RESUMEN
Soymilk is rich in phytochemicals such as soy isoflavones (SIs) and soyasaponins (SSs). Dietary SIs and SSs display inhibitory effects on contact hypersensitivity (CHS), which was reported in a mouse model for allergic contact dermatitis (ACD); however, the beneficial effects of soymilk consumption on CHS remain unknown. Here, we studied the effects of drinking soymilk on CHS and gut microbiota. Soymilk consumption attenuated ear oedema and swelling, decreased the infiltration of Gr-1-positive cells into ear tissues, and reduced the production of chemokine (C-X-C motif) ligand 2 and triggering receptor expressed on myeloid cells-1 in ear tissues. The analysis of bacterial 16S ribosomal RNA gene sequences indicated that CHS caused changes in the gut microbiota structure and that consuming soymilk reduced these changes. These results suggest that soymilk consumption may be of therapeutic value for patients with ACD and may help control the balance of intestinal microbiota.
Asunto(s)
Dermatitis por Contacto/dietoterapia , Dermatitis por Contacto/microbiología , Dinitrofluorobenceno/efectos adversos , Microbioma Gastrointestinal/efectos de los fármacos , Fitoquímicos/farmacología , Leche de Soja/química , Animales , Bacterias/clasificación , Bacterias/genética , Bacterias/aislamiento & purificación , Quimiocina CXCL2/metabolismo , Citocinas/metabolismo , Dieta , Modelos Animales de Enfermedad , Oído/patología , Edema/dietoterapia , Femenino , Microbioma Gastrointestinal/genética , Humanos , Isoflavonas/farmacología , Ratones , Ratones Endogámicos BALB C , ARN Ribosómico 16S/genética , Saponinas/farmacología , Receptor Activador Expresado en Células Mieloides 1/metabolismoRESUMEN
AIM: This literature review analyzed ten articles investigating the effects of low dietary sodium intake on neurohormonal and fluid overload on heart failure (HF). BACKGROUND: Recommendations for low dietary sodium to HF patients has been debated in the past one to two decades. METHODS: This report presents a literature review of interventional studies from 2006 to 2015 investigating adult HF patients. RESULTS: The results of the neurohormonal outcome variables seem to be the primary consideration for recommending a low sodium diet to patients with HF. Most of articles in this review reported that 2.6-3â¯g/day of dietary sodium is effective for decreased BNP, renin, and aldosterone (neurohormonal) plasma levels in patients with HF. CONCLUSIONS: We have to provide the reason, effect, and amount of dietary sodium when providing dietary sodium recommendations to patients.
Asunto(s)
Dieta Hiposódica , Edema/inducido químicamente , Edema/dietoterapia , Insuficiencia Cardíaca/dietoterapia , Insuficiencia Cardíaca/fisiopatología , Neurotransmisores/efectos adversos , Sodio en la Dieta/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Severe acute malnutrition is defined as a weight for height z-score < - 3 standard deviation. Since 2000, joint efforts of the World Health Organization and United Nations Children's Fund allowed to standardize the management of acute malnutrition by improving outcome and preventing complications with the introduction of therapeutic milk and ready-to-use therapeutic foods. However, in the Democratic Republic of Congo, many health facilities face therapeutic milk shortage while managing severe acute malnutrition. At the University Clinics of Graben, cow milk with porridge made of maize, soybean, vegetal oil and sugar is used during stockouts periods. This study was carried out to analyse the efficiency and safety of this treatment compared to the conventional one in SAM patients. METHODS: This study is based on the experience of the University Clinics of Graben in eastern Democratic Republic of Congo whose nutritional centre is often confronted with stockouts in nutritional supplements. During a three months shortage in 2015, patients received cow milk alternating with preparations made from sugar-maize-soybean- vegetal oil. The study compared the evolution of these children with those who had previously been treated with the WHO conventional preparations by analysing weight changes, oedema resolution, gastrointestinal tolerability and clinical outcome over 21 days. Data were analysed with SPSS 20. We used the ANOVA, Chi-square test, odd ratio and p-value to compare the differences. RESULTS: Seventy-nine patients had received cow milk while fifty-seven were submitted to classical therapeutic milk. There was no significant difference between the two groups regardless the type of malnutrition in terms of weight changes, oedema resolution, gastrointestinal tolerability and clinical outcome over 21 days. CONCLUSION: Cow milk alternately with sugar-maize-soybean- vegetal oil preparations is an acceptable alternative in case of stockouts in conventional therapeutic milk in these settings.
Asunto(s)
Alimentos Fortificados , Leche , Desnutrición Aguda Severa/dietoterapia , Animales , Preescolar , Congo , Países en Desarrollo , Edema/dietoterapia , Edema/etiología , Femenino , Alimentos Fortificados/efectos adversos , Alimentos Fortificados/provisión & distribución , Enfermedades Gastrointestinales/etiología , Humanos , Lactante , Recién Nacido , Kwashiorkor/dietoterapia , Masculino , Leche/efectos adversos , Estudios Retrospectivos , Aumento de Peso , Pérdida de PesoRESUMEN
BACKGROUND: The cost of current standard ready-to-use therapeutic food (RUTF) is among the major obstacles to scaling up community-based management of acute malnutrition (CMAM), an important child survival strategy. Identifying a cheaper alternative is a global public health priority. OBJECTIVE: We sought to compare the efficacy of soya-maize-sorghum RUTF (SMS-RUTF) with that of standard peanut paste-based RUTF (P-RUTF). DESIGN: We used a nonblinded, parallel-group, simple randomized controlled trial along with a day care approach that enrolled 2 groups of children aged 6-23 and 24-59 mo, respectively, with severe acute malnutrition (SAM). RESULTS: Intention-to-treat (ITT) and per-protocol (PP) analyses showed noninferiority of SMS-RUTF compared with P-RUTF for the recovery rate [ITT: Δ = -2.0% (95% CI: -7.6%, 3.6%); PP: -1.9% (95% CI: -5.3%, 1.4%)], weight gain [Δ = -0.7 g · kg(-1)· d(-1)(95% CI: -1.3, 0.0 g · kg(-1)· d(-1))], and length of stay [Δ = 2.0 d (95% CI: -1.7, 5.8 d)] in children ≥24 mo of age. In children ≤23 mo of age, the recovery rate of SMS-RUTF was inferior to that of P-RUTF [ITT: Δ = -20.8% (95% CI: -29.9%, -11.7%); PP: -17.2% (95% CI: -25.6%, -8.7%)]. Treatment with SMS-RUTF resulted in a greater increase in hemoglobin [0.670 g/dL (95% CI: 0.420, 0.921 g/dL);P< 0.001]. Treatment with both RUTFs resulted in the replenishment of all of the amino acids tested except for methionine. There were no differences at discharge between RUTF groups in fat mass [Δ = 0.3 kg (95% CI: -0.6, 1.6 kg);P= 0.341] or fat mass index [Δ = 0.4 kg/m(2)(95% CI: -0.3, 1.1 kg/m(2));P= 0.262]. By contrast, comparisons of fat-free mass indicated lower concentrations than the community controls after treatment with either of the 2 RUTFs [Δ = -1.3 kg (95% CI: -2.4, -0.1 kg) andP= 0.034 for comparison between community controls and the SMS-RUTF group; Δ = -1.8 kg (95% CI: -2.9, -0.6 kg) andP= 0.003 for comparison between community controls and the P-RUTF group]. CONCLUSION: SMS-RUTF can be used to treat SAM in children aged ≥24 mo to reduce the costs of CMAM programs. More research is required to optimize SMS-RUTF for younger children. This trial was registered in the Pan African Clinical Trial Registry as PACTR201303000475166.
Asunto(s)
Arachis , Grano Comestible/química , Sustitutos de la Leche/química , Desnutrición Aguda Severa/dietoterapia , Aminoácidos/análisis , Composición Corporal , Preescolar , Edema/dietoterapia , Impedancia Eléctrica , Ingestión de Energía , Comida Rápida , Femenino , Estudios de Seguimiento , Manipulación de Alimentos , Humanos , Lactante , Tiempo de Internación , Masculino , Factores Socioeconómicos , Sorghum , Glycine max , Resultado del Tratamiento , Aumento de Peso , Zea maysRESUMEN
Murine contact hypersensitivity (CHS) is one of the most frequently used animal models of human allergic contact dermatitis. We investigated the inhibitory effects of soybean and soy isoflavone (SI) diets on 2,4-dinitrofluorobenzene- (DNFB) induced CHS in mice. The DNFB-induced ear swelling was inhibited in the soy- and SI-treated groups. Histopathological investigations revealed that oral feeding of soybean and SI attenuated ear tissue edema and reduced the number of Gr-1(+) cell infiltrations into ear tissues. DNA microarray analysis showed that the expression of Ccl24, Xcl1, Ifng, and Ccl17 in the ear tissues was lower in the soy-treated mice than in the positive controls. In addition, CCL24 mRNA and protein expression in the ear tissues were more highly suppressed in the soy- and SI-treated groups. These results suggest that soybean and SI consumption downregulated the gene and protein expression of CCL24, thereby affording protection against CHS in mice.
Asunto(s)
Antialérgicos/administración & dosificación , Dermatitis Alérgica por Contacto/dietoterapia , Edema/dietoterapia , Glycine max/química , Isoflavonas/administración & dosificación , Administración Oral , Animales , Antialérgicos/aislamiento & purificación , Quimiocina CCL17/genética , Quimiocina CCL17/inmunología , Quimiocina CCL24/genética , Quimiocina CCL24/inmunología , Quimiocinas C/genética , Quimiocinas C/inmunología , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/inmunología , Dermatitis Alérgica por Contacto/patología , Dieta , Dinitrofluorobenceno/toxicidad , Modelos Animales de Enfermedad , Oído/irrigación sanguínea , Oído/patología , Edema/inducido químicamente , Edema/inmunología , Edema/patología , Femenino , Perfilación de la Expresión Génica , Regulación de la Expresión Génica , Humanos , Interferón gamma/genética , Interferón gamma/inmunología , Isoflavonas/aislamiento & purificación , Ratones , Ratones Endogámicos BALB C , Análisis de Secuencia por Matrices de Oligonucleótidos , Receptores de Quimiocina/genética , Receptores de Quimiocina/inmunología , Transducción de SeñalRESUMEN
AIMS: European and American guidelines have recommended salt and fluid restriction for patients with chronic heart failure (CHF) despite scarce scientific evidence. Therefore, we investigated the effects of salt and fluid restriction in patients with CHF. METHODS AND RESULTS: Ninety-seven stable patients in NYHA class II-IV, on optimal medication, with previous signs of fluid retention, treated with either >40 mg (NYHA III-IV) or >80 mg (NYHA II-IV) of furosemide daily were randomized to either individualized salt and fluid restriction or information given by the nurse-led heart failure clinics, e.g. be aware not to drink too much and use salt with caution, and followed for 12 weeks. Fluid was restricted to 1.5 L and salt to 5 g daily, and individualized dietary advice and support was given. The 24 h dietary recall procedure, urine collection on three consecutive days, and para-aminobenzoic acid 80 mg t.i.d. was used to assess adherence to diet and completeness of urine collection. The primary endpoint was a composite variable consisting of NYHA class, hospitalization, weight, peripheral oedema, quality of life (QoL), thirst, and diuretics. Results After 12 weeks, significantly more patients in the intervention than in the control group improved on the composite endpoint (51% vs. 16%; P < 0.001), mostly owing to improved NYHA class and leg oedema. No negative effects were seen on thirst, appetite, or QoL. CONCLUSION: Individualized salt and fluid restriction can improve signs and symptoms of CHF with no negative effects on thirst, appetite, or QoL in patients with moderate to severe CHF and previous signs of fluid retention.
Asunto(s)
Dieta Hiposódica , Ingestión de Líquidos , Edema/dietoterapia , Insuficiencia Cardíaca/dietoterapia , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Edema/etiología , Femenino , Insuficiencia Cardíaca/complicaciones , Humanos , Pierna , Masculino , Calidad de Vida , Método Simple Ciego , Resultado del TratamientoRESUMEN
Gallic acid esters or gallates are antioxidants used as preservatives in food and cosmetics. Few cases of gallates causing allergic contact dermatitis (ACD) have been reported in the literature. We present a case report of a 42-year-old beauty therapist who presented with a swollen tongue. Patch testing was positive to dodecyl gallate, commonly reported as being present in edible oil and oily foods such as margarine. Our patient avoided foods presumed to contain gallates and at the 6-week review reported a substantial improvement in her tongue symptoms. We reviewed our database and found 16 (7%) definitely or possibly relevant reactions to dodecyl gallate, seven (15%) definitely or possibly relevant reactions to propyl gallate and six (3%) definitely or possibly relevant reactions to octyl gallate. Most reactions were attributed to margarine, moisturising cream and lipstick. These products are often mentioned in the literature as containing gallates; however, ingredient labelling and discussions with manufacturers made it difficult to establish whether they are currently present in foods. Ascertaining relevance for these reactions is not always possible.
Asunto(s)
Dermatitis Alérgica por Contacto/diagnóstico , Dermatosis Facial/inducido químicamente , Conservantes de Alimentos/efectos adversos , Ácido Gálico/análogos & derivados , Estomatitis/inducido químicamente , Adulto , Anciano , Anciano de 80 o más Años , Dermatitis Alérgica por Contacto/tratamiento farmacológico , Edema/inducido químicamente , Edema/dietoterapia , Dermatosis Facial/tratamiento farmacológico , Femenino , Ácido Gálico/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Pruebas del Parche , Galato de Propilo/efectos adversos , Estomatitis/tratamiento farmacológico , Enfermedades de la Lengua/inducido químicamente , Enfermedades de la Lengua/dietoterapiaRESUMEN
Oedema is a common clinical manifestation of nephrotic syndrome. However, the pathophysiological mechanism of sodium retention in nephrotic syndrome has been intensely debated for decades. Several clinical and experimental observations argue against the classic or "underfill" hypothesis of oedema formation in nephrotic syndrome. In many patients, oedema formation in nephrotic syndrome is due to the kidney being intrinsically unable to excrete salt and is unrelated to systemic factors (i.e. hypoalbuminaemia, decreased “effective” arterial blood volume, and secondary hyperaldosteronism). The cortical collecting duct is the nephron site of sodium retention in nephrotic syndrome. Activation of the epithelial sodium channel in the cortical collecting duct is responsible for sodium retention in nephrotic syndrome. In nephrotic syndrome, a defective glomerular filtration barrier allows the passage of proteolytic enzymes or their precursors, which have the ability to activate the epithelial sodium channel, thereby causing the the subsequent sodium retention and oedema.
Asunto(s)
Edema/fisiopatología , Canales Epiteliales de Sodio/metabolismo , Glomérulos Renales/fisiopatología , Túbulos Renales Colectores/metabolismo , Síndrome Nefrótico/complicaciones , Sodio/metabolismo , Amilorida/farmacología , Amilorida/uso terapéutico , Animales , Dieta Hiposódica , Modelos Animales de Enfermedad , Perros , Edema/dietoterapia , Edema/tratamiento farmacológico , Edema/etiología , Bloqueadores del Canal de Sodio Epitelial , Humanos , Hipoalbuminemia/fisiopatología , Natriuresis/efectos de los fármacos , Síndrome Nefrótico/metabolismo , Proteinuria/etiología , Proteinuria/fisiopatología , Ratas , Ratas Mutantes , Serina Proteasas/fisiología , Serina Proteasas/orina , Intercambiador 3 de Sodio-Hidrógeno , Intercambiadores de Sodio-Hidrógeno/metabolismo , ATPasa Intercambiadora de Sodio-Potasio/metabolismoRESUMEN
The goji berry, Lycium barbarum, has long been recognised in traditional Chinese medicine for various therapeutic properties based on its antioxidant and immune-modulating effects. This study describes the potential for orally consumed goji berry juice to alter the photodamage induced in the skin of mice by acute solar simulated UV (SSUV) irradiation. In Skh:hr-1 hairless mice, 5% goji berry juice significantly reduced the inflammatory oedema of the sunburn reaction. Dilutions of goji berry juice between 1% and 10% dose-dependently protected against SSUV-induced immunosuppression, and against suppression induced by the mediator, cis-urocanic acid, measured by the contact hypersensitivity reaction. The immune protection could not be ascribed to either the minor excipients in the goji juice, pear and apple juice, nor the vitamin C content, nor the preservative, and appeared to be a property of the goji berry itself. Antioxidant activity in the skin was demonstrated by the significant protection by 5% goji juice against lipid peroxidation induced by UVA radiation. Furthermore, two known inducible endogenous skin antioxidants, haem oxygenase-1 and metallothionein, were found to be involved in the photoimmune protection. The results suggest that consumption of this juice could provide additional photoprotection for susceptible humans.
Asunto(s)
Antioxidantes/farmacología , Bebidas , Ingestión de Líquidos , Lycium/química , Traumatismos Experimentales por Radiación/prevención & control , Enfermedades de la Piel/prevención & control , Rayos Ultravioleta/efectos adversos , Animales , Antioxidantes/uso terapéutico , Edema/complicaciones , Edema/dietoterapia , Edema/inmunología , Femenino , Hemo-Oxigenasa 1/metabolismo , Hipersensibilidad/inmunología , Terapia de Inmunosupresión , Inflamación/complicaciones , Inflamación/dietoterapia , Inflamación/inmunología , Peroxidación de Lípido/efectos de los fármacos , Peroxidación de Lípido/efectos de la radiación , Metalotioneína/metabolismo , Ratones , Ratones Pelados , Ácidos Oléicos/inmunología , Estrés Oxidativo/efectos de los fármacos , Estrés Oxidativo/efectos de la radiación , Traumatismos Experimentales por Radiación/inmunología , Traumatismos Experimentales por Radiación/metabolismo , Enfermedades de la Piel/etiología , Enfermedades de la Piel/inmunología , Enfermedades de la Piel/metabolismo , Quemadura Solar/complicaciones , Quemadura Solar/dietoterapia , Quemadura Solar/inmunologíaRESUMEN
A 28-year-old male who underwent uneventful radial keratotomy for myopic correction 8 years earlier presented with sudden decrease in vision in the right eye. Slitlamp examination revealed 16 healed radial corneal scars in both eyes along with marked corneal edema and conjunctival congestion in the right eye. The Scheimpflug cross-sectional image of the right cornea displayed an intrastromal aqueous cleft in communication with the anterior chamber, consistent with the diagnosis of acute hydrops. The topographic and pachymetric analysis of the left eye revealed increased paracentral elevation of the anterior and posterior corneal surfaces along with inferotemporal thinning, consistent with the presence of keratectasia in the fellow eye. The hydrops resolved with subsequent corneal scarring 2 weeks after medical therapy with topical steroids, hypertonic saline, cycloplegics, and lubricants. This case emphasizes the importance of a comprehensive preoperative topographic assessment to rule out subclinical keratoconus to minimize complications such as keratectasia and hydrops.
Asunto(s)
Cicatriz/complicaciones , Cicatriz/etiología , Enfermedades de la Córnea/complicaciones , Enfermedades de la Córnea/etiología , Edema/etiología , Queratotomía Radial/efectos adversos , Enfermedad Aguda , Administración Tópica , Corticoesteroides/administración & dosificación , Adulto , Cicatriz/patología , Enfermedades de la Córnea/patología , Topografía de la Córnea , Edema/dietoterapia , Humanos , Lubricantes/administración & dosificación , Masculino , Registros Médicos , Midriáticos/administración & dosificación , Miopía/cirugía , Solución Salina Hipertónica/administración & dosificación , Factores de TiempoRESUMEN
OBJECTIVES: The goal of this study was to evaluate the effect of sesame oil on functional damage induced by adjuvant arthritis (AA) and on changes of selected biochemical parameters reflecting oxidative tissue injury. DESIGN: Mycobacterium butyricum in incomplete Freund's adjuvans was intradermally administered to Lewis male rats. Hind paw edema and endothelium-dependent relaxation of the aorta were determined on day 28. Further, plasmatic levels of TBARS, gamma-glutamyltransferase (GGT) activity in the joint and spleen tissues, level of protein carbonyls and total antioxidant capacity (TAC) in plasma, as well as activity of the lysosomal enzyme N-acetyl-glucosaminidase (NAGA) in serum were assessed. The effect of sesame oil (SO, 1ml/kg, daily oral administration) was evaluated on day 28. RESULTS: The beneficial effect of sesame oil on markers of oxidative stress accompanying AA was demonstrated by decrease of plasma TBARS and decrease of GGT activity in the joint and spleen tissues. Level of protein carbonyls, TAC in plasma and activity of NAGA in serum and in the kidney were improved, yet not significantly. In the hind paw edema the maximal increase was found on day 28 of AA, and in the same time we observed a significant decrease of aortic endothelium-dependent relaxation. Administration of SO resulted in mild, non-significant decrease of hind paw swelling and in significantly increased acetylcholine-evoked relaxation. CONCLUSION: We conclude that SO has beneficial effects on oxidative stress induced biochemical changes occurring in AA, moreover it improves endothelium-dependent relaxation of the aorta and tends to decrease hind paw edema.
Asunto(s)
Artritis Experimental/dietoterapia , Factores Inmunológicos/uso terapéutico , Aceite de Sésamo/uso terapéutico , Administración Oral , Animales , Antioxidantes/metabolismo , Aorta/fisiopatología , Artritis Experimental/inducido químicamente , Artritis Experimental/fisiopatología , Edema/inducido químicamente , Edema/dietoterapia , Edema/fisiopatología , Adyuvante de Freund , Hexosaminidasas/metabolismo , Factores Inmunológicos/administración & dosificación , Masculino , Mycobacterium , Estrés Oxidativo/fisiología , Carbonilación Proteica/fisiología , Ratas , Ratas Endogámicas Lew , Aceite de Sésamo/administración & dosificación , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo , Factores de Tiempo , gamma-Glutamiltransferasa/metabolismoAsunto(s)
Endoscopía Capsular/métodos , Linfangiectasia Intestinal/diagnóstico , Niño , Preescolar , Diagnóstico Diferencial , Proteínas en la Dieta/administración & dosificación , Proteínas en la Dieta/uso terapéutico , Edema/dietoterapia , Edema/etiología , Humanos , Lactante , Linfangiectasia Intestinal/complicaciones , Linfangiectasia Intestinal/dietoterapia , Linfangiectasia Intestinal/patología , Masculino , Triglicéridos/administración & dosificación , Triglicéridos/uso terapéuticoRESUMEN
El síndrome nefrótico idiopático (SNI) es responsable de más del 80% de los síndromes nefróticos en la infancia y de un 20-25% en los adultos. Aun cuando puede presentarse a cualquier edad es una enfermedad típicamente pediátrica cuya mayor frecuencia de aparición se sitúa entre los 2-6 años y con mayor incidencia en el genero masculino. Dentro del síndrome nefrótico infantil debemos considerar de forma diferencial el que aparece en el primer año de vida. Igualmente, en el momento actual, los conocimientos genéticos identifican otras formas (que excluiríamos de la denominación SNI) las formas genéticas, ligadas a daños estructurales de los podocitos. En pediatría se define síndrome nefrótico una proteinuria superior a 40 mg/m2/hora con albúmina plasmática inferior a 2,5 g/dl. La histología subyacente en el SNI es mayoritariamente las lesiones mínimas, 76,6% en el Estudio Internacional de Enfermedades Renales en el niño (ISKDC). Otras variantes histológicas menos frecuentes, son la glomerulonefritis segmentaria y focal y la glomerulonefritis mesangial difusa, sin depósitos o con depósitos focales o difusos de IgM, no reconocida universalmente como entidad diferenciada por ser considerada por algunas escuelas como una variante de las lesiones mínimas. En niños, el SNI se caracteriza por su buena respuesta al tratamiento, alta tendencia a las recidivas y buen pronóstico final sin deterioro de la función renal. Siendo el curso de la enfermedad habitualmente prolongado, con mayor o menor número de recaídas, la elección del esquema terapéutico con corticoides y/o inmunosupresores deben plantearse con unos objetivos básicos: 1) Inducción lo más rápidamente posible de la remisión. 2) Prevención de las recaídas y 3) Evitar la iatrogenia farmacológica inducida por la inmunosupresión. Los corticoides siguen siendo el tratamiento de elección sin que se haya esclarecido su mecanismo de acción. Los protocolos empleados son múltiples y los únicos con alta evidencia son: la respuesta a los corticoides y la respuesta a la ciclofosfamida o clorambucil para modificar la corticodependencia en los casos que evolucionan de esta forma. El tratamiento inicial del SNI será: Prednisona 60 mg/m2/día 4-6 semanas, seguido de prednisona 40 mg/m2/48 h durante 4-6 semanas con supresión progresiva en 6 semanas (tabla I). El tratamiento de la recaída: 60 mg/m2/día hasta la desaparición de la proteinuria (Albustix negativo o indicios) durante 5 días consecutivos, seguido de prednisona 40 mg/m2/48 h durante 4-6 semanas y supresión en 6 semanas (tabla II). El tratamiento del SNI corticodependiente o corticorresistente (definición en texto) se recoge en las figuras 1 y 2. 33 Ante la falta de niveles altos de evidencia en el tratamiento de estas formas evolutivas, el esquema propuesto es solo recomendado, pudiendo ser aceptables otras alternativas terapéuticas. Junto al tratamiento de base: corticoides y/o inmunosupresores, debemos considerar el tratamiento general: dieta normocalórica y normoproteica, adecuada a la edad. No profilaxis antibiótica. Administración de vacunas cumpliendo el calendario vacunal completo y vacunación de varicela, neumococo y gripe. Aporte de calcio y vit. D. El tratamiento del edema será la restricción de sodio, no de agua, administrando seroalbúmina solo en situaciones especiales como hipovolemia sintomática o edema incapacitante. Consideración específica debe tenerse a las formas genéticas: NPHS1, NPHS2 y WT1 y a los síndromes nefróticos de comienzo durante el primer año de vida, por ser distinto el planteamiento dado su resistencia al tratamiento. En el SNI del niño dado el predominio de lesiones mínimas y corticosensibilidad, no está indicado proceder a una biopsia renal al inicio de la enfermedad sino instaurar un tratamiento esteroideo, realizándose la biopsia con criterios distintos según grupos, aun cuando existe unanimidad en realizarla en el síndrome nefrótico corticorresistente, en los de comienzo dentro del primer año de vida y en los casos con datos clínicos y/o analíticos que sugieran ser formas secundarias a una enfermedad sistémica. Dentro del primer año de vida tienen su manifestación la mayor parte de las formas genéticas; destacando el síndrome nefrótico finlandés (SNF), la esclerosis mesangial difusa aislada o asociada a otras anomalías y las infrecuentes causas infecciosas, aunque también puede observarse histología de lesiones mínimas, mesangial o membranosa más raramente. Por último es de señalar la posibilidad de recidiva postrasplante en las formas corticorresistentes, específicamente la esclerosis segmentaria y focal, con alto índice de recidivas, oscilando en las distintas series entre 10-80%, de tratamiento difícil, sin nivel de evidencia, y repercusión negativa en la evolución del injerto. Algunas formas genéticas, síndrome nefrótico finlandés o esclerosis segmentaria y focal en su forma genética también puede mostrar recidiva postrasplante aunque con menor frecuencia
No disponible
Asunto(s)
Masculino , Femenino , Niño , Humanos , Síndrome Nefrótico/fisiopatología , Corticoesteroides/uso terapéutico , Prednisona/uso terapéutico , Recurrencia , Biopsia , Ciclofosfamida/uso terapéutico , Edema/dietoterapia , Síndrome de Denys-Drash/fisiopatología , Glomerulonefritis Membranoproliferativa/fisiopatología , Glomeruloesclerosis Focal y Segmentaria/fisiopatologíaRESUMEN
BACKGROUND AND OBJECTIVES: The pathogenesis of different malnutrition diseases was suggested to affect the heart. This study was designed to detect cardiac affection in protein energy malnutrition (PEM) patients, whether clinically or by electrocardiogram (ECG) and echocardiogram, and to assess the value of the cardiac marker troponin I in patients at risk of myocardial injury with special emphasis on the effect of nutritional rehabilitation. PATIENTS AND METHODS: The present study was carried out on 30 PEM infants (16 nonedematous - 14 edematous) and 10 apparently healthy age and sex-matched infants acting as the control group. All studied infants were subjected to full history taking laying stress on dietetic history, thorough clinical and anthropometric measurements. Echocardiography and ECG were also performed. Laboratory investigations were performed including complete blood count, CRP, total proteins, albumin, liver and kidney functions as well as estimation of troponin-I in blood by immulite. Following initial evaluation, all malnourished infants were subjected to nutritional rehabilitation program for approximately 8 weeks, after which the patients were re-evaluated using the same preinterventional parameters. RESULTS: The results of the present study demonstrated that electrical properties of myocardium assessed by ECG showed significant decrease of R wave and QTc interval in patients compared to controls with significant improvement after nutritional rehabilitation. Echocardigraphic changes showed that cardiac mass index was significantly lower in both groups of malnourished cases compared to the controls with significant increase after nutritional rehabilitation. The study showed that the parameters of left ventricular (LV) systolic function which are the ejection fraction, fractional shortening and velocity of circumferential fiber shortening were not significantly reduced in patients compared to the controls. The diastolic function also showed no significant difference in the E wave/A wave (e/a) ratio between patients and controls. However, the systolic time interval showed significantly higher LV pre-ejection index in patients in comparison to controls. Edematous and nonedematous cases did not show any significant differences in ECG and echocardigraphic data before or after nutritional rehabilitation. The hearts of two severely affected patients uniquely demonstrated marked decrease of LV end diastolic diameter (LEVDd) together with the detection of troponin-I in their sera. CONCLUSION: We can conclude that malnutrition, regardless of its type, has a definite effect on cardiac volume, muscle mass, as well as the electrical properties of the myocardium. The systolic functions of the heart are affected more than the diastolic functions and this affection becomes manifest only in severe cases and may constitute a bad prognostic parameter thus necessitating more intense management and strict follow-up of such cases.
Asunto(s)
Edema/fisiopatología , Corazón/fisiología , Miocardio/metabolismo , Desnutrición Proteico-Calórica/dietoterapia , Desnutrición Proteico-Calórica/fisiopatología , Troponina I/sangre , Preescolar , Diástole , Ecocardiografía , Edema/dietoterapia , Electrocardiografía , Femenino , Corazón/anatomía & histología , Hemodinámica , Humanos , Lactante , Masculino , Estado Nutricional , Sístole/fisiologíaRESUMEN
A murine model of lipopolysaccharide (LPS)-induced acute lung injury (ALI) was used to evaluate whether aquaporin-1 (AQP1) is involved in lung inflammation and lung edema formation. Swiss strain mice (n = 122) had LPS (5 mg/kg) instilled intratracheally (IT), and were then treated with either 0.9 % saline or dexamethasone (5 mg/kg/day). Mice were euthanized at 2 days and 7 days after treatment. Inflammatory cytokines (TNF-alpha, IL-6), protein concentration in bronchoalveolar lavage (BAL) fluid, lung wet-to-dry weight ratio, histology, immunohistochemistry, and AQP1 Western blot were performed. Lung wet-to-dry weight ratio and lung vascular permeability were also measured in the AQP1 knockout mice (n = 9) that received IT LPS (5 mg/kg) at 2 days. Intratracheal instillation of LPS produced a severe lung injury at 2 days, characterized by elevation of TNF-alpha, IL-6 in the BAL fluid, and by histological changes consistent with increased lung vascular permeability and neutrophil infiltration. AQP1-immunoreactivity in the pulmonary capillary endothelium was reduced at 2 days and 7 days. Administration of dexamethasone improved LPS-induced ALI and retained expression of AQP1. However, depletion of AQP1 did not affect lung edema formation, lung vascular permeability, or lung histology. The results suggest that although AQP1 expression is decreased after lung injury, depletion of AQP1 does not alter lung inflammation and lung edema induced by LPS.
Asunto(s)
Acuaporinas/metabolismo , Regulación de la Expresión Génica/fisiología , Síndrome de Dificultad Respiratoria/metabolismo , Análisis de Varianza , Animales , Antiinflamatorios/farmacología , Antiinflamatorios/uso terapéutico , Acuaporina 1 , Acuaporinas/genética , Western Blotting/métodos , Lavado Broncoalveolar/métodos , Líquido del Lavado Bronquioalveolar/química , Líquido del Lavado Bronquioalveolar/inmunología , Recuento de Células/métodos , Citocinas/metabolismo , Dexametasona/farmacología , Dexametasona/uso terapéutico , Modelos Animales de Enfermedad , Interacciones Farmacológicas , Edema/dietoterapia , Edema/patología , Regulación de la Expresión Génica/efectos de los fármacos , Hemorragia/tratamiento farmacológico , Hemorragia/patología , Inmunohistoquímica/métodos , Lipopolisacáridos , Pulmón/metabolismo , Pulmón/patología , Ratones , Neutrófilos/efectos de los fármacos , Neutrófilos/patología , Tamaño de los Órganos , Proteínas/metabolismo , Síndrome de Dificultad Respiratoria/inducido químicamente , Síndrome de Dificultad Respiratoria/tratamiento farmacológico , Factores de TiempoRESUMEN
No disponible
Asunto(s)
Adolescente , Adulto , Anciano , Femenino , Masculino , Persona de Mediana Edad , Niño , Humanos , Signos y Síntomas , Antieméticos/administración & dosificación , Anemia/diagnóstico , Astenia/complicaciones , Astenia/diagnóstico , Cuidados Paliativos/métodos , Neoplasias/tratamiento farmacológico , Neoplasias/radioterapia , Neoplasias/dietoterapia , Náusea/complicaciones , Vómitos/complicaciones , Vómitos/tratamiento farmacológico , Dolor/complicaciones , Dolor/diagnóstico , Anorexia/complicaciones , Anorexia/diagnóstico , Edema/complicaciones , Edema/dietoterapia , Edema/diagnóstico , Cuidados Paliativos/métodos , Cuidados Paliativos , Neoplasias/epidemiología , Neoplasias/fisiopatologíaRESUMEN
Eryngium foetidum L. (Apiaceae) is a Caribbean endemic plant used in folk medicine for the treatment of several antiinflammatory disorders. A preliminary phytochemical study showed that the hexane extract is rich in terpenic compounds. Chromatographic fractionation of this extract yielded: alpha-cholesterol, brassicasterol, campesterol, stigmasterol (as the main component, 95 percent) clerosterol, beta-sitosterol, delta 5-avenasterol, delta (5) 24-stigmastadienol and delta 7-avenasterol. The topical antiinflammatory activity of the hexane extract and of stigmasterol was evaluated by auricular oedema, induced by 12-0-tetradecanoylphorbol acetate (TPA), in the mouse, using single and multiple applications of the phlogistic agent. Both reduced the oedema in a similar proportion in the two model assays (acute and chronic). Meloperoxidase activity was strongly reduced by both the extract and the compound, in the acute but not the chronic model. These results indicate that the leaves of Eryngium foetidum L may be effective against topical inflammation processes. Stigmasterol also exerts a significant topical antiinflammatory activity although it cannot be considered to be a major antiinflammatory agent, therefore other bioactive components are probably involved in the activity of the hexane extract.(AU)
Asunto(s)
21003 , Femenino , /uso terapéutico , Inflamación/tratamiento farmacológico , Fitosteroles/uso terapéutico , Plantas Medicinales/química , Enfermedad Aguda , Región del Caribe , Enfermedad Crónica , Inflamación/inducido químicamente , Inflamación/enzimología , Ratones , Peroxidasa/metabolismo , Acetato de Tetradecanoilforbol , Edema/inducido químicamente , Edema/dietoterapiaRESUMEN
The antioxidant spice principles curcumin and eugenol when given by gavage lowered the carrageenan-induced edema in the foot pads of rats. This lowering effect was dependent on the concentration, the time gap between the administration of spice principles and the induction of inflammation by carrageenan. Dietary lipids also influenced the extent of inflammation. Animals fed 10% cod liver oil [containing n-3 polyunsaturated fatty acids (PUFA)] for 10 weeks showed a significantly lower inflammation compared to that observed in animals fed diets supplemented with 10% groundnut oil (rich in n-6 PUFA) or 10% coconut oil (rich in medium-chain saturated fatty acids). Supplementation of diets with 1 weight% of curcumin did not affect the inflammatory responses of animals to carrageenan injection. However, supplementation of diets with 0.17 weight% eugenol further lowered inflammation by 16, 32 and 30% in animals fed coconut oil, groundnut oil and cod liver oil, respectively. Therefore, combinations of dietary lipids with spice principles like eugenol can help in lowering inflammation.
Asunto(s)
Curcumina/farmacología , Grasas de la Dieta/farmacología , Edema/patología , Eugenol/farmacología , Ácidos Grasos Omega-3/farmacología , Administración Oral , Animales , Antioxidantes/farmacología , Carragenina/toxicidad , Curcumina/administración & dosificación , Curcumina/uso terapéutico , Grasas de la Dieta/administración & dosificación , Grasas de la Dieta/uso terapéutico , Grasas Insaturadas en la Dieta/administración & dosificación , Grasas Insaturadas en la Dieta/farmacología , Grasas Insaturadas en la Dieta/uso terapéutico , Relación Dosis-Respuesta a Droga , Edema/inducido químicamente , Edema/dietoterapia , Eugenol/administración & dosificación , Eugenol/uso terapéutico , Ácidos Grasos Omega-3/administración & dosificación , Ácidos Grasos Omega-3/uso terapéutico , Ácidos Grasos Omega-6 , Ácidos Grasos Insaturados/administración & dosificación , Ácidos Grasos Insaturados/farmacología , Ácidos Grasos Insaturados/uso terapéutico , Alimentos Fortificados/normas , Pie/patología , Inflamación/inducido químicamente , Inflamación/dietoterapia , Inflamación/patología , Masculino , Ratas , Ratas Wistar , Vitamina E/administración & dosificación , Vitamina E/farmacologíaRESUMEN
For years low sodium diets have been recommended in the treatment of Ménière's syndrome. Elevated levels of insulin play an important role in sodium retention in renal tubules. Insulin production is stimulated by high carbohydrate diets. Adrenaline, cortisone, and glucagon levels may be increased by stress or food or inhalant allergies, further elevating insulin levels. The end result of prolonged hyperinsulinemia includes vasoconstriction and eventually arterial smooth muscle hypertrophy. Individual susceptibility to Ménière's syndrome may occur as a result of inflammatory changes in the endolymphatic sac or cochlear aqueduct secondary to primary or latent viral infections, thus predisposing to fluid retention. Long term medical treatment of Ménière's should be directed towards preventing sodium retention through sodium restriction and carbohydrate management. Other factors including stress and allergy should also be considered.