Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study.

BACKGROUND: Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. OBJECTIVE: To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. METHODS: Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. RESULTS: Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. CONCLUSIONS: In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.

Sistema masculino transobturador ajustable (ATOMS(R)) como tratamiento de la incontinencia urinaria de esfuerzo secundaria a resección transuretral de la próstata / Adjustable transobturator male system (ATOMS(R)) as treatment of stress urinary incontinence secondary to transurethral resection of the prostate

Objetivos: Estudio de viabilidad para evaluar la eficacia y la seguridad del sistema masculino transobturador ajustable (ATOMS(R)) para la incontinencia urinaria de esfuerzo (IUE) masculina después de la resección transuretral de la próstata. Materiales y métodos: Se implantó ATOMS(R) a 20 pacientes con IUE causada por resección transuretral de la próstata con o sin radioterapia. La severidad de la incontinencia fue evaluada como leve (2 compresas/día), moderada (3-5 compresas/día) o severa (≥6 compresas/día), y se consideró paciente seco aquel sin compresas o con una compresa de seguridad al día. Se investigó el cambio en el recuento de compresas (pad-count) y en el peso de las compresas (pad-test), así como otros parámetros operatorios, la satisfacción del paciente con el procedimiento, y el número y grado de complicaciones (Clavien-Dindo). Resultados: La mediana de edad fue de 76,5 años. Cinco pacientes habían recibido radioterapia pélvica (3 por cáncer de próstata, 2 por cáncer rectal) y 2 (10%) habían tenido esfínter urinario artificial con erosión uretral y fallo mecánico, respectivamente. La IUE preoperatoria fue leve en 4 (20%), moderada en 7 (35%) y severa en 9 (45%). La mediana de relleno del sistema fue de 13,5 ml. La mediana de pad-test disminuyó de 375 ± 855 ml basal a 10 ± 31,5 ml y el pad-count, de 4 ± 3 a 0 ± 1,5 tras el ajuste (1 ± 3 rellenos). La IUE postoperatoria fue leve en 2 (10%) pacientes, moderada en uno (5%) y severa en 2 (10%). La tasa de satisfacción fue del 80%, igual para pacientes con o sin radioterapia previa. Ningún paciente tuvo retención urinaria al retirar el catéter. Hubo complicaciones en 3 (15%) casos, todas menores. Tras una mediana de seguimiento de 38,5meses no se ha retirado ningún sistema; 19 (95%) pacientes se consideran mejor que antes y 11 (55%) muchísimo mejor. Conclusión: Según la eficacia a corto plazo y la satisfacción del paciente, ATOMS(R) puede considerarse una alternativa realista para IUE después de la resección transuretral de la próstata, incluso en pacientes radiados. La ausencia de erosión uretral y la escasez de problemas hacen esta alternativa especialmente atractiva para pacientes con destreza disminuida, edad avanzada y tratamientos previos fallidos

Objectives: Feasibility study to evaluate efficacy and safety of Adjustable Transobturator Male System (ATOMS(R)) for male stress urinary incontinence (SUI) after transurethral resection of the prostate. Materials and methods: Twenty patients were implanted ATOMS(R) for SUI caused by transurethral resection of the prostate with or without radiotherapy. Incontinence severity was evaluated as mild (2 pads/day), moderate (3-5 pads/day) or severe (≥ 6pads/day), and dryness as none or one security pad/day. Changes in pad-test and pad-count after adjustment were investigated, together with operative parameters, patient satisfaction with the procedure, and number and grade of complications (Clavien-Dindo). Results: Median age was 76.5 years. Five patients received previous pelvic radiation (3 prostate, 2 rectal cancer) and 2 (10%) previous failed artificial urinary sphincter with urethral erosion and mechanical failure, respectively. Preoperative SUI was mild in 4 (20%), moderate in 7 (35%) and severe in 9 (45%). Median filling of the system was 13.5 ml. Median pad-test decreased from 375 ± 855 ml baseline to 10 ± 31.5 ml and pad-count from 4 ± 3 to 0 ± 1.5 after adjustment (1 ± 3 fillings). Postoperative SUI distribution was mild in 2 (10%), moderate in one (5%) and severe in 2 (10%). Satisfaction rate was 80%, equal for transurethral resection of the prostate with/without previous radiotherapy. No patient had urinary retention after catheter removal. Complications presented in 3 (15%) patients, all minor. After median 38.5mo follow-up no system has been removed, 19 (95%) self-considered better than before and 11 (55%) very much better. Conclusion: Based on short-term efficacy and patient satisfaction ATOMS(R) can be considered a realistic alternative for SUI after transurethral resection of the prostate, even after irradiation. Absence of urethral erosion and very limited problems make this alternative especially attractive for cases with diminished dexterity, advanced age and previous failed treatments

Adjustable transobturator male system (ATOMS®) as treatment of stress urinary incontinence secondary to transurethral resection of the prostate. / Sistema masculino transobturador ajustable (ATOMS®) como tratamiento de la incontinencia urinaria de esfuerzo secundaria a resección transuretral de la próstata.

OBJECTIVES: Feasibility study to evaluate efficacy and safety of Adjustable Transobturator Male System (ATOMS®) for male stress urinary incontinence (SUI) after transurethral resection of the prostate. MATERIALS AND METHODS: Twenty patients were implanted ATOMS® for SUI caused by transurethral resection of the prostate with or without radiotherapy. Incontinence severity was evaluated as mild (2 pads/day), moderate (3-5 pads/day) or severe (≥6pads/day), and dryness as none or one security pad/day. Changes in pad-test and pad-count after adjustment were investigated, together with operative parameters, patient satisfaction with the procedure, and number and grade of complications (Clavien-Dindo). RESULTS: Median age was 76.5years. Five patients received previous pelvic radiation (3 prostate, 2 rectal cancer) and 2 (10%) previous failed artificial urinary sphincter with urethral erosion and mechanical failure, respectively. Preoperative SUI was mild in 4 (20%), moderate in 7 (35%) and severe in 9 (45%). Median filling of the system was 13.5ml. Median pad-test decreased from 375±855ml baseline to 10±31.5ml and pad-count from 4±3 to 0±1.5 after adjustment (1±3fillings). Postoperative SUI distribution was mild in 2 (10%), moderate in one (5%) and severe in 2 (10%). Satisfaction rate was 80%, equal for transurethral resection of the prostate with/without previous radiotherapy. No patient had urinary retention after catheter removal. Complications presented in 3 (15%) patients, all minor. After median 38.5mo follow-up no system has been removed, 19 (95%) self-considered better than before and 11 (55%) very much better. CONCLUSION: Based on short-term efficacy and patient satisfaction ATOMS® can be considered a realistic alternative for SUI after transurethral resection of the prostate, even after irradiation. Absence of urethral erosion and very limited problems make this alternative especially attractive for cases with diminished dexterity, advanced age and previous failed treatments.

Asthma and dietary intake: an overview of systematic reviews.

Epidemiological research on the relationship between diet and asthma has increased in the last decade. Several components found in foods have been proposed to have a series of antioxidant, anti-allergic and anti-inflammatory properties, which can have a protective effect against asthma risk. Several literature reviews and critical appraisals have been published to summarize the existing evidence in this field. In the context of this EAACI Lifestyle and asthma Task Force, we summarize the evidence from existing systematic reviews on dietary intake and asthma, using the PRISMA guidelines. We therefore report the quality of eligible systematic reviews and summarize the results of those with an AMSTAR score ≥32. The GRADE approach is used to assess the overall quality of the existing evidence. This overview is centred on systematic reviews of nutritional components provided in the diet only, as a way to establish what type of advice can be given in clinical practice and to the general population on dietary habits and asthma.

Effects of the addition of transcranial direct current stimulation to virtual reality therapy after stroke: a pilot randomized controlled trial.

BACKGROUND: Upper limb (UL) impairment is the most common disabling deficit following a stroke. Previous studies have suggested that transcranial direct current stimulation (tDCS) enhances the effect of conventional therapies. OBJECTIVE: This pilot double-blind randomized control trial aimed to determine whether or not tDCS, combined with Wii virtual reality therapy (VRT), would be superior to Wii therapy alone in improving upper limb function and quality of life in chronic stroke individuals. METHODS: Twenty participants were randomly assigned either to an experimental group that received VRT and tDCS, or a control group that received VRT and sham tDCS. The therapy was delivered over 15 sessions with 13 minutes of active or sham anodal tDCS, and one hour of virtual reality therapy. The outcomes included were determined using the Fugl-Meyer scale, the Wolf motor function test, the modified Ashworth scale (MAS), grip strength, and the stroke specific quality of life scale (SSQOL). Minimal clinically important differences (MCID) were observed when assessing outcome data. RESULTS: Both groups demonstrated gains in all evaluated areas, except for the SSQOL-UL domain. Differences between groups were only observed in wrist spasticity levels in the experimental group, where more than 50% of the participants achieved the MCID. CONCLUSIONS: These findings support that tDCS, combined with VRT therapy, should be investigated and clarified further.

Persistência de plantas medicinais em sistemas agroflorestais no município de São Bento do Sul, SC, Brasil / Persistence of medicinal plants in agroforestry systems in the city of São Bento do Sul, Santa Catarina, Brazil

No final da década de 90, a comunidade de Rio Natal, no município de São Bento do Sul, SC, passou a fazer parte de uma Área de Preservação Ambiental e desde então, muitas áreas de cultivo, paulatinamente, estão retomando o processo de formação florestal. Neste cenário, foi sugerido pela comunidade, a possibilidade de cultivo de plantas medicinais adaptadas às condições de sombreamento. Em atendimento a essa demanda foi realizada uma pesquisa participativa na comunidade, de 2005 a 2008, onde foram avaliadas 14 espécies de plantas medicinais com potencial de mercado, cultivadas em áreas sombreadas, em três propriedades familiares. Foram avaliados: taxa de sobrevivência das espécies, incidência de doenças e pragas, teor de massa seca e altura das plantas. Apresentaram persistência ao cultivo em áreas sombreadas as espécies: Curcuma longa L. (açafrão-da-índia); Arctium lappa L. (bardana); Pfaffia glomerata (Spreng) Pedersen (fáfia ou ginseng-brasileiro); Mikania glomerata Sprengel (guaco); Alternanthera brasiliana L. Kuntze (penicilina); Pogostemon cablin (Blanco) Benth (patchuli) e Maytenus ilicifolia Mart. Ex Reissek (espinheira-santa).

In the end of the 1990s, the Rio Natal community, located in the city of São Bento do Sul, in the Brazilian State of Santa Catarina, started to be part of an Environmental Protection Area. Since then, many cultivation areas have been increasingly having their forest restored. In this scenario, the community proposed to cultivate medicinal plants that were adapted to shaded conditions. To attend this demand, we carried out a participatory research in the community between 2005 and 2008. Fourteen species of medicinal plants having market potential were evaluated, and were cultivated in shaded areas, in three family properties. The survival of the species, the incidence of illnesses and pests, the dry matter value and the height of the plants were evaluated. The species that presented persistence to be cultivated in shaded areas were: Curcuma longa L.; Arctium lappa L.; Pfaffia glomerata (Spreng) Pedersen.; Mikania glomerata Sprengel.; Alternanthera sp.; Pogostemon cablin (Blanco) Benth. e Maytenus ilicifolia Mart. Ex Reissek.

Position paper on tuberculosis screening in patients with immune mediated inflammatory diseases candidates for biological therapy.

UNLABELLED: Chronic immunosuppression is a known risk factor for tuberculosis. Our aim was to reach a consensus on screening and prevention of tuberculosis in patients with immune mediated inflammatory diseases candidates to biologic therapy. METHODS: Critical appraisal of the literature and expert opinion on immunosuppressive therapies and risk of tuberculosis. RESULTS AND CONCLUSION: The currently recommended method for screening is the tuberculin skin test and the interferon gamma assay, after exclusion of active tuberculosis. Positively screened patients should be treated for latent tuberculosis infection. Patients may start biological therapy after 1 to 2 months, as long as they are strictly adhering to and tolerating their preventive regimen.

Prevalence of aeroallergen sensitization and increased exhaled nitric oxide values in schoolchildren of different socioeconomic status.

BACKGROUND: Screening for allergic diseases allows an early diagnosis to be made, thus reducing socioeconomic burden and enhancing quality of life. We determined the prevalence of elevated exhaled nitric oxide (eNO) levels and sensitization to common airborne allergens in schoolchildren from different socioeconomic backgrounds. MATERIAL AND METHODS: The study population comprised 271 children (136 boys) aged between 8 and 12 years in whom we applied skin prick tests and determined eNO levels. RESULTS: Thirty-five percent of the children were identified as atopic. There was a significantly higher prevalence of atopy in boys (43% vs. 27%). Among the children with a high socioeconomic status, 37% were atopic, compared with 30% of those with a low socioeconomic status. We observed a significantly lower prevalence of pollen sensitization in children of lower socioeconomic status (10% vs. 20%). In the atopic group, 51% had elevated eNO levels, while in the nonatopic group this value was 4%. The mean (SD) eNO level was 33.4 (26.6) ppb in the atopic group and 11.9 (6.4) ppb in the nonatopic group. No differences were found for eNO values in terms of gender or socioeconomic status. CONCLUSIONS: Our results emphasize the high prevalence of atopy in our population and suggest that determination of eNO levels could help to provide an early diagnosis. We also observed the following: (a) a significant difference in mean eNO values between atopic and nonatopic children; (b) a significantly lower prevalence of pollen sensitization in children of lower socioeconomic status; and (c) a higher prevalence of atopy in boys.

Determinação da energia metabolizável de alimentos para codornas japonesas em postura / Metabolizable energy of different feedstuffs tested in female Japanese quails

Foram determinados os valores de energia metabolizável aparente (EMA), de energia metabolizável aparente corrigida por retenção de nitrogênio (EMAn) e do coeficiente de metabolização aparente da energia bruta (CMAEB por cento) do milho, sorgo, farelo de soja, farelo de glúten de milho e óleo de soja refinado. Foram utilizadas 240 codornas japonesas (Coturnix japonica), fêmeas com idade inicial de 60 dias, em delineamento experimental inteiramente ao caso, com seis tratamentos, cinco repetições e oito codornas por unidade experimental. Os tratamentos consistiram de cinco rações experimentais e uma ração referência. Cada ração experimental foi constituída, na base da matéria natural, por 70 por cento da ração referência e 30 por cento do ingrediente a ser testado, com exceção da ração para determinação da EMAn do óleo de soja, com 10 por cento de inclusão e 90 por cento da ração referência. O experimento foi realizado em gaiolas distribuídas em baterias metálicas. Os valores de EMA, EMAn (em kcal/kg de matéria natural) e do CMAEB ( por cento) do milho moído, sorgo, farelo de soja, farelo de glúten de milho e óleo de soja refinado foram, respectivamente: 3.572 e 3.612kcal/kg e 92,6 por cento; 3.108 e 3.149kcal/kg e 80,9 por cento; 2.633 e 2.676kcal/kg e 65,3 por cento; 4.043 e 4.096kcal/kg e 75,0 por cento; 9.335 e 9.379kcal/kg e 98,8 por cento. Os valores de EMA descritos para outras espécies de aves são discrepantes dos obtidos no presente estudo, não sendo recomendado seu uso em formulação de rações para codornas japonesas em postura.

The values of the apparent metabolizable energy (AME), the apparent metabolizable energy corrected for nitrogen retention (AMEn), and the apparent metabolization coefficient of crude energy (AMCCE) were determined in corn, sorghum, soybean meal, corn gluten meal, and refined soybean oil. Two-hundred and forty six-day-old female Japanese quails (Coturnix japonica) were used in a completely randomized design, with five replicates and eight quails per experimental unit. The treatments consisted of six experimental diets and one reference diet. Each experimental diet was constituted, as fed basis, for 70 percent of the reference ration and 30 percent of food that would be tested, except the ration that contained refined soybean oil that was tested, as fed basis, with 10 percent of addition and 90 percent of the reference ration. The biological assay was carried out in wired floor cages distributed in iron batteries. The respective values of AME, AMEn (kcal/kg of natural matter basis), and AMCCE ( percent) of ground corn, sorghum, soybean meal, corn gluten meal, and refined soybean oil were respectively: 3,572, 3,612kcal/kg, and 92.6 percent; 3,108, 3,149kcal/kg, and 80.9 percent; 2,633, 2,676kcal/kg, and 65.3 percent; 4,043, 4,096kcal/kg, and 75.0 percent; and 9,335, 9,379kcal/kg, and 98.8 percent. The values of AME described for other birds species were different from those obtained in this study and are not recommended to be used in ration composition for Japanese quails.

Chronic arthritis directly induces quantitative and qualitative bone disturbances leading to compromised biomechanical properties.

OBJECTIVES: Rheumatoid arthritis (RA) is associated with an increased risk of fragility fractures. In RA patients, the direct effect of inflammation on bone is difficult to study because their skeleton is also affected by medication with corticosteroids and other drugs as well as aging and menopause, which contribute to bone fragility. This study used an animal model of chronic arthritis to evaluate the direct impact of chronic inflammation on biomechanical properties and structure of bone. METHODS: In the SKG mouse chronic arthritis model three point bending tests were performed on femoral bones and compression tests on vertebral bodies. Collagen structure was analysed using second-harmonic generation (SHG) imaging with a two-photon microscope, ultramorphology by scanning electron microscopy (SEM) coupled with energy dispersive x-ray spectroscopy (EDS) and bone density using water pycnometer. RESULTS: Arthritic bones had poor biomechanical quality compared to control bones. SHG, SEM and pycnometry disclosed variable signs of impaired collagen organization, poor trabecular architecture and low bone density. CONCLUSION: Present data demonstrate for the first time that chronic inflammation per se, without confounding influence of drugs and aging, leads to impairment of bone biomechanics in terms of stiffness, ductility and ultimate strength (fracture).

Pilot study of the effects of n-3 polyunsaturated fatty acids on exhaled nitric oxide in patients with stable asthma.

BACKGROUND: The anti-inflammatory effects of n-3 polyunsaturated fatty acids (n-3 PUFA) have been demonstrated both in vitro and in vivo. The results of epidemiological studies suggest that fish consumption has a beneficial effect on lung function and prevalence of asthma. However, data from intervention trials have not revealed a beneficial effect of n-3 PUFA supplementation in patients with established disease. OBJECTIVE: To study the effects of short-term n-3 PUFA supplementation in addition to maintenance therapy on exhaled nitric oxide in asthmatic patients. METHODS: A double-blind, placebo-controlled trial was undertaken in 20 women with asthma. Patients received either a combination of eicosapentaenoic acid and docosahexaenoic acid plus 10 mg vitamin E or placebo twice daily for 2 weeks. The primary outcome measure was the fraction of exhaled nitric oxide (FeNO) and the secondary outcomes were asthma control (score on theAsthma Control Questionnaire [ACQI) and lung function (forced expiratory volume in 1 second [FEV1]). RESULTS: No significant differences were observed in FeNO, ACQ score, or FEV1 between patients receiving n-3 PUFA supplementation and those receiving placebo. CONCLUSIONS: Short-term dietary supplementation with n-3 PUFA in women with stable asthma was not associated with statistically significant changes in FeNO, asthma control, or lung function.

Determinação da energia metabolizável de diferentes alimentos testados em codornas japonesas fêmeas / Metabolizable energy for different foodstuffs tested in japanese female quails

Determinaram-se os valores de energia metabolizável aparente (EMA) e energia metabolizável aparente corrigida por retenção de nitrogênio (EMAn) de sete alimentos testados em dietas para codornas japonesas. Utilizaram-se 280 codornas japonesas (Coturnix japonica) fêmeas, com idade inicial de 26 dias, em delineamento experimental inteiramente ao acaso, com cinco repetições e sete codornas por unidade experimental. Os tratamentos consistiram de sete dietas experimentais e uma dieta referência. Cada dieta experimental foi constituída, na base da matéria natural, por 70 por cento da dieta referência e 30 por cento do alimento a ser testado, à exceção da dieta contendo óleo de soja degomado, que substituiu 10 por cento da dieta referência, na base da matéria natural. Os valores de EMA e EMAn (kcal por kg de matéria natural) foram: 3.124 e 3.122 (milho moído), 3.152 e 3.102 (colorífico), 2.980 e 2.947 (quirera de arroz), 8.065 e 7.940 (óleo de soja degomado), 2.633 e 2.651 (farelo de soja), 2.477 e 2.492 (semente de linhaça) e 1.323 e 1.274 (casca + polpa de abacaxi), respectivamente.

Apparent metabolizable energy (AME) and apparent metabolizable energy corrected for nitrogen retention (AMEn) were determined in seven foodstuffs tested in japanese quail feedings. Two hundred and eighty japanese female quails (Coturnix japonica), twenty-six-days-old were used in a completely randomized experimental design, with five replicates and seven quails per experimental unit. The treatments consisted on seven experimental diets and one reference diet. Each experimental diet was constituted, as fed basis, of 70 percent of the reference diet and 30 percent of food in test, except for the diet containing soy bean oil without phospholipid, which replaced 10 percent of the reference diet, as fed basis. The values of AME and AMEn (kcal/kg of fed basis) were: 3.124 and 3.122 (ground corn), 3.152 and 3.102 (spice), 2.980 and 2.947 (broken rice grains), 8.065 and 7.940 (soy bean oil without phospholipids), 2.633 and 2.651 (soybean meal), 2.477 and 2.492 (linseed meal) and 1.323 and 1.274 (peel and pulp of pineapple), respectively.

Nutritional modulation of exercise-induced immunodepression in athletes: a systematic review and meta-analysis.

BACKGROUND: Heavy exercise induces marked immunodepression that is multifactorial in origin. Nutrition can modulate normal immune function. OBJECTIVE: To assess the efficacy of nutritional supplements in exercise-induced immunodepression in athletes. DESIGN: Systematic review. REVIEW METHODS: Randomised and/or controlled trials of athletes undertaking nutritional supplements to minimise the immunodepression after exercise were retrieved. The primary outcome measure was incidence of upper respiratory tract (URT) illness symptoms after exercise, and secondary outcomes included cortisol, cell counts, plasma cytokine concentration, cell proliferative response, oxidative burst, natural killer cell activity and immunoglobulins. When data were available for a pooled estimate of the effect of intervention, meta-analyses were conducted for direct comparisons. RESULTS: Forty-five studies were included (1603 subjects). The studies were heterogeneous in terms of exercise interventions, selection of athletes, settings and outcomes. The overall methodological quality of most of the trials was poor. Twenty studies addressed carbohydrate supplementation, eight glutamine, 13 vitamin C and four others interventions. Three trials assessed the effect of intervention on prevention of URT infections. The pooled rate ratio for URT infections after vitamin C supplementation against placebo was 0.49 (0.34-0.71). Carbohydrate supplementation attenuated the increase in cortisol and neutrophils after exercise; vitamin C attenuated the decrease in lymphocytes after exercise. No other interventions had significant or consistent effect on any of the studied outcomes. CONCLUSIONS: Although the prevention of URT infections by vitamin C was supported by two trials, further studies are needed. The available evidence failed to support a role for other nutritional supplements in preventing exercise-induced immune suppression. Larger trials with clinically relevant and uniform end points are necessary to clarify the role of these nutritional interventions.

Increased dietary beta-carotene intake associated with better asthma quality of life

Asthma prevalence and morbidity have steadily increased in last decades in face of our imporved knowledge of the disease. Changing patterns and interactions among asthma risk factors may contribute to these trends, in which diet is a recognized risk factor for asthma occurrence. Although a possible protective role of dietary antioxidants in asthma has been proposed, little is known about possible relationship between dietary intake and asthma severity, if any. Our objective was to investigate whether asthma severity is associated with antioxidants consumption. We found that better asthma quality of life was associated in females'. with increased consumption of beta-carotene, even after adjustment or energy intake and potentiaJ confounders (p=0.023) and in males, with lesser consumption of dietary iron (13.9±2.1 vs. 17.8±2.1 mg. p=0.026: after adjustment for energy intake and confounders, p=0.012). Our study shows promising results that need further investigation relating these two nutrients involved in several antioxidant mechanisms (AU)

La prevalencia y la morbilidad del asma han aumentado de forma continua a lo largo de las últimas décadas, a pesar de los avances en nuestro conocimiento de la enfermedad. Cambios en los perfiles e interacciones entre factores de riesgo del asma podrían contribuir a esta tendencia, y entre ellos la dieta es un factor de riesgo reconocido para el desarrollo de asma. Aunque se ha sugerido un posible papel protctor de los antioxidantes dietarios en el asma, es poco lo que se sabe acerca de la posbile relación, si es que existe una, entre ingesta dietaria y gravedad del asma. Nuestro objetivo fue investigar si la gravedad del asma muestra asociación con el consumo de antioxidantes. Hemos observado que existe una asociación entre mejor calidad de vida en el asma y el consumo aumentado de B-caroteno en mujeres, incluso después del ajuste en función de la ingesta calórica y de posibles factores de confusión (p=0,0023), y entre mejor calidad de vida en el asma y menor consumo dietario de hierro (13,9±2.1 frente 17.8 ± 2.1 mb; p=0.026) en varones, asimismo tras ajuste según ingesta calórica y factores de confusión. Nuestro estudio ofrece resultados prometedores que requieren y justifican investigación adicional acerca de estos dos nutrientes involucrados en diversos mecanismos antioxidantes (AU)

Antimalarial activity of neurolenin B and derivates of Eupatorium inulaefolium (Asteraceae).

Dried stems and leaves of Eupatorium inulaefolium (Austroeupatorium inulaefolium) (Asteraceae) were used to obtain four crude extracts (hexane, dichloromethane, methanol and ethanol). Two fractions were obtained from the hexane extract (S1 and S2) and three compounds (neurolenin B, lobatin A and lobatin B) from the dichloromethane extract. The ethanol, hexane, dichloromethane and methanol extracts, two fractions from the hexane extract (S1 and S2), and neurolenin B were evaluated in vitro against Plasmodium falciparum, FCB-2 strain. Two extracts (dichloromethane and methanol), the S2 fraction and neurolenin B showed statistically significant antiplasmodial activity.

Cross-sectional study of 50 patients with calcium pyrophosphate dihydrate crystal arthropathy.

Calcium pyrophosphate dihydrate crystal arthropathy (CPPA) is a well known but heterogeneous disease with a variable presentation and course. We present a cross-sectional study undertaken in a Portuguese rheumatology unit with the aim of analysing clinical and radiological patterns of CPPA in our population. The study population included 50 patients, 34 (68%) women and 16 (32%) men. The mean age was 69.8 +/- 8.8 years. The onset features were acute arthritis in 19 (38%) patients and chronic joint complaints in 26 (52%); five (10%) patients were asymptomatic at the time of diagnosis, which was based only on radiological findings. The diagnosis was established in 37 (74%) cases by clinical and radiographic features, in eight (16%) by clinical, X-ray and synovial fluid analysis, and in five (10%) by clinical features and fluid analysis. The disease course was characterised by acute episodic arthritis in 16 (32%) patients and by persistent symptoms (with or without synovitis) in 34 (68%). The pattern of CPPA in 20 (40%) patients was pseudo-osteoarthritis with synovitis, pseudo-osteoarthritis without synovitis in nine (18%), pseudogout in nine (18%), monoarthropathy in eight (16%) and pseudorheumatoid arthritis in four (8%). The phosphocalcium balance was altered in nine (18%) cases: six patients had hypercalciuria two hyperphosphaturia, two hypocalciuria, one hypophosphaturia and one hypercalcemia. Five patients had abnormal thyroid hormone levels, but only one presented with clinical hypothyroidism. Four patients showed increased parathormone levels, but only one presented with clinical hyperparathyroidism. Radiographic findings showed that 43 (86%) patients had meniscus calcifications, 20 (40%) radiocarpal and 16 (32%) calcification of the symphysis pubis. The study confirms the clinical variability of the disease in a population of Portuguese patients. The knee meniscus calcifications were the most sensitive single finding for establishing the diagnosis of CPPA. Almost all our patients had sporadic idiopathic CPPA without associated pathological conditions.

Acute colitis caused by caustic products.

We report two cases of acute proctocolitis caused by rectal application of caustic products of domestic use. One 61-yr-old woman applied an ammonia solution enema; the other patient, a 63-yr-old woman, accidentally applied an enema containing lye. Both patients presented with intense anal pain, but the first patient also had abdominal pain with guarding, hematochezia, and leucocytosis. An acute proctocolitis was found at sigmoidoscopy in both patients. Only conservative and symptomatic measures were prescribed in both cases, and a clinical and endoscopic recovery was seen. In spite of persistent fibrosis in the lamina propria, no signs of stenosis were found.

Familial lipoprotein lipase deficiency in infancy: clinical, biochemical, and molecular study.

OBJECTIVES: To describe the characteristics of lipoprotein lipase (LPL)-deficient patients seen in infancy and to evaluate the safety and efficacy of severe fat restriction. METHODS: Children <1 year old presenting with chylomicronemia between 1972 and 1995 were identified, and their clinical courses were reviewed retrospectively. RESULTS: LPL deficiency was demonstrated in 16 infants who presented with irritability (n = 7), lower intestinal bleeding (n = 2), pallor, anemia, or splenomegaly (n = 5), and a family history or fortuitous discovery (n = 2). All plasma samples were lactescent at presentation. Chylomicronemia responded rapidly to dietary fat restriction, and it was possible to maintain satisfactory metabolic control for a prolonged period of time. Only 1 adolescent girl had an episode of pancreatitis associated with the use of oral contraceptives. No persistent adverse effects on growth were seen. We obtained abnormal values for serum iron, alkaline phosphatase, and total calcium. CONCLUSIONS: The presentation of LPL deficiency is heterogeneous during infancy. Close dietary monitoring is required to avoid nutritional deficiencies. Estrogen therapy should be avoided in LPL-deficient patients.