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1.
Sci Total Environ ; 753: 142028, 2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-32906049

RESUMO

Although some persistent organic pollutants (POPs) were prohibited or limited in use several decades ago, they are still frequently detected in the human body. The purpose of this study was to understand the levels and profiles of POPs in breast milk in China and assess their potential health risks among breastfed infants under six months of age. A literature review focused on China was performed for studies published from 2001 to 2020. The POP levels in breast milk along with other important variables were extracted, and then the average individual POP levels in breast milk were estimated. This review summarises the distribution of traditional and new POPs, including polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), legacy brominated flame retardants (BFRs), perfluorinated compounds (PFCs), and chlorinated paraffins (CPs) and reported notably high levels of short-chain chlorinated paraffins and 1,1-dichloro-2,2-bis (p-chlorophenyl) ethylene (p,p'-DDE) in breast milk. Although the levels of traditional POPs generally declined over time, especially p,p'-DDE and beta-hexachlorocyclohexane (ß-HCH), women living in coastal areas, urban areas, and southern China still have a high body burden of certain POPs. In the present study, the estimated daily intake (EDI) of POPs through breastfeeding was used to evaluate the health risk for infants by comparing with acceptable levels. The findings suggested that infants born in coastal areas most likely suffered potential health risk from exposure to DDT, and the health risk of hexachlorobenzene (HCB) in infants in most nationwide regions remains a concern. More importantly, the EDI of PCBs for infants exceeds the safe limit on a national scale. Continuous surveillance of PCBs in breast milk is critical to evaluate the potential health effects on humans.


Assuntos
Poluentes Ambientais , Hidrocarbonetos Clorados , Praguicidas , Bifenilos Policlorados , China , Poluentes Ambientais/análise , Feminino , Humanos , Hidrocarbonetos Clorados/análise , Lactente , Leite Humano/química , Praguicidas/análise , Bifenilos Policlorados/análise
4.
Cochrane Database Syst Rev ; 9: CD000280, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32898300

RESUMO

BACKGROUND: Preterm infants are born with low glycogen stores and require higher glucose intake to match fetal accretion rates. In spite of the myriad benefits of breast milk for preterm infants, it may not adequately meet the needs of these rapidly growing infants. Supplementing human milk with carbohydrates may help. However, there is a paucity of data on assessment of benefits or harms of carbohydrate supplementation of human milk to promote growth in preterm infants. This is a 2020 update of a Cochrane Review first published in 1999. OBJECTIVES: To determine whether human milk supplemented with carbohydrate compared with unsupplemented human milk fed to preterm infants improves growth, body composition, and cardio-metabolic and neurodevelopmental outcomes without significant adverse effects. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search Cochrane Central Register of Controlled Trials (CENTRAL 2019, Issue 8) in the Cochrane Library and MEDLINE via PubMed on 22 August 2019. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: Published and unpublished controlled trials were eligible if they used random or quasi-random methods to allocate preterm infants in hospital fed human milk to supplementation or no supplementation with additional carbohydrate. DATA COLLECTION AND ANALYSIS: Two review authors independently abstracted data and assessed trial quality and the quality of evidence at the outcome level using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. We planned to perform meta-analyses using risk ratios (RRs) for dichotomous data and mean differences (MDs) for continuous data, with their respective 95% confidence intervals (CIs). We planned to use a fixed-effect model and to explore potential causes of heterogeneity via sensitivity analyses. We contacted study authors for additional information. MAIN RESULTS: One unblinded, quasi-randomised controlled trial (RCT) assessing effects of carbohydrate supplementation of human milk in the form of a prebiotic in 75 preterm infants was eligible for inclusion in this review. We identified two publications of the same trial, which reported different methods regarding blinding and randomisation. Study authors confirmed that these publications pertain to the same trial, but they have not yet clarified which method is correct. We were unable to reproduce analyses from the data presented. At 30 days of age, the mean weight of preterm infants in the trial was greater in the prebiotic carbohydrate-supplemented group than in the unsupplemented group (MD 160.4 grams, 95% CI 12.4 to 308.4 grams; one RCT, N = 75; very low-quality evidence). We found no evidence of a clear difference in risk of feeding intolerance (RR 0.64, 95% CI 0.36 to 1.15; one RCT, N = 75 infants; very low-quality evidence) or necrotising enterocolitis (NEC) (RR 0.2, 95% CI 0.02 to 1.3; one RCT, N = 75 infants; very low-quality evidence) between the prebiotic-supplemented group and the unsupplemented group. Duration of hospital stay was shorter in the prebiotic group than in the control group at a median (range) of 16 (9 to 45) days (95% CI 15.34 to 24.09) and 25 (11 to 80) days (95% CI 25.52 to 34.39), respectively. No other data were available for assessing effects of carbohydrate supplementation on short- and long-term growth, body mass index, body composition, and neurodevelopmental or cardio-metabolic outcomes. AUTHORS' CONCLUSIONS: We found insufficient evidence on the short- and long-term effects of carbohydrate supplementation of human milk in preterm infants. The only trial included in this review presented very low-quality evidence, and study authors provided uncertain information about study methods and analysis. The evidence may be limited in its applicability because researchers included a small sample of preterm infants from a single centre. However, the outcomes assessed are common to all preterm infants, and this trial demonstrates the feasibility of prebiotic carbohydrate supplementation in upper-middle-income countries. Future trials should assess the safety and efficacy of different types and concentrations of carbohydrate supplementation for preterm infants fed human milk. Although prebiotic carbohydrate supplementation in preterm infants is currently a topic of active research, we do not envisage that further trials of digestible carbohydrates will be conducted, as this is currently done as a component of multi-nutrient human milk fortification. Hence we do not plan to publish any further updates of this review.


Assuntos
Carboidratos da Dieta/administração & dosagem , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido Prematuro/crescimento & desenvolvimento , Leite Humano , Prebióticos , Peso Corporal , Enterocolite Necrosante/epidemiologia , Intolerância Alimentar/epidemiologia , Humanos , Recém-Nascido , Tempo de Internação , Leite Humano/química , Oligossacarídeos/administração & dosagem
5.
Environ Sci Process Impacts ; 22(10): 2023-2030, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32940316

RESUMO

Twenty per- and polyfluoroalkyl substances (PFAS) were determined in human milk from residents of three Chinese cities (Shanghai, Jiaxing, and Shaoxing; [n = 10 individuals per city]), sampled between 2010 and 2016. These data were compared to a combination of new and previously reported PFAS concentrations in human milk from Stockholm, Sweden, collected in 2016 (n = 10 individuals). Across the three Chinese cities, perfluorooctanoate (PFOA; sum isomers), 9-chlorohexadecafluoro-3-oxanone-1-sulfonic acid (9Cl-PF3ONS; also known as 6:2 Cl-PFESA or by its trade name "F53-B"), and perfluorooctane sulfonate (PFOS; sum isomers) occurred at the highest concentrations among all PFAS (up to 411, 976, and 321 pg mL-1, respectively), while in Stockholm, PFOA and PFOS were dominant (up to 89 and 72 pg mL-1, respectively). 3H-Perfluoro-3-[(3-methoxy-propoxy)propanoic acid] (ADONA) was intermittently detected but at concentrations below the method quantification limit (i.e. <10 pg mL-1) in Chinese samples, and was non-detectable in Swedish milk. The extremely high concentrations of F53-B in Chinese milk suggest that human exposure assessments focused only on legacy substances may severely underestimate overall PFAS exposure in breastfeeding infants.


Assuntos
Ácidos Alcanossulfônicos , Fluorcarbonetos , Ácidos Alcanossulfônicos/análise , China , Cidades , Fluorcarbonetos/análise , Humanos , Leite Humano/química , Suécia
6.
Ecotoxicol Environ Saf ; 205: 111331, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32977287

RESUMO

In China, many studies have been carried out on pesticide residues in human milk, yet all of them are on organochlorine pesticides (OCPs) and mostly focused on large, economically developed cities. In this study, 27 pesticides including OCPs, pyrethroid pesticides (PYRs) and organophosphate pesticides (OPPs) in human milk were investigated in Jinhua, an inland and medium sized city in China. Method based on QuEChERS extraction and gas chromatography-mass spectrometer (GC-MS) determination was adopted to analyze the above pesticide residues. The influencing factors as well as the health risks were also evaluated. Results show that PYRs and OPPs in human milk samples were both undetectable. Regarding OCPs, the detection rate of hexachlorobenzene (HCB), ß-hexachlorocyclohexane (ß-HCH) and p,p'-dichlorodiphenyl-dichloroethylene (p,p'-DDE) were 83.6%, 36.4% and 58.2%, respectively, and their mean value were 29.4, 32.0 and 85.2 ng/g lipid, respectively. p,p'-DDE levels in human milk was significantly (p < 0.05) related to maternal age, but no association was detected between OCPs residues and other factors (living environment, dietary habit, living style, etc.), suggesting that OCPs in human milk in Jinhua were originated from nonspecific source. All estimated daily intake of pesticides (EDIpesticides) by infants were under the guideline suggested by Food and Agriculture Organization (FAO) and China Ministry of Health (CMH). Yet 9% of EDIsHCB and 16% of EDIsHCHs exceeded the guideline recommended by Health Canada. The associations between DDE residues and the delivery way as well as HCBs residues and the birth weight were seemly significant, yet the significance disappeared when consider age or gestational age as a cofounder, indicating that OCPs residue in mother's body in Jinhua has no obvious influence on fetus development and the delivery way.


Assuntos
Hidrocarbonetos Clorados/análise , Leite Humano/química , Organofosfatos/análise , Resíduos de Praguicidas/análise , Adulto , China , Cidades , Diclorodifenil Dicloroetileno/análise , Feminino , Hexaclorobenzeno/análise , Hexaclorocicloexano/análise , Humanos , Lactente , Inseticidas/análise , Idade Materna , Medição de Risco
7.
Cochrane Database Syst Rev ; 9: CD000433, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32964431

RESUMO

BACKGROUND: Preterm infants require high protein intake to achieve adequate growth and development. Although breast milk feeding has many benefits for this population, the protein content is highly variable, and inadequate to support rapid infant growth. This is a 2020 update of a Cochrane Review first published in 1999. OBJECTIVES: To determine whether protein-supplemented human milk compared with unsupplemented human milk, fed to preterm infants, improves growth, body composition, cardio-metabolic, and neurodevelopmental outcomes, without significant adverse effects. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search Cochrane Central Register of Controlled Trials (CENTRAL 2019, Issue 8) in the Cochrane Library and MEDLINE via PubMed on 23 August 2019. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: Published and unpublished RCTs were eligible if they used random or quasi-random methods to allocate hospitalised preterm infants who were being fed human milk, to additional protein supplementation or no supplementation. DATA COLLECTION AND ANALYSIS: Two review authors independently abstracted data, assessed risk of bias and the quality of evidence at the outcome level, using GRADE methodology. We performed meta-analyses, using risk ratio (RR) for dichotomous data, and mean difference (MD) for continuous data, with their respective 95% confidence intervals (CIs). We used a fixed-effect model and had planned to explore potential causes of heterogeneity via subgroup or sensitivity analyses. MAIN RESULTS: We included six RCTs, involving 204 preterm infants. The risk of bias for most methodological domains was unclear as there was insufficient detail reported. Low-quality evidence showed that protein supplementation of human milk may increase in-hospital rates of growth in weight (MD 3.82 g/kg/day, 95% CI 2.94 to 4.7; five RCTs, 101 infants; I² = 73%), length (MD 0.12 cm/wk, 95% CI 0.07 to 0.17; four RCTs, 68 infants; I² = 89%), and head circumference (MD 0.06 cm/wk, 95% CI 0.01 to 0.12; four RCTs, 68 infants; I² = 84%). Protein supplementation may lead to longer hospital stays (MD 18.5 days, 95% CI 4.39 to 32.61; one RCT, 20 infants; very low-quality evidence). Very low quality evidence means that the effect of protein supplementation on the risk of feeding intolerance (RR 2.70, 95% CI 0.13 to 58.24; one RCT, 17 infants), or necrotizing enterocolitis (RR 1.11, 95% CI 0.07 to 17.12; one RCT, 76 infants) remains uncertain. No data were available about the effects of protein supplementation on neurodevelopmental outcomes. AUTHORS' CONCLUSIONS: Low-quality evidence showed that protein supplementation of human milk, fed to preterm infants, increased short-term growth. However, the small sample sizes, low precision, and very low-quality evidence regarding duration of hospital stay, feeding intolerance, and necrotising enterocolitis precluded any conclusions about these outcomes. There were no data on outcomes after hospital discharge. Our findings may not be generalisable to low-resource settings, as none of the included studies were conducted in these settings. Since protein supplementation of human milk is now usually done as a component of multi-nutrient fortifiers, future studies should compare different amounts of protein in multi-component fortifiers, and be designed to determine the effects on duration of hospital stay and safety, as well as on long-term growth, body composition, cardio-metabolic, and neurodevelopmental outcomes.


Assuntos
Proteínas na Dieta , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido Prematuro/crescimento & desenvolvimento , Leite Humano , Viés , Estatura , Enterocolite Necrosante/epidemiologia , Cabeça/crescimento & desenvolvimento , Humanos , Recém-Nascido , Tempo de Internação/estatística & dados numéricos , Leite Humano/química , Ensaios Clínicos Controlados Aleatórios como Assunto , Ganho de Peso
8.
Environ Pollut ; 267: 115425, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32882460

RESUMO

Humans are exposed to various anthropogenic chemicals in daily life, including endocrine-disrupting chemicals (EDCs). However, there are limited data on chronic, low-level exposure to such contaminants among the general population. Here hair analysis was used to investigate the occurrence of four polychlorinated biphenyls (PCBs), seven polybrominated diphenyl ethers (PBDEs) and two bisphenols (BPs) in 204 Chinese women living in the urban areas of Baoding and Dalian and 311 pregnant French women. All the PCBs and PBDEs tested here were more frequently detected in the hair samples of the French women than in those of the Chinese women. In both cohorts, PCB 180 and BDE 47 were the dominant PCB and PBDE congener, respectively. PCB 180 was found in 82% of the French women and 44% of the Chinese women, while the corresponding values of BDE 47 were 54% and 11%, respectively. A discriminant analysis further demonstrated the difference in PCBs and PBDEs exposure profile between the two cohorts. These results demonstrate that hair analysis is sufficiently sensitive to detect exposure to these pollutants and highlight differences in exposure between populations even at environmental levels. Although BPA and BPS were found in 100% of the hair samples in both cohorts, the French women had significantly higher levels of BPA and BPS than the Chinese women. The median concentrations of BPA were one order of magnitude higher than BPS in both the Chinese (34.9 versus 2.84 pg/mg) and the French women (118 versus 8.01 pg/mg) respectively. Our results suggest that both French and Chinese populations were extensively exposed to BPA and BPS.


Assuntos
Poluentes Ambientais , Bifenilos Policlorados , Adulto , China , Poluentes Ambientais/análise , Feminino , França , Éteres Difenil Halogenados/análise , Humanos , Leite Humano/química , Bifenilos Policlorados/análise , Gravidez
9.
Int Breastfeed J ; 15(1): 82, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928250

RESUMO

BACKGROUND: The COVID-19 pandemic is disrupting normal life globally, every area of life is touched. The pandemic demands quick action and as new information emerges, reliable synthesises and guidelines for care are urgently needed. Breastfeeding protects mother and child; its health benefits are undisputed and based on evidence. To plan and support breastfeeding within the current pandemic, two areas need to be understood: 1) the clinical characteristics of COVID-19 as it applies to breastfeeding and 2) the protective properties of breastfeeding, including the practice of skin-to-skin care. This review aims to summarise how to manage breastfeeding during COVID-19. The summary was used to create guidelines for healthcare professionals and mothers. METHODS: Current publications on breastfeeding during the COVID-19 pandemic were reviewed to inform guidelines for clinical practice. RESULTS: Current evidence states that the Coronavirus is not transmitted via breastmilk. Breastfeeding benefits outweigh possible risks during the COVID-19 pandemic and may even protect the infant and mother. General infection control measures should be in place and adhered to very strictly. CONCLUSIONS: Breastfeeding should be encouraged, mothers and infant dyads should be cared for together, and skin-to-skin contact ensured throughout the COVID-19 pandemic. If mothers are too ill to breastfeed, they should still be supported to express their milk, and the infant should be fed by a healthy individual. Guidelines, based on this current evidence, were produced and can be distributed to health care facilities where accessible information is needed.


Assuntos
Aleitamento Materno , Infecções por Coronavirus/fisiopatologia , Pneumonia Viral/fisiopatologia , Betacoronavirus/fisiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Humanos , Leite Humano/química , Mães/estatística & dados numéricos , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
10.
Am J Clin Nutr ; 112(4): 1039-1050, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32844187

RESUMO

BACKGROUND: Maternal micronutrient deficits during preconception and pregnancy may persist during lactation and compromise human milk composition. OBJECTIVE: We measured micronutrient concentrations in human milk and investigated their association with maternal micronutrient intakes, status, and milk volume. METHODS: Infant milk intake (measured via a deuterium dose-to-mother technique), milk micronutrient and fat concentrations, and maternal micronutrient intakes were assessed at 2 and 5 mo postpartum in 212 Indonesian lactating mother-infant pairs. Maternal hemoglobin, ferritin, transferrin receptors, retinol binding protein (RBP), zinc, selenium, and vitamin B-12 were measured at 5 mo (n = 163). Multivariate or mixed effects regression examined associations of milk micronutrient concentrations with maternal micronutrient intakes, status, and milk volume. RESULTS: Prevalence of anemia (15%), and iron (15% based on body iron), selenium (2.5%), and vitamin B-12 deficiency (0%) were low compared with deficiencies of zinc (60%) and vitamin A (34%). The prevalence of inadequate intakes was >50% for 7 micronutrients at 2 and 5 mo. Median milk concentrations for most micronutrients were below reference values, and nearly all declined between 2 and 5 mo postpartum and were not associated substantially with milk volume (except for ß-carotene, α-carotene, and ß-cryptoxanthin). At 5 mo postpartum, associations between maternal micronutrient status and corresponding milk concentrations reported as mean percentage difference in human milk concentration for each unit higher maternal biomarker were significant for hemoglobin (1.9%), iron biomarkers (ranging from 0.4 to 7%), RBP (35%), selenium (70%), and vitamin B-12 (0.1%), yet for maternal intakes only a positive association with ß-carotene existed. CONCLUSIONS: Most milk micronutrient concentrations declined during lactation, independent of changes in human milk production, and few were associated with maternal micronutrient intakes. The significant associations between maternal biomarkers and milk micronutrient concentrations at 5 mo warrant further study to investigate whether the declines in milk micronutrients are linked to shifts in maternal status.


Assuntos
Dieta , Micronutrientes/análise , Leite Humano/química , Período Pós-Parto/metabolismo , Adulto , Feminino , Humanos , Micronutrientes/administração & dosagem , Gravidez
11.
J Chromatogr A ; 1626: 461381, 2020 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-32797855

RESUMO

A reliable and sensitive analytical approach has been optimized for the extraction of seven polychlorinated biphenyls (PCBs) from human breast milk. Hollow fiber liquid phase microextraction (HF-LPME) was applied for the first time for the extraction and pre-concentration of the analytes. Analytes were separated by gas chromatography with electron capture detector (GC-µECD) for the sensitive detection and mass spectrometry for the unequivocal identification. A rotable central composite design (RCCD) was performed for the multivariate optimization of the method. The best results were obtained at 40 °C during 30 min and 600 rpm of stirring speed using a hollow fiber length of 5 cm and toluene as an extractant phase and salt addition was not required. The detection limits were in the range 7-14 ng L-1 for PCBs. The coefficients of determination of the calibration curves indicated good linearity (R2> 0.96) and the enrichment factors ranged from 74 to 143. This type of study is of great importance due to the deleterious effect that the presence of contaminants can produce in infants health related to the immature character of the defense system. Moreover, exclusive breastfeeding is recommended by neonatologists up to six months of life and as complementary food during the first two years.


Assuntos
Microextração em Fase Líquida/métodos , Leite Humano/química , Bifenilos Policlorados/análise , Cromatografia Gasosa , Humanos , Concentração de Íons de Hidrogênio , Limite de Detecção , Bifenilos Policlorados/isolamento & purificação , Porosidade , Reprodutibilidade dos Testes , Sais/química
12.
Environ Pollut ; 265(Pt A): 115096, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32806402

RESUMO

In this study, levels of dechlorane plus (DP) in breast milk and matched adipose tissue samples were measured from 54 women living in Wenling, China. Polybrominated diphenyl ethers (PBDEs) and polychlorinated biphenyls (PCBs) were measured simultaneously for comparison. The levels of ∑DPs/∑PBDEs varied from less than one to several dozens of ng g-1 lipid weight (lw) in matrices and the levels of ∑PCBs varied between several to hundreds of ng g-1 lw. In the same matrix, ∑DPs and ∑PCBs/∑PBDEs showed a significant relationship (p < 0.05), indicating that they shared common sources. Accordingly, there was a strong association of lipid-adjusted concentrations of individual compounds (BDE-209 excluded) between matrices (p < 0.001), suggesting that breast milk could be a proxy for adipose tissue in human bioburden monitoring of these compounds. The predicted lipid-adjusted milk/adipose ratios varied from 0.62 to 1.5 but showed significant differences (p<0.001) between compounds, suggesting a compound-specific transfer between milk lipids and adipose tissue lipids. Specifically, the milk/adipose ratios for syn-DP and anti-DP (-1.40 and 1.3, respectively) were significantly higher than those of CB congeners and hexa/hepta-BDE congeners (p < 0.05). In addition, unlike PCBs/PBDEs (excluding BDE-209), DP's hydrophobicity might not be responsible for its preferable distribution in milk lipids. Instead, the interaction with nonlipid factors played a key role. The fraction of anti-DP between the two kinds of matrices was not significantly different, suggesting that the biochemical transfer processes may not be efficient enough to distinguish DP isomers. Nevertheless, the congener patterns of PCBs/PBDEs gave a clue about the compound-specific transfer between milk and adipose tissue. To our knowledge, this is the first to report the relationships of DP between adipose tissue and breast milk. These results could provide useful and in-depth information on biomonitoring of DP and facilitate the understanding of the accumulation and excretion potentials of DP and its distribution-related mechanism in humans.


Assuntos
Poluentes Ambientais/análise , Leite Humano/química , Tecido Adiposo/química , China , Feminino , Humanos , Hidrocarbonetos Clorados , Compostos Policíclicos
13.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32661188

RESUMO

Cannabinoids, the psychoactive compounds in marijuana, are one of the most commonly used substances in the United States. In this review, we summarize the impact of marijuana on child and adolescent health and discuss the implications of marijuana use for pediatric practice. We review the changing epidemiology of cannabis use and provide an update on medical use, routes of administration, synthetic marijuana and other novel products, the effect of cannabis on the developing brain, other health and social consequences of use, and issues related to marijuana legalization.


Assuntos
Cannabis , Uso da Maconha , Adolescente , Comportamento do Adolescente/efeitos dos fármacos , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/embriologia , Encéfalo/crescimento & desenvolvimento , Canabidiol/farmacologia , Canabidiol/uso terapêutico , Canabinoides/efeitos adversos , Canabinoides/síntese química , Canabinoides/farmacologia , Cannabis/efeitos adversos , Cannabis/química , Cannabis/envenenamento , Criança , Comportamento Infantil/efeitos dos fármacos , Interações Medicamentosas , Endocanabinoides/fisiologia , Feminino , Feto/efeitos dos fármacos , Humanos , Drogas Ilícitas/efeitos adversos , Masculino , Abuso de Maconha/epidemiologia , Abuso de Maconha/terapia , Uso da Maconha/efeitos adversos , Uso da Maconha/epidemiologia , Uso da Maconha/legislação & jurisprudência , Uso da Maconha/psicologia , Meios de Comunicação de Massa , Maconha Medicinal/efeitos adversos , Maconha Medicinal/uso terapêutico , Leite Humano/química , Transtornos Neurocognitivos/induzido quimicamente , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Receptores de Canabinoides/efeitos dos fármacos , Receptores de Canabinoides/fisiologia , Uso de Tabaco/epidemiologia
14.
Am J Clin Nutr ; 112(3): 669-682, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32649760

RESUMO

BACKGROUND: Maternal supplementation during lactation could increase milk B-vitamin concentrations, but little is known about the kinetics of milk vitamin responses. OBJECTIVES: We compared acute effects of maternal lipid-based nutrient supplement (LNS) consumption (n = 22 nutrients, 175%-212% of the RDA intake for the nutrients examined), as a single dose or at spaced intervals during 8 h, on milk concentrations and infant intake from milk of B-vitamins. METHODS: This randomized crossover trial in Quetzaltenango, Guatemala included 26 mother-infant dyads 4-6 mo postpartum who were randomly assigned to receive 3 treatments in a random order: bolus 30-g dose of LNS (Bolus); 3 × 10-g doses of LNS (Divided); and no LNS (Control), with control meals. Mothers attended three 8-h visits during which infant milk consumption was measured and milk samples were collected at every feed. Infant intake was assessed as $\mathop \sum \nolimits_{i\ = \ 1}^n ( {{\rm{milk\ volum}}{{\rm{e}}_{{\rm{feed\ }}n}} \times \ {\rm{nutrient\ concentratio}}{{\rm{n}}_{{\rm{feed}}\ n}}} )$ over 8 h. RESULTS: Maternal supplementation with the Bolus or Divided dose increased least-squares mean (95% CI) milk and infant intakes of riboflavin [milk: Bolus: 154.4 (138.2, 172.5) µg · min-1 · mL-1; Control: 84.5 (75.8, 94.3) µg · min-1 · mL-1; infant: Bolus: 64.5 (56.1, 74.3) µg; Control: 34.5 (30.0, 39.6) µg], thiamin [milk: Bolus: 10.9 (10.1, 11.7) µg · min-1 · mL-1; Control: 7.7 (7.2, 8.3) µg · min-1 · mL-1; infant: Bolus: 5.1 (4.4, 6.0) µg; Control: 3.4 (2.9, 4.0) µg], and pyridoxal [milk: Bolus: 90.5 (82.8, 98.9) µg · min-1 · mL-1; Control: 60.8 (55.8, 66.3) µg · min-1 · mL-1; infant: Bolus: 39.4 (33.5, 46.4) µg; Control: 25.0 (21.4, 29.2) µg] (all P < 0.001). Only the Bolus dose increased cobalamin in milk [Bolus: 0.054 (0.047, 0.061) µg · min-1 · mL-1; Control: 0.041 (0.035, 0.048) µg · min-1 · mL-1, P = 0.039] and infant cobalamin intake [Bolus: 0.023 (0.020, 0.027) µg; Control: 0.015 (0.013, 0.018) µg, P = 0.001] compared with Control. Niacin was unaffected. CONCLUSIONS: Maternal supplementation with LNS as a Bolus or Divided dose was similarly effective at increasing milk riboflavin, thiamin, and pyridoxal and infant intakes, whereas only the Bolus dose increased cobalamin. Niacin was unaffected in 8 h. This trial was registered at clinicaltrials.gov as NCT02464111.


Assuntos
Aleitamento Materno , Lactação , Micronutrientes/administração & dosagem , Micronutrientes/sangue , Vitaminas/administração & dosagem , Vitaminas/sangue , Adulto , Área Sob a Curva , Estudos Cross-Over , Suplementos Nutricionais , Feminino , Guatemala , Humanos , Lactente , Micronutrientes/química , Leite Humano/química , Niacina/administração & dosagem , Niacina/sangue , Niacina/farmacocinética , Piridoxal/administração & dosagem , Piridoxal/sangue , Piridoxal/farmacocinética , Riboflavina/administração & dosagem , Riboflavina/sangue , Riboflavina/farmacocinética , Tiamina/administração & dosagem , Tiamina/sangue , Tiamina/farmacocinética , Vitamina B 12/administração & dosagem , Vitamina B 12/sangue , Vitamina B 12/farmacocinética , Vitaminas/farmacocinética , Adulto Jovem
15.
SAR QSAR Environ Res ; 31(6): 457-475, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32627677

RESUMO

In silico methods are often used for predicting pharmacokinetic properties of drugs due to their simplicity and cost-effectiveness. This study evaluates the penetration of 83 active pharmaceutical ingredients into human breast milk with an experimental milk-to-plasma ratio (M/P) obtained from the literature. Multiple linear regression (MLR), partial least squares (PLS) and random forest (RF) regression methods were compared to uncover the relationship between physicochemical, pharmacokinetic and membrane crossing properties of active pharmaceutical ingredients (APIs) using their rapid reference measurement value (Rf values), thin-layer chromatography (TLC) data from albumin-impregnated plates. Molecular descriptors of APIs proven to be important for their crossing into breast milk, including protein binding, ionisation state and lipophilicity and TLC data, have been included in the development of the prediction models. The best regression results were achieved by MLR (r 2 = 0.83 and r 2 = 0.86, n = 28) and RF (r 2 = 0.85, n = 58). In addition, the discriminant function analysis (DFA) was performed on acidic, basic and neutral drugs separately and showed a prediction accuracy of 93%, with M/P included as the discriminating variable.


Assuntos
Análise dos Mínimos Quadrados , Modelos Lineares , Leite Humano/química , Preparações Farmacêuticas/metabolismo , Relação Quantitativa Estrutura-Atividade , Preparações Farmacêuticas/química
16.
Sci Total Environ ; 744: 140710, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-32712415

RESUMO

The main objective of the present research was to evaluate the levels of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and dioxin-like polychlorinated biphenyls (dl-PCBs) in the human milk of Spanish lactating women who participated in the BETTERMILK project so that exposure and risk could be assessed for these mothers and their breastfed children. The total ∑PCDD/Fs + dl-PCBs TEQ2005 concentrations in the upper-bound (UB) ranged from 1.29 to 13.48 pgTEQ2005 g-1 lipid. The estimated geometric mean level for the sum of PCDD/F and dl-PCBs was 4.10 and 4.42 pgTEQ2005 g-1 lipid, lower-bound (LB) and UB respectively and were below the reference level reported by EFSA, which is associated with adverse effects in boys of 9 years and related to lactating mothers' exposure values of the tolerable weekly intake (TWI) of around 2 pgTEQ2005 kg-1 bw per week. Nevertheless, it was exceeded when the 95th percentile (8.31 pgTEQ2005 g-1 lipid, as UB) was considered. Results from a multiple regression analysis showed that age has a significant impact on milk ∑PCDD/Fs + dl-PCBs levels, with higher concentrations observed in the milk from older mothers.


Assuntos
Benzofuranos/análise , Dioxinas , Bifenilos Policlorados/análise , Dibenzodioxinas Policloradas/análise , Animais , Monitoramento Biológico , Criança , Dibenzofuranos , Dibenzofuranos Policlorados , Feminino , Humanos , Lactação , Masculino , Leite Humano/química , Mães , Medição de Risco , Espanha
17.
Environ Pollut ; 266(Pt 3): 115243, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32702605

RESUMO

In this study, biomonitoring of nursing Portuguese mothers to polycyclic aromatic hydrocarbons (PAHs) exposure and assessment of potential health risks of their infants were performed through determination of 18 PAHs and 6 major metabolites (OH-PAHs) in breast milk. Concentrations of total PAHs ranged between 55.2 and 1119 ng/g fat, being naphthalene, dibenz(a,h)anthracene, benzo(g,h,i)perylene, and phenanthrene the most abundant compounds (68.4% of ∑PAHs). Benzo(a)pyrene, known carcinogenic, was not detected. Total levels of OH-PAHs ranged from 6.66 to 455 ng/g fat with 1-hydroxyphenanthrene, 1-hydroxynaphthalene and 1-hydroxyacenaphthene as major compounds (96% of ∑OH-PAHs). Concentrations of ∑PAHs and ∑OH-PAHs were strongly correlated between each other (r = 0.692; p ≤ 0.001) and moderately-to-strongly associated with individual compounds (0.203 < r < 0.841; p ≤ 0.001). The attained data suggest increased levels of PAHs in older nursing mothers (>30 years) and in those whose child had lower weight (up to 3.0 kg). Breast-fed infant presented a median PAHs daily intake of 1.41 µg/kg body weight (total benzo(a)pyrene equivalents of 0.0679 µg/kg) and were exposed to 0.024 µg/kg body weight of ∑PAH4 [benz(a)anthracene, benzo(b)fluoranthene, benzo(j)fluoranthene, and chrysene]. Although breast milk is a secure food for newborns, un-metabolized and metabolized PAHs should be included in biomonitoring surveillance studies during breastfeeding to prevent potential health risks for infants.


Assuntos
Hidrocarbonetos Policíclicos Aromáticos/análise , Idoso , Benzo(a)pireno/análise , Criança , Monitoramento Ambiental , Feminino , Humanos , Lactente , Recém-Nascido , Leite Humano/química , Mães
18.
CMAJ ; 192(31): E871-E874, 2020 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-32646870

RESUMO

BACKGROUND: Provision of pasteurized donor human milk, as a bridge to mother's own milk, is the standard of care for very low-birth-weight infants in hospital. The aim of this research was to confirm that Holder pasteurization (62.5°C for 30 min) would be sufficient to inactivate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in donated human milk samples. METHODS: We spiked frozen milk samples from 10 donors to the Rogers Hixon Ontario Human Milk Bank with SARS-CoV-2 to achieve a final concentration of 1 × 107 TCID50/mL (50% of the tissue culture infectivity dose per mL). We pasteurized samples using the Holder method or held them at room temperature for 30 minutes and plated serial dilutions on Vero E6 cells for 5 days. We included comparative controls in the study using milk samples from the same donors without addition of virus (pasteurized and unpasteurized) as well as replicates of Vero E6 cells directly inoculated with SARS-CoV-2. We reported cytopathic effects as TCID50/mL. RESULTS: We detected no cytopathic activity in any of the SARS-CoV-2-spiked milk samples that had been pasteurized using the Holder method. In the SARS-CoV-2-spiked milk samples that were not pasteurized but were kept at room temperature for 30 minutes, we observed a reduction in infectious viral titre of about 1 log. INTERPRETATION: Pasteurization of human milk by the Holder method (62.5°C for 30 min) inactivates SARS-CoV-2. Thus, in the event that donated human milk contains SARS-CoV-2 by transmission through the mammary gland or by contamination, this method of pasteurization renders milk safe for consumption and handling by care providers.


Assuntos
Betacoronavirus/crescimento & desenvolvimento , Infecções por Coronavirus/prevenção & controle , Bancos de Leite , Leite Humano/virologia , Pandemias/prevenção & controle , Pasteurização/métodos , Pneumonia Viral/prevenção & controle , Inativação de Vírus , Temperatura Alta , Humanos , Leite Humano/química , Ontário , Fatores de Tempo , Ensaio de Placa Viral
19.
Nat Commun ; 11(1): 3285, 2020 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-32620774

RESUMO

The early life human gut microbiota exerts life-long health effects on the host, but the mechanisms underpinning its assembly remain elusive. Particularly, the early colonization of Clostridiales from the Roseburia-Eubacterium group, associated with protection from colorectal cancer, immune- and metabolic disorders is enigmatic. Here, we describe catabolic pathways that support the growth of Roseburia and Eubacterium members on distinct human milk oligosaccharides (HMOs). The HMO pathways, which include enzymes with a previously unknown structural fold and specificity, were upregulated together with additional glycan-utilization loci during growth on selected HMOs and in co-cultures with Akkermansia muciniphila on mucin, suggesting an additional role in enabling cross-feeding and access to mucin O-glycans. Analyses of 4599 Roseburia genomes underscored the preponderance and diversity of the HMO utilization loci within the genus. The catabolism of HMOs by butyrate-producing Clostridiales may contribute to the competitiveness of this group during the weaning-triggered maturation of the microbiota.


Assuntos
Butiratos/metabolismo , Clostridiales/metabolismo , Leite Humano/metabolismo , Mucinas/metabolismo , Oligossacarídeos/metabolismo , Bifidobacterium/metabolismo , Clostridiales/genética , Colo/microbiologia , Eubacterium/metabolismo , Microbioma Gastrointestinal/fisiologia , Humanos , Lactente , Recém-Nascido , Metabolismo/fisiologia , Leite Humano/química , Polissacarídeos/metabolismo , Verrucomicrobia/metabolismo , Desmame
20.
J Environ Sci Health B ; 55(8): 756-766, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32663053

RESUMO

This study aims to establish the relationship between the consumption of certain foods and the presence of organochlorine pesticides in human milk. A total of 167 samples of breastmilk were collected. Sample analysis was carried out by gas chromatography with electron capture detector. Pesticide concentrations (op'DDT, pp'DDT, pp'DDE, Σ-DDT, HCB, ß-HCH) were grouped by consumption level of fish, dairy products, meat, eggs, and seafood and then were compared to each other. The odds ratio (OR) was calculated between the concentration of pesticides (higher and/or lower than median) and the exposure variable (high consumption). The results indicated low median concentrations of HCB, ß - HCH, op'DDT and pp'DDT, whose fluctuations and trends between different frequencies of food consumption were not significant. pp'DDE and Σ - DDT values according to the increase in consumption of fish were significantly increased. Women with high fish consumption have a higher risk of high concentrations of pp'DDE and Σ-DDT (OR: high consumption: 5.6 (1.3-23.6). A protective effect was observed in the consumption of dairy products (ß-HCH and op'DDT), meat (HCB), and seafood (pp'DDT). These results suggest that it is possible that the consumption of fish, dairy products, meat, and seafood influences the presence of organochlorine pesticides in the studied population.


Assuntos
Exposição Dietética/análise , Hidrocarbonetos Clorados/análise , Leite Humano/química , Praguicidas/análise , Adulto , Laticínios , Diclorodifenil Dicloroetileno , Ovos/análise , Comportamento Alimentar , Feminino , Produtos Pesqueiros , Contaminação de Alimentos , Humanos , Carne/análise , México
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