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The detonation nanodiamonds form the aggregate having interparticle voids, giving a marked hygroscopic property. As the relationship between pore structure and water adsorption of aggregated nanodiamonds is not well understood yet, adsorption isotherms of N2 at 77 K and of water vapor at 298 K of the well-characterized aggregated nanodiamonds were measured. HR-TEM and X-ray diffraction showed that the nanodiamonds were highly crystalline and their average crystallite size was 4.5 nm. The presence of the graphitic layers on the nanodiamond particle surface was confirmed by the EELS examination. The pore size distribution analysis showed that nanodiamonds had a few ultramicropores with predominant mesopores of 4.5 nm in average size. The water vapor adsorption isotherm of IUPAC Type V indicates the hydrophobicity of the nanodiamond aggregates, with the presence of hydrophilic sites. Then the hygroscopic nature of nanodiamonds should be associated with the surface functionalities of the graphitic shell and the ultramicropores on the mesopore walls.
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Fabrication of nanographene shows a promising route for production of designed porous carbons, which is indispensable for highly efficient molecular separation and energy storage applications. This process requires a better understanding of the mechanical properties of nanographene in their aggregated structure. We studied the structural and mechanical properties of nanographene monoliths compressed at 43 MPa over different times from 3 to 25 h. While in monoliths compressed over shorter time adsorption isotherms of Ar at 87 K or N2 at 77 K exhibited a prominent hysteresis due to presence of predominant mesopores, compression for long time induces a low pressure hysteresis. On the other hand, compression for 25 h increases the microporosity evaluated by Ar adsorption, not by N2 adsorption, indicating that 25 h compression rearranges the nanographene stacking structure to produce ultramicropores that can be accessible only for Ar. TEM, X-ray diffraction, and Raman spectroscopic studies indicated that the compression for 25 h unfolds double-bent-like structures, relaxing the unstable nanographene stacked structure formed on the initial compression without nanographene sheets collapse. This behavior stems from the highly elastic nature of the nanographenes.
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High surface area graphene monoliths consist mainly of single graphene layers wider than 10 nm. The interlayer porosity of high temperature treated nanoporous graphene monoliths with tuned intergraphene layer structures is evaluated by hybrid analysis of Ar adsorption at 87 K, N2 adsorption at 77 K, high resolution transmission electron microscopic observation, and small-angle X-ray scattering (SAXS) measurements. SAXS analysis results in surface areas that are 1.4 and 4.5 times larger than those evaluated by Ar adsorption for graphene monoliths nontreated and treated at 2273 K, respectively. A distorted graphene sheet structure model is proposed for the high surface area graphene monoliths on the basis of the hybrid analysis.
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Although specific microRNA (miRNA) signatures in classical Hodgkin lymphoma (cHL) have been proposed, their relationship with clinical outcome remains unclear. Despite treatment advances, a substantial subset of patients with advanced cHL are refractory to standard therapies based on adriamycin and its variants. Global miRNA expression data of 29 advanced cHL patients and five cHL-derived cell lines were used to identify profiles from Hodgkin-Reed-Sternberg (HRS) cells and their non-tumoural microenvironment. A cHL-miRNA signature was identified with 234 miRNAs differentially expressed. A subset of these miRNAs was associated with outcome and selected for study in an independent set of 168 cHL samples using quantitative reverse transcription polymerase chain reaction. Multivariate Cox regression analyses including cross-validation with failure-free survival (FFS) as clinical endpoint revealed a miRNA signature with MIR21, MIR30E, MIR30D and MIR92B* that identified two risk-groups with significant differences in 5-year FFS (81% vs. 35.7%; P < 0.001). Additionally, functional silencing of MIR21 and MIR30D in L428 cells showed increased sensitivity to doxorubicin-induced apoptosis, pointing towards abnormalities of mitochondrial intrinsic and TP53-CDKN1A pathways as related to miRNA deregulation in cHL. These results suggest that clinical outcome in cHL is associated with a specific miRNA signature. Moreover, functional analyses suggest a role for MIR21 and MIR30D in cHL pathogenesis and therapeutic resistance.
Assuntos
Biomarcadores Tumorais/genética , Doença de Hodgkin/genética , MicroRNAs/genética , RNA Neoplásico/genética , Adulto , Idoso , Antibióticos Antineoplásicos/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Apoptose/efeitos dos fármacos , Doxorrubicina/farmacologia , Feminino , Perfilação da Expressão Gênica/métodos , Inativação Gênica , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/patologia , Humanos , Masculino , MicroRNAs/metabolismo , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Células de Reed-Sternberg/metabolismo , Análise de Sobrevida , Resultado do Tratamento , Células Tumorais Cultivadas , Microambiente Tumoral , Adulto JovemRESUMO
Postbiotics were defined in 2021 by the International Scientific Association for Probiotics and Prebiotics (ISAPP) as a "preparation of inanimate microorganisms and/or their cellular components that confers a health benefit to the host." The field of postbiotics is a new area within the biotics family; numerous products have already been developed for clinical applications, such as immune stimulation, the management of diarrhea in children and adults, the management of irritable bowel syndrome, and 3 infant formulas. In particular, infant formulas with postbiotics obtained from milk fermented with Bifidobacterium breve C50 and Streptococcus thermophilus O65 -and their metabolites-, including the oligosaccharide 3'-GL, have demonstrated to be safe and to contribute to the development of the gut microbiota and the gutassociated immune system. These modifications help to prevent and manage functional gastrointestinal disorders in infants.
Los postbióticos fueron definidos en 2021 por la Asociación Científica Internacional de Probióticos y Prebióticos (ISAPP) como "una preparación de microorganismos inanimados y/o sus componentes celulares capaces de conferir un efecto benéfico al hospedador". El campo de los postbióticos es un área nueva dentro de la familia de los bióticos; se han desarrollado ya numerosos productos con aplicaciones clínicas, como la estimulación inmunológica, el manejo de diarreas en niños y adultos, el abordaje del intestino irritable, además de tres fórmulas infantiles. En particular, las fórmulas infantiles con postbióticos obtenidos a partir de la fermentación de la leche con Bifidobacterium breve C50 y Streptococcus thermophilus O65, y sus metabolitos, incluido el oligosacárido 3'-GL, han demostrado seguridad y contribución al desarrollo de la microbiota intestinal y el sistema inmune asociado al intestino. Estas modificaciones contribuyen a la prevención y el manejo de los trastornos funcionales digestivos del lactante.
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Tongue necrosis is a rare clinical finding because of its rich vascularisation. Giant cell arteritis (GCA) is the most frequent cause of it, and when present, it is usually one side affected. We describe a patient with several months of constitutional syndrome; during that period, she develops headache followed by tongue necrosis, which lead to clinical suspicion of GCA, later confirmed by a temporal artery biopsy. Before the biopsy, she was treated with corticosteroids. We discuss this illness and tongue necrosis as a rare manifestation to consider.
Assuntos
Arterite de Células Gigantes , Doenças da Língua , Feminino , Humanos , Arterite de Células Gigantes/complicações , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/tratamento farmacológico , Necrose/patologia , Doenças da Língua/etiologia , Doenças da Língua/complicações , Artérias Temporais/patologia , Biópsia/efeitos adversos , Língua/patologiaRESUMO
Despite improvement in the treatment of advanced classical Hodgkin lymphoma, approximately 30% of patients relapse or die as result of the disease. Current predictive systems, determined by clinical and analytical parameters, fail to identify these high-risk patients accurately. We took a multistep approach to design a quantitative reverse-transcription polymerase chain reaction assay to be applied to routine formalin-fixed paraffin-embedded samples, integrating genes expressed by the tumor cells and their microenvironment. The significance of 30 genes chosen on the basis of previously published data was evaluated in 282 samples (divided into estimation and validation sets) to build a molecular risk score to predict failure. Adequate reverse-transcription polymerase chain reaction profiles were obtained from 262 of 282 cases (92.9%). Best predictor genes were integrated into an 11-gene model, including 4 functional pathways (cell cycle, apoptosis, macrophage activation, and interferon regulatory factor 4) able to identify low- and high-risk patients with different rates of 5-year failure-free survival: 74% versus 44.1% in the estimation set (P < .001) and 67.5% versus 45.0% in the validation set (P = .022). This model can be combined with stage IV into a final predictive model able to identify a group of patients with very bad outcome (5-year failure-free survival probability, 25.2%).
Assuntos
Biomarcadores Tumorais/genética , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/genética , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/genética , Transdução de Sinais/efeitos dos fármacos , Algoritmos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/metabolismo , Feminino , Perfilação da Expressão Gênica , Doença de Hodgkin/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasia Residual/diagnóstico , Neoplasia Residual/tratamento farmacológico , Neoplasia Residual/genética , Análise de Sequência com Séries de Oligonucleotídeos , Inclusão em Parafina , RNA Mensageiro/genética , Indução de Remissão , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Medição de Risco , Taxa de Sobrevida , Resultado do TratamentoRESUMO
Preterm birth, C-section, antibiotic use, and limited breastfeeding are blamed in part for the increasing incidence of chronic non-communicable diseases among children, such as allergies, mainly cow's milk protein allergy (CMPA). Those who develop allergic diseases, against those who do not, show differences in the composition of their gut microbiota during the first months of life. Early interventions to modulate the intestinal microbiota and the immune system may be the key tools for the management of CMPA. Clinical judgment and the interdisciplinary work of allergists, gastroenterologists, immunologists, microbiologists, and nutritionists will allow pediatricians to achieve an adequate diagnosis and a timely treatment. In this setting, the use of biotics (prebiotics, probiotics, synbiotics, and postbiotics) as supplementary dietary tools is scientifically supported at present and seems to be very promising for the prevention and treatment of these conditions.
El parto prematuro, la cesárea, el uso de antibióticos y la lactancia materna limitada son señalados como responsables en parte del aumento de enfermedades crónicas no transmisibles en niños, como las alergias, principalmente la alergia a la proteína de la leche de vaca (APLV). Quienes desarrollan enfermedades alérgicas muestran diferencias en la composición de su microbiota intestinal durante los primeros meses de vida, en comparación con los que no lo hacen. Las intervenciones tempranas para modular la microbiota intestinal y el sistema inmunológico pueden ser herramientas claves para el abordaje y tratamiento de la APLV. El criterio clínico y el trabajo interdisciplinario de alergólogos, gastroenterólogos, inmunólogos, microbiólogos y nutricionistas le permitirá al pediatra lograr un adecuado diagnóstico y un tratamiento oportuno. En este contexto, el empleo de bióticos (prebióticos, probióticos, sinbióticos y posbióticos) como herramientas nutricionales complementarias tiene un presente con sustento científico y un futuro promisorio para la prevención y tratamiento de estas patologías.
Assuntos
Hipersensibilidade Alimentar , Hipersensibilidade a Leite , Nascimento Prematuro , Probióticos , Animais , Bovinos , Feminino , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/terapia , Humanos , Imunomodulação , Recém-Nascido , Probióticos/uso terapêuticoRESUMO
Preterm birth, C-sections, antibiotics, and limited breastfeeding contribute to the increase in noncommunicable diseases. Our objective was to perform a descriptive review of probiotic use in pediatrics, focused on Lactobacillus rhamnosus GG. Certain probiotics have demonstrated to be effective in acute diarrhea and antibiotic-associated diarrhea. L. rhamnosus GG and Saccharomyces boulardii may shorten their duration and symptoms. L. reuteri DSM 17938 and L. rhamnosus GG were effective to manage infant colic. The use of this strain in infant formulas for cow's milk protein allergy may promote an earlier tolerance acquisition. In relation to the prevention of atopic dermatitis, the administration of L. rhamnosus GG during pregnancy reduced its development in the infant. The use of probiotics as adjuvants is a possibility to consider in current pediatric practice.
El parto prematuro, las cesáreas, los antibióticos y la lactancia materna limitada contribuyen al aumento de enfermedades crónicas no transmisibles. El objetivo fue realizar una revisión descriptiva del uso de probióticos en pediatría, con foco en la cepa Lactobacillus rhamnosus GG. Ciertos probióticos han demostrado ser eficaces en la diarrea aguda y en la diarrea asociada a antibióticos. L. rhamnosus GG y Saccharomyces boulardii pueden acortar la duración y los síntomas. L. reuteri DSM 17938 y L. rhamnosus GG fueron efectivos para el abordaje del cólico del lactante. El uso de esta cepa en fórmulas infantiles para alergia a las proteínas de leche de vaca promovería la adquisición más temprana de tolerancia. En la prevención de dermatitis atópica, la administración de L. rhamnosus GG durante el embarazo redujo su manifestación en el bebé. El empleo de probióticos como coadyuvantes es una posibilidad para considerar en la práctica pediátrica actual.
Assuntos
Lacticaseibacillus rhamnosus , Hipersensibilidade a Leite , Pediatria , Nascimento Prematuro , Probióticos , Animais , Bovinos , Criança , Feminino , Humanos , Recém-Nascido , Probióticos/uso terapêuticoRESUMO
The efficient separation of hydrogen from methane and light hydrocarbons for clean energy applications remains a technical challenge in membrane science. To address this issue, we prepared a graphene-wrapped MFI (G-MFI) molecular-sieving membrane for the ultrafast separation of hydrogen from methane at a permeability reaching 5.8 × 106 barrers at a single gas selectivity of 245 and a mixed gas selectivity of 50. Our results set an upper bound for hydrogen separation. Efficient molecular sieving comes from the subnanoscale interfacial space between graphene and zeolite crystal faces according to molecular dynamic simulations. The hierarchical pore structure of the G-MFI membrane enabled rapid permeability, indicating a promising route for the ultrafast separation of hydrogen/methane and carbon dioxide/methane in view of energy-efficient industrial gas separation.
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Isotopes of heavier gases including carbon (13C/14C), nitrogen (13N), and oxygen (18O) are highly important because they can be substituted for naturally occurring atoms without significantly perturbing the biochemical properties of the radiolabelled parent molecules. These labelled molecules are employed in clinical radiopharmaceuticals, in studies of brain disease and as imaging probes for advanced medical imaging techniques such as positron-emission tomography (PET). Established distillation-based isotope gas separation methods have a separation factor (S) below 1.05 and incur very high operating costs due to high energy consumption and long processing times, highlighting the need for new separation technologies. Here, we show a rapid and highly selective adsorption-based separation of 18O2 from 16O2 with S above 60 using nanoporous adsorbents operating near the boiling point of methane (112 K), which is accessible through cryogenic liquefied-natural-gas technology. A collective-nuclear-quantum effect difference between the ordered 18O2 and 16O2 molecular assemblies confined in subnanometer pores can explain the observed equilibrium separation and is applicable to other isotopic gases.
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In recent years, the evidence has demonstrated the relevance of the gut microbiota in an individual's health. The dynamics of an early colonization and the establishment of a community of plenty, diverse, and healthy microorganisms from a vaginal delivery and breastfeeding are critical for the development of a healthy immune matrix. The objective of this review is to describe the available evidence on microbiota development in the first year of life and the current possibilities offered by prebiotics, probiotics, symbiotics, and postbiotics during such critical stage of life.
En los últimos años, las evidencias han demostrado la importancia de la microbiota intestinal en la salud del individuo. La dinámica de la colonización temprana y el establecimiento de una comunidad abundante y diversa de microorganismos saludables, a partir de un parto vaginal y lactancia materna, resultan fundamentales en la conformación de una matriz inmunológica saludable. Esta revisión tiene como objetivo describir las evidencias disponibles sobre el desarrollo de la microbiota en el primer año de vida y el actual potencial que ofrece el uso de prebióticos, probióticos, simbióticos y posbióticos durante esta etapa esencial de la vida.
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Microbioma Gastrointestinal/fisiologia , Prebióticos/administração & dosagem , Probióticos/administração & dosagem , Aleitamento Materno , Parto Obstétrico , Feminino , Microbioma Gastrointestinal/imunologia , Humanos , Lactente , Recém-Nascido , GravidezRESUMO
OBJECTIVE: To evaluate the daily practice of pediatricians, physician-perceived reasons for unsatisfactory effects of treatment, and unmet needs in the management of acute pain and/or fever. METHODS: This was a multinational (n=13), multicenter, non interventional, cross-sectional study conducted in Latin America, Africa, and the Middle East in children under 16 years of age with fever (defined as a central body temperature ≥38°C) and/or acute pain (defined as pain lasting ≤6 weeks). Data were collected during a single visit using a structured physician-administered questionnaire and case report forms. RESULTS: A total of 2125 patients were recruited by 178 physicians between September 2010 and September 2011. From the 2117 analyzed patients, 1856 (87.7%) had fever, 705 (33.3%) had acute pain, and 446 (21.1%) had both. Of 1843 analyzed patients with fever, 1516 (82.3%) were previously prescribed a pharmacological treatment for the management of fever concomitantly with a non pharmacological approach, while 1817/1856 patients (97.9%) were currently receiving a prescribed pharmacological treatment for fever. Paracetamol/acetaminophen was the most commonly prescribed antipyretic medication during both previous (70.8%) and current (64.1%) consultations. With regard to acute pain management, 67.2% of the patients received previous and 93.9% received current treatment for pain. The most frequently prescribed analgesic during previous consultations was paracetamol/acetaminophen (53.7%), and the current most commonly prescribed analgesics were non steroidal anti-inflammatory drugs (55.2%). Treatment patterns for patients with both fever and acute pain were similar. Overall, 53.4% of the physicians reported poor treatment compliance as a reason for the unsatisfactory effect of the pain/fever treatment, and the most common unmet need was the availability of new drugs (according to 63.5% of the physicians). CONCLUSIONS: Adequate management of fever was observed; however, due to the complex etiology of pediatric pain, better evaluation and management of pain in pediatrics is necessary.
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BACKGROUND: Multiple studies have focused on the influence of obesity on natriuretic peptide levels. However, the effect of obesity on amino-terminal propeptide of B-type natriuretic peptide (NT-proBNP) levels in hypertensive (HT) patients remains uncertain. METHODS: We studied 252 asymptomatic patients (60 +/- 13 years, 136 men) with essential HT. A routine physical examination, anthropometry, laboratory analyses, echo-Doppler study, and NT-proBNP level determination were performed. RESULTS: NT-proBNP levels were similar in both obese and nonobese HT (median 56 (25-130) pg/ml vs. median 51 (26-129) pg/ml, P = 0.488). No significant differences were found in obese or nonobese patients with left ventricular hypertrophy (LVH) (median 135 (73-425) pg/ml vs. median 151 (64-274) pg/ml, P = 0.597). The area under the curve was 0.89 +/- 0.03 for NT-proBNP to diagnose LVH in the obese HT patients and 0.88 +/- 0.03 in the nonobese. A logistic regression analysis showed that age, gender, and left ventricular mass index (LVMI) were independent predictors of NT-proBNP levels. Body mass index (BMI) was not significantly associated with NT-proBNP in LVH HT patients. CONCLUSIONS: Obesity is not statistically associated with NT-proBNP levels in HT asymptomatic patients. The same results were observed in our group of patients with LVH. These data are in contrast with those previously found in heart failure, and raise questions about the role of obesity per se as primary cause of decreased NT-proBNP levels in other pathophysiological conditions.
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Hipertensão/metabolismo , Hipertrofia Ventricular Esquerda/etiologia , Peptídeo Natriurético Encefálico/sangue , Obesidade/metabolismo , Fragmentos de Peptídeos/sangue , Fatores Etários , Idoso , Biomarcadores/sangue , Feminino , Humanos , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/diagnóstico , Hipertrofia Ventricular Esquerda/metabolismo , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Valor Preditivo dos Testes , Curva ROC , Medição de Risco , Fatores de Risco , Fatores SexuaisRESUMO
Nanoscale windows in graphene (nanowindows) have the ability to switch between open and closed states, allowing them to become selective, fast, and energy-efficient membranes for molecular separations. These special pores, or nanowindows, are not electrically neutral due to passivation of the carbon edges under ambient conditions, becoming flexible atomic frameworks with functional groups along their rims. Through computer simulations of oxygen, nitrogen, and argon permeation, here we reveal the remarkable nanowindow behavior at the atomic scale: flexible nanowindows have a thousand times higher permeability than conventional membranes and at least twice their selectivity for oxygen/nitrogen separation. Also, weakly interacting functional groups open or close the nanowindow with their thermal vibrations to selectively control permeation. This selective fast permeation of oxygen, nitrogen, and argon in very restricted nanowindows suggests alternatives for future air separation membranes.
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BACKGROUND: Plasma B-type natriuretic peptide (BNP) is a useful biomarker for diagnosis and prognosis of heart failure (HF); however, urine BNP has never been calculated. We sought to compare urinary and plasma BNP levels and to investigate the potential diagnostic and prognostic value of this peptide in HF. METHODS AND RESULTS: Urine and plasma BNP levels were measured in 92 HF patients and 30 control subjects. Urinary BNP levels were higher in HF patients than in control subjects (P < .0001), correlating with plasma BNP levels (r = 0.64, P < .0001). Urine BNP was a good tool for the diagnosis of HF, the area under the curve (AUC) being 0.91 +/- 0.06 (P < .0001). Urinary BNP levels had prognostic power for cardiac events (cardiac admissions + mortality) with an odds ratio of 6.6 (P < .05). To determine the prognostic power of urinary BNP in detecting 12-month cardiac mortality, we obtained an AUC of 0.76 +/- 0.6 (P = .014). CONCLUSIONS: The data suggest that urine BNP is a new candidate marker for diagnosis and prognosis of HF mortality and cardiac events. This raises the possibility of using this relatively simple noninvasive test in primary care settings or in specific conditions where the collection of blood samples could be difficult.
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Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/urina , Peptídeo Natriurético Encefálico/urina , Idoso , Área Sob a Curva , Biomarcadores/urina , Feminino , Cardiopatias/etiologia , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Razão de Chances , PrognósticoRESUMO
Warty dyskeratoma is an uncommon entity characterized by a solitary keratotic papule or nodule usually located in the head and neck of young adults. The histopathology shows a pattern of acantholytic dyskeratosis. We report a 32-year-old man who presented pain, serous exudation, a distal onycholysis with subungual hyperkeratosis, and roundish erythronychia in the nail plate of his left first toe 2 years ago. A histopathologic diagnosis of subungual warty dyskeratoma was made. When dealing with focal acantholytic dyskeratosis several differential diagnoses should be considered including Darier's disease, transient focal acantholytic dyskeratosis or Grover disease, and Hailey-Hailey disease. We present an unusual location of warty dyskeratoma in the nail bed using a clinicohistopathological correlation for the diagnosis.
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El parto prematuro, la cesárea, el uso de antibióticos y la lactancia materna limitada son señalados como responsables en parte del aumento de enfermedades crónicas no transmisibles en niños, como las alergias, principalmente la alergia a la proteína de la leche de vaca (APLV). Quienes desarrollan enfermedades alérgicas muestran diferencias en la composición de su microbiota intestinal durante los primeros meses de vida, en comparación con los que no lo hacen. Las intervenciones tempranas para modular la microbiota intestinal y el sistema inmunológico pueden ser herramientas claves para el abordaje y tratamiento de la APLV. El criterio clínico y el trabajo interdisciplinario de alergólogos, gastroenterólogos, inmunólogos, microbiólogos y nutricionistas le permitirá al pediatra lograr un adecuado diagnóstico y un tratamiento oportuno. En este contexto, el empleo de bióticos (prebióticos, probióticos, sinbióticos y posbióticos) como herramientas nutricionales complementarias tiene un presente con sustento científico y un futuro promisorio para la prevención y tratamiento de estas patologías.
Preterm birth, C-section, antibiotic use, and limited breastfeeding are blamed in part for the increasing incidence of chronic noncommunicable diseases among children, such as allergies, mainly cow's milk protein allergy (CMPA). Those who develop allergic diseases, against those who do not, show differences in the composition of their gut microbiota during the first months of life. Early interventions to modulate the intestinal microbiota and the immune system may be the key tools for the management of CMPA. Clinical judgment and the interdisciplinary work of allergists, gastroenterologists, immunologists, microbiologists, and nutritionists will allow pediatricians to achieve an adequate diagnosis and a timely treatment. In this setting, the use of biotics (prebiotics, probiotics, synbiotics, and postbiotics) as supplementary dietary tools is scientifically supported at present and seems to be very promising for the prevention and treatment of these conditions.
Assuntos
Humanos , Animais , Recém-Nascido , Hipersensibilidade a Leite , Probióticos/uso terapêutico , Nascimento Prematuro , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/terapia , Bovinos , ImunomodulaçãoRESUMO
Annular urticarial lesions in a child must establish a main differential diagnosis with urticaria multiforme, common urticaria, acute hemorrhagic edema of infancy, erythema marginatum, erythema annulare centrifugum, annular erythema in childhood, erythema multiforme, Sweet's syndrome, Schönlein-Henoch purpura, erythematosus lupus, several systemic vasculitis, and serum sickness.
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El parto prematuro, las cesáreas, los antibióticos y la lactancia materna limitada contribuyen al aumento de enfermedades crónicas no transmisibles. El objetivo fue realizar una revisión descriptiva del uso de probióticos en pediatría, con foco en la cepa Lactobacillus rhamnosus GG. Ciertos probióticos han demostrado ser eficaces en la diarrea aguda y en la diarrea asociada a antibióticos. L. rhamnosus GG y Saccharomyces boulardii pueden acortar la duración y los síntomas. L. reuteri DSM 17938 y L. rhamnosus GG fueron efectivos para el abordaje del cólico del lactante. El uso de esta cepa en fórmulas infantiles para alergia a las proteínas de leche de vaca promovería la adquisición más temprana de tolerancia. En la prevención de dermatitis atópica, la administración de L. rhamnosus GG durante el embarazo redujo su manifestación en el bebé. El empleo de probióticos como coadyuvantes es una posibilidad para considerar en la práctica pediátrica actual.
Preterm birth, C-sections, antibiotics, and limited breastfeeding contribute to the increase in noncommunicable diseases. Our objective was to perform a descriptive review of probiotic use in pediatrics, focused on Lactobacillus rhamnosus GG. Certain probiotics have demonstrated to be effective in acute diarrhea and antibiotic-associated diarrhea. L. rhamnosus GG and Saccharomyces boulardii may shorten their duration and symptoms. L. reuteri DSM 17938 and L. rhamnosus GG were effective to manage infant colic. The use of this strain in infant formulas for cow's milk protein allergy may promote an earlier tolerance acquisition. In relation to the prevention of atopic dermatitis, the administration of L. rhamnosus GG during pregnancy reduced its development in the infant. The use of probiotics as adjuvants is a possibility to consider in current pediatric practice.