RESUMO
Background: The benefits of facilitating breastmilk feeding and close contact between mother and neonate (family-centred care; FCC) in the perinatal period are well-established. The aim of this study was to determine how the delivery of FCC practices were impacted for neonates born to mothers with perinatal SARS-CoV-2 infection during the COVID-19 pandemic. Methods: Neonates born to mothers with confirmed SARS-CoV-2 infection during pregnancy were identified from the 'EsPnIC Covid paEdiatric NeonaTal REgistry' (EPICENTRE) multinational cohort between 10 March 2020 and 20 October 2021. The EPICENTRE cohort collected prospective data on FCC practices. Rooming-in and breastmilk feeding practice were the main outcomes, and factors influencing each were determined. Other outcomes included mother-baby physical contact prior to separation and the pattern of FCC components relative to time and local site guidelines. Findings: 692 mother-baby dyads (13 sites, 10 countries) were analysed. 27 (5%) neonates were positive for SARS-CoV-2 (14 (52%) asymptomatic). Most sites had policies that encouraged FCC during perinatal SARS-CoV-2 infection for most of the reporting period. 311 (46%) neonates roomed-in with their mother during the admission. Rooming-in increased over time from 23% in March-June 2020 to 74% in January-March 2021 (boreal season). 330 (93%) of the 369 separated neonates had no FCC physical contact with their mother prior, and 319 (86%) were asymptomatic. Maternal breastmilk was used for feeding in 354 (53%) neonates, increasing from 23% to 70% between March-June 2020 and January-March 2021. FCC was most impacted when mothers had symptomatic COVID-19 at birth. Interpretation: This is the largest report of global FCC practice during the COVID-19 pandemic to date. The COVID-19 pandemic may have impacted FCC despite low perinatal transmission rates. Fortunately, clinicians appear to have adapted to allow more FCC delivery as the COVID-19 pandemic progressed. Funding: The National Health and Medical Research Council (Australia): Grant ID 2008212 (DGT), Royal Children's Hospital Foundation: Grant ID 2019-1155 (EJP), Victorian Government Operational Infrastructure Support Program.
RESUMO
We present a pilot study on the effects of milk protein fractions [αS1-casein (CN), αS2-CN, κ-CN, ß-CN, and a mix of α-lactalbumin (α-LA) and ß-lactoglobulin (ß-LG)] from different animal species (bovine, ovine, and caprine) on pro- and anti-inflammatory cytokines and oxidative status in cultured peripheral blood mononuclear cells from children with generalized epilepsy. Peripheral blood mononuclear cells (PBMC) were obtained by density gradient from blood of 10 children with generalized epilepsy (5 males; mean age 33.6 ± 5.4 mo) and 10 controls (5 males; mean age 35.6 ± 6.8 mo). Children with epilepsy were grouped according to cytokine levels as follows: children with epilepsy having low levels of cytokines not different from those of control children (LL-EC); children with epilepsy having cytokine levels at least 5-fold higher (medium levels) than those of control children (ML-EC); and children with epilepsy having cytokine levels at least 10-fold higher (high levels) than those of control children (HL-EC). The production of tumor necrosis factor-α (TNF-α), IL-10, IL-6, and IL-1ß was studied in cultured PBMC incubated with αS1-CN, αS2-CN, κ-CN, ß-CN, and a mix of α-LA and ß-LG from bovine, caprine, and ovine milks. The levels of reactive oxygen and nitrogen species (ROS/RNS) and catalase activity were assessed in cultured supernatant. In the HL-EC group, ß-CN from small ruminant species (ovine and caprine) induced the highest levels of TNF-α, whereas PBMC incubated with αS2-CN from ovine milk and the mix of ß-LG and α-LA from all tested milk species had the lowest levels of TNF-α. Within the HL-EC group, production of IL-1ß was higher for bovine and ovine αS2-CN fractions and lower for caprine and ovine ß-CN and κ-CN. In the HL-EC group, IL-6 was higher in cultured PBMC incubated with αS2-CN from bovine and ovine milk than from caprine milk. The cytokine IL-10 did not differ among milking species. The highest levels of ROS/RNS were found after incubation of PBMC with the ß-CN fraction in bovine milk. Catalase activity was higher in PBMC cultured with ß-CN isolated from bovine and caprine milk and with αS1-CN from ovine milk.
Assuntos
Epilepsia Generalizada/metabolismo , Leucócitos Mononucleares/metabolismo , Proteínas do Leite/metabolismo , Estresse Oxidativo , Animais , Caseínas/metabolismo , Bovinos , Células Cultivadas , Pré-Escolar , Citocinas/metabolismo , Epilepsia Generalizada/etiologia , Feminino , Cabras , Humanos , Interleucina-10/metabolismo , Interleucina-6/metabolismo , Lactalbumina/metabolismo , Masculino , Proteínas do Leite/efeitos adversos , Proteínas do Leite/análise , Projetos Piloto , Espécies Reativas de Nitrogênio/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Ovinos , Fator de Necrose Tumoral alfa/metabolismoRESUMO
The main objective of this research was to determine whether a commercial orange juice rich in anthocyanins could have an effect on body weight and on clinical parameters related to obesity including antioxidant status, lipid profile, and metabolic and inflammatory biomarkers. 11 women with an average BMI of 34.4 ± 4.8 kg/m2 were enrolled in a pilot study. Over a period of 12 weeks they received 500 mL daily dose into two doses (250 mL) of commercial red orange juice (COJ). The biochemical parameters were measured at baseline and at the end of the study (12 weeks). One month later upon free diet, a follow-up was performed measuring the same variables. The daily consumption of 500 mL of COJ had no significant effects on body weight, while there was a decrease in total cholesterol and LDL cholesterol. The grade of obesity implies different changes in inflammation biomarkers. In obese women, our data do not seem to support evidence that commercial red orange juice consumption acts as functional food preventing obesity and metabolic disorders such as insulin resistance and/or inflammatory status.
Assuntos
Bebidas/análise , Citrus sinensis/química , Obesidade/prevenção & controle , Sobrepeso/prevenção & controle , Adulto , Antocianinas/farmacologia , Biomarcadores/análise , Índice de Massa Corporal , Peso Corporal/efeitos dos fármacos , Colesterol/sangue , LDL-Colesterol/sangue , Citrus sinensis/metabolismo , Feminino , Hemodinâmica/efeitos dos fármacos , Humanos , Estado Nutricional , Projetos PilotoRESUMO
The present study was undertaken to evaluate the effect of protein fractions from bovine, caprine, and ovine milk on production of cytokines and reactive oxygen species (ROS) and reactive nitrogen species (RNS) by cultured peripheral blood mononuclear cells (PMBC) from infants with generalized epilepsy. Bovine, caprine, and ovine bulk milks were pasteurized and analyzed for chemical composition. Then, PBMC were isolated from 10 patients with generalized epilepsy (5 males; mean age 33.6±5.4mo). Production of tumor necrosis factor-α (TNF-α), IL-10, IL-6, and IL-1ß was studied in cultured PBMC (from infants with epilepsy and controls) stimulated by bovine, caprine, and ovine milk and casein and whey protein fractions, and levels of ROS and RNS were measured in the culture supernatant. The ability of PBMC to secrete cytokines in response to milk and protein fraction stimulation may predict the secretion of soluble factor TNF-α in the bloodstream of challenged patients. Bovine, caprine, and ovine bulk milks induced low-level production of IL-10 by cultured PBMC in at least 50% of cases; the same behavior was observed in both casein and whey protein fractions for all species studied. Bovine and ovine milk and their casein fractions induced production of lower levels of IL-1ß in 80% of patients, whereas caprine milk and its casein fraction induced the highest levels in 80% of patients. The amount of IL-6 detected after stimulation of PBMC by milk and its fractions for all species was lower than that of other proinflammatory cytokines. In the bovine, total free radicals were higher in bulk milk and lower in the casein fraction, whereas the whey protein fraction showed an intermediate level; in caprine, ROS/RNS levels were not different among milk fractions, whereas ovine had higher levels for bulk milk and casein than the whey protein fraction. Lower levels of ROS/RNS detected in PBMC cultured with caprine milk fraction could be responsible for the lower levels of TNF-α cytokine in the corresponding fraction. Cytokines might be useful biomarkers to discriminate the effects of foods on the inflammatory response; dietary strategies could help in alleviating the negative effects of epilepsy in infants.
Assuntos
Citocinas/metabolismo , Epilepsia Generalizada/dietoterapia , Leucócitos Mononucleares/efeitos dos fármacos , Proteínas do Leite/farmacologia , Espécies Reativas de Oxigênio/metabolismo , Animais , Bovinos , Pré-Escolar , Citocinas/efeitos dos fármacos , Cabras , Humanos , Lactente , Itália , Masculino , Proteínas do Leite/administração & dosagem , Carneiro Doméstico , Especificidade da EspécieRESUMO
OBJECTIVES: The aim of this work was to evaluate the effect of long term supplementation with two moderate dose of Zn on plasma and cellular red-ox status markers in elderly volunteers. DESIGN, SETTING AND SUBJECTS: In a double blind study 108 healthy volunteers, aged 70-85 years, were enrolled. They were randomly divided in 3 groups of treatment, receiving placebo, 15 mg/day and 30 mg/day of Zn for 6 months. Red-ox status markers were assessed at baseline and after 6 months evaluating carotenoids, vitamin A and E in plasma; glutathione (GSH), thiol groups (RSH), malondialdehyde (MDA), percentage of haemolysis and methemoglobin in erythrocytes. RESULTS: Zn supplementation had no significant effects on red-ox status markers except for vitamin A levels (from 1.94±0.44 to 2.18±0.48 µM in volunteers receiving 15 mg of Zn and from 1.95±0.46 to 2.26±0.56 µM in volunteers receiving 30 mg of Zn), which increased proportionally to zinc dose. CONCLUSIONS: It appears that, differently from unhealthy populations, long-term supplementation with two moderate doses of Zn in a healthy elderly population, with an adequate Zn nutritive status and macro and micronutrients intakes in the range of normality, is an inefficient way to increase antioxidant defences.
Assuntos
Antioxidantes/administração & dosagem , Zinco/administração & dosagem , Zinco/farmacologia , Idoso , Idoso de 80 Anos ou mais , Antioxidantes/análise , Antioxidantes/farmacologia , Carotenoides/sangue , Inquéritos sobre Dietas , Suplementos Nutricionais , Método Duplo-Cego , Eritrócitos/efeitos dos fármacos , Eritrócitos/metabolismo , Feminino , Glutationa/sangue , Voluntários Saudáveis , Hemólise/efeitos dos fármacos , Humanos , Itália , Masculino , Malondialdeído/sangue , Metemoglobina/análise , Oxirredução/efeitos dos fármacos , Compostos de Sulfidrila/sangue , Vitamina A/sangue , Vitamina E/sangueRESUMO
This study aims at investigating the effect of an experimental period of intake of whole grain foods rich in lignans as part of an habitual diet on the plasma and urinary excretion of enterolignans, the biomarkers of lipid metabolism and the immunological and antioxidant status in a group of postmenopausal women with moderate serum cholesterol. A randomized double-blind crossover study was completed on 13 subjects in 12-weeks after protocol approval of an ethical committee. The subjects consumed whole grain foods high in lignans (30 g/d of breakfast cereals or biscuits, etc., 80 g/d of whole grain pasta) or refined grain foods for 4 weeks, separated by a 2-weeks wash-out period. A modest hypocholesterolemic effect (p < 0.05) of the whole grain diet was observed and the intake of whole grain products rich in lignans was also associated with an increase in urinary enterodiol excretion (p < 0.05).
Assuntos
Colesterol/sangue , Grão Comestível/química , Lignanas/administração & dosagem , Pós-Menopausa , Pressão Sanguínea , Índice de Massa Corporal , Peso Corporal , Estudos Cross-Over , Dieta , Método Duplo-Cego , Feminino , Glutationa Peroxidase/sangue , Humanos , Interleucina-1beta/sangue , Interleucina-6/sangue , Itália , Lignanas/urina , Pessoa de Meia-Idade , Projetos Piloto , Superóxido Dismutase/sangue , Fator de Necrose Tumoral alfa/sangueRESUMO
OBJECTIVE: We aimed to examine the association between adolescents' sleep time and a cardiometabolic risk score. A second aim was to examine associations between sleep time and individual cardiometabolic risk factors. METHODS: Adolescents (N=699; ages, 12.5-17.5 years) participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study were examined. Sleep time was reported by a questionnaire. Physical activity (PA) was assessed by accelerometry (n=497). Cardiometabolic risk factors measurements included insulin resistance, blood pressure, adiposity markers, cardiorespiratory fitness, and blood lipids. A cardiovascular disease risk score was computed. Associations were examined by a multilevel regression analysis (linear for individual risk factors and Poisson for the clustered risk score). RESULTS: For school days no association was found between sleep time and cardiometabolic risk factors. At weekend days, the prevalence ratio (PR) of having a clustered risk score increased by 15% for each additional hour of sleep controlling for age, sex, and socioeconomic status (SES); however, the prevalence disappeared when adjusting for PA. CONCLUSIONS: In European adolescents sleep time is not associated with cardiometabolic risk factors when important confounders are considered. Future research about sleep cardiovascular risk factors should register other sleep dimensions (sleep patterns or disturbances) to provide a better insight in this scientific field.
Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Metabólicas/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Sono , Acelerometria , Adolescente , Comportamento do Adolescente , Criança , Fatores de Confusão Epidemiológicos , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Estilo de Vida , Masculino , Aptidão Física , Prevalência , Análise de Regressão , Fatores de RiscoRESUMO
BACKGROUND AND AIMS: Although sedentary behaviours are linked with mortality for cardiovascular reasons, it is not clear whether they are negatively related with cardio-metabolic risk factors. The aim was to examine the association between time engaged in television (TV) viewing or playing with videogames and a clustered cardio-metabolic risk in adolescents. METHODS AND RESULTS: Sedentary behaviours and physical activity were assessed in 769 adolescents (376 boys, aged 12.5-17.5 years) from the HELENA-CSS study. We measured systolic blood pressure, HOMA index, triglycerides, TC/HDL-c, VO2max and the sum of four skinfolds, and a clustered metabolic risk index was computed. A multilevel regression model (by Poisson) was performed to calculate the prevalence ratio of having a clustered metabolic risk. In boys, playing >4 h/day with videogames (weekend) and moderate to vigorous PA (MVPA) was associated with cardio-metabolic risk after adjustment for age, maternal education and MVPA. In contrast, TV viewing was not associated with the presence of cardio-metabolic risk. CONCLUSION: In boys, playing with videogames may impair cardio-metabolic health during the adolescence. Adolescents should be encouraged to increase their participation in physical activity of at least moderate intensity to obtain a more favourable risk factor profile.
Assuntos
Comportamento do Adolescente , Doenças Cardiovasculares/epidemiologia , Doenças Metabólicas/epidemiologia , Comportamento Sedentário , Acelerometria , Adolescente , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Humanos , Atividades de Lazer , Masculino , Doenças Metabólicas/sangue , Doenças Metabólicas/etiologia , Atividade Motora , Distribuição de Poisson , Prevalência , Fatores de Risco , Instituições Acadêmicas , Caracteres Sexuais , Televisão , Jogos de Vídeo/efeitos adversosRESUMO
BACKGROUND: To determine long-term functional and morphological changes after full macular translocation (FMT) with 360° retinotomy in patients with retinal pigment epithelium (RPE) tears, in light of the increasing number of reports of this complication following vascular endothelial growth factor (VEGF)-modulating therapy. METHODS: We retrospectively reviewed a consecutive series of six patients with RPE tears secondary to neovascular age-related macular degeneration who underwent FMT with 360° retinotomy between March 2005 and June 2006. Preoperative and postoperative visual acuity, fundus fluorescein angiography (FA) and optical coherence tomography (OCT) were reviewed. RPE tears occurred spontaneously in three cases and after intravitreal triamcinolone in three cases. Preoperative and postoperative best-corrected visual acuity was converted to logarithm of the minimal angle of resolution visual acuity for analysis. RESULTS: Mean postoperative follow-up was 39 months (range 36-50 months). At 12, 24 and 36 months mean visual acuity increased by 6.00 (5.3), 5.57 (5.54) and 6.67 (4.76) lines, respectively. This improvement was maintained at final examination. FA and OCT revealed pigment epithelium atrophy extending to the new fovea in one case only, which also had longer symptom duration. CONCLUSIONS: Long-term follow-up of FMT showed significant improvement in the majority of patients. FMT may be an option for cases of RPE tears of recent onset. Further investigations are necessary to determine FMT's role in tears developing during the course of anti-VEGF therapy.
Assuntos
Macula Lutea/cirurgia , Descolamento Retiniano/cirurgia , Epitélio Pigmentado da Retina/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Degeneração Macular/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Estudos Retrospectivos , Tomografia de Coerência Óptica , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologiaRESUMO
BACKGROUND/OBJECTIVES: Data from human studies that have investigated the association between vitamin D status and cognitive function in elderly adults are conflicting. The objective of this study was to assess vitamin D status (reflected by serum 25-hydroxyvitamin D (25(OH)D)) in older European subjects (n=387; aged 55-87 years) and examine its association with measures of cognitive function. SUBJECTS/METHODS: Serum 25(OH)D was assessed using enzyme-linked immunosorbent assay, whereas measures of cognitive function were assessed using a comprehensive Cambridge Neuropsychological Testing Automated Battery (CANTAB). RESULTS: In all, 12, 36 and 64% of subjects had serum 25(OH)D concentrations <30, <50 and <80 nmol/l, respectively, throughout the year. Serum 25(OH)D was significantly and inversely correlated with four assessments within the spatial working memory (SWM) test parameter (SWM between errors (r=-0.166; P=0.003); SWM between errors 8 boxes (r=-0.134; P=0.038); SWM strategy (r=-0.246; P<0.0001); and SWM total errors (r=-0.174; P<0.003)). When subjects were stratified on the basis of tertiles (T) of serum 25(OH)D (<47.6 (T(1)); 47.6-85.8 (T(2)); and >85.8 (T(3)) nmol/l), fewer errors in SWM test scores occurred in subjects in the third T when compared with the first T (P<0.05-0.084). Stratification by sex showed that these differences between tertiles strengthened (P<0.001-0.043) in the females, but the differences were not significant (P>0.6) in males. CONCLUSIONS: Vitamin D insufficiency, but not deficiency, is widespread in the older population of several European countries. Low vitamin D status was associated with a reduced capacity for SWM, particularly in women.
Assuntos
25-Hidroxivitamina D 2/sangue , Calcifediol/sangue , Transtornos Cognitivos/epidemiologia , Estado Nutricional , Deficiência de Vitamina D/complicações , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Cognição , Transtornos Cognitivos/sangue , Transtornos Cognitivos/complicações , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Transtornos da Memória/sangue , Transtornos da Memória/complicações , Transtornos da Memória/epidemiologia , Memória de Curto Prazo , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologiaRESUMO
The main objective of this study was to evaluate the accuracy of self-reported weight and height among women with eating disorders. The study sample consisted of 271 women aged 18-50 yrs: 73 anorexic patients (AN) with a body mass index (BMI) of <18.50 kg/m2, 54 normal weight bulimic or rehabilitated patients (BU/RE: 18.5Assuntos
Estatura
, Imagem Corporal
, Peso Corporal
, Transtornos da Alimentação e da Ingestão de Alimentos/psicologia
, Autoimagem
, Adulto
, Índice de Massa Corporal
, Feminino
, Humanos
, Modelos Lineares
, Obesidade/psicologia
, Sobrepeso/psicologia
, Reprodutibilidade dos Testes
, Inquéritos e Questionários
RESUMO
Obesity is increasing in middle-aged adults and the elderly. This multifactorial phenomenon may have different causes, such as incorrect nutritional and dietary habits, psycho-social aspects and sedentary life-style. It is becoming a serious problem, due also to the world's ageing society. The aim of this study is to provide preliminary results on BMI, life-style and psycho-social aspects in a sample of Italian subjects, which also assesses the relationship between obesity and psychological health. We hypothesize that obesity is related to many factors, such as life-style, behavioral, socio-economic, and psychological aspects. The sample was made up of 107 obese and non-obese subjects, aged 50-74. All participants were given a multidimensional assessment, which included anthropometric, psycho-social and life-style evaluation. As per the protocol a structured life-style questionnaire designed to gather information on anthropometric measurements, socio-economic factors, physical activity, smoking, alcohol and food intake. The Symptom Checklist-90 (SCL-90) for the evaluation of a broad range of psychological problems and symptoms of psychopathology; the Binge Eating Scale (BES) for the assessment of disorders in the eating habits were administered. BMI was associated with age and education, socio-economic status and smoking in both genders. Psychological factors for obesity differed between overweight men and women. In conclusion, obesity and non-obesity appear as two different entities in some aspects. The increase in the prevalence of obesity in elderly subjects could lead to disability and age-related diseases. For this reason, greater insight of the factors related to the development of obesity is required to develop treatment strategies weight-loss prevention programs.
Assuntos
Índice de Massa Corporal , Ingestão de Energia/fisiologia , Comportamentos Relacionados com a Saúde , Estilo de Vida , Avaliação Nutricional , Obesidade/psicologia , Fatores Etários , Idoso , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/prevenção & controle , Prevalência , Estudos Retrospectivos , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To examine the reliability of a set of health-related physical fitness tests used in the European Union-funded Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study on lifestyle and nutrition among adolescents. DESIGN: A set of physical fitness tests was performed twice in a study sample, 2 weeks apart, by the same researchers. PARTICIPANTS: A total of 123 adolescents (69 males and 54 females, aged 13.6+/-0.8 years) from 10 European cities participated in the study. MEASUREMENTS: Flexibility, muscular fitness, speed/agility and aerobic capacity were tested using the back-saver sit and reach, handgrip, standing broad jump, Bosco jumps (squat jump, counter movement jump and Abalakov jump), bent arm hang, 4 x 10 m shuttle run, and 20-m shuttle run tests. RESULTS: The ANOVA analysis showed that neither systematic bias nor sex differences were found for any of the studied tests, except for the back-saver sit and reach test, in which a borderline significant sex difference was observed (P=0.044). The Bland-Altman plots graphically showed the reliability patterns, in terms of systematic errors (bias) and random error (95% limits of agreement), of the physical fitness tests studied. The observed systematic error for all the fitness assessment tests was nearly 0. CONCLUSIONS: Neither a learning nor a fatigue effect was found for any of the physical fitness tests when repeated. The results also suggest that reliability did not differ between male and female adolescents. Collectively, it can be stated that the reliability of the set of physical fitness tests examined in this study is acceptable. The data provided contribute to a better understanding of physical fitness assessment in young people.
Assuntos
Teste de Esforço/métodos , Estado Nutricional/fisiologia , Aptidão Física/fisiologia , Adolescente , Análise de Variância , Antropometria , Índice de Massa Corporal , Europa (Continente) , Feminino , Humanos , Estilo de Vida , Masculino , Reprodutibilidade dos Testes , Fatores SexuaisRESUMO
OBJECTIVE: To assess the effects of zinc supplementation on vitamin status in middle-aged and older volunteers. SUBJECTS/METHODS: Three hundred and eighty-seven healthy middle-aged (55-70 years) and older (70-85 years) men and women, randomly allocated to three groups to receive 15 or 30 mg Zn/day or placebo for 6 months. Dietary intake was assessed by means of a validated 4-day recall record. Fasting blood samples were simultaneously analysed for levels of plasma retinol and alpha-tocopherol by high-performance liquid chromatography. Erythrocyte folates were measured by a competitive immunoassay with direct chemiluminescence detection on an automatized immunoanalyser. Biochemical measurements were performed at baseline and after 3 and 6 months of zinc supplementation. RESULTS: Plasma vitamin A levels were significantly increased proportionally with zinc dose and period of treatment, particularly at 6 months (for 15 mg Zn/day, P<0.05; for 30 mg Zn/day, P<0.0001); no significant changes were observed in the placebo group. There was no effect of zinc supplementation on vitamin E/cholesterol ratio and erythrocyte folates. CONCLUSIONS: Our results show that a long-term zinc supplementation increases plasma vitamin A levels in middle-aged and older people of similar characteristics to those involved in this study. Moreover, supplementation influences serum zinc levels but does not affect erythrocyte zinc concentration and both plasma vitamin E and erythrocyte folate status.
Assuntos
Dieta , Estado Nutricional , Oligoelementos/administração & dosagem , Zinco/administração & dosagem , Zinco/sangue , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Cromatografia Líquida de Alta Pressão/métodos , Suplementos Nutricionais , Relação Dose-Resposta a Droga , Método Duplo-Cego , Eritrócitos/química , Feminino , Ácido Fólico/sangue , Ácido Fólico/metabolismo , Humanos , Medições Luminescentes/métodos , Masculino , Rememoração Mental , Pessoa de Meia-Idade , Inquéritos Nutricionais , Vitamina A/sangue , Vitamina E/sangueRESUMO
OBJECTIVE: To report a case of a newborn patient with renal failure due to polycystic kidneys requiring renal replacement therapy, and total anomalous pulmonary venous return requiring major cardiosurgical intervention. SETTING: Pediatric cardiosurgery operatory room and pediatric cardiologic intensive care. PATIENT: A 6-day-old newborn child weighing 3.1 kg. RESULTS: Renal function (creatinine value and urine output) was monitored during the course of the operation and intraoperative renal replacement therapy was not initiated. Serum creatinine concentration decreased from 4.4 to 3 mg/dL at cardiopulmonary bypass (CPB) start and to 1.5 at the end of surgery: the creatinine decrease was provided by the dilutional effect of CPB priming and the infusion of fresh blood from transfusions together with an adequate filtration rate (800 m/L in about 120 minutes). After the operation, extracorporeal membrane oxygenation (ECMO) for ventricular dysfunction and continuous hemofiltration for anuria refractory to medical therapy were prescribed. The hemofiltration machine was set in parallel with the ECMO machine at a blood flow rate of 60 ml/min and a predilution replacement solution infusion of 600 ml/h (4.5 ml/min of creatinine clearance once adjusted on extracorporeal circuits; 3000 mL/m2 hemofiltration): after a single hemofiltration session lasting 96 hours, serum creatinine reached optimal steady state levels around 0.5 mg/dL on postoperative day 2 and 3. CONCLUSION: Administration of intraoperative continuous hemofiltration is not mandatory in the case of a 3-kg newborn patient with established renal failure needing major cardiosurgery: hemodilution secondary to CPB, transfusion of hemoderivates, and optimal UF rate appear to be effective methods for achieving solute removal. If postoperative continuous hemofiltration is started, however, a "dialytic dose" of 4.5 ml/min allows an adequate creatinine clearance, quick achievement of a steady state of serum creatinine concentration and an eventual acceptable rate of inflammatory mediator removal.
Assuntos
Cardiopatias Congênitas/complicações , Hemofiltração/métodos , Insuficiência Renal/terapia , Ponte Cardiopulmonar , Cardiopatias Congênitas/cirurgia , Humanos , Recém-Nascido , Doenças Renais Policísticas/congênito , Insuficiência Renal/etiologiaRESUMO
OBJECTIVE: The objective of this paper is to provide descriptive information on anthropometric status, pathological conditions, cognitive impairment and lifestyle in apparently healthy elderly Italian people. DESIGN, SETTING AND SUBJECTS: In order to recruit the volunteers for the ZENITH study, 359 Italian participants (167 men and 192 women), aged between 70 and 85 years, free living in Rome, were selected. Volunteers underwent a full clinical examination, anthropometric measurements (height, weight), a lifestyle questionnaire and mental health assessment (cognitive impairment and depression). RESULTS: The prevalence of overweight and obesity was high (57% and 22% in men; 43% and 27% in women). Obesity was associated with low socio-economic profile in about 40% of participants. Although the sample was selected by family doctors and was apparently healthy, after medical screening the presence of several pathologies, particularly diabetes in 21% of participants was observed. There was a low prevalence of cognitive impairment in 4% of men and 7% of women and possible depression in 9% of men and 19% of women. The lifestyle questionnaire showed that most of their time was spent in light activities such as reading, watching TV or playing cards and significant differences between sex and BMI categories were observed (P=0.000). CONCLUSION: The results confirm the increasingly sedentary lifestyle of modern populations and demonstrate the need for sensitive and individualised strategies to design appropriate health promotion and disease prevention programs for older adults.
Assuntos
Antropometria , Diabetes Mellitus Tipo 2/epidemiologia , Nível de Saúde , Estilo de Vida , Saúde Mental , Obesidade/epidemiologia , Atividades Cotidianas , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Depressão/diagnóstico , Depressão/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Humanos , Itália/epidemiologia , Masculino , Obesidade/diagnóstico , Fatores Sexuais , Fatores SocioeconômicosRESUMO
Saltatory conduction in the nervous system is enabled through the intimate association between the leading edge of the myelin sheath and the axonal membrane to demarcate the node of Ranvier. The 186 kDa neuron specific isoform of the adhesion molecule neurofascin (Nfasc186) is required for the clustering of voltage gated Na+ channels at the node, whilst the 155 kDa glial specific isoform (Nfasc155) is required for the assembly of correct paranodal junctions. In order to understand the relationship between these vital structures and how they are affected in multiple sclerosis we have examined the expression of Nfasc155 and Nfasc186 in areas of inflammation, demyelination and remyelination from post-mortem brains. Fourteen cases of neuropathologically confirmed multiple sclerosis (8 female and 6 male; post-mortem delay 7-24 h; age 37-77 years; and disease duration 15-40 years), comprising 20 tissue blocks with 32 demyelinating or remyelinating lesions, were used in this study. A significant early alteration in Nfasc155+ paranodal structures occurs within and adjacent to actively demyelinating white matter lesions that are associated with damaged axons. Shaker-type Kv1.2 channels, normally located distally to the paranode, overlapped with the disrupted Nfasc155+ structures. In the absence of Nfasc155, Kv1.2 channels abutted normally clustered Nfasc186+ nodes, indicating that complete disruption of the paranodal structure and movement of Kv1.2 channels precede alterations at the node itself. Within areas of partial remyelination, a number of atypical triple-Nfasc155+ structures were noted that may represent transient oligodendrocyte-axonal contacts during the process of myelin repair or aberrant interactions. Within shadow plaques discretely clustered Na+v, Nfasc186+ and Nfasc155+ domains indicated the restoration of normal nodal architecture. The alterations in oligodendrocyte Nfasc155 expression that accompany inflammation and demyelination suggest an ongoing disruption to the axonal-oligodendrocyte complex within newly forming as well as established lesions in multiple sclerosis, resulting in destruction of the Nfasc186+/Na+v nodal complex vital to successful fast neurotransmission in the CNS.
Assuntos
Encéfalo/patologia , Moléculas de Adesão Celular/análise , Esclerose Múltipla/patologia , Bainha de Mielina/fisiologia , Fibras Nervosas Mielinizadas/patologia , Fatores de Crescimento Neural/análise , Adulto , Idoso , Autopsia , Axônios/química , Axônios/patologia , Axônios/fisiologia , Encéfalo/fisiopatologia , Química Encefálica , Feminino , Humanos , Imuno-Histoquímica/métodos , Inflamação/patologia , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/metabolismo , Esclerose Múltipla/fisiopatologia , Bainha de Mielina/patologia , Fibras Nervosas Mielinizadas/química , Fibras Nervosas Mielinizadas/fisiologia , Oligodendroglia/patologia , Canais de Potássio , Isoformas de Proteínas/análise , Nós Neurofibrosos/patologiaRESUMO
OBJECTIVE: To describe health and lifestyle factors of participants in the ZENITH study. DESIGN: A prospective multicentre intervention study employing a randomised double-blind design. PARTICIPANTS: Community dwelling older adults (n = 387), aged 55-87 y were recruited from regions in France, Italy and the UK. INTERVENTION: A self-report questionnaire comprising socio-demographic variables, dietary habits, physical activity in the home, at work and recreation. RESULTS: Participants differed with regards dietary habits and physical activity for each region. Recreational activity was higher in France and women generally tend to perform less hours of recreational activity per week than men. CONCLUSIONS: The differences found for these regions of Europe in relation to lifestyle factors will affect health and well-being within these countries and may mediate the impact of zinc supplementation on various biological and psychological parameters.