RESUMEN
OBJECTIVE: detecting and treating depression early on in pregnancy can improve health outcomes for women and their children. UK guidelines recommend that Midwives screen for antenatal depression (AND) at the woman's first Midwife appointment using recommended depression case finding questions. This is the first qualitative study to explore Midwives' and women's views of using these questions in the context of antenatal care. DESIGN: Semi-structured interviews with Midwives and pregnant women exploring their views and experiences of screening for AND, conducted alongside a validation study of the depression case finding questions. SETTING: the initial appointment with the Midwife when the woman is 10-12 weeks pregnant. Interviewees were working or living in Bristol, England. PARTICIPANTS: maximum variation samples of 15 Midwives and 20 pregnant women. MEASUREMENTS AND FINDINGS: Midwives and pregnant women viewed the depression case finding questions as a useful way of introducing mental health issues. Midwives often adapted the questions rather than using the phrasing specified in the UK guideline. Sometimes Midwives chose not to use the questions, for example if a partner was present. Both Midwives and women struggled to differentiate symptoms of early pregnancy from antenatal depression; yet thought that detecting depression early on in pregnancy was important. Women were unsure about the kind of help that was available; some women reported this as a reason for withholding their true feelings. There was a general lack of awareness among Midwives about the range of non-drug treatments potentially available to women and referral pathways to access them. KEY CONCLUSION: both Midwives and women regard screening for AND as acceptable and important but reported shortcomings with the recommended depression case finding questions. IMPLICATIONS FOR PRACTICE: providing training for Midwives on how to frame the questions and increase their knowledge and application of the referral pathways suggested by UK guidelines will help address some of the issues raised by Midwives and women in our study.
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Depresión , Partería/métodos , Rol de la Enfermera , Complicaciones del Embarazo , Diagnóstico Prenatal , Adulto , Depresión/diagnóstico , Depresión/enfermería , Diagnóstico Precoz , Femenino , Humanos , Relaciones Enfermero-Paciente , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/enfermería , Atención Prenatal/organización & administración , Atención Prenatal/normas , Diagnóstico Prenatal/métodos , Diagnóstico Prenatal/psicología , Escalas de Valoración Psiquiátrica , Mejoramiento de la Calidad , Derivación y Consulta , Encuestas y Cuestionarios , Reino UnidoRESUMEN
AIM: Evidence from epidemiological studies suggests that higher consumption of dairy products may be inversely associated with risk of type 2 diabetes and other components of the metabolic syndrome, although the evidence is mixed. Intervention studies that increase dairy intake often involve lifestyle changes, including weight loss, which alone will improve insulin sensitivity. The aim of this review was to examine weight stable intervention studies that assess the effect of an increased intake of dairy products or dairy derived supplements on glucose metabolism and insulin sensitivity. DATA SYNTHESIS: An electronic search was conducted using MEDLINE, EMBASE, the Cochrane Database and Web of Science for randomised controlled trials altering only dairy intake in humans with no other lifestyle or dietary change, particularly no weight change, and with measurement of glucose or insulin. Healthy participants and those with features of the metabolic syndrome were included. Chronic whey protein supplementation was also included. Ten studies were included in this systematic review. CONCLUSIONS: In adults, four of the dairy interventions showed a positive effect on insulin sensitivity as assessed by Homeostasis Model Assessment (HOMA); one was negative and five had no effect. As the number of weight stable intervention studies is very limited and participant numbers small, these findings need to be confirmed by larger trials in order to conclusively determine any relationship between dairy intake and insulin sensitivity.
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Productos Lácteos/efectos adversos , Suplementos Dietéticos/efectos adversos , Resistencia a la Insulina , Proteínas de la Leche/efectos adversos , Animales , Humanos , Proteínas de la Leche/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Reproducibilidad de los Resultados , Proteína de Suero de LecheRESUMEN
The experiment evaluated traditional U.S. sheep (Suffolk), hair sheep (Katahdin), and meat goat (Boer crossbred; Goat) carcass and meat quality parameters when finished on pasture with and without supplemental whole cottonseed (Gossypium hirsutum L.). Supplemented animals had greater ribeye area (P<0.01), body wall thickness (P<0.001), and lean quality score (P<0.05) than unsupplemented animals. Whole cottonseed increased fatty acids (FA) 18:1 trans-10, 18:1 trans-12, 18:2, and Omega6:Omega3 ratio and decreased FA 18:1 trans-11, 18:3, and Omega3 in longissimus muscle (LM). Katahdin LM had greater (P<0.001) intramuscular fat compared to Suffolk and Goat. Goat LM had less (P<0.001) FA 14:0, 18:0, 18:1 t11, 18:3, 20:3n-6, and saturated FA when compared to Suffolk or Katahdin. Carcass weights from pasture-finished sheep and goats would be acceptable for most ethnic markets in the USA. Omega6:Omega3 ratios in chevon and lamb were within the guidelines for meats that can improve human diets and health.
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Alimentación Animal , Suplementos Dietéticos , Carne/análisis , Animales , Peso Corporal , Fabaceae/química , Ácidos Grasos Omega-3/administración & dosificación , Ácidos Grasos Omega-3/análisis , Ácidos Grasos Omega-6/administración & dosificación , Ácidos Grasos Omega-6/análisis , Calidad de los Alimentos , Cabras , Músculo Esquelético/química , Poaceae/química , Oveja Doméstica/clasificación , Estados UnidosRESUMEN
Numerous studies suggest that silicon (Si) supplementation is beneficial for mineral metabolism and bone health. Mineral balance studies have not been performed in horses to determine how these supplements affect absorption of other minerals. The purpose of these studies was to investigate the effects of two different Si supplements on mineral absorption and retention in horses. Eight geldings were randomly placed in one of two groups: control (CO) or supplemental Si, which was provided by one of two supplements. The first, sodium aluminium silicate (SA), contains a bioavailable form of Si and is high in aluminium (Al). The second supplement contains oligomeric orthosilicic acid (OSA). All horses received textured feed and ad libitum access to hay. Supplemented horses received either 200 g of SA or 28.6 ml of OSA per day. Following a 10-day adaptation period, the horses underwent a 3-day total collection. Blood samples were taken on days 0 and 13. The two balance studies were conducted 4 months apart to reduce carryover effects. Intakes of Al and Si were greater with SA supplementation (p < 0.05). Sodium aluminium silicate increased faecal and urinary Si excretion (p < 0.05). Calcium retention and apparent digestion were increased by SA (p < 0.05). It also maintained plasma Si compared with the CO which tended to have a decrease in plasma Si (p = 0.08). Supplemental OSA increased retention of Ca and B (p < 0.05) and apparent digestion of B (p < 0.01). Orthosilicic acid tended to increase Si retention (p = 0.054), apparent digestion (p < 0.065), and also increased plasma Si. Both supplements were able to alter Ca retention and B metabolism, however, only OSA was able to alter Si retention, digestibility and plasma concentration. Orthosilicic acid, an Si supplement without substantial Al, appears to be a viable option for Si supplementation as it increased Si retention and digestibility.
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Huesos/metabolismo , Digestión , Caballos/metabolismo , Minerales/farmacocinética , Silicio/farmacología , Alimentación Animal , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Disponibilidad Biológica , Huesos/química , Estudios Cruzados , Suplementos Dietéticos , Caballos/sangre , Caballos/orina , Absorción Intestinal/efectos de los fármacos , Masculino , Distribución Aleatoria , Ácido Silícico , Silicio/metabolismoRESUMEN
Twenty calves were placed on study at 3 days of age and were placed according to birth order into one of two groups: SS, which received 0.05% BW sodium zeolite A (SZA) added to their milk replacer, and CO, which received only milk replacer. Blood samples were taken on days 0, 30, and 60 for osteocalcin (OC) and deoxypyridinoline (DPD) analysis. On day 60, the calves were euthanized, and synovial fluid, articular cartilage, and both fused metacarpals were collected for bone quality analyses such as architecture and mechanical properties, mineral composition, and glycosaminoglycan concentration. There were no differences in OC concentrations because of treatment (p = 0.12), and CO calves had lower DPD concentrations than SS calves (p = 0.01), but the OC-to-DPD ratio was not different between treatments (p = 0.98). No differences in bone architecture or mechanical properties were detected. SZA supplementation increased cortical bone (p = 0.0002) and articular cartilage (p = 0.05) aluminum content. Glycosaminoglycan concentrations were not different in synovial fluid or cartilage. Supplementation of SZA appeared to alter the rate of bone turnover without altering bone strength. Aluminum concentrations in the bone and cartilage increased, which may be a concern, although the long-term consequences of such remain to be determined.
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Remodelación Ósea/efectos de los fármacos , Suplementos Dietéticos , Huesos del Metacarpo/metabolismo , Zeolitas/farmacología , Aluminio/metabolismo , Aminoácidos/metabolismo , Animales , Cartílago Articular/metabolismo , Cartílago Articular/patología , Bovinos , Suplementos Dietéticos/efectos adversos , Glicosaminoglicanos/metabolismo , Huesos del Metacarpo/patología , Osteocalcina/metabolismo , Líquido Sinovial/metabolismo , Zeolitas/efectos adversosRESUMEN
The objective was to determine the effects of sodium zeolite A (SZA) on mineral metabolism and tissue mineral composition in calves. Twenty calves were placed on study at 3 days of age and were placed into one of two groups: SS, which received 0.05% BW SZA added to their milk replacer, and CO, which received only milk replacer. Blood samples were taken on days 0, 30, and 60 for mineral analysis. Urine and feces were collected on day 30 for mineral metabolism, and on day 60, the calves were euthanized, and samples were taken from numerous organs for mineral analyses. Aluminum retention was increased in the SS calves (p = 0.001). Silicon concentrations were increased in the aorta, spleen, lung, muscle, and kidney of the SS calves, and aluminum was increased in all SS tissues (p < 0.05). Calcium concentrations were increased in aorta, liver, muscle, and tendon; phosphorus concentrations were increased in aorta, but decreased in plasma; magnesium concentrations were increased in aorta, heart, kidney, liver, and pancreas, but decreased in plasma; and iron concentrations were decreased in kidney and liver (p < 0.05). The accumulation of tissue aluminum and therefore potential adverse consequences may preclude any benefits of using SZA as a dietary supplement.
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Suplementos Dietéticos , Metales/metabolismo , Silicio/metabolismo , Zeolitas/farmacología , Animales , Bovinos , Suplementos Dietéticos/efectos adversos , Especificidad de Órganos/efectos de los fármacos , Zeolitas/efectos adversos , Zeolitas/metabolismoRESUMEN
The objective of this study was to determine the efficacy of supplementation of Dynamic Trio 50/50, a bee pollen-based product, to improve physical fitness, blood leukocyte profiles, and nutritional variables in exercised horses. Ten Arabian horses underwent a standardised exercise test (SET), then were pair-matched by sex and fitness and randomly assigned to BP (receiving 118 g of Dynamic Trio 50/50 daily) or CO (receiving 73 g of a placebo) for a period of 42 days. A total collection was conducted from days 18 to 21 on six geldings to determine nutrient retention and neutral detergent fibre (NDF) and acid detergent fibre (ADF) digestibility. Horses were exercise conditioned and completed another SET on day 42. V160 and V200 were calculated from SET heart rates (HR). Lactate, glucose, haematocrit (HT) and haemoglobin (HB) concentrations were determined from SET blood samples. Total leukocyte count, and circulating numbers of various leukocytes and IgG, IgM and IgA concentrations were determined in rest and recovery blood samples from both SETs. Geldings on BP (n = 3) ate more feed than CO. BP had less phosphorus excretion, and tended to retain more nitrogen. BP tended to digest more NDF and ADF while having lower NDF digestibility and tending to have lower ADF digestibility. No treatment differences existed for V160 and V200, HR, lactate, HT and HB. There was a trend for lymphocyte counts to be lower in BP than CO on day 42. Dynamic Trio 50/50 supplementation may have a positive effect on performance by helping horses in training meet their potentially increased nutrient demands by increasing feed intake and thus nutrient retention.
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Fenómenos Fisiológicos Nutricionales de los Animales , Digestión , Ingestión de Alimentos/efectos de los fármacos , Caballos/fisiología , Recuento de Leucocitos/veterinaria , Condicionamiento Físico Animal/fisiología , Polen , Animales , Formación de Anticuerpos , Abejas , Detergentes , Fibras de la Dieta/metabolismo , Suplementos Dietéticos , Prueba de Esfuerzo/veterinaria , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Caballos/sangre , Caballos/inmunología , Masculino , Consumo de Oxígeno/efectos de los fármacos , Consumo de Oxígeno/fisiología , Proyectos Piloto , Distribución AleatoriaRESUMEN
Current policy documents stress that raising standards in education and health are inextricably linked, with schools identified as well placed to advance both agendas. This paper considers these assumptions in the light of data derived from 27 staff interviews conducted in two secondary schools. These schools served relatively disadvantaged communities, but differed in their pupil smoking rates with one school being 'high-smoking', the other 'low-smoking'. It explores whether this difference reflects the differential emphasis placed by each school on education or health. Analysis reveals that the 'low-smoking' school subscribes to holistic values and operates according to a child-centred bottom-up philosophy offering a differentiated programme of pupil support contingent on needs. In contrast, the 'high-smoking' school maintains a narrow focus on educational outcomes, and its high expectations are viewed as running counter to those held by pupils and parents. The contrasting school philosophies bring different unintended consequences. The holistic focus of the low-smoking school is associated with tempered educational expectations, thus conflicting with recommendations in education policies. The singular education focus of the high-smoking school leaves little room for a health agenda, and can overlook and disenfranchise the educationally disinclined. The school systems' impact on pupil engagement may explain their different smoking rates.
Asunto(s)
Conducta del Adolescente/psicología , Educación en Salud/métodos , Instituciones Académicas/organización & administración , Fumar/epidemiología , Adolescente , Curriculum , Docentes , Humanos , Objetivos Organizacionales , Formulación de Políticas , Investigación Cualitativa , Asunción de Riesgos , Servicios de Salud Escolar , Instituciones Académicas/clasificación , Instituciones Académicas/estadística & datos numéricos , Prevención del Hábito de Fumar , Encuestas y Cuestionarios , Reino Unido/epidemiologíaRESUMEN
The present water quality of the Humber rivers and coastal zone depends on a complex interplay of factors, including physical ones, such as the underlying geology, which influences soil type, climatic ones, such as the rainfall, which influences runoff, socio-economic ones, which influence present-day human activities in the catchment, and the legacy of former activities, such as contaminated sediments from mining. All of these factors affect the fluxes of nutrients and other contaminants to the rivers and coastal zone. The Water Framework Directive (WFD) requires the production of a river basin management plan intended to lead to the achievement of good chemical and ecological status for all water bodies in the catchment over the next two decades. This paper provides an overview of the current environmental and socio-economic state of the Humber catchment and coastal zone, and broadly examines how socio-economic drivers affect the fluxes of nutrients and contaminants to the coastal zone, using the driver-pressure-state-impact-response (DPSIR) approach. This is followed by an overview of future research, describing the use of scenarios to simulate future fluxes and provide a consistent framework to evaluate potential policies to improve water quality in the estuary. The Humber catchment is one of eight case studies within a European research project, EUROCAT (EVK1-CT-2000-00044), which aims to achieve integrated catchment and coastal zone management by analysing the response of the coastal sea to changes in fluxes of nutrients and contaminants from the catchments. For the Humber case study, the research focuses on the fluxes of two nutrient elements, N and P, and four metal contaminants, As, Cu, Pb and Zn. The project requires the integration of scientific and socio-economic approaches, bringing together quantitative environmental data garnered for individual river catchments and coastal zones in previous research programmes, and local and regional socio-economic data, to aid decision-makers in their search for integrated and sustainable coastal zone management strategies.
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Ecosistema , Ambiente , Contaminación Ambiental/economía , Contaminación Ambiental/prevención & control , Animales , Conservación de los Recursos Naturales , Toma de Decisiones , Monitoreo del Ambiente , Europa (Continente) , Humanos , Metales Pesados , Nitrógeno , Fósforo , Formulación de Políticas , Condiciones Sociales , Reino UnidoRESUMEN
Two experiments were conducted to evaluate alpha-tocopherol accumulation in muscle of lambs finished on pasture or concentrates. The objective for Exp. 1 was to compare accumulation of alpha-tocopherol in the longissimus muscle of pasture-fed lambs to that of lambs fed three concentrations (15, 150, and 300 IU/kg of DM) of supplemental vitamin E (all rac alpha-tocopheryl acetate) in all-concentrate diets. The objective in Exp. 2 was to investigate the effect of duration of supplemental vitamin E feeding on alpha-tocopherol content and color change during display case storage of lamb muscle. Treatments evaluated in Exp. 2 were: 15 IU of supplemental vitamin E/kg DM fed to finish; 15 IU/kg followed by 300 IU/kg of DM during the last 21 d; and 15 IU/kg DM until 7 d prior to finish, then 300 IU/kg DM. In Exp. 1, alpha-tocopherol concentration of rotational grazed alfalfa and perennial ryegrass averaged 137 and 169 mg/kg of DM. Vitamin E treatments for lambs fed concentrate diets did not affect ADG (P > 0.15), but ADG was greater (P < 0.01) for concentrate-fed lambs than for grazing lambs. For the concentrate-fed lambs, alpha-tocopherol in longissimus muscle increased quadratically (P < 0.05) as dietary concentrations of vitamin E increased. Predicted maximum alpha-tocopherol concentration in muscle occurred at about 400 IU/kg of diet DM. Longissimus muscle from lambs grazing alfalfa or ryegrass had similar (P > 0.50) alpha-tocopherol concentrations, and those concentrations were similar to values obtained when the concentrate diet supplemented with 150 IU of vitamin E/kg was fed. In Exp. 2, no differences (P > 0.10) in ADG were observed. Concentrations of longissimus alpha-tocopherol were highest when 300 IU supplemental vitamin E was fed for 21 d prior to slaughter. During a 6-d display period, semimembranosus steaks from lambs fed 300 IU of supplemental vitamin E/kg for either 7 or 21 d had higher a* and b* color readings than steaks from lambs fed 15 IU/kg of supplemental vitamin E. Increased consumption of vitamin E either via pasture or supplementation results in higher alpha-tocopherol concentrations in meat.
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Conservación de Alimentos/métodos , Carne/normas , Músculo Esquelético/metabolismo , Ovinos/metabolismo , alfa-Tocoferol/farmacocinética , Alimentación Animal , Animales , Color , Relación Dosis-Respuesta a Droga , Femenino , Manipulación de Alimentos/métodos , Masculino , Carne/análisis , Músculo Esquelético/química , Pigmentación , Ovinos/crecimiento & desarrollo , Factores de Tiempo , Distribución Tisular , alfa-Tocoferol/administración & dosificaciónRESUMEN
Previous studies have demonstrated that phenobarbital treatment impairs the biliary excretion of acetaminophen glucuronide (AG), although the transport system(s) responsible for AG excretion into bile has not been identified. Initial studies in rat canalicular liver plasma membrane vesicles indicated that AG uptake was stimulated modestly by ATP, but not by membrane potential, HCO(3)(-), or pH gradients. To examine the role of the ATP-dependent canalicular transporter multidrug resistance-associated protein 2 (Mrp2)/canalicular multispecific organic anion transporter (cMOAT) in the biliary excretion of AG, the hepatobiliary disposition of acetaminophen, AG, and acetaminophen sulfate (AS) was examined in isolated perfused livers from control and TR(-) (Mrp2-deficient) Wistar rats. Mean bile flow in TR(-) livers was approximately 0.3 microl/min/g of liver ( approximately 4-fold lower than control). AG biliary excretion was decreased (>300-fold) to negligible levels in TR(-) rat livers, indicating that AG is an Mrp2 substrate. Similarly, AS biliary excretion in TR(-) livers was decreased ( approximately 5-fold); however, concentrations were still measurable, suggesting that multiple mechanisms, including Mrp2-mediated active transport, may be involved in AS biliary excretion. AG and AS perfusate concentrations were significantly higher in livers from TR(-) compared with control rats. Pharmacokinetic modeling of the data revealed that the rate constant for basolateral egress of AG increased significantly from 0.028 to 0.206 min(-1), consistent with up-regulation of a basolateral organic anion transporter in Mrp2-deficient rat livers. In conclusion, these data indicate that AG biliary excretion is mediated by Mrp2, and clearly demonstrate that substrate disposition may be influenced by alterations in complementary transport systems in transport-deficient animals.
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Subfamilia B de Transportador de Casetes de Unión a ATP/metabolismo , Acetaminofén/análogos & derivados , Acetaminofén/farmacocinética , Sistema Biliar/metabolismo , Hígado/metabolismo , Proteínas de Transporte de Membrana , Proteínas Asociadas a Resistencia a Múltiples Medicamentos , Subfamilia B de Transportador de Casetes de Unión a ATP/deficiencia , Adenosina Trifosfato/farmacología , Animales , Bicarbonatos/farmacología , Transporte Biológico , Membrana Celular/metabolismo , Concentración de Iones de Hidrógeno , Masculino , Potenciales de la Membrana/fisiología , Modelos Biológicos , Proteína 2 Asociada a Resistencia a Múltiples Medicamentos , Perfusión , Ratas , Ratas Sprague-Dawley , Ratas WistarRESUMEN
OBJECTIVE: To evaluate the effect of contact laser prostate surgery in the treatment of benign prostatic hyperplasia. PATIENTS AND METHODS: A prospective double-blind randomized controlled trial of transurethral resection of the prostate (TURP) and contact laser prostatectomy was conducted, with an economic evaluation of both procedures. The primary outcome measure was the change in the American Urologic Association symptom score, with secondary outcome measures being the peak urinary flow rate, treatment-related complications, re-operation rate and health service costs. RESULTS: The perioperative blood loss and transfusion requirements were statistically significantly lower for laser prostatectomy than for TURP. There was no clinically significant difference between TURP and contact laser prostatectomy in the mean change in symptom scores and flow rates. There were distinct perioperative advantages in favour of the contact laser treatment, but some disadvantages in terms of re-catheterization and re-operation rates. CONCLUSIONS: Contact laser prostatectomy is a valid treatment for benign prostatic hypertrophy. The performance of contact laser prostatectomy as day-case surgery would have cost advantages to the National Health Service.
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Terapia por Láser/métodos , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata/métodos , Anciano , Anciano de 80 o más Años , Costos y Análisis de Costo , Método Doble Ciego , Estudios de Seguimiento , Humanos , Terapia por Láser/economía , Masculino , Persona de Mediana Edad , Hiperplasia Prostática/economía , Resección Transuretral de la Próstata/economía , Resultado del TratamientoRESUMEN
An experiment was conducted with turkey poults to determine the apparent digestibility and derivation of ME from diets containing a high proportion of carbohydrate from corn (CHO; 60% of diet) or 10%) supplemental fat from an animal-vegetable blended fat (FAT) or a synthetic medium-chain triglyceride (MCT). Poults fed the FAT diet consumed more feed from 6 to 8 and 9 to 11 d of age than poults fed the CHO diet, intake of the MCT diet was intermediate. From 3 to 11 d of age, the percentage apparent digestibility of nonlipid DM by poults fed the CHO diet was greater than that observed for either the FAT or MCT diets (P < or = 0.05). The percentage apparent digestibility of lipid was consistently greater for poults fed the MCT diet (> or = 90%) and could be attributed to the high apparent digestibility of C8:0 (>95%), which accounted for 76% of total MCT dietary fatty acids. Over the course of the experiment, the mean percentage apparent digestibility of lipid in the CHO and FAT diets was 76.4 and 70.8%, respectively, and did not change with increasing age. The lower percentage apparent digestibility of lipid in the CHO and FAT diets was attributed to the low apparent digestibility of C16:0 (70.4, 52.7%) and C18:0 (58.4, 26.8%), respectively. The apparent digestibility of the polyunsaturated fatty acids, C18:2 (n-6) and C18:3 (n-3), was consistently high and ranged from 72 to 85% and 81 to 88%, respectively. The CHO diet resulted in an approximate 6% increase in determined AMEn compared with either the FAT or MCT diets. The results of this study showed that commercial feed-grade fats are poorly digested by very young poults. The digestibility of polyunsaturated fatty acids, however, was shown to be quite high, and the data suggest that vegetable oils containing high proportions of polyunsaturated fatty acids or alternative fat sources containing high proportions of medium-chain fatty acids could be well utilized by the very young poult.
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Fenómenos Fisiológicos Nutricionales de los Animales , Carbohidratos de la Dieta/administración & dosificación , Grasas de la Dieta/administración & dosificación , Digestión , Metabolismo Energético , Pavos/fisiología , Envejecimiento , Animales , Ácidos Grasos Insaturados/metabolismo , Femenino , Triglicéridos/administración & dosificación , Pavos/crecimiento & desarrollo , Zea maysRESUMEN
We report the design, synthesis and antiviral evaluation of a series of lipophilic, masked phosphoramidate derivatives of the anti-human immunodeficiency virus (HIV) nucleoside analogue d4T, designed to act as membrane-soluble prodrug forms for the free nucleotide. In particular, we report a series of 12 novel compounds with systematic variation in the structure of the carboxylate ester function. In order to rationalize the changes in antiviral action with variation of this moiety we applied our recently developed 31P NMR-based assay for carboxyesterase lability to this series. However, no clear positive correlation emerged, indicating that, at least within this series, factors other than simple esterase lability may be the major determinants of antiviral potency.
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Fármacos Anti-VIH/farmacología , Hidrolasas de Éster Carboxílico/metabolismo , VIH-1/efectos de los fármacos , VIH-2/efectos de los fármacos , Profármacos/farmacología , Inhibidores de la Transcriptasa Inversa/farmacología , Estavudina/análogos & derivados , Células 3T3 , Animales , Fármacos Anti-VIH/síntesis química , Fármacos Anti-VIH/química , Carboxilesterasa , Ácidos Carboxílicos , Línea Celular , Diseño de Fármacos , Evaluación Preclínica de Medicamentos , Esterificación , VIH-1/fisiología , VIH-2/fisiología , Humanos , Linfocitos/virología , Espectroscopía de Resonancia Magnética , Lípidos de la Membrana/metabolismo , Ratones , Profármacos/síntesis química , Profármacos/química , Inhibidores de la Transcriptasa Inversa/síntesis química , Inhibidores de la Transcriptasa Inversa/química , Solubilidad , Estavudina/síntesis química , Estavudina/química , Estavudina/farmacología , Relación Estructura-Actividad , Porcinos , Timidina Quinasa/deficiencia , Timidina Quinasa/metabolismo , Replicación Viral/efectos de los fármacosRESUMEN
OBJECTIVES: To determine whether continuous waking day dopaminergic stimulation with the dopamine agonist apomorphine can reduce levodopa induced dyskinesias in Parkinson's disease METHODS: 19 patients with severe unpredictable refractory motor fluctuations and functionally disabling levodopa induced dyskinesias were treated with continuous subcutaneous apomorphine monotherapy for a minimum duration of 2.7 years RESULTS: A mean 65% reduction in dyskinetic severity and a mean 85% reduction in frequency and duration occurred. On discontinuing levodopa a concomitant reduction in off period time was also seen (35% of waking day "off" reduced to 10%) CONCLUSION: Continuous waking day dopaminergic stimulation with apomorphine reset the threshold for dyskinesias and led to a pronounced reduction in their frequency. Apomorphine should be considered as a less invasive alternative to pallidotomy or deep cerebral stimulation in controlling levodopa induced interdose dose dyskinesias.
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Antiparkinsonianos/efectos adversos , Apomorfina/administración & dosificación , Agonistas de Dopamina/administración & dosificación , Discinesia Inducida por Medicamentos/tratamiento farmacológico , Bombas de Infusión Implantables , Levodopa/efectos adversos , Enfermedad de Parkinson/tratamiento farmacológico , Anciano , Antiparkinsonianos/administración & dosificación , Apomorfina/efectos adversos , Cronoterapia , Agonistas de Dopamina/efectos adversos , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Discinesia Inducida por Medicamentos/etiología , Femenino , Humanos , Inyecciones Subcutáneas , Levodopa/administración & dosificación , Masculino , Persona de Mediana Edad , Examen Neurológico/efectos de los fármacos , Resultado del TratamientoRESUMEN
Three years ago it was hypothesized that the reported adverse changes in male reproductive health could be explained by exposure to compounds with oestrogenic (or other hormone disruptive) activity. Although this issue has been highly publicized, there has been little progress towards a realistic assessment of whether environmental oestrogens pose a health risk to humans. This article attempts to give a brief overview of the current status of knowledge concerning environmental oestrogens and highlights some of the difficulties associated with risk assessment. Compounds within several major groups of chemicals, including organochlorine pesticides, polychlorinated biphenyls, phenolic compounds and phthalate esters, have been identified as being weakly oestrogenic by in vitro and in vivo screening methods. Many of these compounds are widespread and persistent in the environment. They are likely to be present in the food chain, drinking water, plastics, household products and food packaging, although which is the most important route of human exposure is unclear. In addition to exposure to man-made chemicals, the consumption of plant-derived oestrogens in foodstuffs poses a potential risk to human health as phytoestrogens are more potent oestrogens and their intake by some infants is likely to be considerable.
Asunto(s)
Exposición a Riesgos Ambientales/efectos adversos , Estrógenos/efectos adversos , Gónadas/efectos de los fármacos , Isoflavonas , Reproducción/efectos de los fármacos , Animales , Estrógenos no Esteroides/efectos adversos , Femenino , Aditivos Alimentarios/efectos adversos , Humanos , Masculino , Fitoestrógenos , Preparaciones de Plantas , Factores de RiesgoRESUMEN
Sixty-one traditional birth attendants residing in the southern sector of Zimbabwe were interviewed concerning their midwifery practice. Traditional midwives were interviewed individually to gather information concerning: (a) the development of traditional midwifery skills, (b) the nature of traditional birthing patterns, (c) the features of the one-week midwifery training program provided to upgrade traditional midwives, and (d) traditional midwifery as practiced today, post the one-week training program. In describing past and present traditional midwifery, they reported a change in the use of sanitation practices, a heightened understanding of at-risk pregnancies and the need for formal medical intervention, and the adoption of mechanisms to record new births.
PIP: Since the early 1980s, midwives in Zimbabwe have been enrolled in a 1-week training program focused on normal and high-risk childbirth. In 1992, 61 trained rural midwives (mean age, 59.9 years) from the Ndebele ethnic group in southern Zimbabwe were interviewed about changes in their practice resulting from the training. The majority of respondents (96.7%) indicated they had learned midwifery skills from their mother, grandmother, or grandmother-in-law. Training-related changes reported included increased understanding of the importance of a hygienic environment for delivery, attempts to work with pregnant women early in their pregnancies rather than only after labor had started, referral of potential high-risk births to the clinic, collaboration with clinic nurses, and institution of record keeping. The training program has enabled midwives to maintain harmless traditional practices (e.g., the ritual burying of the placenta) while abandoning those that are unhygienic (e.g., placing cow dung around the mother and newborn). About 50-60% of all practicing traditional midwives in Zimbabwe have participated in this training.
Asunto(s)
Competencia Clínica , Conocimientos, Actitudes y Práctica en Salud , Medicina Tradicional , Partería , Enfermeras Obstetrices/educación , Enfermeras Obstetrices/psicología , Femenino , Humanos , Embarazo , Estudios Retrospectivos , Encuestas y Cuestionarios , Enfermería Transcultural , ZimbabweRESUMEN
Interleukin 11 (IL-11) is a multifunctional cytokine which may play a role in regulating the growth and development of cells in both the hematopoietic and lymphoid systems. IL-11 activity was originally detected in the conditioned medium of a primate bone marrow stromal cell line, and the human cDNA was cloned from a human fetal lung fibroblast cell line. The purified protein shows multifunctional activity, influencing lymphohematopoietic stem cell proliferation and differentiation, megakaryocyte progenitor cell proliferation and differentiation, erythroid progenitor cell proliferation, B lymphocyte maturation, activation of hepatocyte acute phase protein synthesis, and adipogenesis. At the molecular level, IL-11 is unique, containing no asparagine-linked glycosylation sites and no cysteine residues. The IL-11 receptor belongs to a family of cytokine receptors which includes the receptors for IL-6, leukemia inhibitory factor (LIF), oncostatin M (OSM), and ciliary neurotrophic factor (CNTF), which are all capable of interacting with the signal transducing receptor gp130 after ligand binding. IL-11 has demonstrated activity in preclinical models for the treatment of thrombocytopenia and, in some cases, neutropenia; studies are underway to confirm its usefulness in the clinic for treatment of myelosuppression associated with cancer chemotherapy and bone marrow transplantation.
Asunto(s)
Interleucina-11/fisiología , Animales , Trasplante de Médula Ósea , Diferenciación Celular/efectos de los fármacos , División Celular/efectos de los fármacos , Evaluación Preclínica de Medicamentos , Genes , Células Madre Hematopoyéticas/efectos de los fármacos , Humanos , Factores Inmunológicos/uso terapéutico , Interleucina-11/genética , Interleucina-11/farmacología , Interleucina-11/uso terapéutico , Subunidad alfa del Receptor de Interleucina-11 , Interleucina-6/fisiología , Tejido Linfoide/efectos de los fármacos , Ratones , Neutropenia/terapia , Primates/genética , Receptores de Interleucina/genética , Receptores de Interleucina/metabolismo , Receptores de Interleucina-11 , Homología de Secuencia de Ácido Nucleico , Trombocitopenia/terapiaRESUMEN
Two selenium (Se) supplementation trials were conducted in successive years involving a total of 70 red deer calves 3-15 months of age grazing pasture containing 30-57 ppb of Se on a dry matter basis. The trials compared growth rate, whole blood Se and glutathione peroxidase (GSHpx) concentrations of calves which received periodic doses of oral Se or a single injection of barium selenate (equivalent to 50 mg Se) or no Se supplementation. There were no significant weight gain differences between treated and untreated groups in either trial. Whole blood GSHpx levels were strongly correlated with blood Se levels (r = 0.9278) and produced the following regression equation: GSHpx = 0.0155 Se - 2.292. In both years the 3 month old calves had GSHpx levels of 6-9 kU/I which probably derived from maternal transfer of Se. The GSHpx levels in unsupplemented calves declined from these levels to a minimum in winter (group means approximately 2.6) and then progressively rose the following spring and summer. Periodical oral dosing with Se or a single injection of barium selenate significantly elevated blood Se and GSHpx levels throughout the trials.
RESUMEN
Three experiments were conducted with ewes to determine the effects of pregnancy and(or) supplemental protein source on amino acid absorption and digestive criteria. In Exp. 1, four mated and five nonmated ewes fitted with abomasal and ileal cannulas were offered 272 g of cracked corn/d and ad libitum alfalfa hay (22% CP). Mated ewes absorbed greater quantities (P less than .10) and percentages (P less than .05) of amino acids presented to the abomasum than did nonmated ewes between d 121 and 124 of gestation. In Exp. 2, three nonmated ewes were used in a latin square design experiment to compare amino acid absorption when timothy hay (6% CP; 67% NDF) was offered alone or with supplements of corn plus either alfalfa hay (ALF) or soybean meal (SBM). Supplementation increased total, essential and nonessential amino acid flow to the abomasum and amino acid disappearance. In Exp. 3, 12 mated and 12 nonmated ewes were assigned to treatments in a 2 x 2 factorial arrangement to compare the effects of production status (gestation followed by lactation vs nonmated) and supplemented protein source (ALF vs SBM) on voluntary intake and digestive criteria. Ewes were pulse-dosed with Yb-marked NDF from hay on d 124 and 137 of gestation and d 26 of lactation. During lactation (d 7 to 28), dietary DM intakes were greater (P less than .05) by ewes consuming ALF compared with SBM and by lactating ewes compared with nonmated ewes. Flow rates were greater (P less than .05) from mated ewes throughout the experiment. It appears that pregnant ewes met their increased nutrient demands by increasing flow rates and by more efficient apparent absorption of amino acids.