Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.105
Filtrar
1.
JAMA ; 323(1): 35-48, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31910279

RESUMO

Importance: Dietary supplements marketed for male fertility commonly contain folic acid and zinc based on limited prior evidence for improving semen quality. However, no large-scale trial has examined the efficacy of this therapy for improving semen quality or live birth. Objective: To determine the effect of daily folic acid and zinc supplementation on semen quality and live birth. Design, Setting, and Participants: The Folic Acid and Zinc Supplementation Trial was a multicenter randomized clinical trial. Couples (n = 2370; men aged ≥18 years and women aged 18-45 years) planning infertility treatment were enrolled at 4 US reproductive endocrinology and infertility care study centers between June 2013 and December 2017. The last 6-month study visit for semen collection occurred during August 2018, with chart abstraction of live birth and pregnancy information completed during April 2019. Interventions: Men were block randomized by study center and planned infertility treatment (in vitro fertilization, other treatment at a study site, and other treatment at an outside clinic) to receive either 5 mg of folic acid and 30 mg of elemental zinc (n = 1185) or placebo (n = 1185) daily for 6 months. Main Outcomes and Measures: The co-primary outcomes were live birth (resulting from pregnancies occurring within 9 months of randomization) and semen quality parameters (sperm concentration, motility, morphology, volume, DNA fragmentation, and total motile sperm count) at 6 months after randomization. Results: Among 2370 men who were randomized (mean age, 33 years), 1773 (75%) attended the final 6-month study visit. Live birth outcomes were available for all couples, and 1629 men (69%) had semen available for analysis at 6 months after randomization. Live birth was not significantly different between treatment groups (404 [34%] in the folic acid and zinc group and 416 [35%] in the placebo group; risk difference, -0.9% [95% CI, -4.7% to 2.8%]). Most of the semen quality parameters (sperm concentration, motility, morphology, volume, and total motile sperm count) were not significantly different between treatment groups at 6 months after randomization. A statistically significant increase in DNA fragmentation was observed with folic acid and zinc supplementation (mean of 29.7% for percentage of DNA fragmentation in the folic acid and zinc group and 27.2% in the placebo group; mean difference, 2.4% [95% CI, 0.5% to 4.4%]). Gastrointestinal symptoms were more common with folic acid and zinc supplementation compared with placebo (abdominal discomfort or pain: 66 [6%] vs 40 [3%], respectively; nausea: 50 [4%] vs 24 [2%]; and vomiting: 32 [3%] vs 17 [1%]). Conclusions and Relevance: Among a general population of couples seeking infertility treatment, the use of folic acid and zinc supplementation by male partners, compared with placebo, did not significantly improve semen quality or couples' live birth rates. These findings do not support the use of folic acid and zinc supplementation by male partners in the treatment of infertility. Trial Registration: ClinicalTrials.gov Identifier: NCT01857310.


Assuntos
Suplementos Nutricionais , Ácido Fólico/farmacologia , Infertilidade Masculina/tratamento farmacológico , Sêmen/efeitos dos fármacos , Zinco/farmacologia , Adolescente , Adulto , Fragmentação do DNA/efeitos dos fármacos , Suplementos Nutricionais/efeitos adversos , Feminino , Fertilização In Vitro , Ácido Fólico/efeitos adversos , Ácido Fólico/uso terapêutico , Humanos , Nascimento Vivo , Masculino , Pessoa de Meia-Idade , Análise do Sêmen , Contagem de Espermatozoides , Falha de Tratamento , Adulto Jovem , Zinco/efeitos adversos , Zinco/uso terapêutico
2.
Medicine (Baltimore) ; 98(37): e17095, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517834

RESUMO

BACKGROUND: The effectiveness of folic acid supplementation in stroke risk has been investigated, however, the available results are inconclusive and conflicting. The purpose of this systemic review and meta-analysis was to assess the effect of folic acid in patients with cardiovascular disease (CVD). METHODS: By searching the PubMed, EMBASE, and Cochrane library databases, we conducted a meta-analysis to evaluate effect of folic acid supplementation in patients with CVD. All-cause mortality, cardiovascular mortality, the risk of coronary heart disease (CHD) and stroke were summarized; hazard ratios (HR), the relative risk (RR) and its 95% confidence interval (CI) were also calculated. Fixed effects models were used to combine the data. A total of 12 randomized controlled trials, which involved 47,523 participants, met the inclusion criteria in this systematic review and meta-analysis. RESULTS: Our meta-analysis showed that cardiovascular patients who received folic acid therapy had significantly decreased risk of stroke (RR = 0.85, 95% CI = 0.77-0.94, Pheterogeneity = .347, I = 10.6%) compared with patients who received control treatment. However, no significant difference in all-cause mortality (HR, 0.97, 95% CI, 0.86-1.10, Pheterogeneity = .315, I = 15.4%), cardiovascular mortality (HR, 0.87, 95% CI, 0.66-1.15, Pheterogeneity = .567, I = 0) and risk of CHD (RR, 1.04, 95% CI, 0.99-1.10, Pheterogeneity = .725, I = 0) were found between the 2 groups. CONCLUSION: This meta-analysis suggested that folic acid supplementation significantly reduced the risk of stroke in patients with CVD.


Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Ácido Fólico/farmacologia , Doenças Cardiovasculares/mortalidade , Suplementos Nutricionais , Ácido Fólico/uso terapêutico , Humanos , Complexo Vitamínico B/farmacologia , Complexo Vitamínico B/uso terapêutico
3.
Int J Nanomedicine ; 14: 5527-5540, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31413561

RESUMO

Background: Nonspecific tumor targeting, potential relapse and metastasis of tumor after treatment are the main barriers in clinical photodynamic therapy (PDT) for cancer, hence, inhibiting relapse and metastasis of tumor is significant issues in clinic. Purpose: In this work, chidamide as a histone deacetylases inhibitor (HADCi) was bound onto a pH-responsive block polymer folate polyethylene glycol-b-poly(aspartic acid) (PEG-b-PAsp) grafted folate (FA-PEG-b-PAsp) to obtain the block polymer folate polyethylene glycol-b-poly(asparaginyl-chidamide) (FA-PEG-b-PAsp-chidamide, FPPC) as multimodal tumor-targeting drug-delivery carrier to inhibiting tumor cell proliferation and tumor metastasis in mice. Methods: Model photosensitizer pyropheophorbide-a (Pha) was encapsulated by FPPC in PBS to form the polymer micelles Pha@FPPC [folate polyethylene glycol-b-poly(asparaginyl-chidamide) micelles encapsulating Pha]. Pha@FPPC was characterized by transmission electron microscope and dynamic light scattering; also, antitumor activity in vivo and in vitro were investigated by determination of cellular ROS level, detection of cell apoptosis and cell cycle arrest, PDT antitumor activity in vivo and histological analysis. Results: With favorable and stable sphere morphology under transmission electron microscope (TEM) (~93.0 nm), Pha@FPPC greatly enhanced the cellular uptake due to its folate-mediated effective endocytosis by mouse melanoma B16-F10 cells and the yield of ROS in tumor cells induced by PDT, and mainly caused necrocytosis and blocked cell growth cycle not only in G2 phase but also in G1/G0 phase after PDT. Pha@FPPC exhibited lower dark cytotoxicity in vitro and a better therapeutic index because of its higher dark cytotoxicity/photocytotoxicity ratio. Moreover, Pha@FPPC not only significantly inhibited the growth of implanted tumor and prolonged the survival time of melanoma-bearing mice due to both its folate-mediated tumor-targeting and selectively accumulation at tumor site by EPR (enhanced permeability and retention)effect as micelle nanoparticles but also remarkably prevented pulmonary metastasis of mice melanoma after PDT compared to free Pha, demonstrating its dual antitumor characteristics of PDT and HDACi. Conclusion: As a folate-mediated and acid-activated chidamide-grafted drug-delivery carrier, FPPC may have great potential to inhibit tumor metastasis in clinical photodynamic treatment for cancer because of its effective and multimodal tumor-targeting performance as photosensitizer vehicle.


Assuntos
Aminopiridinas/química , Benzamidas/química , Ácido Fólico/uso terapêutico , Micelas , Fotoquimioterapia , Fármacos Fotossensibilizantes/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Pontos de Checagem do Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Clorofila/análogos & derivados , Clorofila/farmacologia , Sistemas de Liberação de Medicamentos , Liberação Controlada de Fármacos , Endocitose/efeitos dos fármacos , Ácido Fólico/farmacologia , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Concentração de Íons de Hidrogênio , Melanoma Experimental/tratamento farmacológico , Melanoma Experimental/patologia , Camundongos Endogâmicos C57BL , Nanopartículas/química , Nanopartículas/ultraestrutura , Fármacos Fotossensibilizantes/farmacologia , Polietilenoglicóis/química , Espécies Reativas de Oxigênio/metabolismo
4.
PLoS Med ; 16(8): e1002870, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31408467

RESUMO

BACKGROUND: Infant DNA methylation profiles are associated with their mother's periconceptional nutritional status. DNA methylation relies on nutritional inputs for one-carbon metabolic pathways, including the efficient recycling of homocysteine. This randomised controlled trial in nonpregnant women in rural Gambia tests the efficacy of a novel nutritional supplement designed to improve one-carbon-related nutrient status by reducing plasma homocysteine, and assesses its potential future use in preconception trials. METHODS AND FINDINGS: We designed a novel drink powder based on determinants of plasma homocysteine in the target population and tested it in a three-arm, randomised, controlled trial. Nonpregnant women aged between 18 and 45 from the West Kiang region of The Gambia were randomised in a 1:1:1 allocation to 12 weeks daily supplementation of either (a) a novel drink powder (4 g betaine, 800 µg folic acid, 5.2 µg vitamin B12, and 2.8 mg vitamin B2), (b) a widely used multiple micronutrient tablet (United Nations Multiple Micronutrient Preparation [UNIMMAP]) containing 15 micronutrients, or (c) no intervention. The trial was conducted between March and July 2018. Supplementation was observed daily. Fasted venepuncture samples were collected at baseline, midline (week 5), and endline (week 12) to measure plasma homocysteine. We used linear regression models to determine the difference in homocysteine between pairs of trial arms at midline and endline, adjusted for baseline homocysteine, age, and body mass index (BMI). Blood pressure and pulse were measured as secondary outcomes. Two hundred and ninety-eight eligible women were enrolled and randomised. Compliance was >97.8% for both interventions. At endline (our primary endpoint), the drink powder and UNIMMAP reduced mean plasma homocysteine by 23.6% (-29.5 to -17.1) and 15.5% (-21.2 to -9.4), respectively (both p < 0.001), compared with the controls. Compared with UNIMMAP, the drink powder reduced mean homocysteine by 8.8% (-15.8 to -1.2; p = 0.025). The effects were stronger at midline. There was no effect of either intervention on blood pressure or pulse compared with the control at endline. Self-reported adverse events (AEs) were similar in both intervention arms. There were two serious AEs reported over the trial duration, both in the drink powder arm, but judged to be unrelated to the intervention. Limitations of the study include the use of a single targeted metabolic outcome, homocysteine. CONCLUSIONS: The trial confirms that dietary supplements can influence metabolic pathways that we have shown in previous studies to predict offspring DNA methylation. Both supplements reduced homocysteine effectively and remain potential candidates for future epigenetic trials in pregnancy in rural Gambia. TRIAL REGISTRATION: Clinicaltrials.gov Reference NCT03431597.


Assuntos
Suplementos Nutricionais , Homocisteína/sangue , Adolescente , Adulto , Betaína/administração & dosagem , Betaína/uso terapêutico , Feminino , Ácido Fólico/administração & dosagem , Ácido Fólico/uso terapêutico , Gâmbia , Homocisteína/antagonistas & inibidores , Humanos , Pessoa de Meia-Idade , Estado Nutricional , Riboflavina/administração & dosagem , Riboflavina/uso terapêutico , Vitamina B 12/administração & dosagem , Vitamina B 12/uso terapêutico , Adulto Jovem
5.
Med Arch ; 73(2): 104-108, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31391697

RESUMO

Introduction: The dietary supplements are defined as vitamins and minerals or herbal products and are typically given in the form of a capsule or tablet. The nonsmokers are more attempted to use dietary supplements than individuals who smoke. Aim: In our investigation, we examined associations between vitamin B, folic acid, multivitamin or mineral intake among the student population and their correlation with smoking prevalence and drinking coffee. Materials and methods: We used a questionnaire to examine the general characteristics of the subjects, age, sex, their lifestyle, cigarette smoking, coffee intake and their use of dietary supplements. Data were collected from participants of the University of Sarajevo and a longitudinal study of 960 men and women aged 18-24 years from 2017 to 2018 was conducted. Results: The results showed that 32% of students took vitamin B supplements and 10% folic acid. In opposite, more than half of students took multivitamins (59.5%) and minerals (60.4%) less than one year. About a quarter or less took multivitamins (23.9%) and minerals (24.3%) for years. Less than 20% of students took multivitamins and minerals within a period of one year. In student population smoking prevalence was estimated at 21.2% and coffee intake in 71.2%. The smoking and use of vitamin B supplements were independent of each other, p = 0.201. The use of folic acid did not depend on smoking p = 0.501. There were no observed correlations between multivitamin and mineral supplement consumption compared to smoking status or drinking coffee. Conclusion: Deficient dietary intake of folic acid and B vitamins from food and supplemental sources appear to be one of the atherosclerosis incidences. Further studies should examine associations between dietary supplements intake and lifestyle of students, as well as smoking status and coffee intake.


Assuntos
Fumar Cigarros/epidemiologia , Café , Suplementos Nutricionais , Comportamento de Ingestão de Líquido , Estudantes/estatística & dados numéricos , Oligoelementos/uso terapêutico , Vitaminas/uso terapêutico , Bósnia e Herzegóvina/epidemiologia , Feminino , Ácido Fólico/uso terapêutico , Humanos , Masculino , Prevalência , Universidades , Complexo Vitamínico B/uso terapêutico , Adulto Jovem
6.
Saudi Med J ; 40(7): 727-731, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31287135

RESUMO

OBJECTIVES: To evaluate the awareness of spina bifida (SB), risk factors and possible preventive measures among mothers who had been following in our clinic with a spina bifida affected child. Methods: A cross-sectional questionnaire-based study with 38 mothers of SB patients who are following at SB and hydrocephalus clinic at King Fahad University Hospital, Khobar, Eastern Province, Saudi Arabia. RESULTS: Thirty-eight mother were included in this questionnaire. Most of the participants were Saudi (94.7%). Ten out of 38 women (26.3%) had used medications during pregnancy (pain medications and herbal drugs), 4 out of 38 (10.5%) had been exposed to imaging radiation, while 9 (23.7%) had experienced moderate to high grade fever (39-41°C) during pregnancy. Moreover, the majority (86.8%) of these women did not receive folic acid (FA) before pregnancy, and 42.1% of them did not have FA during their first trimester. Only one (2.6%) gave positive family history of SB while, 6 (15.8%) reported having other SB children.  Conclusion: There is a considerably low level of awareness in mothers of SB patients despite prevalence of this anomaly in the Eastern province. This necessitates an effort from health care providers to educate the community about this birth defect entity. Furthermore, genetic counseling should be encouraged especially in those who have a positive familial history for better understanding. Also, larger sample size with randomized controlled trials and larger epidemiological studies should be implemented.


Assuntos
Conscientização , Conhecimentos, Atitudes e Prática em Saúde , Mães , Disrafismo Espinal , Adolescente , Adulto , Analgésicos/uso terapêutico , Estudos Transversais , Feminino , Febre/epidemiologia , Ácido Fólico/uso terapêutico , Educação em Saúde , Humanos , Masculino , Anamnese , Meningocele/epidemiologia , Meningomielocele/epidemiologia , Preparações de Plantas/uso terapêutico , Gravidez , Complicações na Gravidez/epidemiologia , Diagnóstico Pré-Natal , Exposição à Radiação , Arábia Saudita/epidemiologia , Espinha Bífida Oculta/epidemiologia , Inquéritos e Questionários , Adulto Jovem
7.
Oxid Med Cell Longev ; 2019: 1342549, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308875

RESUMO

The aim of this study was to examine the effects of folic acid administration on the antioxidant enzyme (superoxide dismutase (SOD) and catalase (CAT)) activities, lactate and malate dehydrogenase (LDH and MDH) activities, and certain LDH and MDH isoform distribution in the cardiac tissue of diabetic Wistar male rats. Diabetes mellitus (DM) was induced by streptozotocin (STZ). There were five groups: C1-control (physiological saline 1 ml/kg, i.p. one day), C2-control with daily physiological saline treatment (1 ml/kg, i.p. 28 days), DM-diabetes mellitus (STZ 100 mg/kg in physiological saline, i.p. one day), FA-folic acid (5 mg/kg in physiological saline, i.p. 28 days), and DM+FA-diabetes mellitus and folic acid group (STZ 100 mg/kg in physiological saline, i.p. one day, and folic acid 5 mg/kg in physiological saline, i.p. 28 days). After four weeks, animal hearts were isolated for measurement of enzyme activities, as well as for histomorphometry analyses. An elevated glucose level and a decreased insulin level were obtained in the DM group. SOD, CAT, and MDH activities were elevated in the DM group, while there was no difference in LDH activity among the groups. In all tested groups, four LDH and three MDH isoforms were detected in the heart tissue, but with differences in their relative activities among the groups. Left ventricular cardiomyocyte transversal diameters were significantly smaller in both diabetic groups. Folic acid treatment of diabetic rats induced a reduced glucose level and reduced CAT, SOD, and MDH activities and alleviated the decrease in cardiomyocyte diameters. In conclusion, increased activities of antioxidant enzymes and MDH may be the consequence of oxidative stress caused by DM. Administration of the folic acid has a protective effect since it leads to reduction in glycemia and activities of the certain examined enzymes in the rats with experimentally induced DM.


Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Experimental/metabolismo , Ácido Fólico/uso terapêutico , Estresse Oxidativo/efeitos dos fármacos , Animais , Antioxidantes/metabolismo , Biomarcadores/metabolismo , Glicemia/efeitos dos fármacos , Catalase/metabolismo , Diabetes Mellitus Experimental/induzido quimicamente , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Oxirredução/efeitos dos fármacos , Ratos , Ratos Wistar , Estreptozocina/toxicidade , Superóxido Dismutase/metabolismo
8.
BMJ Case Rep ; 12(6)2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31253660

RESUMO

Transient splenial lesion(TSL) is seen in a variety of conditions and is detectable only on MRI of the brain. Dengue fever (DF) is a common viral infection encountered in the tropics. The affected patients may face neurological complications like encephalopathy and intracranial haemorrhage, or even ischaemic stroke. Non-cirrhotic hyperammonaemia is a rare scenario; and its occurrence in DF is unknown. The patient being described had DF and developed dysarthria. His MRI brain showed splenial hyperintensity. Further evaluation revealed non-cirrhotic hyperammonaemia. To the best of our knowledge, TSL due to non-cirrhotic hyperammonaemia in DF is an unreported scenario.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/virologia , Dengue/complicações , Dengue/diagnóstico , Hiperamonemia/etiologia , Acetaminofen/uso terapêutico , Analgésicos não Entorpecentes/uso terapêutico , Diagnóstico Diferencial , Ácido Fólico/uso terapêutico , Fármacos Gastrointestinais/uso terapêutico , Humanos , Lactulose/uso terapêutico , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Pantoprazol/uso terapêutico , Inibidores da Bomba de Prótons/uso terapêutico
9.
Nutr Clin Pract ; 34(4): 521-527, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31172585

RESUMO

Folate and its derivatives have long been used as an adjunctive treatment in methanol poisoning. Methanol is ultimately metabolized to formate, the toxic compound. The accumulation of formate can lead to acidemia, retinal damage, visual impairment, and death. Formate is converted to carbon dioxide and water in a folate-dependent manner, and folate is often given in cases of methanol poisoning. In this paper, the evidence for folate as an adjunctive therapy in methanol poisoning is reviewed.


Assuntos
Ácido Fólico/uso terapêutico , Metanol/envenenamento , Envenenamento/tratamento farmacológico , Complexo Vitamínico B/uso terapêutico , Quimioterapia Adjuvante , Humanos
10.
Medicina (Kaunas) ; 55(6)2019 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-31216637

RESUMO

Regarding cancer as a genetic multi-factorial disease, a number of aspects need to be investigated and analyzed in terms of cancer's predisposition, development and prognosis. One of these multi-dimensional factors, which has gained increased attention in the oncological field due to its unelucidated role in risk assessment for cancer, is diet. Moreover, as studies advance, a clearer connection between diet and the molecular alteration of patients is becoming identifiable and quantifiable, thereby replacing the old general view associating specific phenotypical changes with the differential intake of nutrients. Respectively, there are two major fields concentrated on the interrelation between genome and diet: nutrigenetics and nutrigenomics. Nutrigenetics studies the effects of nutrition at the gene level, whereas nutrigenomics studies the effect of nutrients on genome and transcriptome patterns. By precisely evaluating the interaction between the genomic profile of patients and their nutrient intake, it is possible to envision a concept of personalized medicine encompassing nutrition and health care. The list of nutrients that could have an inhibitory effect on cancer development is quite extensive, with evidence in the scientific literature. The administration of these nutrients showed significant results in vitro and in vivo regarding cancer inhibition, although more studies regarding administration in effective doses in actual patients need to be done.


Assuntos
Micronutrientes/uso terapêutico , Neoplasias/dietoterapia , Neoplasias/prevenção & controle , Nutrigenômica/métodos , Ácido Ascórbico/farmacologia , Ácido Ascórbico/uso terapêutico , Ácidos Graxos Insaturados/farmacologia , Ácidos Graxos Insaturados/uso terapêutico , Ácido Fólico/farmacologia , Ácido Fólico/uso terapêutico , Humanos , Micronutrientes/farmacologia , Nutrigenômica/instrumentação , Prebióticos , Probióticos/farmacologia , Probióticos/uso terapêutico , Medição de Risco/métodos , Selênio/farmacologia , Selênio/uso terapêutico , Vitamina A/farmacologia , Vitamina A/uso terapêutico , Vitamina D/farmacologia , Vitamina D/uso terapêutico
11.
Prensa méd. argent ; 105(5): 296-301, jun 2019. tab
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1024635

RESUMO

Folate deficiency in pregnant has been linked to neural tube defects in a substantial to neural tube defects in a substantial amount of medical literatures and has become a well-known fact among doctors; however, the knowledge of pregnant ladies about this association is poorly evaluated in our community. Vitamin and mineral deficiency is common among people in developing countries;however, the awareness of those people about such deficits and their associating compications is lacking. This study was conducted to evaluate the knowledge, attitude and practice of a cohort of pregnant ladies in Al-Diwaniyiah province in Mid-Euphrates region in Iraq. The present cross sectional study included 30 pregnant ladies. The study started on November 2018 and ended on January 2019. The study was carried out inAl-Diwaniyah maternity and child teaching hospital in Al-Diwaniyah province in Mid-Euphrates region, Iraq. The knowledge, attitude and practice of women regardin folie acid supplementation during early pregnancy was assessed according to 7 knowledge questions, 5 attitude questions and 5 practice questions. These questions and the demopgraphic data concerning women enrolled in the current study were obtained. The results of current study revealed poor knowledge about the advantage of folic acid in preventing congenital abnormalities was very obvious since ost of responses to the 7 questions concerning knowledge domain were within strongy disagreeing, disagree and neutral scores. Majority of response within attitude domain were in the form of disagree and strongly disagree. No correlation was found between any of the demain and the demographic characteristies of the study sample. Current study concluded that in Iraqi community, the knowledge and attitude of women toward the benefit of folie acid during early pregnancy in preventing neural tube defect iis poor; however, they practice well with this regard not due to their knowledge but because of the policy adopted by governmental antenatal care clinics and institutes (AU)


Assuntos
Humanos , Feminino , Gravidez , Estudos Transversais , Estudos de Coortes , Gestantes , Tubo Neural/anormalidades , Ácido Fólico/uso terapêutico
12.
Int J Mol Sci ; 20(9)2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31052503

RESUMO

Craniofacial bone defect anomalies affect both soft and hard tissues and can be caused by trauma, bone recessions from tumors and cysts, or even from congenital disorders. On this note, cleft/lip palate is the most prevalent congenital craniofacial defect caused by disturbed embryonic development of soft and hard tissues around the oral cavity and face area, resulting in most cases, of severe limitations with chewing, swallowing, and talking as well as problems of insufficient space for teeth, proper breathing, and self-esteem problems as a consequence of facial appearance. Spectacular advances in regenerative medicine have arrived, giving new hope to patients that can benefit from new tissue engineering therapies based on the supportive action of 3D biomaterials together with the synergic action of osteo-inductive molecules and recruited stem cells that can be driven to the process of bone regeneration. However, few studies have focused on the application of tissue engineering to the regeneration of the cleft/lip and only a few have reported significant advances to offer real clinical solutions. This review provides an updated and deep analysis of the studies that have reported on the use of advanced biomaterials and cell therapies for the regeneration of cleft lip and palate regeneration.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Fenda Labial/terapia , Fissura Palatina/terapia , Medicina Regenerativa/métodos , Animais , Fenda Labial/epidemiologia , Fenda Labial/patologia , Fenda Labial/fisiopatologia , Fissura Palatina/epidemiologia , Fissura Palatina/patologia , Fissura Palatina/fisiopatologia , Ácido Fólico/análogos & derivados , Ácido Fólico/uso terapêutico , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Osteogênese/efeitos dos fármacos , Transplante de Células-Tronco/métodos , Engenharia Tecidual/métodos
13.
Muscle Nerve ; 60(2): 124-136, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31074875

RESUMO

Complementary and alternative treatment modalities are commonly utilized by patients for neuropathy and neuropathic pain due to perceived lack of benefit from conventional medical treatment. As the association between metabolic syndrome and neuropathy is increasingly recognized, diet and lifestyle interventions are becoming important components in the management of neuropathy. Progress in the understanding of the gut-immune interaction highlights the role the gut microbiome and inflammation plays in the modulation of neuropathy and neuropathic pain. Evidence for nutritional interventions, exercise, supplements, acupuncture, and mindfulness-based practices in the treatment of neuropathic pain is encouraging. This article reviews the available evidence to support the safe use of complementary and alternative treatments for commonly encountered conditions associated with neuropathy and neuropathic pain. Muscle Nerve 60: 124-136, 2019.


Assuntos
Dietoterapia , Suplementos Nutricionais , Terapia por Exercício , Estilo de Vida , Neuralgia/terapia , Doenças do Sistema Nervoso Periférico/terapia , Complexo Vitamínico B/uso terapêutico , Acetilcarnitina/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Curcumina/uso terapêutico , Dieta , Disbiose/metabolismo , Exercício , Ácidos Graxos Ômega-3/uso terapêutico , Ácido Fólico/análogos & derivados , Ácido Fólico/uso terapêutico , Microbioma Gastrointestinal , Humanos , Medicina Integrativa , Síndrome Metabólica/metabolismo , Neuralgia/metabolismo , Doenças do Sistema Nervoso Periférico/metabolismo , Fosfato de Piridoxal/uso terapêutico , Ácido Tióctico/uso terapêutico , Vitamina B 12/análogos & derivados , Vitamina B 12/uso terapêutico , Complexo Vitamínico B/metabolismo , Deficiência de Vitaminas do Complexo B , Vitamina D/uso terapêutico
14.
Neurology ; 92(24): e2815-e2821, 2019 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-31101739

RESUMO

OBJECTIVE: To determine (1) the proportion of women with epilepsy (WWE) at risk of unintended pregnancy who use highly effective contraception, (2) demographic predictors, and (3) folic acid (FA) use. METHODS: These cross-sectional data come from 311 US WWE, 18-47 years, who participated in the Epilepsy Birth Control Registry (EBCR) web-based survey in 2017. They provided demographic, epilepsy, antiepileptic drug (AED), contraceptive, and FA data. We report frequencies of highly effective contraception use and use logistic regression to determine demographic predictors. We report the proportion who take FA. RESULTS: A total of 186 (59.8%) of the 311 WWE were at risk of unintended pregnancy. A total of 131 (70.4%) used a highly effective contraceptive category; 55 (29.6%) did not. An additional 13 (7.0%) used a combination of generally effective hormonal contraception with an enzyme-inducing AED, which poses increased risk of unintended pregnancy. Overall, 68 (36.6%) of the 186 WWE at risk did not use highly effective contraception. Increasing income (p = 0.004) and having insurance (p = 0.048) were predictors of highly effective contraception. A total of 50.0% took FA supplement. There was no significant difference in relation to the use or lack of use of highly effective contraception. CONCLUSION: A total of 36.6% of WWE in the EBCR did not use highly effective contraception and 50.0% did not take FA in 2017 despite the important negative consequences of unintended pregnancy on pregnancy outcomes. There is a need for more readily available information and counseling on safe and effective contraception and FA use for this community.


Assuntos
Anticonvulsivantes/uso terapêutico , Anticoncepção/estatística & dados numéricos , Eficácia de Contraceptivos , Epilepsia/tratamento farmacológico , Ácido Fólico/uso terapêutico , Complexo Vitamínico B/uso terapêutico , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Renda/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Modelos Logísticos , Pessoa de Meia-Idade , Adulto Jovem
15.
Int J Pediatr Otorhinolaryngol ; 122: 18-26, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30928866

RESUMO

OBJECTIVE: Anotia and microtia are congenital malformations of the external ear with few known risk factors. We conducted a comprehensive assessment of a wide range of potential risk factors using data from the National Birth Defects Prevention Study (NBDPS), a population-based case-control study of non-chromosomal structural birth defects in the United States. METHODS: Mothers of 699 infants with anotia or microtia (cases) and 11,797 non-malformed infants (controls) delivered between 1997 and 2011 were interviewed to obtain information about sociodemographic, health behavioral, and clinical characteristics. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated with logistic regression. RESULTS: Infants with anotia/microtia were more likely to be male (aOR, 1.29; 95% CI, 1.10-1.50) and from a multifetal pregnancy (aOR, 1.68; 95% CI, 1.16-2.42). Cases were also more likely to have parents of Hispanic ethnicity (maternal aOR, 3.19; 95% CI, 2.61-3.91; paternal aOR, 2.11; 95% CI, 1.54-2.88), and parents born outside the United States (maternal aOR, 1.29; 95% CI, 1.06-1.57; paternal aOR, 1.92; 95% CI, 1.53-2.41). Maternal health conditions associated with increased odds of anotia/microtia included obesity (aOR, 1.31; 95% CI, 1.06-1.61) and pre-pregnancy diabetes (type I aOR, 9.89; 95% CI, 5.46-17.92; type II aOR, 4.70; 95% CI, 2.56-8.63). Reduced odds were observed for black mothers (aOR, 0.57; 95% CI, 0.38-0.85) and mothers reporting daily intake of folic acid-containing supplements (aOR, 0.59; 95% CI, 0.46-0.76). CONCLUSION: We identified several risk factors for anotia/microtia, some which have been previously reported (e.g., diabetes) and others which we investigate for perhaps the first time (e.g., binge drinking) that warrant further investigation. Our findings point to some potentially modifiable risk factors and provide further leads toward understanding the etiology of anotia/microtia.


Assuntos
Microtia Congênita/epidemiologia , Diabetes Mellitus/epidemiologia , Adulto , Afro-Americanos/estatística & dados numéricos , Estudos de Casos e Controles , Microtia Congênita/etnologia , Suplementos Nutricionais , Orelha Externa/anormalidades , Pai/estatística & dados numéricos , Feminino , Ácido Fólico/uso terapêutico , Comportamentos Relacionados com a Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Recém-Nascido , Masculino , Mães/estatística & dados numéricos , Obesidade/epidemiologia , Gravidez , Gravidez Múltipla , Fatores de Proteção , Fatores de Risco , Fatores Sexuais , Estados Unidos/epidemiologia
16.
Chemosphere ; 227: 551-560, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31004822

RESUMO

Precise in vivo toxicological assays to determine the cardiotoxicity of pharmaceuticals and their waste products are essential in order to evaluate their risks to humans and the environment following industrial release. In the present study, we aimed to develop the sensitive imaging-based cardiotoxicity assay and combined 3D light-sheet microscopy with a zebrafish model to identify hidden cardiovascular anomalies induced by valproic acid (VPA) exposure. The zebrafish model is advantageous for this assessment because its embryos remain transparent. The 3D spatial localization of fluorescence-labeled cardiac cells in and around the heart using light-sheet technology revealed dislocalization of the heart from the outflow tract in two-day-old zebrafish embryos treated with 50 µM and 100 µM VPA (P < 0.01) and those embryos exposed to 20 µM VPA presented hypoplastic distal ventricles (P < 0.01). These two observed phenotypes are second heart field-derived cardiac defects. Quantitative analysis of the light-sheet imaging demonstrated that folic acid (FA) supplementation significantly increased the numbers of endocardial and myocardial cells (P < 0.05) and the accretion of second heart field-derived cardiomyocytes to the arterial pole of the outflow tract. The heart rate increased in response to the cellular changes occurring in embryonic heart development (P < 0.05). The present study disclosed the cellular mechanism underlying the role of FA in spontaneous cellular changes in cardiogenesis and in VPA-associated cardiotoxicity. The 3D light-sheet assay may be the next-generation test to evaluate the risks of previously undetected pharmaceutical and environmental cardiotoxicities in both humans and animals.


Assuntos
Cardiotoxicidade/diagnóstico por imagem , Ácido Fólico/uso terapêutico , Cardiopatias Congênitas/induzido quimicamente , Ácido Valproico/toxicidade , Peixe-Zebra/embriologia , Animais , Bioensaio/métodos , Cardiotoxicidade/tratamento farmacológico , Cardiotoxicidade/etiologia , Diagnóstico por Imagem/métodos , Embrião não Mamífero/efeitos dos fármacos , Desenvolvimento Embrionário/efeitos dos fármacos , Microscopia Intravital/métodos , Miócitos Cardíacos/efeitos dos fármacos , Miócitos Cardíacos/patologia
17.
Am J Clin Nutr ; 109(5): 1452-1461, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31005964

RESUMO

BACKGROUND: For women of reproductive age, a population-level red blood cell (RBC) folate concentration below the threshold 906 nmol/L or 400 ng/mL indicates folate insufficiency and suboptimal neural tube defect (NTD) prevention. A corresponding population plasma/serum folate concentration threshold for optimal NTD prevention has not been established. OBJECTIVE: The aim of this study was to examine the association between plasma and RBC folate concentrations and estimated a population plasma folate insufficiency threshold (pf-IT) corresponding to the RBC folate insufficiency threshold (RBCf-IT) of 906 nmol/L. METHODS: We analyzed data on women of reproductive age (n = 1673) who participated in a population-based, randomized folic acid supplementation trial in northern China. Of these women, 565 women with anemia and/or vitamin B-12 deficiency were ineligible for folic acid intervention (nonintervention group); the other 1108 received folic acid supplementation for 6 mo (intervention group). We developed a Bayesian linear model to estimate the pf-IT corresponding to RBCf-IT by time from supplementation initiation, folic acid dosage, methyltetrahydrofolate reductase (MTHFR) genotype, body mass index (BMI), vitamin B-12 status, or anemia status. RESULTS: Using plasma and RBC folate concentrations of the intervention group, the estimated median pf-IT was 25.5 nmol/L (95% credible interval: 24.6, 26.4). The median pf-ITs were similar between the baseline and postsupplementation samples (25.7 compared with 25.2 nmol/L) but differed moderately (±3-4 nmol/L) by MTHFR genotype and BMI. Using the full population-based baseline sample (intervention and nonintervention), the median pf-IT was higher for women with vitamin B-12 deficiency (34.6 nmol/L) and marginal deficiency (29.8 nmol/L) compared with the sufficient group (25.6 nmol/L). CONCLUSIONS: The relation between RBC and plasma folate concentrations was modified by BMI and genotype and substantially by low plasma vitamin B-12. This suggests that the threshold of 25.5 nmol/L for optimal NTD prevention may be appropriate in populations with similar characteristics, but it should not be used in vitamin B-12 insufficient populations. This trial was registered at clinicaltrials.gov as NCT00207558.


Assuntos
Suplementos Nutricionais , Eritrócitos/metabolismo , Deficiência de Ácido Fólico/diagnóstico , Ácido Fólico/uso terapêutico , Defeitos do Tubo Neural/prevenção & controle , Cuidado Pré-Concepcional/métodos , Vitamina B 12/sangue , Adulto , Teorema de Bayes , Índice de Massa Corporal , China , Feminino , Ácido Fólico/sangue , Deficiência de Ácido Fólico/sangue , Deficiência de Ácido Fólico/tratamento farmacológico , Genótipo , Humanos , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Terapia Nutricional , Saúde da População , Cuidado Pré-Concepcional/normas , Gravidez , Valores de Referência , Deficiência de Vitamina B 12/sangue , Adulto Jovem
19.
Psychiatr Danub ; 31(1): 69-77, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30948692

RESUMO

BACKGROUND: Folate is important for the synthesis of serotonin the neurotransmitter which plays a main role in OCD. We, therefore, explored the efficacy of folic acid as add on treatment to fluoxetine in a double blind study among patients with OCD. SUBJECTS AND METHODS: A double blind, 12-week study comparing the efficacy of folic acid as add on treatment and placebo in patients with OCD was conducted on thirty six (36) patients. Patients were randomly assigned to folic acid (5 mg/day) or placebo group in addition to fluoxetine (40 mg/day). After the baseline assessment, on week 2, 4, 6, 8 and 12 assessments were performed by using YBOCS, HAM-D, HAM-A and CGI-S. Serum folate, erythrocyte folate, serum homocysteine and B12 levels were measured both baseline and the end of study. RESULTS: A mixed model repeated measures ANCOVA on Y-BOCS scores were used to determine the difference between folic acid and placebo groups. No significant differences were found in the ratios of gender or in the mean age, serum folic acid level, erythrocyte folate level, serum homocysteine level and serum B12 level between the treatment groups at the baseline. Consecutively scores collected over six measurements on YBOCS, HAM-D, HAM-A and CGI showed non-significant differences between folic acid and placebo groups. CONCLUSION: None of the biological markers of one carbon metabolism were associated with the change in YBOCS scores. It may be assumed that there is no beneficial effect of folic acid addition to fluoxetine in the treatment of OCD.


Assuntos
Fluoxetina , Ácido Fólico , Transtorno Obsessivo-Compulsivo , Inibidores de Captação de Serotonina , Complexo Vitamínico B , Método Duplo-Cego , Quimioterapia Combinada , Fluoxetina/uso terapêutico , Ácido Fólico/uso terapêutico , Humanos , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Serotonina , Inibidores de Captação de Serotonina/uso terapêutico , Complexo Vitamínico B/uso terapêutico
20.
Ophthalmic Res ; 62(2): 80-92, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31018207

RESUMO

This study aimed to evaluate the therapeutic effect of folic acid (FA) on diabetic retinopathy (DR) in a genetic mouse model of obese type 2 diabetes mellitus (T2D). C57BL/KsJ-db/db (db/db) T2D mice were divided into control, FA, metformin (MET), and FA plus MET groups (n = 10/group). Serum levels of glucose, glycated hemoglobin, and insulin were determined weekly. The retinal thickness was measured using optical coherence tomography (OCT) at 4 weeks after treatments. The retinal expression and serum levels of vascular formation, inflammation, and oxidative stress-associated molecules were examined. Our results demonstrated that FA, but not MET, played a protective role against retinal thinning in the early stage of DR in db/db mice, although FA did not exhibit antihyperglycemic effect. In addition, retinal expression and serum levels of a panel of molecules associated with angiogenesis (CD31 and VEGFR), inflammation (IL-1ß and NLRP3), and oxidative stress (3-NT, 4-HNE, Vav2, and NOX4) were significantly downregulated in FA-treated diabetic mice compared with those in saline-treated controls. Furthermore, the serum level of homocysteine was also markedly decreased following FA treatments. These findings suggest that through potential suppressions on angiogenesis, inflammation, and oxidative stress, FA may serve as a potential therapeutic agent against DR.


Assuntos
Retinopatia Diabética/tratamento farmacológico , Ácido Fólico , Inflamação/metabolismo , Neovascularização Patológica/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Retina , Análise de Variância , Animais , Biomarcadores/metabolismo , Retinopatia Diabética/metabolismo , Retinopatia Diabética/patologia , Modelos Animais de Doenças , Feminino , Ácido Fólico/farmacologia , Ácido Fólico/uso terapêutico , Hemoglobina A Glicada/análise , Insulina/sangue , Interleucina-1beta/sangue , Camundongos , Camundongos Endogâmicos C57BL , Retina/metabolismo , Retina/patologia , Fator A de Crescimento do Endotélio Vascular/sangue
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA