RESUMEN
Understanding the level and type of resistance in potato varieties is relevant for integrating varietal resistance into the management of potato late blight. Accordingly, 54 potato varieties were tested for their level and type of resistance to late blight in 2019 and 2020 in Denmark. Spreader rows were artificially inoculated to ensure an even inoculum distribution in the trial. Disease severity was assessed once or twice per week. Cluster analysis (CA) was done based on the weighted mean absolute rate (WMAR), the relative area under the disease progress curve, the onset of disease (Xo), the severity of disease in the middle of the season, the time to reach 1% disease severity, the time to reach final disease severity, and the maximum disease severity. The resistance types were determined by comparing the tested varieties to Bintje (susceptible reference) for Xo and WMAR. The CA ranked the varieties as susceptible, moderately resistant, resistant, and very resistant based on their level of resistance. Except for a few varieties, the expressed resistance levels varied between the years. Several varieties that were susceptible in 2019 were moderately resistant in 2020. Also, the types of resistance that the varieties exhibited varied from year to year. In 2020, most varieties exhibited race-specific resistance, while in 2019 they mostly showed susceptible characteristics. The variation between years for the level and types of resistance of the varieties highlights the importance of regularly monitoring varietal resistance across time and space.
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Phytophthora infestans , Solanum tuberosum , Enfermedades de las Plantas , Solanum tuberosum/genéticaRESUMEN
The nutrition management guideline for very-long chain acyl-CoA dehydrogenase deficiency (VLCAD) is the fourth in a series of web-based guidelines focusing on the diet treatment for inherited metabolic disorders and follows previous publication of guidelines for maple syrup urine disease (2014), phenylketonuria (2016) and propionic acidemia (2019). The purpose of this guideline is to establish harmonization in the treatment and monitoring of individuals with VLCAD of all ages in order to improve clinical outcomes. Six research questions were identified to support guideline development on: nutrition recommendations for the healthy individual, illness management, supplementation, monitoring, physical activity and management during pregnancy. This report describes the methodology used in its development including review, critical appraisal and abstraction of peer-reviewed studies and unpublished practice literature; expert input through two Delphi surveys and a nominal group process; and external review from metabolic physicians and dietitians. It includes the summary statements of the nutrition management recommendations for each research question, followed by a standardized rating based on the strength of the evidence. Online, open access of the full published guideline allows utilization by health care providers, researchers and collaborators who advise, advocate and care for individuals with VLCAD and their families and can be accessed from the Genetic Metabolic Dietitians International (https://GMDI.org) and Southeast Regional Genetics Network (https://southeastgenetics.org/ngp) websites.
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Acil-CoA Deshidrogenasa de Cadena Larga/genética , Síndromes Congénitos de Insuficiencia de la Médula Ósea/dietoterapia , Errores Innatos del Metabolismo Lipídico/dietoterapia , Enfermedades Mitocondriales/dietoterapia , Enfermedades Musculares/dietoterapia , Política Nutricional , Acil-CoA Deshidrogenasa de Cadena Larga/metabolismo , Síndromes Congénitos de Insuficiencia de la Médula Ósea/genética , Síndromes Congénitos de Insuficiencia de la Médula Ósea/metabolismo , Síndromes Congénitos de Insuficiencia de la Médula Ósea/patología , Femenino , Guías como Asunto , Humanos , Errores Innatos del Metabolismo Lipídico/genética , Errores Innatos del Metabolismo Lipídico/metabolismo , Errores Innatos del Metabolismo Lipídico/patología , Enfermedades Mitocondriales/genética , Enfermedades Mitocondriales/metabolismo , Enfermedades Mitocondriales/patología , Enfermedades Musculares/genética , Enfermedades Musculares/metabolismo , Enfermedades Musculares/patología , Terapia Nutricional , EmbarazoRESUMEN
STUDY AIM: Retrospective studies have demonstrated a worse outcome in breast cancer patients not developing leukopenia during adjuvant chemotherapy. The SBG 2000-1 is the first randomised trial designed to compare individually dosed chemotherapy without G-CSF support based on grade of toxicity to standard-dosed chemotherapy based on body surface area (BSA). METHODS: Patients with early breast cancer were included and received the first cycle of standard FEC (fluorouracil 600 mg/m2, epirubicin 60 mg/m2, cyclophosphamide 600 mg/m2). Patients with nadir leukopenia grade 0-2 after first cycle were randomised between either 6 additional courses of tailored FEC with increased doses (E 75-90 mg/m2, C 900-1200 mg/m2) or fixed treatment with 6 standard FEC. Patients with grade 3-4 leukopenia were registered and treated with 6 standard FEC. Primary end-point was distant disease-free survival (DDFS). RESULTS: The study enrolled 1535 patients, of which 1052 patients were randomised to tailored FEC (N = 524) or standard FEC (N = 528), whereas 401 patients with leukopenia grade 3-4 continued standard FEC and formed the registered cohort. Dose escalation did not statistically significantly improve 10-year DDFS (79% and 77%, HR 0.87, CI 0.67-1.14, P = 0.32) or OS (82% and 78%, respectively, HR 0.89, CI 0.57-1.16, P = 0.38). Corresponding estimates for the registered group of patients were DDFS 79% and OS 82%, respectively. CONCLUSIONS: The SBG 2000-1 study failed to show a statistically significant improvement of escalated and tailored-dosed chemotherapy compared with standard BSA-based chemotherapy in patients with low haematological toxicity, although all efficacy parameters showed a numerical advantage for tailored treatment.
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Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Neoplasias de la Mama/tratamiento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/mortalidad , Ciclofosfamida/administración & dosificación , Ciclofosfamida/efectos adversos , Supervivencia sin Enfermedad , Esquema de Medicación , Epirrubicina/administración & dosificación , Epirrubicina/efectos adversos , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/efectos adversos , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Modelos de Riesgos ProporcionalesRESUMEN
BACKGROUND: Menactra® vaccine (MenACWY-D) was licensed in the United States in 2005 for persons 11-55â¯years of age, in 2007 for children 2-10â¯years of age, and in 2011 for infants/toddlers 9-23â¯months of age. We conducted two studies at Kaiser Permanente Northern California (KPNC), an integrated health care organization, to assess the safety of MenACWY-D in 2-10-year-olds and 9-23-month-olds receiving the vaccine during routine clinical care. METHODS: We conducted observational, retrospective studies of MenACWY-D in 2-10-year-olds (October 2007-October 2010) and in 9-23-month-olds (June 2011-June 2014). We monitored all subjects for non-elective hospitalizations, emergency department visits, and selected outpatient outcomes (specified neurological conditions, hypersensitivity reactions and new-onset autoimmune diseases) up to 6â¯months after vaccination, depending on the study. Using a self-control risk-interval design, we calculated incidence rate ratios (IRRs) comparing outcomes during the post-vaccination risk interval (0-30â¯days) with those during more remote post-vaccination comparison intervals (31-60 and 31-180â¯days [children] or 31-75â¯days [infants/toddlers]). RESULTS: There were 1421 children aged 2-10â¯years and 116 infants/toddlers aged 9-23â¯months who received MenACWY-D. Approximately 30% of the 2-10-year-olds and 67% of the 9-23-month-olds were considered at increased risk of meningococcal disease. Among 2-10-year-olds, there was 1 hospitalization on post-vaccination day 5 for fever, which was considered possibly related to vaccination. The only significantly elevated outcome among 2-10-year-olds was cellulitis/abscess (2 cases occurred during the risk interval versus 0 during comparison interval; IRR not evaluable [NE], 95% CI: 1.42, NE). After medical record review, the 2 cases were considered unrelated to vaccination. Among 9-23-month-olds, no outcomes were significantly elevated after vaccination and there were no hospitalizations. There were no deaths observed during the three-year accrual and subsequent six-month surveillance period for either study. CONCLUSIONS: Immunization of infants and young children with MenACWY-D vaccine was not associated with any new safety concerns; however, these small studies had limited power to detect rare or uncommon safety events. ClinicalTrials.gov Identifiers are NCT00728260 and NCT01689155.
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Meningitis Meningocócica/epidemiología , Meningitis Meningocócica/prevención & control , Vacunas Meningococicas/inmunología , Neisseria meningitidis/inmunología , Vigilancia de Productos Comercializados , Vacunación , California/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Vacunas Meningococicas/administración & dosificación , Evaluación de Resultado en la Atención de Salud , Estudios Retrospectivos , Estaciones del Año , Vacunación/efectos adversosRESUMEN
BACKGROUND AND AIM: The Danish Health and Medicines Authority assembled a group of experts to develop a national clinical guideline for patients with schizophrenia and complex mental health needs. Within this context, ten explicit review questions were formulated, covering several identified key issues. METHODS: Systematic literature searches were performed stepwise for each review question to identify relevant guidelines, systematic reviews/meta-analyses, and randomized controlled trials. The quality of the body of evidence for each review question was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Clinical recommendations were developed on the basis of the evidence, assessment of the risk-benefit ratio, and perceived patient preferences. RESULTS: Based on the identified evidence, a guideline development group (GDG) recommended that the following interventions should be offered routinely: antipsychotic maintenance therapy, family intervention and assertive community treatment. The following interventions should be considered: long-acting injectable antipsychotics, neurocognitive training, social cognitive training, cognitive behavioural therapy for persistent positive and/or negative symptoms, and the combination of cognitive behavioural therapy and motivational interviewing for cannabis and/or central stimulant abuse. SSRI or SNRI add-on treatment for persistent negative symptoms should be used only cautiously. Where no evidence was available, the GDG agreed on a good practice recommendation. CONCLUSIONS: The implementation of this guideline in daily clinical practice can facilitate good treatment outcomes within the population of patients with schizophrenia and complex mental health needs. The guideline does not cover all available interventions and should be used in conjunction with other relevant guidelines.(AU)
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Humanos , Esquizofrenia/terapia , Antipsicóticos/uso terapéutico , Terapia Cognitivo-Conductual , Terapia Familiar , Accesibilidad a los Servicios de Salud , Resultado del Tratamiento , Diagnóstico Dual (Psiquiatría) , Enfoque GRADERESUMEN
To characterise self-reported levels of stress and autonomic responses in healthy humans evoked by different rates of the Paced Auditory Serial Addition Task (PASAT). Fifteen participants performed PASATs with different rates (3·6-, 2·4-, 1·6- or 1·2-s intervals) and a control task, in random order. Correct responses, self-reported levels of stress and autonomic responses to the PASATs were estimated. Increased PASAT rates were associated with decreases in correct responses (P < 0·001) and increases in self-reported levels of stress (P < 0·001). For autonomic responses, significant changes were seen in 10 variables during 2·4-s PASAT compared with the respective baseline; however, significant differences in relative changes from baseline were found between the 2·4-s PASAT and control task only for mean RR-intervals (P < 0·001), systolic and diastolic blood pressure (P = 0·002 and P = 0·006) and cardiac output (P < 0·001). Regarding comparison between the four PASATs, significant differences in the relative changes from baseline were seen between the 3·6-s PASAT and faster PASATs, for example mean RR-intervals, high-frequency power and respiration rate; however, there were no differences between the faster PASATs. The autonomic responses during the PASATs with different rates were quite similar for the faster PASATs (intervals < 2·4 s); however, the slowest 3·6-s PASAT evoked significantly less self-reported stress and autonomic arousal compared with the faster PASATs. Standardization of the PASAT rate may be important for studies on autonomic nervous system function and self-reported measures of stress. Future studies may test more complex interactions between stress, autonomic responses and pain responses.
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Estimulación Acústica , Sistema Nervioso Autónomo/fisiopatología , Pruebas Neuropsicológicas , Estrés Psicológico/fisiopatología , Análisis y Desempeño de Tareas , Adulto , Electrocardiografía , Femenino , Voluntarios Sanos , Frecuencia Cardíaca/fisiología , Hemodinámica/fisiología , Humanos , MasculinoRESUMEN
The interest in the role of ferrous iron in diabetes pathophysiology has been revived by recent evidence of iron as an important determinant of pancreatic islet inflammation and as a biomarker of diabetes risk and mortality. The iron metabolism in the ß-cell is complex. Excess free iron is toxic, but at the same time, iron is required for normal ß-cell function and thereby glucose homeostasis. In the pathogenesis of diabetes, iron generates reactive oxygen species (ROS) by participating in the Fenton chemistry, which can induce oxidative damage and apoptosis. The aim of this review is to present and discuss recent evidence, suggesting that iron is a key pathogenic factor in both type 1 and type 2 diabetes with a focus on inflammatory pathways. Pro-inflammatory cytokine-induced ß-cell death is not fully understood, but may include iron-induced ROS formation resulting in dedifferentiation by activation of transcription factors, activation of the mitochondrial apoptotic machinery or of other cell death mechanisms. The pro-inflammatory cytokine IL-1ß facilitates divalent metal transporter 1 (DMT1)-induced ß-cell iron uptake and consequently ROS formation and apoptosis, and we propose that this mechanism provides the relay between inflammation and oxidative ß-cell damage. Iron chelation may be a potential therapeutic approach to reduce disease severity and mortality among diabetes patients. However, the therapeutic effect and safety of iron reduction need to be tested in clinical trials before dietary interventions or the use of iron chelation therapy titrated to avoid anaemia.
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Diabetes Mellitus/metabolismo , Diabetes Mellitus/fisiopatología , Hierro/metabolismo , Transporte Biológico , Humanos , Células Secretoras de Insulina/metabolismo , Hierro de la Dieta/metabolismoRESUMEN
Producing organic fish diets requires that the use of both fishmeal and fish oil (FO) be minimized and replaced by sustainable, organic sources. The purpose of the present study was to replace FO with organic oils and evaluate the effects on feed intake, feed conversion ratio (FCR), daily specific growth rate (SGR) and nutrient digestibility in diets in which fishmeal protein was partly substituted by organic plant protein concentrates. It is prohibited to add antioxidants to organic oils, and therefore the effects of force-oxidizing the oils (including FO) on feed intake and nutrient digestibility was furthermore examined. Four organic oils with either a relatively high or low content of polyunsaturated fatty acids were considered: linseed oil, rapeseed oil, sunflower oil and grapeseed oil. Substituting FO with organic oils did not affect feed intake (P > 0.05), FCR or SGR (P > 0.05) despite very different dietary fatty acid profiles. All organic plant oils had a positive effect on apparent lipid digestibility compared with the FO diet (P < 0.05), whereas there were no effects on the apparent digestibility of other macronutrients when compared with the FO diet (P > 0.05). Organic vegetable oils did not undergo auto-oxidation as opposed to the FO, and the FO diet consequently had a significantly negative effect on the apparent lipid digestibility. Feed intake was not affected by oxidation of any oils. In conclusion, the study demonstrated that it is possible to fully substitute FO with plant-based organic oils without negatively affecting nutrient digestibility and growth performance. Furthermore, plant-based organic oils are less likely to oxidize than FOs, prolonging the shelf life of such organic diets.
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Alimentación Animal/análisis , Fenómenos Fisiológicos Nutricionales de los Animales/fisiología , Acuicultura/métodos , Digestión/fisiología , Oncorhynchus mykiss/crecimiento & desarrollo , Aceites de Plantas/farmacología , Análisis de Varianza , Fenómenos Fisiológicos Nutricionales de los Animales/efectos de los fármacos , Animales , Cromatografía de Gases , Digestión/efectos de los fármacos , Ingestión de Alimentos/fisiología , Oxidación-Reducción , Aceites de Plantas/metabolismoRESUMEN
BACKGROUND: Several studies have investigated the association between coffee consumption and cardiovascular disease, but little is known about coffee intake and the risk of venous thromboembolism (VTE). OBJECTIVE: The aim of this prospective cohort study was to investigate the association between coffee consumption and the risk of incident VTE in a general population. METHODS: Information about coffee consumption habits was obtained with a self-administered questionnaire in 26, 755 subjects, aged 25-97 years, who participated in the fourth survey of the Tromsø study (1994-1995). Incident VTE events were registered until the end of follow-up, 1 September 2007. RESULTS: There were 462 incident VTE events (1.60 per 1000 person-years, 95% confidence interval [CI] 1.46-1.75) during a median of 12.5 years of follow-up. A daily consumption of three to four cups was borderline associated (hazard ratio [HR] 0.70; 95% CI 0.48-1.02) and a daily consumption of five to six cups (HR 0.67; 95% CI 0.45-0.97) was significantly associated with reduced risk of VTE as compared with coffee abstainers in multivariable analysis adjusted for age, sex, body mass index (BMI), smoking status, physical activity, diabetes, history of cardiovascular disease and cancer. Similar risk estimates were found for provoked and unprovoked VTE, and in sex-stratified analyses. CONCLUSION: Our findings suggest a possible U-shaped relationship between coffee consumption and VTE, and that moderate coffee consumption may be associated with a reduced risk of VTE. However, more studies are needed to establish whether moderate coffee consumption is inversely associated with the risk of VTE.
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Café/efectos adversos , Tromboembolia Venosa/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Encuestas y Cuestionarios , Tromboembolia Venosa/etiología , Tromboembolia Venosa/prevención & controlRESUMEN
Meta-analyses have been carried out to quantify the effect of dietary vitamin E on α-tocopherol accumulation and on lipid oxidation in porcine M. longissimus. Published results of 13 (vitamin E accumulation) and 10 (lipid oxidation) experiments respectively were used for the analyses. After a number of standardization procedures, a nonlinear relationship was found between the supplementary vitamin E and the accumulation of α-tocopherol in pork which approached a maximum value of 6.4 µg/g tissue. Pork lipid oxidation levels were described in terms of Thiobarbituric Acid Reacting Substances (TBARS) values. The statistical analysis revealed significant effect of vitamin E dose, muscle α-tocopherol concentration and supplementation time on TBARS, resulting in two prediction models for lipid oxidation. Meta-analysis has proven to be a valuable tool for combining results from previous studies to quantify the effects of dietary vitamin E. Further studies, carried out with standardized experimental protocols would be beneficial for model validation and to increase the predictive power of the derived models.
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Dieta/veterinaria , Suplementos Dietéticos , Peroxidación de Lípido , Carne , alfa-Tocoferol/administración & dosificación , alfa-Tocoferol/análisis , Alimentación Animal , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Músculos/metabolismo , Dinámicas no Lineales , Porcinos , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismoRESUMEN
Improper management of pig manure has resulted in environmental problems such as surface water eutrophication, ground water pollution, and greenhouse gas emissions. This study develops and compares 14 alternative manure management scenarios aiming at energy and nutrient extraction. The scenarios based on combinations of thermal pretreatment, anaerobic digestion, anaerobic co-digestion, liquid/solid separation, drying, incineration, and thermal gasification were compared with respect to their energy, nutrient and greenhouse gas balances. Both sole pig manure and pig manure mixed with other types of waste materials were considered. Data for the analyses were obtained from existing waste treatment facilities, experimental plants, laboratory measurements and literature. The assessment reveals that incineration combined with liquid/solid separation and drying of the solids is a promising management option yielding a high potential energy utilization rate and greenhouse gas savings. If maximum electricity production is desired, anaerobic digestion is advantageous as the biogas can be converted to electricity at high efficiency in a gas engine while allowing production of heat for operation of the digestion process. In conclusion, this study shows that the choice of technology has a strong influence on energy, nutrient and greenhouse gas balances. Thus, to get the most reliable results, it is important to consider the most representative (and up-to-date) technology combined with data representing the area or region in question.
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Dióxido de Carbono/análisis , Fuentes Generadoras de Energía , Estiércol/análisis , Nitrógeno/análisis , Fósforo/análisis , Porcinos , Administración de Residuos/métodos , Anaerobiosis , Animales , Suministros de Energía EléctricaRESUMEN
BACKGROUND: Intense capsaicin-induced C-fiber stimulation results in reversible lysis of the nerve soma, thereby making capsaicin wound instillation of potential interest for the treatment of post-operative pain. Clinical histological and short-term sensory studies suggest that the C-fiber function is partly re-established after skin injection of capsaicin. However, no study has evaluated the long-term effects of wound instillation of purified capsaicin on sensory functions. METHODS: Patients included in a double-blind placebo-controlled randomized study of the analgesic effect of capsaicin after groin hernia repair were examined by quantitative sensory testing before, 1 week and 2 years post-operatively. The primary endpoint was occurrence of hyperalgesia/allodynia. The secondary endpoints were acute and late sensory changes between the two patient groups. Patients were blinded to the allocated treatment. RESULTS: Twenty (100%) capsaicin and 16 (76%) placebo-treated patients were seen at the 2 1/2 year follow-up. Hyperalgesia was seen in five capsaicin- vs. one placebo-treated patient (P=0.2). The mechanical detection threshold was significantly increased on the operated side in the capsaicin vs. placebo group at the 1-week follow-up (P<0.05), but was not different at the 2 1/2 year follow-up (P=0.3). There were no other significant differences in sensory function on the operated side between groups at the pre-operative, 1-week or 2 1/2 year post-operative follow-up (P>0.05). The sensory function on the contralateral side was comparable between groups throughout the study (P>0.1). CONCLUSION: This small-volume study calls for further long-term safety studies of wound capsaicin instillation.
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Analgésicos/uso terapéutico , Capsaicina/uso terapéutico , Cuidados Intraoperatorios , Dolor Postoperatorio/prevención & control , Fármacos del Sistema Sensorial/uso terapéutico , Adolescente , Adulto , Anciano , Analgésicos/administración & dosificación , Capsaicina/administración & dosificación , Método Doble Ciego , Estudios de Seguimiento , Hernia Inguinal/cirugía , Humanos , Hiperalgesia/etiología , Instilación de Medicamentos , Masculino , Persona de Mediana Edad , Fibras Nerviosas/efectos de los fármacos , Dimensión del Dolor , Umbral del Dolor/efectos de los fármacos , Placebos , Presión , Sensación/efectos de los fármacos , Fármacos del Sistema Sensorial/administración & dosificación , Umbral Sensorial/efectos de los fármacos , Mallas Quirúrgicas , Sensación Térmica/efectos de los fármacos , Tacto/efectos de los fármacos , Resultado del Tratamiento , Adulto JovenRESUMEN
New ways of integrating and scaling up control of neglected tropical diseases (including schistosomiasis) are presently underway. In this context consideration of social science perspectives is essential. In this article, we review social science publications of relevance to sustained control of schistosomiasis in Africa including diagnosis and screening, treatment, supply of clean water and improved sanitation, as well as health communication. Studies of community involvement and links between schistosomiasis control programmes and broader health care systems are also explored. Directions for future social science of relevance to sustainable schistosomiasis control are outlined, including ways of ensuring equitable access to health services as well as involvement of endemic communities and local health care systems based on equal partnership.
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Esquistosomiasis/epidemiología , Esquistosomiasis/prevención & control , Esquistosomicidas/uso terapéutico , África/epidemiología , Control de Enfermedades Transmisibles/economía , Control de Enfermedades Transmisibles/métodos , Participación de la Comunidad , Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Salud Pública , Saneamiento , Esquistosomicidas/economía , Factores Socioeconómicos , AguaRESUMEN
PURPOSE: We investigated whether patients with neurogenic detrusor overactivity can sense the onset of bladder contraction and in turn suppress the contraction by electrical stimulation of the dorsal penile-clitoral nerve. MATERIALS AND METHODS: A total of 67 patients with different neurological disorders were recruited to undergo 3 filling cystometries. The first cystometry was done without stimulation. The second cystometry was performed with automatic controlled stimulation based on detrusor pressure. The third cystometry was done with patient controlled stimulation using a push button. RESULTS: Four females and 13 males underwent all 3 fillings. Compared to cystometry 1 average bladder capacity for cystometries 2 and 3 was 60% higher. Compared to peak pressure for cystometry 1 average peak pressure during suppressed contractions for cystometries 2 and 3 was 49% and 26% lower, respectively. The average delay of the onset of stimulation during cystometry 3 with respect to cystometry 2 was 5.7 seconds. CONCLUSIONS: The study shows that patient controlled genital nerve stimulation is as effective as automatic controlled stimulation to treat neurogenic detrusor overactivity. Thus, patient controlled stimulation is feasible in select patients, although patients must be trained in the technique.
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Terapia por Estimulación Eléctrica/métodos , Músculo Liso/fisiopatología , Vejiga Urinaria Neurogénica/terapia , Vejiga Urinaria Hiperactiva/terapia , Vejiga Urinaria/inervación , Adulto , Vías Aferentes , Automatización , Clítoris/inervación , Terapia por Estimulación Eléctrica/instrumentación , Femenino , Estudios de Seguimiento , Humanos , Plexo Hipogástrico , Masculino , Persona de Mediana Edad , Contracción Muscular/fisiología , Músculo Liso/inervación , Pene/inervación , Medición de Riesgo , Estimulación Eléctrica Transcutánea del Nervio , Resultado del Tratamiento , Vejiga Urinaria Neurogénica/diagnóstico , Vejiga Urinaria Hiperactiva/diagnóstico , UrodinámicaRESUMEN
Diversity of traditional leafy vegetables consumed by the Luo people of Nyang'oma, Bondo District, western Kenya, was evaluated in relation to their ecological habitats. The study generally revealed high species diversity within different ecological areas. A total of 60 leafy vegetable species (domesticated and wild) belonging to 47 genera and 29 families were collected. Most of the vegetable species were gathered from the wild but a few were domesticated on farmlands and kitchen gardens. Plant families that comprised most leafy vegetable species were Fabaceae, Amaranthaceae, Acanthaceae, Asteraceae and Solanaceae.
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Etnobotánica , Hojas de la Planta/clasificación , Verduras/clasificación , Biodiversidad , Ecosistema , Humanos , Kenia , Valor Nutritivo , Población RuralRESUMEN
PURPOSE: The feasibility of automatic event driven electrical stimulation of the dorsal penile/clitoral nerve in the treatment of neurogenic detrusor overactivity (NDO) was evaluated in individuals with spinal cord injury. MATERIALS AND METHODS: The study included 2 women and 14 men older than 18 years with NDO, bladder capacity below 500 ml and complete or incomplete suprasacral spinal cord injury. Detrusor pressure (Pdet) was recorded during ordinary, natural bladder filling. In a similar subsequent recording Pdet was used to trigger electrical stimulation when pressure exceeded 10 cm H2O. RESULTS: Of the 16 patients enrolled in this study 13 had increased bladder capacity together with a storage pressure decrease as a result of automatic, event driven electrical stimulation. In 2 patients stimulation could not inhibit the first undesired contraction, leakage occurred and finally 1 could not tolerate stimulation. During stimulated filling Pdet never exceeded 55 cm H2O. Thus, storage pressure was sufficiently low to prevent kidney damage. An average bladder capacity increase of 53% was achieved. CONCLUSIONS: This study demonstrates the feasibility of automatic, event driven electrical stimulation in the treatment of NDO. Although the setup in this experiment is not suitable in a clinical setting, the treatment modality is promising and it warrants further investigation.
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Clítoris/inervación , Terapia por Estimulación Eléctrica/instrumentación , Hipertonía Muscular/terapia , Pene/inervación , Traumatismos de la Médula Espinal/complicaciones , Terapia Asistida por Computador/instrumentación , Vejiga Urinaria Neurogénica/terapia , Adulto , Diseño de Equipo , Femenino , Humanos , Presión Hidrostática , Masculino , Microcomputadores , Inhibición Neural/fisiología , Nervios Periféricos/fisiopatología , Reflejo Anormal/fisiología , Urodinámica/fisiologíaRESUMEN
OBJECTIVE: To study the calcium homeostasis in healthy, calcium and vitamin D replete early postmenopausal women during oral supplementation with calcium and vitamin D3. DESIGN: A prospective, placebo-controlled, randomised, double-single-blind, 3-week study. SETTING: Outpatient clinic at Copenhagen University Hospital, Denmark. SUBJECTS: In all, 17 started, one was excluded. Totally, 16 healthy women, 45-61 y of age (mean 57.3 y) who were at least 4 y after menopause (mean 6.7 y) completed. INTERVENTIONS: All underwent three consecutive 7-day study periods. Each began with 4 days of normal diet followed by 3 days treatment of either C: one tablet of 1.250 mg calcium carbonate (ie 500 mg Ca2+ per tablet) twice daily (breakfast and dinner), or CD3: as in C but plus 400 IU vitamin D3 b.i.d., or P (only) placebo tablets b.i.d. RESULTS: At baseline plasma 25-hydroxycholecalciferol was normal (66+/-22 nmol/l) and the calcium intake without supplements 850 mg/day. In group C, the 24-h urinary calcium increased by 35% (6.9+/-2.0 mmol), vs the placebo group P (5.1+/-1.6 mmol) (P < 0.05). Addition of 800 IU vitamin D3 daily (CD3) did not increase calcium excretion further (6.6+/-2.1 mmol) but decreased plasma 1,25-(OH)2-vitamin D3 by 21% (P < 0.05). CONCLUSIONS: In this carefully controlled study calcium plus vitamin D3 supplements only had minor influences of uncertain significance on the calcium balance in healthy, calcium and vitamin D sufficient early postmenopausal women.
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Calcio de la Dieta/administración & dosificación , Calcio de la Dieta/metabolismo , Colecalciferol/administración & dosificación , Osteoporosis Posmenopáusica/prevención & control , Posmenopausia/metabolismo , Administración Oral , Calcitriol/sangre , Calcio de la Dieta/orina , Estudios Cruzados , Suplementos Dietéticos , Dihidroxicolecalciferoles/sangre , Método Doble Ciego , Sinergismo Farmacológico , Femenino , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Método Simple CiegoRESUMEN
We studied the influence of age, gender, latitude, season, diet and ethnicity on plasma 25-hydroxyvitamin D 25 OHD, PTH, 1,25-dihydroxyvitamin D, vitamin D-binding protein, bone-specific alkaline phosphatase, and osteocalcin levels in 46 Greenlanders living in Nuuk (64 degrees N) on a traditional fare (group A), 45 Greenlanders living in Nuuk on a westernized fare (group B), 54 Greenlanders (group C), and 43 Danes (Group D) living in Denmark (55 degrees N) on a westernized fare. Blood specimens were drawn both summer and winter. Vitamin D insufficiency (plasma 25 OHD <40 nmol/l) was common in all four study groups during summer (23-74%) and winter (42-81%). Compared to groups A and D, vitamin D insufficiency was significantly more frequent in groups B and C. In all groups, summer levels of 25 OHD were above winter levels. Multiple regression analysis revealed a significant effect of ethnicity. Compared to Danes, Greenlanders had higher 1,25-dihydroxyvitamin D levels, but lower 25 OHD and PTH levels despite relatively low plasma calcium concentrations. In addition to ethnicity, 25(OH)D levels were influenced by age, season (summer > winter), and diet (a traditional Inuit diet>westernized diet). Ethnic differences exist between Greenlanders and Danes. Our results suggest that Greenlanders may have an inherent lower "set-point" for calcium-regulated PTH release or an enhanced renal 1,25(OH)(2)D production. In addition to ethnicity, age, season, and diet were important determinants of vitamin D status. Changes from a traditional to a westernized fare are associated with a reduced vitamin D status in Greenlanders. Vitamin D supplementation should be considered.
Asunto(s)
Dieta , Osteocalcina/sangre , Hormona Paratiroidea/sangre , Deficiencia de Vitamina D/etnología , Vitamina D/sangre , Adulto , Biomarcadores/sangre , Calcio/sangre , Dinamarca/epidemiología , Femenino , Geografía , Groenlandia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estaciones del Año , Vitamina D/análogos & derivados , Deficiencia de Vitamina D/sangreRESUMEN
Pork quality is influenced by nutrition, genetics, management, and pork-processing procedures. Pigs of lean genotype fed diets high in unsaturated fat may have thinner, lower-quality bellies with a soft fat composition. Therefore, we investigated the effects of supplementing 5% choice white grease that had been chemically hydrogenated to iodine values of 80, 60, 40, or 20 on pork quality. Diets were fed to barrows and gilts of two genotypes (NPD [Ham-line x Manor hybrid] and PIC [406, 419, or 420 x C22]; n = 240) in a 4 x 2 x 2 factorial design. Pigs (76.8 kg of mean initial weight) were placed on test at a common age and were fed dietary treatments for 52 d. Pigs of PIC genotype were heavier at trial initiation, had higher feed intake and feed conversion ratio (F/G; P < 0.05), and greater backfat (26.3 vs. 24.0 mm; P < 0.001) and loin depth (59.0 vs. 55.3 mm; P < 0.001) compared with the NPD genotype pigs. As the iodine value of dietary fat was reduced, belly thickness increased (P < 0.05) and length decreased linearly (P < 0.05). Congruently, belly fat iodine value decreased from 73.9 to 67.4 (linear effect; P < 0.001) and belly fat C18:2 concentration declined from 20.6 to 16.3% (linear and quadratic effect; P < 0.001). The belly mono- and polyunsaturated fat ratio increased 29% as diet iodine value declined from 80 to 20 (linear and quadratic effect; P < 0.001). Further, there was a linear increase (P < 0.001) in saturated fatty acid concentration of belly fat (C14:0, C16:0, and C18:0) as dietary fat iodine value declined. Quadratic (P < 0.005) effects were detected in the level of C18:1trans as iodine value decreased from 80 to 20, paralleling dietary content. Dietary fat iodine value did not affect fat digestibility, ADFI, or F/G. Pork belly quality was improved as defined by reduced iodine value, C18:2 content, increased saturated fatty acid content, increased thickness, and decreased length as dietary iodine value decreased. Results indicate that reduction of dietary fat iodine value by chemical hydrogenation has the desirable effect of improving pork quality and does not alter growth performance.
Asunto(s)
Tejido Adiposo/metabolismo , Grasas de la Dieta/metabolismo , Carne/normas , Porcinos/genética , Abdomen , Tejido Adiposo/anatomía & histología , Tejido Adiposo/química , Alimentación Animal , Animales , Grasas de la Dieta/administración & dosificación , Relación Dosis-Respuesta a Droga , Ácidos Grasos/metabolismo , Femenino , Genotipo , Hidrogenación , Yodo/administración & dosificación , Yodo/química , Masculino , Carne/análisis , Porcinos/crecimiento & desarrollo , Porcinos/metabolismoRESUMEN
Activation of factor (F)VII by tissue factor may represent a critical event during plaque rupture in acute coronary syndromes. Patients with combined hyperlipemia are at high risk for developing coronary heart disease and their tendency to thrombosis may be accelerated during postprandial hyperlipemia. In the present double-blind, placebo-controlled parallel study, 42 patients with combined hyperlipemia and serum triglycerides between 2.0 and 15.0 mmol L(-1 )and serum cholesterol >5.3 mmol L-1 at the end of a 3-month dietary run-in period were treated with atorvastatin at 10 mg day-1 for at least 10 weeks. During the last 5 weeks the patients were randomized into two groups receiving 1.68 g day(-1) omega-3 fatty acids (omega-3 FA) or placebo (corn oil). The fasting levels of FVII antigen (FVII-Ag) and FVII coagulant activity (FVII:C) were high compared with healthy males. The fasting levels of activated FVII (FVIIa) and FVII-Ag correlated both to serum triglycerides and apolipoprotein A1 (apoA1). FVIIa and FVII:C increased during postprandial hyperlipemia. This increase of FVIIa correlated to the fasting triglyceride and apoA1 levels, but not to the degree of postprandial hypertriglyceridemia. The concentrations of fasting FVIIa in these patients were reduced in parallel with a reduction of fasting triglycerides by treatment with atorvastatin + placebo. This treatment also reduced the postprandial level of FVIIa. omega-3 FA in addition to atorvastatin further reduced FVIIa concentrations, fasting and postprandially, and also significantly reduced FVII:C and FVII-Ag during postprandial hyperlipemia. Prothrombin fragment 1 + 2 (F1 + 2) increased during postprandial hyperlipemia. This increase was significantly reduced after treatment with atorvastatin plus omega-3 FA. The increase of F1 + 2 measured as incremental area under the curve (iAUC) during postprandial hyperlipemia correlated to the fasting levels of FVIIa, FVII:C and FVII-Ag and also to the levels of these factors during postprandial lipemia. In conclusion, patients with combined hyperlipemia are at risk for activation of the coagulation system, particularly during postprandial lipemia. This activation may be significantly reduced by statins and omega-3 FA.