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1.
Wei Sheng Yan Jiu ; 49(5): 724-730, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-33070812

RESUMO

OBJECTIVE: To identify the relationship between fever and diarrhea 2-week prevalence and Yingyangbao(YYB) effective consumption among infants and young children. METHODS: A total of 2952 infants and young children aged from 6 to 24 month in 10 impoverished counties of Henan province were selected by multi-stage random sampling between June and September 2017. To acquire 2-week prevalence information of infants and young children, their caregivers were investigated by self-made questionnaire. The structural equation model was utilized in multi-factor analysis. RESULTS: After adjusting potential confounders, YYB effective consumption reduced2-week prevalence of fever(ß=-0. 279, P=0. 001) and diarrhea(ß=-0. 182, P=0. 042) among infants and young children. Nutrition knowledge and YYB benefit cognition of caregivers reduced2-week prevalence of fever(γ=-0. 002, 95%CI-0. 004~-0. 001, P=0. 003) and diarrhea(γ=-0. 001, 95%CI-0. 003~0. 000, P=0. 049) indirectly through chain mediation path of "nutrition knowledge-YYB benfit cognition-YYB effective consumption-fever/diarrheal". CONCLUSION: YYB effective consumption can reduce 2-week prevalence of fever and diarrhea among infants and young children. Nutrition knowledge and YYB benefit cognition can improve YYB effective consumption and thus reduce 2-week prevalence of fever and diarrhea indirectly.


Assuntos
Suplementos Nutricionais , População Rural , Criança , Pré-Escolar , Diarreia/epidemiologia , Diarreia/prevenção & controle , Alimentos Fortificados , Humanos , Lactente , Prevalência
3.
Medicine (Baltimore) ; 99(40): e22240, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019398

RESUMO

Children with end stage renal disease (ESRD) are liable to various health disorders that possibly impair their quality of life (QoL). Low dietary intake of Omega-3 fatty acids also called marine n-3 fatty acid (n-3 FA) may be associated with health problems which are among the leading causes of impaired QoL.The objective of this study was to assess the effect of omega-3 Fatty acid (n-3 FA) supplements on quality of life among children on dialysis and to evaluate its use regarding adequacy of dialysis and inflammatory markers.A prospective cohort study was conducted on 31 hemodialysis children. Quality of life was measured for patients and an equal number of matched controls using the PedsQL Inventory where the higher the score the poorer is the quality of life. n-3FA supplementation had been given to the patients for 3 months to study its effects on QoL. Laboratory investigations like hemoglobin, lipid profile, inflammatory markers, and tests for adequacy of dialysis had been carried out.Patients had significantly higher QoL scores (42.22 ±â€Š13.31) than controls (22.70 ±â€Š1.31) (P < .001). Young ages showed higher score of physical functioning (18.23 ±â€Š4.22) than older ones (13.92 ±â€Š6.84) (P = .049). Females had significantly higher total QoL score (25.53 ±â€Š6.61) than males (20.06 ±â€Š7.09) (P = .010). The total QoL score was significantly lower post than pre administration of n-3FA (35.41 ±â€Š10.36 vs 42.22 ±â€Š13.31) (P < .001). Triglycerides and CRP were significantly lower post than pre n-3FA supplementation (160.64 ±â€Š32.55 vs 169.35 ±â€Š31.82) (P < .001) and (10.29 ±â€Š4.39 vs 11.19 ±â€Š4.83) (P = .006) respectively. Means of Kt/V and urea reduction ratio (URR) were significantly higher post (1.37 ±â€Š0.09, 70.0 ±â€Š5.99 respectively) than pre n-3FA (1.31 ±â€Š0.07 and 65.25 ±â€Š6.06 respectively) (P = .005, .001 respectively).Quality of life and adequacy of dialysis get improved after n-3FA supplementation among children on dialysis which encourages its testing for more patients to evaluate its long term effects and support its routine use.


Assuntos
Suplementos Nutricionais , Ácidos Graxos Ômega-3/administração & dosagem , Qualidade de Vida , Diálise Renal/efeitos adversos , Adolescente , Estudos de Casos e Controles , Criança , Feminino , Humanos , Falência Renal Crônica , Masculino , Estudos Prospectivos , Melhoria de Qualidade , Diálise Renal/psicologia
4.
Medicine (Baltimore) ; 99(41): e22318, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031270

RESUMO

INTRODUCTION: The market for dietary supplements in the sports sector has been growing rapidly for several years, though there is still lacking evidence regarding their claimed benefits. One group is that of nitric oxide increasing supplements, so-called "NO-boosters," which are claimed to improve the supply of oxygen and nutrients to the muscle by enhancing vasodilation.The aim of this study was to investigate 3 of these supplements in healthy male athletes for their muscle perfusion-enhancing potential using contrast-enhanced ultrasound (CEUS). METHODS: This placebo-controlled, double-blind, randomized cross-over trial will be carried out at the Center for Orthopedics, Trauma Surgery and Spinal Cord Injury of the University Hospital Heidelberg. Three commercial NO enhancing products including 300 mg of the specific green tea extract VASO6 and a combination of 8 g L-citrulline malate and 3 g L-arginine hydrochloride will be examined for their potential to increase muscular perfusion in 30-male athletes between 18 and 40 years and will be compared with a placebo. On each of the 3 appointments CEUS of the dominant biceps muscle will be performed at rest and after a standardized resistance training. Every athlete receives each of the 3 supplements once after a wash-out period of at least 1 week. Perfusion will be quantified via VueBox quantification software. The results of CEUS perfusion measurements will be compared intra- and interindividually and correlated with clinical parameters. DISCUSSION: The results of this study may help to establish CEUS as a suitable imaging modality for the evaluation of potentially vasodilatory drugs in the field of sports. Other supplements could also be evaluated in this way to verify the content of their advertising claims. TRIAL REGISTRATION: German Clinical Trials Register (DRKS), ID: DRKS00016972, registered on 25.03.2019.


Assuntos
Arginina/administração & dosagem , Citrulina/administração & dosagem , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Chá , Ultrassonografia/métodos , Adolescente , Adulto , Meios de Contraste , Estudos Cross-Over , Suplementos Nutricionais , Método Duplo-Cego , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Vasodilatação
5.
Rev Prat ; 70(5): 561-565, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-33058648

RESUMO

Nutrition in sports. Recommendations for nutritional intake by athletes, whatever their sports level, first requires ensuring that daily energy expenditure is covered and that nutrition recommendations for health are applied. For endurance athletes, carbohydrate intake before and during exercise plays a decisive role in glucose availability and performance. In strength/power athletes, protein intake is important for optimizing the training responses. For all these athletes, nutritional intakes during recovery ensure good tolerance of training programs. Nutritional supplements are only justified on the basis of scientific evidence, and relate only to products available on the official market and produced in accordance with quality procedures.


Assuntos
Esportes , Atletas , Suplementos Nutricionais , Exercício Físico , Humanos , Estado Nutricional
6.
Nutrients ; 12(10)2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-33003648

RESUMO

The third coronavirus outbreak in the last two decades has caused significant damage to the world's economy and community health. The highly contagious COVID-19 infection has affected millions of people to date and has led to hundreds of thousands of deaths worldwide. Aside from the highly infectious nature of SARS-CoV-2, the lack of a treatment or vaccine has been the main reason for its spread. Thus, it has become necessary to find alternative methods for controlling SARS-CoV-2. For the present review, we conducted an online search for different available nutrition-based therapies for previously known coronavirus infections and RNA-based virus infections as well as general antiviral therapies. These treatments have promise for combating COVID-19, as various nutrients and minerals play direct and indirect roles in the control and prevention of this newly emerged viral infection. The patients' nutritional status with COVID-19 must be analyzed before administering any treatment, and nutritional supplements should be given to the affected individuals along with routine treatment. We suggest a potential interventional role of nutrients to strengthen the immune system against the emerging infection caused by COVID-19.


Assuntos
Infecções por Coronavirus/imunologia , Sistema Imunitário/efeitos dos fármacos , Minerais/farmacologia , Pneumonia Viral/imunologia , Oligoelementos/farmacologia , Vitaminas/farmacologia , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/virologia , Suplementos Nutricionais , Humanos , Sistema Imunitário/fisiologia , Micronutrientes , Minerais/uso terapêutico , Estado Nutricional , Pandemias , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/virologia , Síndrome Respiratória Aguda Grave , Oligoelementos/uso terapêutico , Vitaminas/uso terapêutico
7.
Nutrients ; 12(10)2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: covidwho-813007

RESUMO

The third coronavirus outbreak in the last two decades has caused significant damage to the world's economy and community health. The highly contagious COVID-19 infection has affected millions of people to date and has led to hundreds of thousands of deaths worldwide. Aside from the highly infectious nature of SARS-CoV-2, the lack of a treatment or vaccine has been the main reason for its spread. Thus, it has become necessary to find alternative methods for controlling SARS-CoV-2. For the present review, we conducted an online search for different available nutrition-based therapies for previously known coronavirus infections and RNA-based virus infections as well as general antiviral therapies. These treatments have promise for combating COVID-19, as various nutrients and minerals play direct and indirect roles in the control and prevention of this newly emerged viral infection. The patients' nutritional status with COVID-19 must be analyzed before administering any treatment, and nutritional supplements should be given to the affected individuals along with routine treatment. We suggest a potential interventional role of nutrients to strengthen the immune system against the emerging infection caused by COVID-19.


Assuntos
Infecções por Coronavirus/imunologia , Sistema Imunitário/efeitos dos fármacos , Minerais/farmacologia , Pneumonia Viral/imunologia , Oligoelementos/farmacologia , Vitaminas/farmacologia , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/virologia , Suplementos Nutricionais , Humanos , Sistema Imunitário/fisiologia , Micronutrientes , Minerais/uso terapêutico , Estado Nutricional , Pandemias , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/virologia , Síndrome Respiratória Aguda Grave , Oligoelementos/uso terapêutico , Vitaminas/uso terapêutico
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1075-1079, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018172

RESUMO

Brain tumor is among the deadliest cancers, whose effective treatment is partially dependent on the accurate diagnosis of the tumor type. Convolutional neural networks (CNNs), which have been the state-of-the-art in brain tumor classification, fail to identify the spatial relations in the image. Capsule networks, proposed to overcome this drawback, are sensitive to miscellaneous backgrounds and cannot manage to focus on the main target. To address this shortcoming, we have recently proposed a capsule network-based architecture capable of taking both brain images and tumor rough boundary boxes as inputs, to have access to the surrounding tissue as well as the main target. Similar to other architectures, however, this network requires extensive search within the space of all possible configurations, to find the optimal architecture. To eliminate this need, in this study, we propose a boosted capsule network, referred to as BoostCaps, which takes advantage of the ability of boosting methods to handle weak learners, by gradually boosting the models. BoosCaps, to the best of our knowledge, is the first capsule network model that incorporates an internal boosting mechanism. Our results show that the proposed BoostCaps framework outperforms its single capsule network counterpart.


Assuntos
Neoplasias Encefálicas , Encéfalo , Suplementos Nutricionais , Humanos , Redes Neurais de Computação
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1400-1403, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018251

RESUMO

As many algorithms depend on a suitable representation of data, learning unique features is considered a crucial task. Although supervised techniques using deep neural networks have boosted the performance of representation learning, the need for a large sets of labeled data limits the application of such methods. As an example, high-quality delineations of regions of interest in the field of pathology is a tedious and time-consuming task due to the large image dimensions. In this work, we explored the performance of a deep neural network and triplet loss in the area of representation learning. We investigated the notion of similarity and dissimilarity in pathology whole-slide images and compared different setups from unsupervised and semi-supervised to supervised learning in our experiments. Additionally, different approaches were tested, applying few-shot learning on two publicly available pathology image datasets. We achieved high accuracy and generalization when the learned representations were applied to two different pathology datasets.


Assuntos
Algoritmos , Redes Neurais de Computação , Coleta de Dados , Suplementos Nutricionais , Sistema Linfático
10.
Vestn Oftalmol ; 136(4. Vyp. 2): 317-323, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32880157

RESUMO

Glaucoma is the leading cause of irreversible blindness in the world. Intraocular pressure (IOP) is currently the only proven modifiable risk factor for POAG. IOP-independent mechanisms contributing to the development of glaucomatous neurodegeneration include oxidative stress, excitotoxicity, mitochondrial dysfunction, and impaired ocular blood flow. In this regard, there has recently been growing interest in the use of various antioxidant dietary supplements as neuroprotective therapy for glaucoma. The issue of the effectiveness and safety of these biologically active additives is an urgent scientific problem reflected in numerous studies. This article reviews current concepts of oxidative/nitrosative stress, the role of reactive oxygen species (ROS)/reactive nitrogen (Nr) and their participation in the development of POAG, as well as experimental models and clinical studies using essential fatty acids, natural compounds and a number of other antioxidant substances that can counteract oxidative stress in glaucoma.


Assuntos
Antioxidantes , Glaucoma , Suplementos Nutricionais , Humanos , Pressão Intraocular , Estresse Oxidativo
11.
Medicina (Kaunas) ; 56(9)2020 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-32867260

RESUMO

The positive impact of probiotic strains on human health has become more evident than ever before. Often delivered through food, dietary products, supplements, and drugs, different legislations for safety and efficacy issues have been prepared. Furthermore, regulatory agencies have addressed various approaches toward these products, whether they authorize claims mentioning a disease's diagnosis, prevention, or treatment. Due to the diversity of bacteria and yeast strains, strict approaches have been designed to assess for side effects and post-market surveillance. One of the most essential delivery systems of probiotics is within food, due to the great beneficial health effects of this system compared to pharmaceutical products and also due to the increasing importance of food and nutrition. Modern lifestyle or various diseases lead to an imbalance of the intestinal flora. Nonetheless, as the amount of probiotic use needs accurate calculations, different factors should also be taken into consideration. One of the novelties of this review is the presentation of the beneficial effects of the administration of probiotics as a potential adjuvant therapy in COVID-19. Thus, this paper provides an integrative overview of different aspects of probiotics, from human health care applications to safety, quality, and control.


Assuntos
Infecções por Coronavirus/prevenção & controle , Suplementos Nutricionais/normas , Gastroenteropatias/terapia , Hepatopatias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Probióticos/uso terapêutico , Betacoronavirus , Doença Celíaca/terapia , Infecções por Clostridium/terapia , Constipação Intestinal/terapia , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/terapia , Transtorno Depressivo/terapia , Doenças Diverticulares/terapia , Disenteria/terapia , Enterocolite Necrosante/terapia , Alimentos e Bebidas Fermentados , Hipersensibilidade Alimentar/terapia , Infecções por Helicobacter/terapia , Encefalopatia Hepática/terapia , Humanos , Doenças Inflamatórias Intestinais/terapia , Hepatopatia Gordurosa não Alcoólica/terapia , Pneumonia Viral/terapia , Probióticos/efeitos adversos , Probióticos/normas , Controle de Qualidade
12.
Br J Community Nurs ; 25(Sup8): S6-S10, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32936703

RESUMO

The impact of nutrition on recovery from various illnesses is well recognised. Malnutrition can affect duration of hospitalisation and impede recovery, and therefore it is important to monitor this condition, especially in at-risk groups, such as older adults and those with chronic disease. Underlying malnutrition impairs the immune system, potentially making people more vulnerable to infections such as COVID-19 and impacting recovery. Patients recovering from severe illness are likely to have muscle wasting or feel weak and may have increased protein needs. In addition individuals who have been discharged from hospital may need ongoing nutritional rehabilitation. This article explores the range of symptoms of COVID-19 that can interfere with dietary intake, such as respiratory issues, loss of taste and smell and fatigue and weakness. It goes on to describe how community nurses can identify risk of malnutrition and dietary issues when working remotely. Additionally, it signposts to a range of resources developed to assist patients and carers in accessing appropriate dietary advice.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Desnutrição/diagnóstico , Desnutrição/prevenção & controle , Pneumonia Viral/complicações , Enfermagem em Saúde Comunitária , Infecções por Coronavirus/terapia , Suplementos Nutricionais , Humanos , Desnutrição/etiologia , Papel do Profissional de Enfermagem , Estado Nutricional , Apoio Nutricional , Pandemias , Pneumonia Viral/terapia
13.
Medicine (Baltimore) ; 99(33): e20978, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871975

RESUMO

BACKGROUND: The number of people with diabetes is growing exponentially.Human studies have shown that vitamin D supplementation is beneficial for type 2 diabetic microangiopathy. However, owing to the low quality, small sample size, and methodological heterogeneity of these studies, this conclusion is not convincing. Consequently, in order to determine whether vitamin D supplementation is effective and safe in type 2 diabetic microangiopathy, it is necessary to conduct a meta-analysis of high-quality clinical trials. METHODS: We will search each database from the built-in until March 2020. The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science, while the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Simultaneously we will retrieval clinical registration tests and grey literatures. In this study, only the clinical randomized controlled trials were selected to evaluate the efficacy and safety of vitamin D in the treatment of type 2 diabetic microangiopathy. The two researchers independently conducted literature selection, data extraction and quality assessment. Statistical heterogeneity among studies will be evaluated using the Cochran Q test (x) and the I statistical value. We will utilize the Review Manage software V5.3.0 (The Nordic Cochrane Center, The Cochrane Collaboration, 2014, Copenhagen, Denmark) to statistically analyze all data. ETHICS AND DISSEMINATION: Ethics and dissemination: This study is a systematic review of vitamin D supplementation as a treatment of type 2 diabetic microangiopathy. RESULTS: This study will provide high-quality synthesis of effectiveness and safety of vitamin D supplementation for type 2 diabetic microangiopathy. CONCLUSION: This systematic review aims to provide new options for vitamin D treatment of type 2 diabetic microangiopathy in terms of its efficacy and safety. REGISTRATION NUMBER: LNPLASY202050055.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/terapia , Suplementos Nutricionais , Metanálise como Assunto , Revisões Sistemáticas como Assunto , Vitamina D/uso terapêutico , Diabetes Mellitus Tipo 2/terapia , Humanos , Vitamina D/efeitos adversos
14.
Medicine (Baltimore) ; 99(33): e21143, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871982

RESUMO

BACKGROUND: The impact of vitamin K in ameliorating diabetes-associated complications, especially those linked with platelet activation and coagulation remains unclear. The current study aims to systematically explore and discuss the available evidence on the impact of vitamin K on the diabetes-cardiovascular disease (CVD)-associated complications. METHODS: A systematic review of studies published on the MEDLINE (PubMed), EMBASE, and Google Scholar electronic database will be conducted. The review will include studies published from inception until May 25, 2020, reporting on the effect of vitamin K on CVD-related markers, especially coagulation factors and platelet activation in type 2 diabetes mellitus. Before the full-text screening, all studies will be screened by title, abstract, and keywords. The Downs and Black checklist will be used to assess the quality of the studies. Additionally, the Cochrane collaboration tool will also be used to evaluate the risk of bias across the included studies. Kappa Cohen's calculator will be used to assess the level of agreement between the authors. DISCUSSIONS: This systematic review will not require ethical approval, and the results will be distributed through conference and peer-reviewed publications. Our results will assist current and future research scientists on the potential use of vitamin K as a protective therapy against CVD-related complications. SYSTEMATIC REVIEW REGISTRATION: This protocol is registered on the International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42020151667.


Assuntos
Transtornos da Coagulação Sanguínea/etiologia , Transtornos da Coagulação Sanguínea/terapia , Diabetes Mellitus Tipo 2/complicações , Metanálise como Assunto , Revisões Sistemáticas como Assunto , Vitamina K/uso terapêutico , Diabetes Mellitus Tipo 2/terapia , Suplementos Nutricionais , Humanos
16.
Medicine (Baltimore) ; 99(35): e21722, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871891

RESUMO

BACKGROUND: In recent years, the role of vitamin D (VD) as a protective factor in cardiovascular disease has been recognized. Thus, there is a need to study the effect of vitamin D supplementation in the control of different cardiovascular risk factors and metabolic syndrome, especially in young populations where few studies have been conducted. METHODS: Pilot study of a randomized, parallel two-arm, triple-blind clinical controlled trial in 150 adolescents and young adults in the city of Bucaramanga-Colombia. The intervention group will receive 1000 IU of VD and the control group 200 IU of VD daily for 15 weeks. The main outcomes are: serum calcifediol levels (25(OH) D), body mass index and lipid profile; secondary outcomes are complementary to the previous ones (skin folds, waist-hip ratio). Other variables will be analyzed such as assessment of dietary intake, physical activity, sun exposure, cigarette and tobacco consumption and compliance with VD supplementation. DISCUSSION: This study is innovative since there is little evidence from clinical trials in adolescents and young adults; similar studies are not known in our context. The results of this study may facilitate the recommendation of oral vitamin D supplementation in the population of interest. In addition, it is a low-cost and easy-to-apply intervention that could contribute to the formulation and implementation of health policies. TRIAL REGISTRATION: NCT04377386.


Assuntos
Índice de Massa Corporal , Calcifediol/sangue , Lipídeos/sangue , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Administração Oral , Adolescente , Colômbia , Suplementos Nutricionais , Método Duplo-Cego , Humanos , Projetos Piloto , Ensaios Clínicos Controlados Aleatórios como Assunto , Pregas Cutâneas , Relação Cintura-Quadril , Adulto Jovem
18.
Lancet ; 396(10254): 854-866, 2020 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-32910907

RESUMO

Asthma is a complex disease that often starts in childhood. Genomic and environmental factors as well as aberrant immune maturation early in life can contribute to the onset of disease, with great disparity over time and geographical regions. Epidemiological studies have scrutinised environmental exposures and attempted to translate these exposures into prevention strategies. Some approaches for patients with asthma have been successful (eg, smoking ban, the Finnish Asthma Programme), and primary prevention of wheeze in pre-school children (age 0-5 years) by the supplementation of vitamin D or fish oil, or both, to pregnant women seems promising. Several recent prevention initiatives are based on strong asthma-protective environmental microbial exposures associated with traditional rural lifestyles. Preclinical studies with various bacterial lysates, bacterial and dietary metabolites, or helminthic compounds have yielded promising results that await translation into clinical practice. Given the immense societal and individual burden of asthma, there is an urgent need to further develop novel strategies to eradicate the disease.


Assuntos
Asma/epidemiologia , Asma/prevenção & controle , Prevenção Primária/métodos , Asma/dietoterapia , Asma/imunologia , Pré-Escolar , Suplementos Nutricionais/provisão & distribução , Exposição Ambiental/efeitos adversos , Feminino , Finlândia/epidemiologia , Óleos de Peixe/administração & dosagem , Óleos de Peixe/provisão & distribução , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Prevalência , Fatores de Proteção , Fatores de Risco , Prevenção do Hábito de Fumar/métodos , Vitamina D/administração & dosagem , Vitamina D/provisão & distribução
19.
Cochrane Database Syst Rev ; 9: CD009422, 2020 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-32892350

RESUMO

BACKGROUND: People with cystic fibrosis are at an increased risk of fat-soluble vitamin deficiency, including vitamin E. Vitamin E deficiency can cause a host of conditions such as haemolytic anaemia, cerebellar ataxia and cognitive difficulties. Vitamin E supplementation is widely recommended for people with cystic fibrosis and aims to ameliorate this deficiency. This is an updated version of the review. OBJECTIVES: To determine the effects of any level of vitamin E supplementation on the frequency of vitamin E deficiency disorders in people with cystic fibrosis. SEARCH METHODS: We searched the Cochrane Group's Cystic Fibrosis Trials Register and also searched international online trial registries for any ongoing clinical trials that were not identified during our register search. Date of last search of the Register: 11 August 2020. Date of last search of international online trial registries: 20 July 2020. SELECTION CRITERIA: Randomised controlled trials and quasi-randomised controlled trials comparing any preparation of vitamin E supplementation to placebo or no supplement, regardless of dosage or duration. DATA COLLECTION AND ANALYSIS: Two authors extracted outcome data from each study (published information) and assessed the risk of bias of each included study. They assessed the quality of the evidence using GRADE. MAIN RESULTS: Four studies with a total of 141 participants were included in the review, two of these were in children (aged six months to 14.5 years), and two did not specify participants' age. All studies used different formulations and doses of vitamin E for various durations of treatment (10 days to six months). Two studies compared the supplementation of fat-soluble as well as water-soluble formulations to no supplementation in different arms of the same study. A third study compared a water-soluble formulation to a placebo; and in the fourth study a fat-soluble formulation of vitamin E was assessed against placebo. There was limited detail about randomisation and blinding in the included studies which compromises the quality of the evidence base for the review. The heterogeneous mix of the formulations with differing biovailabilities among these studies also limits the generalisability of the data to the wider cystic fibrosis population. None of the studies in either comparison report the review's primary outcomes of vitamin E total lipid ratio or the incidence of vitamin E-specific deficiency disorders, or the secondary outcomes lung function or quality of life. Water-soluble vitamin E Water-soluble vitamin E may improve serum vitamin E levels compared with control at six months, one study (45 participants), mean difference (MD) 19.74 umol/L (95% confidence interval (CI) 13.48 to 26.00) (low-quality evidence). Similar results were also seen at one month, two studies (32 participants), MD 17.66 umol/L (95% CI 10.59 to 24.74) and at three months, one study (45 participants), MD 11.61 umol/L (95% CI 4.77 to 18.45). Only one study (45 participants) reported weight (secondary outcome of growth and nutritional status) at one and six months, but showed no difference between treatment and control at either time point. Fat-soluble vitamin E Two studies (36 participants) reported higher levels of serum vitamin E at one month with fat-soluble vitamin E compared with control, MD 13.59 umol/L (95% CI 9.52 to 17.66); however, at three months one study (36 participants) showed no difference between treatment and control. No studies in this comparison reported on growth or nutritional status. AUTHORS' CONCLUSIONS: Vitamin E supplementation may lead to an improvement in vitamin E levels in people with cystic fibrosis, although evidence we assessed was low quality. No data on other outcomes of interest were available to allow conclusions about any other benefits of this therapy. In future, larger studies are needed, especially in people already being treated with enteric-coated pancreatic enzymes and supplemented with vitamin E, to look at more specific outcome measures such as vitamin E status, lung function and nutritional status. Future studies could also look at the optimal dose of vitamin E required to achieve maximal clinical effectiveness.


Assuntos
Fibrose Cística/sangue , Suplementos Nutricionais , Vitamina E/administração & dosagem , Vitaminas/administração & dosagem , Adolescente , Adulto , Viés , Criança , Pré-Escolar , Insuficiência Pancreática Exócrina/complicações , Feminino , Humanos , Lactente , Masculino , Placebos/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Vitamina E/sangue , Vitamina E/química , Deficiência de Vitamina E/prevenção & controle , Vitaminas/química , alfa-Tocoferol/administração & dosagem
20.
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
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