limb injuries represented 74% of the total, with the lower limb accounting for 25%. Treatment was nonoperative or operative. The number of patients, and the types of injuries presenting demonstrates the workload involved in diagnosing and treating these injuries. A total of 827 casts were applied. With almost half of those attending the clinic requiring a cast, the workload on the plaster technicians is substantial, and has implications for future service planning.
Assuntos
Acidentes/estatística & dados numéricos , Traumatismos em Atletas/epidemiologia , Hospitais Pediátricos/estatística & dados numéricos , Recreação , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Irlanda/epidemiologia , Masculino , Pacientes Ambulatoriais/estatística & dados numéricos , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
In Europe injury is the leading cause of death in those aged between 1 and 14 years. In Ireland over 800,000 people are aged less than 14 years. There is currently no national trauma register to collect data on the morbidity and mortality associated with major trauma in the paediatric population in Ireland. We prospectively collected data on 153 patients admitted to our hospital with major trauma. There were 99 males and 54 females. The majority of patients were transported by ambulance (n= 138). Road traffic accidents (n=69) and thermal injuries (n=49) represented the majority of admissions. 68% (n=47) of the vehicle occupants in this study were either unrestrained or incorrectly restrained. Most patients (n=133) had an in patient stay of <50 days, with only 4 patients staying >100 days. 14 patients died. A paediatric trauma register as well as a level 1 paediatric trauma centre are required in Ireland.
Assuntos
Ferimentos e Lesões/epidemiologia , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Queimaduras/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Irlanda/epidemiologia , Masculino , Estudos Prospectivos , Sistema de Registros , Fatores de Risco , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/mortalidadeRESUMO
The binding of human erythrocyte spectrin to large unilamellar vesicles (LUVET) formed by the extrusion technique has been studied using fluoresceinphosphatidylethanolamine (FPE) as a reporter of electrostatic membrane potential. Spectrin aliquots were added to a suspension of FPE-labelled LUVETs to elucidate both the type of charge involved and the dissociation constants for spectrin binding to various lipids. All binding experiments showed serial increases in FPE fluorescence intensity upon serial additions of spectrin, indicative of increasing positive charge at the membrane surface. This proves for the first time that although exhibiting an overall net negative charge, spectrin binds to lipid surfaces by presenting positive charges to the lipid surface. Binding curves were obtained from the change in fluorescence intensity upon each spectrin addition and analysed to determine dissociation constants. A K(d) of 0.14+/-0.12 microM was found for spectrin binding to FPE-labelled phosphatidylcholine/phosphatidylserine (PC/PS) LUVETs at 22 degrees C in high salt conditions. A similar K(d) of 0.17+/-0.11 microM was obtained for spectrin binding to neutral LUVETs composed of PC. However, binding was found to be much weaker for PC/PS LUVETs under low salt conditions with a K(d) of 1.22+/-0.48 microM.