Need of nutritional assessment and monitoring in a population with acquired brain injury: an analytical cross-sectional study.

INTRODUCTION: Patients with acquired brain injury (ABI) may be at an increased risk of malnutrition due to the pathophysiology of their condition, which can affect their anthropometrical profile and therefore their quality of life. The present study analyzes the anthropometrical profile of these individuals, describes their dietary habits and nutrients intake and identifies the related risk factors influencing health status and quality of life. METHODS: Twenty-three volunteers with ABI from the province of Granada (Spain) were recruited for this cross-sectional study. Nutritional assessment was quantitatively and qualitatively performed using a 72-h dietary record and a food frequency questionnaire, respectively. Body composition parameters were evaluated by bioelectrical impedance. RESULTS: Low intakes of minerals related to bone health, extra virgin olive oil (EVOO) and fruits were reported. Moreover, women presented a poorer anthropometrical profile compared to men. With reference to age, a significant inverse correlation was observed with sarcopenic obesity, appendicular muscle mass index and Vitamin B6 intake [(r = -0.617, p < 0.01), (r = -0.475, p < 0.05) and (r = -0.498, p < 0.05), respectively]. Intake of EVOO was inversely correlated to body mass index (r = -0.767, p < 0.001). Lastly, a direct correlation was observed between the consumption of alcohol and sweets and snacks (r = 0.608, p < 0.01). CONCLUSION: The main findings support the existence of poor dietary quality and anthropometrical profile. Interdisciplinary team assessment would be beneficial to enhance the quality of life and attenuate the development of comorbidities in subjects with ABI.

Imbalanced dietary patterns, anthropometric, and body composition profiles amongst adults with Down syndrome.

Introduction: We aimed to analyze the anthropometric and body composition profiles of Down syndrome (DS) adults; to describe their dietary habits, nutrient intake, and physical activity patterns; and to identify the related risk factors which may influence their health status and quality of life.Methods: A cross-sectional study was conducted on a cohort of 23 DS adults (45% women) aged 21-44 years. Anthropometry and body composition were assessed by bioelectrical impedance. Dietary nutrient intake was assessed quantitatively using a 72-h recall. A food frequency questionnaire and the prevention with Mediterranean diet-PREDIMED questionnaire were used for qualitative rating.Results: Higher fat mass (FM) and lower lean mass (LM), bone mass (BM), and waist to hip ratio (WHR) were observed in women compared to men. LM and BM decreased, and body mass index (BMI), FM, and WHR increased with aging (all P < 0.05). Vitamin D and iodine intakes were not met by 70% and 60% of the studied participants, respectively. A total of 82% of the participants consumed less than 5 portions of fruits and vegetables per day and overconsumed food groups such as sweets and snacks and red meat (> 2 times per week). Protein intake showed a significant positive correlation with height (r = 0.489, P < 0.05), whereas fat intake was positively correlated with sweets and snacks (r = 0.521, P < 0.05).Conclusion: The present findings support the existence of poor anthropometric and body composition profiles, and diet quality, underscoring the need for an interdisciplinary team assessment to enhance health and quality of life in DS adults.

Folic acid and vitamin B12 as biomarkers of morbidity and mortality in patients with septic shock / El ácido fólico y la vitamina B12 como biomarcadores de morbilidad y mortalidad en pacientes con shock séptico

Introduction and objective: a study was made of the folic acid (Fol) and vitamin B12 (B12) serum concentrations in critical patients with septic shock upon admission and after three days of stay in the Intensive Care Unit (ICU), with an analysis of their association to inflammatory parameters and patient morbidity-mortality. Methods: a prospective analytical study was made of 30 critically ill patients with septic shock. Demographic data, comorbidities, clinical information and severity scores were recorded. Data collected included serum Fol and B12 levels using the DxI® Autoanalyzer (Beckman Coulter) based on a competitive electrochemoluminescence immunoassay. Results: mean serum Fol was within the reference range stipulated by the laboratory on the first day. Nevertheless, a total of 21.4 % of the patients had high Fol levels, with 14.2 % being Fol deficient. An association was observed between Fol (p < 0.012) status and 28-day mortality, and the number of days of mechanical ventilation, fraction of inspired oxygen (FiO2) and fibrinogen increased in patients with higher Fol levels (p < 0.05). In addition, 85.7 % of cases had B12 levels above the reference values, with a correlation being observed between B12 and Fol. Conclusions: this study proposes Fol as a novel morbidity-mortality biomarker in critical septic patients, and reinforces the usefulness of B12 as a morbidity biomarker. It is thus suggested that the measurement of Fol upon admission and over the first 72 hours of hospital stay could provide prognostic information about the clinical course and outcome of septic shock patients (AU)

Introducción y objetivo: se realizó un estudio de las concentraciones séricas de ácido fólico (Fol) y vitamina B12 (B12) en pacientes críticos con shock séptico al ingreso y después de tres días de estancia en la Unidad de Cuidados Intensivos (UCI), con un análisis de su asociación con los parámetros inflamatorios y la morbimortalidad de los pacientes. Método: se realizó un estudio analítico prospectivo de 30 pacientes críticos con shock séptico. Se registraron datos demográficos, comorbilidades, información clínica y puntuaciones de gravedad. Los datos recopilados incluyeron los niveles séricos de Fol y B12 utilizando el autoanalizador DxI® (Beckman Coulter) basado en un inmunoensayo de electroquimioluminiscencia competitivo. Resultados: la media de Fol sérico estuvo dentro del rango de referencia estipulado por el laboratorio el primer día. Sin embargo, el 21,4 % de los pacientes presentaban niveles altos de Fol y el 14,2 % presentaban deficiencia de Fol. Se observó una asociación entre el estado de Fol (p < 0,012) con la mortalidad a los 28 días, con el número de días de ventilación mecánica, con la fracción de oxígeno inspirado (FiO2) y con el fibrinógeno, que aumentaron en los pacientes con niveles de Fol más altos (p < 0,05). Además, el 85,7 % de los casos tenían niveles de B12 por encima de los valores de referencia, observándose una correlación entre B12 y Fol. Conclusiones: este estudio propone al Fol como nuevo biomarcador de morbimortalidad en los pacientes críticos con sepsis y refuerza la utilidad de la B12 como biomarcador de morbilidad. Por tanto, se sugiere que la medición de Fol al ingreso y durante las primeras 72 horas de estancia hospitalaria podría proporcionar información pronóstica sobre el curso clínico y el resultado de los pacientes con shock séptico (AU)

[We and zinc]. / Nosotros y el cinc.

Nutrition is the basis of human physiological processes. Inadequate nutrition can lead to dysfunction in the metabolic chain links. One of the most important micronutrients is zinc, as evidenced by its wide range of carriers in the body. Zinc intake has a large margin in the current world population, may be 7 mg/d in the UK, reaching 15 mg/d in the U.S., although of course, the RDA's are set according to age, sex , physiological status (pregnancy, lactation, etc..), or disease. It is known that zinc is essential for the structure and function as well as DNA and enzymes, coenzymes, hormones and so on. Life is short, zinc, since the most rapidly absorbed and is transferred to tanks where it is stored, so the amount available zinc in the blood cannot be the amount "real". In this work we have done a mini-review of the passage of zinc by the body trying since their intake to their tour of the blood in both healthy and sick people.

Deficient selenium status of a healthy adult Spanish population.

INTRODUCTION: Selenium is an essential micronutrient for human health, being a cofactor for enzymes with antioxidant activity that protect the organism from oxidative damage. An inadequate intake of this mineral has been associated with the onset and progression of chronic diseases such as hypertension, diabetes, coronary diseases, asthma, and cancer. For this reason, knowledge of the plasma and erythrocyte selenium levels of a population makes a relevant contribution to assessment of its nutritional status. OBJECTIVE: The objective of the present study was to determine the nutritional status of selenium and risk of selenium deficiency in a healthy adult population in Spain by examining food and nutrient intake and analyzing biochemical parameters related to selenium metabolism, including plasma and erythrocyte levels and selenium-dependent glutathione peroxidase (GPx) enzymatic activity. MATERIAL AND METHODS: We studied 84 healthy adults (31 males and 53 females) from the province of Granada, determining their plasma and erythrocyte selenium concentrations and the association of these levels with the enzymatic activity of glutathione peroxidase (GPx) and with life style factors. We also gathered data on their food and nutrient intake and the results of biochemical analyses. Correlations were studied among all of these variables. RESULTS: The mean plasma selenium concentration was 76.6 ± 17.3 µg/L (87.3 ± 17.4 µg/L in males, 67.3 ± 10.7 µg/L in females), whereas the mean erythrocyte selenium concentration was 104.6 µg/L (107.9 ± 26.1 µg/L in males and 101.7 ± 21.7 µg/L in females). The nutritional status of selenium was defined by the plasma concentration required to reach maximum GPx activity, establishing 90 µg/L as reference value. According to this criterion, 50% of the men and 53% of the women were selenium deficient. CONCLUSIONS: Selenium is subjected to multiple regulation mechanisms. Erythrocyte selenium is a good marker of longer term selenium status, while plasma selenium appears to be a marker of short-term nutritional status. The present findings indicate a positive correlation between plasma selenium concentration and the practice of physical activity. Bioavailability studies are required to establish appropriate reference levels of this mineral for the Spanish population.

Nosotros y el cinc / We and zinc

La Nutrición es la base de los procesos fisiológicos humanos. Una nutrición inadecuada puede inducir a la disfunción en eslabones de la cadena metabólica. Todos los nutrientes esenciales son imprescindibles y el déficit o exceso de cualquiera de ellos conlleva a efectos adversos en la salud. El cinc es un micronutriente extensamente demandado en el organismo, como lo demuestra la amplia diversidad de funciones biológicas que presenta. La ingesta de cinc presenta un gran margen en la población mundial actual, pudiendo ser de 7 mg/d en Reino Unido y llegando a 15 mg/d en EEUU, aunque por supuesto, las RDAs se fijan en función de la edad, sexo, situación fisiológica (embarazo, lactancia, etc.), o enfermedad. Se conoce que el cinc es fundamental para la estructura y funcionamiento del DNA y así como de enzimas, coenzimas, hormonas, etc. La vida del cinc es corta, dado que la mayor cantidad se absorbe y rápidamente es transferida a depósitos, donde se almacena, por lo tanto la cantidad se cinc disponible en sangre puede no ser la cantidad "real". En el presente trabajo hemos realizado una breve revisión del paso del cinc por nuestro organismo, tratando desde su ingesta hasta su recorrido por la sangre tanto en personas sanas como enfermas (AU)

Nutrition is the basis of human physiological processes. Inadequate nutrition can lead to dysfunction in the metabolic chain links. One of the most important micronutrients is zinc, as evidenced by its wide range of carriers in the body. Zinc intake has a large margin in the current world population, may be 7 mg/d in the UK, reaching 15 mg/d in the U.S., although of course, the RDA's are set according to age, sex , physiological status (pregnancy, lactation, etc..), or disease. It is known that zinc is essential for the structure and function as well as DNA and enzymes, coenzymes, hormones and so on. Life is short, zinc, since the most rapidly absorbed and is transferred to tanks where it is stored, so the amount available zinc in the blood cannot be the amount "real". In this work we have done a mini-review of the passage of zinc by the body trying since their intake to their tour of the blood in both healthy and sick people (AU)

Deficient selenium status of a healthy adult Spanish population / Deficiencia de selenio en una población adulta sana española

Introduction: Selenium is an essential micronutrient for human health, being a cofactor for enzymes with antioxidant activity that protect the organism from oxidative damage. An inadequate intake of this mineral has been associated with the onset and progression of chronic diseases such as hypertension, diabetes, coronary diseases, asthma, and cancer. For this reason, knowledge of the plasma and erythrocyte selenium levels of a population makes a relevant contribution to assessment of its nutritional status. Objetive: The objective of the present study was to determine the nutritional status of selenium and risk of selenium deficiency in a healthy adult population in Spain by examining food and nutrient intake and analyzing biochemical parameters related to selenium metabolism, including plasma and erythrocyte levels and selenium-dependent glutathione peroxidase (GPx) enzymatic activity. Material and methods: We studied 84 healthy adults (31 males and 53 females) from the province of Granada, determining their plasma and erythrocyte selenium concentrations and the association of these levels with the enzymatic activity of glutathione peroxidase (GPx) and with life style factors. We also gathered data on their food and nutrient intake and the results of biochemical analyses. Correlations were studied among all of these variables. Results: The mean plasma selenium concentration was 76.6 ± 17.3 μg/L (87.3 ± 17.4 μg/L in males, 67.3 ± 10.7 μg/L in females), whereas the mean erythrocyte selenium concentration was 104.6 μg/L (107.9 ± 26.1 μg/L in males and 101.7 ± 21.7 μg/L in females). The nutritional status of selenium was defined by the plasma concentration required to reach maximum GPx activity, establishing 90 μg/L as reference value. According to this criterion, 50% of the men and 53% of the women were selenium deficient. Conclusions: Selenium is subjected to multiple regulation mechanisms. Erythrocyte selenium is a good marker of longer term selenium status, while plasma selenium appears to be a marker of short-term nutritional status. The present findings indicate a positive correlation between plasma selenium concentration and the practice of physical activity. Bioavailability studies are required to establish appropriate reference levels of this mineral for the Spanish population (AU)

Introducción: El selenio es un micronutriente esencial para la salud del ser humano, debido fundamentalmente a su implicación como cofactor de enzimas con actividad antioxidante que protegen al organismo del daño oxidativo, de modo que una ingesta inadecuada de este mineral está asociada con la aparición y desarrollo de enfermedades crónicas tales como hipertensión, diabetes, enfermedades coronarias, asma y cáncer. Por esta razón, la determinación de selenio plasmático y eritrocitario contribuirá a la valoración del estado nutricional de la población estudiada. Objetivo: El objetivo de estudio fue valorar el estado nutricional de selenio en una población adulta sana en riesgo de deficiencia, a través de una evaluación de la ingesta, así como de los niveles de selenio en plasma y eritrocito, y la actividad de la enzima selenio-dependiente Glutation Peroxidasa (GPx) en eritrocito. Material y métodos: El estudio se realizó en un grupo de población de 84 adultos sanos pertenecientes a la provincia de Granada (31 hombres y 53 mujeres) en los que se determinó la ingesta de nutrientes y selenio, sus niveles plasmáticos y eritrocitarios, así como su asociación con la actividad de la enzima Glutation Peroxidasa y con diversos factores del estilo de vida. Resultados: Las concentraciones medias de selenio en plasma fueron de 76,6 ± 17,3 μg/L (87,3 ± 17,4 μg/L en los hombres, y de 67,3 ± 10,7 μg/L para las mujeres), mientras que los valores eritrocitarios de selenio de la poblacion total del estudio fue de 104,6 μg/L (107,9 ± 26,1 μg/L en hombres y 101,7 ± 21,7 μg/L en mujeres). La evaluacion del estado nutricional de selenio, se realizo en funcion de la concentracion en plasma necesaria para alcanzar la maxima actividad de GPx, estableciendo como valor de referencia 90 μg/L, observamos que el 50% de los hombres y el 53% de las mujeres se encuentran en situacion de deficiencia. Conclusiones: El selenio es un mineral sujeto a múltiples mecanismos de regulación. El selenio eritrocitario es un buen indicador del estatus mineral de selenio a largo plazo, mientras que el selenio plasmático es un indicador de estatus nutricional de selenio a corto plazo. Los resultados obtenidos mostraron una correlación positiva entre los niveles de selenio en plasma y la realización de actividad física. Es necesario disponer de más estudios de biodisponibilidad de selenio con el fin de poder establecer niveles de referencia de este mineral para la población española (AU)

An artificial enhancer with multiple response elements stimulates prokaryotic transcriptional activation medicated by various regulatory proteins.

Regulation of transcription by the form of RNA polymerase that contains sigma(N) involves activation at a distance by activators bound to sites located far upstream of the transcription start site, which contact RNA polymerase bound to the promoter via formation of a DNA loop. At the g/nAp2 promoter, binding sites for the activator NtrC show features characteristic of eukaryotic enhancers. A multiple response element containing binding sites for five sigma(N)-dependent activators from different systems has been cloned in different positions relative to the glnAp2 promoter. These promoter regions indeed allowed activation in vivo by each regulator, thus showing that transcription from an eubacterial promoter may be controlled in a very versatile way by different signals. The activation capability of each activator has been assessed in relation to its concentration, and the presence and relative positions of the corresponding binding sites in the DNA. Results show that most activators can function from any position. However, activation mediated by DctD-L64 was very sensitive to changes in the position of its binding sites. Transcriptional activation by combinations of two regulators was also tested and no significant synergism or interference was detected. Mapping of the 5' ends of the transcripts showed that neither the activator nor the position from which they activate influences selection of the transcription start site.

Binding of diarrheagenic Escherichia coli to 32- to 33-kilodalton human intestinal brush border proteins.

We have detected human intestinal brush border proteins to which Escherichia coli strains adhere by means of a blotting-nitrocellulose method in which the binding of radiolabeled bacteria to sodium dodecyl sulfate-polyacrylamide gel electrophoresis-separated intestinal cell membranes was evaluated. The brush border fraction contained several polypeptides that bound only adherent E. coli strains. The most prominent and consistent of these proteins had apparent molecular masses of 32 to 33 kDa. Additional polypeptides ranging from 50 to 70, from 105 to 130, and from 180 to 200 kDa were also recognized by adherent E. coli strains, although with less intensity (in accordance with the number of bound bacteria to these polypeptides). Independently of the pattern of adherence (localized [LA], diffuse [DA], or aggregative [AggA]) all HEp-2-adhering strains recognized, with different intensities, the 32- to 33-kDa brush border proteins, whereas nonadhesive strains did not. The relative avidity of an LA strain to bind to the 32- to 33-kDa proteins was approximately seven- and sixfold higher than the binding of strains with aggregative and diffuse adherence, respectively. Thus, it is reasonable to think that LA, DA, and AggA strains have a common adhesin that mediates binding to the 32- to 33-kDa bands. Inhibition experiments using HEp-2 cells demonstrated that isolated 32- to 33-kDa proteins or specific antiserum blocked preferentially bacterial adherence of the LA pattern. Delipidization and protein digestion of the human brush borders confirmed that E. coli bound to structures of a proteinaceous nature. Deglycosylation studies and sodium meta-periodate oxidation of the intestinal cell membranes decreased bacterial binding activity significantly, indicating that E. coli bound to carbohydrate moieties in the glycoproteins. These results suggest that binding of E. coli strains, mainly of the LA phenotype, to the 32- to 33-kDa proteins could play a role in colonization through adherence to the intestinal mucosa.

Mechanism of coordinated synthesis of the antagonistic regulatory proteins NifL and NifA of Klebsiella pneumoniae.

The nifLA operon of Klebsiella pneumoniae codes for the two antagonistic regulatory proteins which control expression of all other nitrogen fixation genes. NifA is a transcriptional activator, and NifL inhibits NifA. The importance of a correct NifL-NifA stoichiometry for efficient regulation of nitrogen fixation genes has been investigated by constructing a strain with an altered nifL-nifA gene dosage ratio, resulting from the integration of an extra copy of nifA. Results showed that a balanced synthesis of both gene products is essential for correct regulation. Effects of mutations provoking translation termination of nifL upstream or downstream of its natural stop codon, combined with overproduction of both proteins when the genes are transcribed and translated from signals of the phi10 gene of the phage T7, showed that, in addition to the previously reported transcriptional polarity, there is translational coupling between nifL and nifA. In spite of the apparently efficient ribosome binding site of nifA, its rate of independent translation is very low. This is due to a secondary structure masking the Shine-Dalgarno sequence of nifA, which could be melted by ribosomes translating nifL. Mutational analysis confirmed the functional significance of the secondary structure in preventing independent translation of nifA. Translational coupling between the two cistrons is proposed as an efficient mechanism to prevent production of an excess of NifA, which would affect the normal regulation of nitrogen fixation genes.

Geometry of the process of transcription activation at the sigma 54-dependent nifH promoter of Klebsiella pneumoniae.

The Klebsiella pneumoniae nifH promoter is very strictly controlled by nitrogen availability and highly dependent on sigma 54 and integration host factor (IHF) for expression. This promoter region has been used to examine the role of IHF in the activation of transcription from sigma 54-dependent promoters and to analyze the positional restrictions which may exist for an activation mechanism from distant sites such as this one. By functionally replacing the binding site of IHF by sequence-directed curved DNA fragments, it has been shown that the role of IHF in stimulating transcription is structural; it brings the molecules directly involved in the process into close proximity. Unlike other promoter regions with an activation mechanism at a distance, this IHF-dependent promoter requires a precise geometry for efficient transcription. In this sense, it resembles an activation mechanism from near sites. However, alternative functional structures which are very different from the native one can be isolated.

Fentiazac in osteoarthritis: comparison of BID and QID regimens.

This study compares two regimens (twice-a-day and four-times-a-day) of fentiazac for osteoarthritis. The total daily dose for both groups was 400 mg, and the drugs were administered for two months with follow-up evaluations after one, four, and eight weeks of treatment. Thirty patients were studied to evaluate the effect on pain, the functional importance, and the tolerability of fentiazac. Both dosage regimens were equally efficacious, and no advantage except convenience was found for one dosage schedule over the other.