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1.
Crit Rev Food Sci Nutr ; : 1-24, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38803274

RESUMO

Adult humans generally experience a 0.5-1%/year loss in whole-body skeletal muscle mass and a reduction of muscle strength by 1.5-5%/year beginning at the age of 50 years. This results in sarcopenia (aging-related progressive losses of skeletal muscle mass and strength) that affects 10-16% of adults aged ≥ 60 years worldwide. Concentrations of some amino acids (AAs) such as branched-chain AAs, arginine, glutamine, glycine, and serine are reduced in the plasma of older than young adults likely due to insufficient protein intake, reduced protein digestibility, and increased AA catabolism by the portal-drained viscera. Acute, short-term, or long-term administration of some of these AAs or a mixture of proteinogenic AAs can enhance blood flow to skeletal muscle, activate the mechanistic target of rapamycin cell signaling pathway for the initiation of muscle protein synthesis, and modulate the metabolic activity of the muscle. In addition, some AA metabolites such as taurine, ß-alanine, carnosine, and creatine have similar physiological effects on improving muscle mass and function in older adults. Long-term adequate intakes of protein and the AA metabolites can aid in mitigating sarcopenia in elderly adults. Appropriate combinations of animal- and plant-sourced foods are most desirable to maintain proper dietary AA balance.

2.
Microorganisms ; 9(3)2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-33809423

RESUMO

In 2013, the U.S. Department of Agriculture Food Safety and Inspection Service (USDA-FSIS) began transitioning to whole genome sequencing (WGS) for foodborne disease outbreak- and recall-associated isolate identification of select bacterial species. While WGS offers greater precision, certain hurdles must be overcome before widespread application within the food industry is plausible. Challenges include diversity of sequencing platform outputs and lack of standardized bioinformatics workflows for data analyses. We sequenced DNA from USDA-FSIS approved, non-pathogenic E. coli surrogates and a derivative group of rifampicin-resistant mutants (rifR) via both Oxford Nanopore MinION and Illumina MiSeq platforms to generate and annotate complete genomes. Genome sequences from each clone were assembled separately so long-read, short-read, and combined sequence assemblies could be directly compared. The combined sequence data approach provides more accurate completed genomes. The genomes from these isolates were verified to lack functional key E. coli elements commonly associated with pathogenesis. Genetic alterations known to confer rifR were also identified. As the food industry adopts WGS within its food safety programs, these data provide completed genomes for commonly used surrogate strains, with a direct comparison of sequence platforms and assembly strategies relevant to research/testing workflows applicable for both processors and regulators.

3.
Eur J Neurol ; 28(1): 81-89, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32888367

RESUMO

BACKGROUND AND PURPOSE: Little is known about the epidemiological features of amyotrophic lateral sclerosis (ALS) in sub-Saharan Africa, and data from the region are limited to clinical series or case reports. The aim of the study was to investigate the incidence rate and presentation of ALS in an ethnically diverse region of South Africa. METHODS: We performed a 4-year prospective incidence study in the Western Cape Province of South Africa between 1 July 2014 and 30 June 2018, and used a two-source capture-recapture method for case ascertainment. Age- and sex-adjusted incidence rates (ASAIRs) were calculated using the 2010 US population as the reference. RESULTS: A total of 203 incident cases were identified over the study period, resulting in a crude incidence rate (IR) of 1.09 [95% confidence interval (CI) 0.94-1.24] per 100 000 person-years in the at-risk population (aged >15 years). Capture-recapture analysis resulted in an estimated IR of 1.11 (95% CI 1.01-1.22) per 100 000 person-years. The ASAIR was 1.67 (95% CI 1.09-2.26) overall; 1.99 (95% CI 1.60-2.39) for men and 1.37 (95% CI 1.06-1.68) for women. When analysed separately, there was a substantial difference in ASAIRs between the different population groups, with the highest in the European ancestry group (2.62; 95% CI 2.49-2.75), the lowest in the African ancestry group (0.56, 95% CI 0.0-1.23), and an ASAIR in between these two in the mixed ancestry group (1.09, 95% CI 0.80-1.37). CONCLUSION: The overall incidence of ALS in the Western Cape Province of South Africa appears to be lower than in North African and Western countries, but higher than in Asian countries. As suggested by previous epidemiological studies, ALS may be less frequent in people of African ancestry.


Assuntos
Esclerose Lateral Amiotrófica , Doença dos Neurônios Motores , Esclerose Lateral Amiotrófica/epidemiologia , Feminino , Humanos , Incidência , Masculino , Doença dos Neurônios Motores/epidemiologia , Estudos Prospectivos , África do Sul/epidemiologia
4.
S Afr Med J ; 108(4): 271-274, 2018 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-29629676

RESUMO

A high proportion of HIV-positive patients in South Africa receive concomitant efavirenz (EFV) and isoniazid (INH) therapy. EFV is metabolised in the liver via CYP2B6, and genetic polymorphism of CYP2B6 is known to result in slowed metabolism of the drug. INH is also metabolised in the liver, causing inhibition of a pathway that plays an important role in slow EFV metabolisers. Concomitant INH use therefore affects plasma levels of EFV. EFV is well known to cause neuropsychiatric side-effects on initiation, and a recent adult case series described late-onset neurotoxicity in the form of subacute ataxia and encephalopathy in patients treated with EFV for a median of 2 years, in association with toxic plasma levels of the drug. We have seen an increase in cases of EFV toxicity presenting to our neurology referral unit. All cases have been in the context of recent initiation of concomitant INH. We therefore conducted a retrospective case record audit to describe these seven cases with the additional advantage of tertiary-level assessment. We outline the clinical features and investigation results, as well as outcomes after EFV was stopped. Our main objectives are to highlight the probable role of concomitant INH use in the development of this syndrome, and to suggest that only limited work-up may be warranted in suspected cases.


Assuntos
Algoritmos , Benzoxazinas/toxicidade , Encefalopatias/induzido quimicamente , Encefalopatias/prevenção & controle , Ataxia Cerebelar/induzido quimicamente , Ataxia Cerebelar/prevenção & controle , Infecções por HIV/tratamento farmacológico , Neurotoxinas/toxicidade , Inibidores da Transcriptase Reversa/toxicidade , Adulto , Alcinos , Antituberculosos/metabolismo , Antituberculosos/toxicidade , Benzoxazinas/metabolismo , Ciclopropanos , Eletroencefalografia , Feminino , Humanos , Isoniazida/metabolismo , Isoniazida/toxicidade , Neurotoxinas/metabolismo , Estudos Retrospectivos , Inibidores da Transcriptase Reversa/metabolismo , África do Sul , Testes de Toxicidade
5.
7.
Epilepsy Behav ; 69: 161-169, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28256379

RESUMO

This is the second of three papers that summarize the second symposium on Transition in Epilepsies held in Paris in June 2016. This paper addresses the outcome for some particularly challenging childhood-onset epileptic disorders with the goal of recommending the best approach to transition. We have grouped these disorders in five categories with a few examples for each. The first group includes disorders presenting in childhood that may have late- or adult-onset epilepsy (metabolic and mitochondrial disorders). The second group includes disorders with changing problems in adulthood (tuberous sclerosis complex, Rett syndrome, Dravet syndrome, and autism). A third group includes epilepsies that change with age (Childhood Absence Epilepsy, Juvenile Myoclonic Epilepsy, West Syndrome, and Lennox-Gastaut syndrome). A fourth group consists of epilepsies that vary in symptoms and severity depending on the age of onset (autoimmune encephalitis, Rasmussen's syndrome). A fifth group has epilepsy from structural causes that are less likely to evolve in adulthood. Finally we have included a discussion about the risk of later adulthood cerebrovascular disease and dementia following childhood-onset epilepsy. A detailed knowledge of each of these disorders should assist the process of transition to be certain that attention is paid to the most important age-related symptoms and concerns.


Assuntos
Congressos como Assunto , Epilepsia/diagnóstico , Epilepsia/terapia , Transição para Assistência do Adulto/tendências , Adolescente , Adulto , Criança , Pré-Escolar , Encefalite/diagnóstico , Encefalite/terapia , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/terapia , Doença de Hashimoto/diagnóstico , Doença de Hashimoto/terapia , Humanos , Lactente , Epilepsia Mioclônica Juvenil/diagnóstico , Epilepsia Mioclônica Juvenil/terapia , Síndrome de Rett/diagnóstico , Síndrome de Rett/terapia , Espasmos Infantis/diagnóstico , Espasmos Infantis/terapia , Resultado do Tratamento , Esclerose Tuberosa/diagnóstico , Esclerose Tuberosa/terapia , Adulto Jovem
8.
J Anim Sci ; 94(6): 2603-13, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27285936

RESUMO

Meat is a food for humans. However, beef consumption in the United States has steadily declined by >14% over the past decade due to a variety of factors, including insufficient knowledge of animal protein. This study quantified all proteinogenic AA as well as nutritionally and physiologically significant nonproteinogenic AA and small peptides in beef cuts from 3 subprimals (chuck, round, and loin). Beef carcasses ( = 10) were selected at 3 commercial packing plants in the United States. Retail-cut samples were analyzed for the nitrogenous substances after acid, alkaline, or enzymatic hydrolysis and after deproteinization. In these chuck, round, and loin cuts, total amounts of glutamate (free plus peptide bound) were the highest (69-75 mg/g dry weight) followed by lysine, leucine, arginine, and glutamine in descending order. This is the first study to determine aspartate, asparagine, glutamate, and glutamine in meat proteins of any animal species. In all the beef samples evaluated, glutamine was the most abundant free AA (4.0-5.7 mg/g dry weight) followed by taurine, alanine, glutamate, and ß-alanine. Additionally, samples from all beef cuts had high concentrations of anserine, carnosine, and glutathione, which were 2.8 to 3.7, 15.2 to 24.2, and 0.68 to 0.79 mg/g dry weight, respectively. Beef top loin steaks appear to provide higher protein nutrition values than top round steaks and under blade roasts, but all are excellent sources of proteinogenic AA as well as antioxidant AA and peptides to improve human growth, development, and health. Our findings may help guide future decisions regarding human and animal nutrition.


Assuntos
Aminoácidos/análise , Qualidade dos Alimentos , Peptídeos/química , Carne Vermelha/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Bovinos , Humanos , Estados Unidos
9.
Ann N Y Acad Sci ; 1328: 18-28, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25376888

RESUMO

Land-based production of high-quality protein by livestock and poultry plays an important role in improving human nutrition, growth, and health, as well as economical and social developments worldwide. With exponential growth of the global population and marked rises in meat consumption per capita, demands for animal-source protein are expected to increase by 72% between 2013 and 2050. This raises concerns about the sustainability and environmental impacts of animal agriculture. An attractive solution to meeting the increasing needs for animal products and mitigating undesired effects of agricultural practices is to enhance the efficiency of animal growth, reproduction, and lactation. Breeding techniques may help achieve this goal, but have only met with limited success. A promising, mechanism-based approach is to optimize the proportion and amounts of amino acids in diets for maximizing whole-body protein synthesis and feed efficiency. Improvements in farm animal productivity will not only decrease the contamination of soils, groundwater, and air by excessive manure, but will also help sustain animal agriculture to produce high-quality protein for the expanding population in the face of diminishing resources.


Assuntos
Agricultura , Carne/provisão & distribuição , Agricultura/normas , Animais , Conservação dos Recursos Naturais , Proteínas Alimentares/normas , Proteínas Alimentares/provisão & distribuição , Qualidade dos Alimentos , Abastecimento de Alimentos , Humanos , Carne/normas , Crescimento Demográfico , Melhoria de Qualidade
10.
S Afr Med J ; 103(10): 758-62, 2013 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-24079630

RESUMO

BACKGROUND: The human immunodeficiency virus (HIV) can give rise to a spectrum of neuropsychological impairments known collectively as HIV-associated neurocognitive disorders (HAND). Although antiretroviral therapy (ART) has reduced the incidence of HIV dementia, the prevalence of milder forms of HAND has increased. It has been postulated that incomplete central nervous system (CNS) viral suppression or potential drug toxicity, both of which could be related to the CNS penetration effectiveness (CPE) of ART regimens, may contribute to this phenomenon. OBJECTIVE: This study compared cognitive outcomes in clade C-infected HIV patients in South Africa treated for 1 year with ART regimens with differing CPE scores. METHODS: We assessed 111 HIV-positive patients with varying levels of cognitive function at baseline (pre-ART) and then a year later. A neuropsychological battery was administered at both visits to derive global deficit scores. ART regimen data were collected at the follow-up visit. Some participants remained ART-naïve during this period, thus providing a non-treatment control group. RESULTS: Significantly more ART recipients maintained or improved cognitive function compared with patients not on ART (p=0.017). There was no significant difference in cognitive outcomes between higher and lower CPE regimen groups (p=0.473). CONCLUSIONS: ART preserves or improves cognition in HIV-infected patients after 1 year, irrespective of the regimen's CPE. South Africa's current low CPE-scored first-line regimen performed as well as higher CPE-scored regimens. These findings are reassuring for South Africa, but larger, longer-term studies would be more definitive.


Assuntos
Antirretrovirais/farmacocinética , Sistema Nervoso Central/metabolismo , Transtornos Cognitivos/etiologia , Cognição/efeitos dos fármacos , Infecções por HIV/complicações , Antirretrovirais/efeitos adversos , Sistema Nervoso Central/efeitos dos fármacos , Cognição/fisiologia , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/fisiopatologia , Seguimentos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/metabolismo , Humanos , Incidência , Estudos Retrospectivos , África do Sul/epidemiologia
11.
J Small Anim Pract ; 51(7): 382-6, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20536691

RESUMO

OBJECTIVES: To assess if the volumes of the caudal cranial fossa (CCF), parenchyma within the caudal cranial fossa (CCFP) or ventricles (V) are associated with syringomyelia (SM) in cavalier King Charles spaniels (CKCS) with Chiari-like malformation (CM). To evaluate if volumes are associated with transverse syrinx width. METHODS: Magnetic resonance images of 59 CKCS with CM were retrospectively reviewed and grouped with or without SM. Three-dimensional images were created and volumes of the fossae, brain parenchyma and ventricular system were calculated from which percentages of CCF, CCFP and V were created. If present, syrinx size was measured from its maximal transverse width. The percentages were statistically compared between groups, and correlation between percentages and syrinx dimensions was made. RESULTS: CKCS with SM had significantly higher CCFP (P=0.0001) and V (P=0.0002) to those without but no significant difference in CCF (P=0.925). There was a positive correlation between CCFP and syrinx width (Pearson r=0.437) and ventricle size to syrinx width (Spearman r=0.627). CLINICAL SIGNIFICANCE: A more marked overcrowding of the CCF is associated with SM, which may explain the high incidence of SM in CKCS with CM. The association between ventricle and syrinx dimensions supports the theory that SM development is the result of altered cerebrospinal fluid dynamics.


Assuntos
Malformação de Arnold-Chiari/veterinária , Fossa Craniana Posterior/patologia , Doenças do Cão/patologia , Siringomielia/veterinária , Animais , Malformação de Arnold-Chiari/patologia , Cruzamento , Líquido Cefalorraquidiano/fisiologia , Cães , Feminino , Imageamento por Ressonância Magnética/veterinária , Masculino , Estudos Retrospectivos , Siringomielia/patologia
12.
Eur J Clin Nutr ; 63(12): 1377-86, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19724293

RESUMO

A compromised vitamin D status, characterized by low 25-hydroxyvitamin D (25-(OH)D) serum levels, and a nutritional calcium deficit are widely encountered in European and North American countries, independent of age or gender. Both conditions are linked to the pathogenesis of many degenerative, malignant, inflammatory and metabolic diseases. Studies on tissue-specific expression and activity of vitamin D metabolizing enzymes, 25-(OH)D-1 alpha-hydroxylase and 25-(OH)D-24-hydroxylase, and of the extracellular calcium-sensing receptor (CaR) have led to the understanding of how, in non-renal tissues and cellular systems, locally produced 1,25-dihydroxyvitamin D(3) (1,25-(OH)(2)D(3)) and extracellular Ca(2+) act jointly as key regulators of cellular proliferation, differentiation and function. Impairment of cooperative signalling from the 1,25-(OH)(2)D(3)-activated vitamin D receptor (VDR) and from the CaR in vitamin D and calcium insufficiency causes cellular dysfunction in many organs and biological systems, and, therefore, increases the risk of diseases, particularly of osteoporosis, colorectal and breast cancer, inflammatory bowel disease, insulin-dependent diabetes mellitus type I, metabolic syndrome, diabetes mellitus type II, hypertension and cardiovascular disease. Understanding the underlying molecular and cellular processes provides a rationale for advocating adequate intake of vitamin D and calcium in all populations, thereby preventing many chronic diseases worldwide.


Assuntos
Cálcio/deficiência , Cálcio/fisiologia , Deficiência de Vitamina D/metabolismo , Deficiência de Vitamina D/fisiopatologia , Vitamina D/fisiologia , Doenças Autoimunes/etiologia , Doenças Autoimunes/metabolismo , Cálcio da Dieta/administração & dosagem , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/metabolismo , Doença Crônica , Regulação da Expressão Gênica , Humanos , Doenças Metabólicas/etiologia , Doenças Metabólicas/metabolismo , Neoplasias/etiologia , Neoplasias/metabolismo , Proteína G de Ligação ao Cálcio S100/fisiologia , Vitamina D/administração & dosagem , Vitamina D/análogos & derivados , Vitamina D/sangue
13.
J Small Anim Pract ; 50(8): 399-405, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19689667

RESUMO

OBJECTIVES: To ascertain whether cavalier King Charles spaniels (CKCSs) have a proportionately smaller caudal fossa compared with other small dogs and with Labradors. To evaluate if cerebellar herniation in CKCS correlates with caudal fossa volume. METHODS: In this retrospective study, three-dimensional images were created from magnetic resonance imaging brain series of 117 dogs (split into three groups: CKCS, Labradors and small breeds) from which the volumes of the fossae and brain parenchyma were calculated. These volumes were transformed into percentages of total cranial cavity and parenchyma volumes, respectively. The percentages were statistically compared among the groups. The percentage of herniated cerebellum in the CKCS was compared using linear regression with the caudal fossa and parenchyma percentages. RESULTS: Cavalier King Charles spaniels had a proportionately smaller caudal fossa compared with Labradors (P=0.002) but not to small breeds (P=0.103). Their caudal fossa parenchyma was proportionately the same volume as Labradors (P=0.976) but greater than small breeds (P=0.005). No relationship was found for the per cent of cerebellum herniated. CLINICAL SIGNIFICANCE: The results support mesoderm insufficiency or craniosynostosis as the pathogenesis of Chiari-like malformation (CM) in CKCS. It presents evidence for overcrowding of the caudal fossa due to a mismatch of brain parenchyma and fossa volumes as to why CKCS and not other small dogs are affected.


Assuntos
Malformação de Arnold-Chiari/veterinária , Doenças do Cão/patologia , Crânio/patologia , Animais , Malformação de Arnold-Chiari/patologia , Fossa Craniana Posterior/patologia , Cães , Encefalocele/patologia , Encefalocele/veterinária , Feminino , Imageamento por Ressonância Magnética , Masculino , Estudos Retrospectivos
14.
Acta Physiol Hung ; 96(3): 307-23, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19706373

RESUMO

The p38 MAP kinases are stress-activated MAP kinases whose induction is often associated with the onset of heart failure. This study investigated the role of p38 MAP kinase isoforms in the regulation of myocardial contractility and ischemia/reperfusion injury using mice with cardiac-specific expression of kinase dead (dominant negative) mutants of p38alpha (p38alphadn) or p38beta (p38betadn). Hearts were subjected to 20 min ischemia and 40 min reperfusion. Immunofluorescence staining for p38alphadn and p38betadn protein was performed on neonatal cardiomyocytes infected with adenovirus expressing flag-tagged p38alphadn and p38betadn protein. Basal contractile function was increased in both p38alphadn and p38betadn hearts compared to WT. Ischemic injury was increased in p38betadn vs. WT hearts, as indicated by lower posti-schemic recoveries of contractile function and ATP. However, despite a similar increase in contractility, ischemic injury was not increased in p38alphadn vs. WT hearts. Immunohistological analysis of cardiomyocytes with comparable levels of protein overexpression show that p38alphadn and p38betadn proteins were co-localized with sarcomeric alpha-actinin, however, p38alphadn was detected in the nucleus while p38betadn was exclusively detected in the cytosol. In summary, attenuated p38 activity led to increased myocardial contractility; specific isoforms of p38 and their sub-cellular localization may have different roles in modulating ischemic injury.


Assuntos
Proteína Quinase 11 Ativada por Mitógeno/metabolismo , Proteína Quinase 14 Ativada por Mitógeno/metabolismo , Contração Miocárdica , Traumatismo por Reperfusão Miocárdica/enzimologia , Miocárdio/enzimologia , Trifosfato de Adenosina/metabolismo , Animais , Animais Recém-Nascidos , Núcleo Celular/enzimologia , Células Cultivadas , Citosol/enzimologia , Modelos Animais de Doenças , Humanos , Concentração de Íons de Hidrogênio , Isoenzimas , Camundongos , Camundongos Transgênicos , Proteína Quinase 11 Ativada por Mitógeno/genética , Proteína Quinase 14 Ativada por Mitógeno/genética , Mutação , Traumatismo por Reperfusão Miocárdica/fisiopatologia , Cadeias Pesadas de Miosina/genética , Fosfocreatina/metabolismo , Regiões Promotoras Genéticas , Ratos , Ratos Sprague-Dawley , Recuperação de Função Fisiológica , Fatores de Tempo , Transfecção , Miosinas Ventriculares/genética
15.
Heart ; 94(10): 1326-30, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18467358

RESUMO

BACKGROUND: Familial hypertrophic cardiomyopathy (HCM) is a leading cause of sudden cardiac death among young and apparently healthy people. Autosomal dominant mutations within genes encoding sarcomeric proteins have been identified. An autosomal recessive form of HCM has been discovered in a group of Amish children that is associated with poor prognosis and death within the first year of life. Affected patients experienced progressive cardiac failure despite maximal medical treatment. Postmortem histology showed myofibre disarray and myocyte loss consistent with refractory clinical deterioration in affected infants. OBJECTIVE: To conduct a genome-wide screen for linkage and try to identify an autozygous region which cosegregates with the infant cardiac phenotype METHODS AND RESULTS: An autozygous region of chromosome 11 which cosegregates with the infant cardiac phenotype was identified. This region contained the MYBPC3 gene, which has previously been associated with autosomal dominant adult-onset HCM. Sequence analysis of the MYBPC3 gene identified a splice site mutation in intron 30 which was homozygous in all affected infants. All surviving patients with the homozygous MYBPC3 gene mutations (3330+2T>G) underwent an orthotopic heart transplantation. CONCLUSIONS: Homozygous mutations in the MYBPC3 gene have been identified as the cause of severe infantile HCM among the Amish population.


Assuntos
Cardiomiopatia Hipertrófica/genética , Proteínas de Transporte/genética , Homozigoto , Mutação/genética , Protestantismo , Feminino , Humanos , Lactente , Masculino
16.
Cochrane Database Syst Rev ; (1): CD005222, 2007 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-17253546

RESUMO

BACKGROUND: Epilepsy is a disorder with recurrent epileptic seizures. Corticosteroids have been used in the treatment of children with epilepsy and have significant adverse effects. Their efficacy and tolerability have not been not clearly established. OBJECTIVES: To determine the efficacy of corticosteroids in terms of seizure control, improvements in cognition and in quality of life and tolerability of steroids compared to placebo or other antiepileptic drugs. SEARCH STRATEGY: We searched the following databases: The Cochrane Epilepsy Group Specialized Register (September 2006); Cochrane Central Register of Controlled Trials (CENTRAL)(The Cochrane Library Issue 2, 2006); MEDLINE (1966 - April 2004); EMBASE (1966 - December 2004); Database of Abstracts of Reviews of Effectiveness (DARE) (December 2004). We checked the reference lists of retrieved studies for additional reports of relevant studies. SELECTION CRITERIA: All randomized controlled trials of administration of corticosteroids to children (less than 16 years) with epilepsy. DATA COLLECTION AND ANALYSIS: Three review authors independently selected trials for inclusion and extracted data. Outcomes included cessation of seizures, reduction in seizure frequency, improvement in cognition, quality of life and adverse effects of steroids. MAIN RESULTS: A single RCT was included that recruited five patients in double blind crossover trial. One was withdrawn prematurely from the study and another had infantile spasms and hence was excluded from further analysis. ACTH 4-9 was administered. The overall reduction in seizure frequency of more than 25% and less than 50% occurred in one child at low dose and in two children at higher dose. One child did not show any reduction in seizure frequency. No adverse effects were reported. AUTHORS' CONCLUSIONS: No evidence was found for the efficacy or safety of corticosteroids in treating childhood epilepsies. Clinicians using steroids in childhood epilepsies, other than for epileptic spasms, should take this into account before using these agents.


Assuntos
Corticosteroides/uso terapêutico , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Hormônio Adrenocorticotrópico/uso terapêutico , Criança , Humanos
17.
Eur J Clin Invest ; 35(5): 290-304, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-15860041

RESUMO

There is evidence from both observational studies and clinical trials that calcium malnutrition and hypovitaminosis D are predisposing conditions for various common chronic diseases. In addition to skeletal disorders, calcium and vitamin D deficits increase the risk of malignancies, particularly of colon, breast and prostate gland, of chronic inflammatory and autoimmune diseases (e.g. insulin-dependent diabetes mellitus, inflammatory bowel disease, multiple sclerosis), as well as of metabolic disorders (metabolic syndrome, hypertension). The aim of the present review was to provide improved understanding of the molecular and cellular processes by which deficits in calcium and vitamin D cause specific changes in cell and organ functions and thereby increase the risk for chronic diseases of different aetiology. 1,25-Dihydroxyvitamin D(3) and extracellular Ca(++) are both key regulators of proliferation, differentiation and function at the cellular level. However, the efficiency of vitamin D receptor-mediated intracellular signalling is limited by the negative effects of hypovitaminosis D on extrarenal 25-hydroxyvitamin D-1alpha-hydroxylase activity and thus on the production of 1,25-dihydroxyvitamin D(3). Calcium malnutrition eventually causes a decrease in calcium concentration in extracellular fluid compartments, resulting in organ-specific modulation of calcium-sensing receptor activity. Hence, attenuation of signal transduction from the ligand-activated vitamin D receptor and calcium-sensing receptor seems to be the prime mechanism by which calcium and vitamin D insufficiencies cause perturbation of cellular functions in bone, kidney, intestine, mammary and prostate glands, endocrine pancreas, vascular endothelium, and, importantly, in the immune system. The wide range of diseases associated with deficits in calcium and vitamin D in combination with the high prevalence of these conditions represents a special challenge for preventive medicine.


Assuntos
Cálcio/deficiência , Deficiência de Vitamina D/complicações , Doenças Autoimunes/etiologia , Cálcio da Dieta/administração & dosagem , Doença Crônica , Doenças Transmissíveis/etiologia , Humanos , Hipertensão/etiologia , Doenças Musculoesqueléticas/etiologia , Neoplasias/etiologia , Osteoporose/etiologia , Prevalência , Vitamina D/análogos & derivados , Vitamina D/biossíntese
18.
Br J Dermatol ; 152(2): 231-41, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15727633

RESUMO

BACKGROUND: 1alpha,25-dihydroxyvitamin D(3)[1,25(OH)(2)D(3)], the active metabolite of vitamin D, exerts its activities by binding to the vitamin D receptor (VDR) with subsequent function as a transcription factor. Targeted ablation of the VDR in mice results in rickets and alopecia. OBJECTIVES: To study the consequences of VDR deficiency for skin physiology, and to investigate the mechanisms of the immunosuppressive effect of 1,25(OH)(2)D(3) on LC. METHODS: We studied the structural, phenotypic and functional properties of skin and individual skin leucocyte populations in VDR(-/-) mice. RESULTS: The lack of VDR induced a wide spectrum of pathologies including dermal deposition of collagen, enlargement of sebaceous glands, dilation of the hair follicles, development of epidermal cysts, increased numbers of dendritic epidermal T cells (DETC) and hyperkeratosis. Ageing aggravated these changes. Intriguingly, Langerhans cells (LC) were indistinguishable in distribution, morphology and number compared with controls. In vitro, LC underwent a maturation/migration process similar to LC from control mice. Pretreatment of epidermal cells or LC-enriched epidermal cell suspensions with 1,25(OH)(2)D(3) impaired LC maturation and T-cell stimulatory capacity from VDR(+/+) but not VDR(-/-) mice, demonstrating that LC are targets of vitamin D(3) and that interaction between vitamin D(3) and LC results in a suppression of LC activity. CONCLUSIONS: Our data imply that VDR expression controls dermal collagen production, hair development and growth, proliferation of sebaceous glands and the homeostasis of DETC. Surprisingly, VDR deficiency does not influence LC phenotype and function.


Assuntos
Células Dendríticas/metabolismo , Células de Langerhans/metabolismo , Receptores de Calcitriol/fisiologia , Pele/patologia , Envelhecimento/metabolismo , Animais , Calcitriol/farmacologia , Diferenciação Celular/efeitos dos fármacos , Movimento Celular/efeitos dos fármacos , Movimento Celular/imunologia , Células Cultivadas , Colágeno/metabolismo , Células Dendríticas/efeitos dos fármacos , Epiderme/imunologia , Epiderme/patologia , Folículo Piloso/patologia , Imunofenotipagem , Células de Langerhans/efeitos dos fármacos , Células de Langerhans/imunologia , Ativação Linfocitária/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Receptores de Calcitriol/deficiência , Pele/imunologia , Pele/metabolismo , Subpopulações de Linfócitos T/imunologia , Subpopulações de Linfócitos T/metabolismo
19.
Neurology ; 62(12): 2214-20, 2004 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-15210885

RESUMO

INTRODUCTION: Posterior quadrantic dysplasia (PQD), a developmental malformation involving the temporal, parietal, and occipital lobes of one cerebral hemisphere, leads to intractable epilepsy. OBJECTIVE: To characterize the clinical features of 19 patients with PQD and analyze the postsurgical outcome of those who underwent resection of dysplastic tissue. METHODS: The extent and nature of the malformation were primarily assessed with high-resolution brain imaging. Fourteen patients underwent complete or partial temporoparieto-occipital resection or temporal resection associated with parieto-occipital disconnection. Postoperative follow-up period ranged from 8 months to 7 years. The authors used the Engel classification for postoperative outcome. RESULTS: All patients were sporadic. Clinical features included infantile spasms, partial seizures, mental retardation, mild hemiparesis, and visual field defects. Neuroimaging localized the malformation within the posterior cerebral quadrant contralateral to the neurologic deficit and demonstrated hemi-hemimegalencephaly in 14 of 19 patients and multilobar cortical dysplasia in 5 of 19 patients. The authors observed class I outcome in six patients. Two patients had class II and four patients had class III outcome. Class IV outcome was seen in two patients. After surgery, two patients developed mild hemiparesis, and two developed a visual field defect. CONCLUSIONS: Widespread cortical dysplasia is more frequent in the posterior quadrant. In our series, posterior quadrantic dysplasia represents either hemi-hemimegalencephaly or multilobar cortical dysplasia. Individuals with posterior quadrantic dysplasia share a spectrum of clinical features. The intractable epilepsy in these patients may be alleviated by a large quadrantic temporoparieto-occipital resection.


Assuntos
Córtex Cerebral/anormalidades , Córtex Cerebral/cirurgia , Epilepsias Parciais/cirurgia , Adolescente , Idade de Início , Criança , Pré-Escolar , Eletroencefalografia , Epilepsias Parciais/etiologia , Epilepsias Parciais/patologia , Feminino , Hemisferectomia , Humanos , Lactente , Masculino , Resultado do Tratamento
20.
Meat Sci ; 66(1): 55-61, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22063931

RESUMO

At approximately 8 weeks of age, four-way cross (Chester White×Landrace×Large White×Yorkshire) pigs (n=24) were selected based on genetically high (H) or low (L) serum cholesterol levels-12 from each genetic group-to determine the relationship between genetics, fat source, and sex class on plasma cholesterol, growth, carcass characteristics, and cholesterol and lipid content of muscle and adipose tissues. Boars and gilts, six each from the two genetic groups, were assigned randomly to one of three dietary treatments for 46 days. A standard grower diet was modified to include beef tallow (T), corn oil (CR) or coconut oil (CC), and the pigs were given ad libitum access to feed. Cholesterol was added to each diet to ensure the diets contained the same amount of cholesterol. Except for the plasma lipids, there were no differences between boars and gilts at the initial evaluation or at the end of the treatment; therefore, sex means were pooled for statistical analyses. Body weight was unaffected by diet on days 18, 29 or 46. Blood samples were taken on days 1, 29, and 46 via the anterior vena cava. Plasma total cholesterol (TC) and low density lipoprotein cholesterol (LDL) concentrations were greater in the H than L groups (overall TC in H and L pigs=150 and 124 mg/dl, respectively, and LDL in H and L pigs=105 and 76 mg/dl, respectively). Pigs fed diets containing saturated fats had greater TC and LDL than pigs fed unsaturated fats (TC=165, 149, and 126 mg/dl for T, CC, and CR diets, respectively, and LDL=108, 88, and 77 mg/dl for T, CC, and CR diets, respectively). There were significant time×gene×sex interactions for both TC and LDL yielding subtle differences in the response of the sexes from the two genetic groups over time. Pigs were slaughtered on day 46, and carcass data were collected. There were no differences in fat at the first rib, 10th rib, last rib, or last lumbar vertebra, but differences (P <0.05) were found between genetic groups for M. longissimus thoracis et lumborum (LTL) muscle area (H=21.0±0.8 cm(2), L=18.1±1.0 cm(2)) and USDA muscle score (H=2.1±0.1, L=1.7±0.1). There were no genetic or diet effects for cholesterol content of pre-rigor or post-rigor LTL muscle. Neither genetics nor dietary treatment affected the cholesterol content of the adipose tissue. There were no differences in fat percentage between genetic groups for muscle or adipose tissue. There were differences (P <0.05) in total lipid content among the dietary treatments for the pre-rigor (T=6.0±0.6%, CC=4.3±0.3%, CN=3.9±0.5%) and post-rigor (T=6.4±0.9%, CC=4.1±0.3%, CN=5.0±0.4%) LTL. Cholesterol accretion in muscle and adipose tissues of growing pigs was not influenced by source of fat in the diet or by their genetic propensity for high or low plasma cholesterol.

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