Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.696
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.
J Sports Sci ; 38(2): 187-191, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31783721

RESUMO

The popularity of pre-workout supplements is rising amongst professional athletes and fitness enthusiasts. Despite increased usage, the safety profile of pre-workout supplements is likely to be not well understood. Additionally, many different brands use various undisclosed proprietary blends of active ingredients creating safety regulation difficulties. This lack of oversight could prove unsafe for certain patients. This patient MK is a 33-year-old healthy housewife who presented with central chest tightness, pre-syncope and mild dyspnoea to the emergency department via ambulance. The presentation was in the context of recent strenuous exercise and ingestion of a pre-workout supplement (Alpha Lean-7). Most striking in her presentation was a troponin rise of 50 ng/L, while not very high it is unusual given her lack of cardiac risk factors. She had a 3-day uneventful admission with a downtrending troponin prior to discharge. This case highlights the possible dangers of pharmacologically active ingredients in pre-workout supplements.


Assuntos
Suplementos Nutricionais/efeitos adversos , Isquemia Miocárdica/etiologia , Corrida/fisiologia , Adulto , Cafeína/efeitos adversos , Estimulantes do Sistema Nervoso Central/efeitos adversos , Dispneia/etiologia , Serviço Hospitalar de Emergência , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Humanos , Isquemia Miocárdica/sangue , Síncope/etiologia , Troponina/sangue
3.
Toxicol Lett ; 320: 46-51, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31812603

RESUMO

Pterostilbene (PT) is a natural stilbene common in small berries and food supplements, possessing numerous pharmacological activities. However, whether PT can affect the activities of UDP-glucuronosyltransferases (UGT) enzymes remains unclear. The aim of the present study was to investigate the effect of PT on UGT activities and to quantitatively evaluate the food-drug interaction potential due to UGT inhibition. Our data indicated that PT exhibited potent inhibition against HLM, UGT1A6, UGT1A9, UGT2B7, and UGT2B15, moderate inhibition against UGT1A1, UGT1A3, UGT1A8, and UGT2B4, negligible inhibition against UGT1A4, UGT1A7, UGT1A10, and UGT2B17. Further kinetic investigation demonstrated that PT exerted potent noncompetitive inhibition 4-MU glucuronidation by UGT1A9, with IC50 and Ki values of 0.92 µM and 0.52 ± 0.04 µM, respectively. Quantitative prediction study suggested that coadministration of PT supplements at 100 mg/day or higher doses may result in at least a 50% increase in the AUC of drugs predominantly cleared by UGT1A9. Thus, the coadministration of PT supplements and drugs primarily cleared by UGT1A9 may result in potential drug interaction, and precautions should be taken when coadministration of PT supplements and drugs metabolized by UGT1A9.


Assuntos
Suplementos Nutricionais/efeitos adversos , Inibidores Enzimáticos/toxicidade , Interações Alimento-Droga , Glucuronosiltransferase/antagonistas & inibidores , Estilbenos/toxicidade , Glucuronídeos/metabolismo , Glucuronosiltransferase/metabolismo , Humanos , Cinética , Taxa de Depuração Metabólica , Desintoxicação Metabólica Fase II , Modelos Biológicos , Medição de Risco , Estilbenos/farmacocinética
4.
Clin Biochem ; 75: 53-61, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31677994

RESUMO

BACKGROUND: Biotin and streptavidin are commonly used reagents in clinical immunoassays. Several cases of biotin interference with immunoassay testing for patients taking biotin supplements have been reported, yet, not all analytes and platforms susceptible to biotin interference have been characterized. The objectives of this study are to characterize biotin interference with 21 immunoassays using the Ortho Clinical Diagnostics Vitros 5600, evaluate a biotin-depletion method, and apply risk mitigation strategies for biotin interference during routine clinical testing at our institution. METHODS: Residual serum without and with increasing concentrations of exogenous biotin were used to evaluate biotin interference with 21 immunoassays using the Vitros 5600. Biotin-depletion was evaluated by comparing measured analyte concentrations in serum with and without exogenous biotin and streptavidin-microparticle pretreatment. Focused education for healthcare professionals about biotin interference was performed in February 2018. Samples with suspected biotin interference were investigated using this biotin-depletion method, and analyte testing by alternate methodology for select samples. RESULTS: Exogenous biotin in serum caused dose-dependent negative biases in 15 immunometric assays, and dose-dependent positive biases in 6 competitive immunoassays. Streptavidin-microparticle pretreatment of serum containing exogenous biotin demonstrated recoveries 100 ±â€¯15% of expected values for all 21 analytes. Physicians identified 21 samples suspicious for biotin interference over 11 months, and streptavidin-microparticle pretreatment verified 11 cases of biotin interference. CONCLUSIONS: Analytical bias caused by biotin interference is dependent on biotin concentration but independent of analyte concentration for immunometric methods using the Vitros 5600, and dependent on both biotin and analyte concentration for competitive immunoassays. Multi-disciplinary education and a lab streptavidin-microparticle pretreatment method help mitigate risk of erroneous results due to biotin interference for patient safety.


Assuntos
Artefatos , Biotina/administração & dosagem , Biotina/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Imunoensaio/normas , Segurança do Paciente , Centros Médicos Acadêmicos , Métodos Analíticos de Preparação de Amostras , Biotina/sangue , Reações Falso-Negativas , Pessoal de Saúde/educação , Humanos , Estreptavidina/química
5.
Angiology ; 71(1): 10-16, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30966756

RESUMO

Cardiovascular disease (CVD) remains the major cause of death and disability worldwide, and residual risk after implementing all current therapies is still high. In this context, the latest (2016) European Cardiology Society/European Atherosclerosis Society guidelines recommend that triglyceride (TG)-lowering drugs should be used in high-risk patients with TGs levels >2.3 mmol/L (200 mg/dL), after lifestyle measures fail to lower them. After several neutral CVD outcome trials with n-3 fatty acids, the Reduction of Cardiovascular Events with EPA-Intervention Trial met its primary end point, that is, among patients with elevated TGs levels despite the use of statins, the risk of ischemic events, including cardiovascular death, was significantly lower in those who received 4 g of icosapent ethyl daily. In this review, we comment on the findings of previous and recently published randomized controlled CVD outcome trials assessing n-3 fatty acids supplementation. Both efficacy and safety, as well as future perspectives, are discussed.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais , Dislipidemias/tratamento farmacológico , Ácido Eicosapentaenoico/análogos & derivados , Ácidos Graxos Insaturados/uso terapêutico , Lipídeos/sangue , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Suplementos Nutricionais/efeitos adversos , Dislipidemias/sangue , Dislipidemias/epidemiologia , Ácido Eicosapentaenoico/efeitos adversos , Ácido Eicosapentaenoico/uso terapêutico , Ácidos Graxos Insaturados/efeitos adversos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Resultado do Tratamento
6.
J Agric Food Chem ; 67(49): 13737-13750, 2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31789024

RESUMO

Genistein is abundant in animal feed. In this study, the side effects of high-dose genistein on intestinal health and hypothalamic RNA profile were evaluated. Chicks exposed to high-dose genistein by intraperitoneal injection (416 ± 21, 34.5 ± 2.5) and feed supplementation (308 ± 19, 27.2 ± 2.1) both showed a reduced body weight gain and feed intake in comparison with the control group (261 ± 16, 22.7 ± 1.6, P < 0.01). In comparison with the control (22.4 ± 0.5, 33.3 ± 2.4), serum levels of albumin and total protein were decreased after high-dose genistein injection (21.6 ± 0.5, 31.8 ± 1.6) and diet supplementation (20.6 ± 0.9, 29.9 ± 2.5, P < 0.001). Interestingly, the genistein diet presented the chick hypothalamus with downregulated expression of bitter receptors (TAS1R3, P < 0.05). Meanwhile, it upregulated the expressions of TAS2R1 (P < 0.05) and downstream genes (PLCB2 and IP3R3) in the ileum (P < 0.05). Accordingly, high-dose dietary genistein reduced villus height and the abundance of Lactobacillus, along with the increased abundance of pathogenic bacteria in the ileum (P < 0.05). Furthermore, transcriptomic analysis identified 348 differently expressed genes (168 upregulated and 224 downregulated) in the high-dose dietary genistein treated group in comparison with the control (P < 0.05, |log2FoldChange| > 0.585). Therefore, high-dose dietary genistein altered the hypothalamic RNA profile and signal processing. Cluster analysis further revealed that high-dose dietary genistein significantly influenced apoptosis, the immune process, and the whole synthesis of steroid hormones in the hypothalamus (P < 0.05). In conclusion, high-dose dietary genistein altered the hypothalamic RNA profile and intestinal health of female chicks.


Assuntos
Galinhas/metabolismo , Suplementos Nutricionais/efeitos adversos , Genisteína/efeitos adversos , Hipotálamo/metabolismo , RNA/genética , Ração Animal/efeitos adversos , Ração Animal/análise , Animais , Peso Corporal/efeitos dos fármacos , Galinhas/genética , Galinhas/crescimento & desenvolvimento , Galinhas/imunologia , Ingestão de Alimentos/efeitos dos fármacos , Feminino , Genisteína/análise , Hipotálamo/efeitos dos fármacos , Íleo/efeitos dos fármacos , Íleo/metabolismo , RNA/metabolismo , Esteroides/metabolismo
7.
Rev Med Chil ; 147(5): 628-633, 2019 May.
Artigo em Espanhol | MEDLINE | ID: mdl-31859895

RESUMO

Creatine supplements may transitorily rise serum creatinine levels and mimic a kidney disease. If its use is associated with a high protein diet, the resulting increase in blood urea nitrogen will increase the confusion. Since clinical laboratories usually inform the estimated glomerular filtration rate based on serum creatinine, its elevation may lead to over diagnose a chronic renal failure, with the inherent personal and public health consequences. Creatine supplements are safe and do not cause renal disease. Reports of kidney damage associated with its use are scanty. However, creatine supplements should not be used in people with chronic renal disease or using potentially nephrotoxic medications.


Assuntos
Creatina/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Nefropatias/induzido quimicamente , Rim/efeitos dos fármacos , Rim/fisiopatologia , Creatinina/sangue , Humanos , Nefropatias/fisiopatologia , Fatores de Risco
8.
Methodist Debakey Cardiovasc J ; 15(3): 179-184, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687096

RESUMO

Vitamins and minerals are dietary supplements used by almost half of the US adult population based on the presumption that they help prevent or treat cardiovascular disease. Many studies, including randomized trials, have investigated the possible role of these substances in cardiovascular disease. We reviewed the available data on multivitamins/multiminerals, antioxidants, folic acid, vitamin E, niacin (B3), and beta-carotene. Despite extensive investigation, the evidence to date fails to support the use of exogenous supplements of vitamins and minerals for the prevention or treatment of cardiovascular disease. Here, we review some of the common supplements used by adults for cardiovascular health and the available evidence for risks/benefits.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais , Minerais/uso terapêutico , Serviços Preventivos de Saúde , Vitaminas/uso terapêutico , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/mortalidade , Suplementos Nutricionais/efeitos adversos , Medicina Baseada em Evidências , Humanos , Minerais/efeitos adversos , Estudos Observacionais como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Resultado do Tratamento , Vitaminas/efeitos adversos
9.
Methodist Debakey Cardiovasc J ; 15(3): 185-191, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687097

RESUMO

Coenzyme Q10 (CoQ10) is among the most widely used dietary and nutritional supplements on the market. CoQ10 has several fundamental properties that may be beneficial in several clinical situations. This article reviews the pertinent chemical, metabolic, and physiologic properties of CoQ10 and the scientific data and clinical trials that address its use in two common clinical settings: statin-associated myopathy syndrome (SAMS) and congestive heart failure (CHF). Although clinical trials of CoQ10 in SAMS have conflicting conclusions, the weight of the evidence, as seen in meta-analyses, supports the use of CoQ10 in SAMS overall. In CHF, there is a lack of large-scale randomized clinical trial data regarding the use of statins in patients receiving contemporary treatment. However, one relatively recent randomized clinical trial, Q-SYMBIO, suggests an adjunctive role for CoQ10 in CHF. Recommendations regarding the use of CoQ10 in these clinical situations are presented.


Assuntos
Antioxidantes/uso terapêutico , Suplementos Nutricionais , Insuficiência Cardíaca/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Ubiquinona/análogos & derivados , Animais , Antioxidantes/efeitos adversos , Antioxidantes/farmacocinética , Suplementos Nutricionais/efeitos adversos , Metabolismo Energético/efeitos dos fármacos , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/metabolismo , Humanos , /epidemiologia , Estresse Oxidativo/efeitos dos fármacos , Fatores de Risco , Síndrome , Resultado do Tratamento , Ubiquinona/efeitos adversos , Ubiquinona/farmacocinética , Ubiquinona/uso terapêutico
10.
Methodist Debakey Cardiovasc J ; 15(3): 192-199, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687098

RESUMO

The extract of red yeast rice (RYR) is the most effective cholesterol-lowering nutraceutical on the market. In particular, its effectiveness is directly related to the amount of monacolin K within the extract (up to 10 mg/day). Consuming monacolin K on a daily basis reduces low-density lipoprotein (LDL) cholesterol plasma levels between 15% and 25% within 6 to 8 weeks. Certainly, the decrease in LDL-cholesterol is accompanied by a similar reduction in total cholesterol, non-high-density lipoprotein cholesterol, plasma apolipoprotein B, matrix metalloproteinases 2 and 9, and high-sensitivity C-reactive protein. Furthermore, the RYR lipid-lowering effect is associated with significant improvements in pulse wave velocity and endothelial function, which are validated and reliable biomarker tools able to detect vascular aging. Although it has a mechanism of action similar to statins, a daily consumption of between 3 and 10 mg monacolin K has only minimal associated risks, and mild myalgias are seen only in the frailest patients (those who also cannot tolerate minimal dosages of statin). The monacolin K found in RYR is a safe and effective supplement for managing mild to moderate hypercholesterolemia in people with no additional cardiovascular risk factors.


Assuntos
Produtos Biológicos/uso terapêutico , Colesterol/sangue , Suplementos Nutricionais , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipercolesterolemia/tratamento farmacológico , Lovastatina/uso terapêutico , Animais , Produtos Biológicos/efeitos adversos , Biomarcadores/sangue , Suplementos Nutricionais/efeitos adversos , Regulação para Baixo , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Hipercolesterolemia/sangue , Hipercolesterolemia/diagnóstico , Lovastatina/efeitos adversos , Resultado do Tratamento
11.
Methodist Debakey Cardiovasc J ; 15(3): 200-206, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687099

RESUMO

Nitric oxide (NO) is continually produced by the enzyme nitric oxide synthase (NOS) and is essential to the control and effectiveness of the cardiovascular system. However, there is a substantial reduction in NOS activity with aging that can lead to the development of hypertension and other cardiovascular complications. Fortunately, NO can also be produced by the sequential reduction of inorganic nitrate to nitrite and then to NO. Nitric oxide from inorganic nitrate supplementation has been found to have the same cardioprotective benefits of NO produced by NOS. Moreover, it can effectively compensate for declining NOS activity due to aging or NOS inhibition by oxidative stress, hypoxia, or other factors. This review covers some of the major cardiovascular regulatory actions of NO and presents evidence that NO from inorganic nitrate supplementation can provide (1) compensation when NOS activity is inadequate, and (2) cardioprotective benefits beyond that provided by a healthy NOS system. In addition, it discusses how to obtain a safe and efficacious range of inorganic nitrate.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Sistema Cardiovascular/efeitos dos fármacos , Suplementos Nutricionais , Nitratos/uso terapêutico , Óxido Nítrico/metabolismo , Animais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/fisiopatologia , Sistema Cardiovascular/metabolismo , Sistema Cardiovascular/fisiopatologia , Suplementos Nutricionais/efeitos adversos , Nível de Saúde , Humanos , Nitratos/efeitos adversos , Óxido Nítrico Sintase/metabolismo , Fatores de Risco , Resultado do Tratamento
12.
Methodist Debakey Cardiovasc J ; 15(3): 207-213, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687100

RESUMO

Vitamin D has traditionally been known as the "bone vitamin". However, a large body of observational data has also linked low concentrations of serum 25-hydroxyvitamin D (25[OH]D), the primary storage form of vitamin D, to an increased risk of incident cardiovascular disease (CVD) and mortality, garnering public excitement about the purported nonskeletal benefits of vitamin D. Despite this, more recent meta-analyses and randomized clinical trials have failed to find a beneficial effect of vitamin D supplements on CVD and cancer outcomes. These findings, along with the lack of consensus on optimal serum 25(OH)D concentrations, have dampened some of the initial enthusiasm for vitamin D supplements. Residual confounding or reverse causation may explain some of the discrepancy between the observational and trial results. At this time, vitamin D supplements should not be prescribed for the primary purpose of CVD prevention. Adding to this complexity is the fact that many adults take vitamin D and calcium supplements together for bone health, and there is some concern (albeit inconclusive) related to calcium use and increased CVD risk. In this light, it may be best to achieve the recommended daily allowances of calcium intake through food and reserve calcium supplementation only for those at risk for calcium intake deficiency, with the smallest dosage needed after dietary modifications have been exhausted. In this review, we discuss vitamin D and calcium supplementation and how they may affect cardiovascular health.


Assuntos
Cálcio/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Animais , Biomarcadores/sangue , Cálcio/efeitos adversos , Cálcio/deficiência , Cálcio na Dieta/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Suplementos Nutricionais/efeitos adversos , Humanos , Fatores de Proteção , Recomendações Nutricionais , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Vitamina D/efeitos adversos , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/epidemiologia
13.
Methodist Debakey Cardiovasc J ; 15(3): 228-230, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687105

RESUMO

This column is supplied by Amita Jain, MD, and Juan Jose Olivero, MD. Dr. Jain completed an internal medicine residency at Houston Methodist Hospital in Houston, Texas, and recently joined a primary care practice in Delaware. She earned a Bachelor of Medicine and Surgery (MBBS) degree, with a distinction in microbiology, from Terna Medical College at the Maharashtra University of Health Sciences in Navi Mumbai, India. Before coming to Houston, Dr. Jain completed residency training in internal medicine and allied subspecialties at the Dr. Babasaheb Ambedkar Memorial Hospital in Byculla, Mumbai. Dr. Olivero is a nephrologist at Houston Methodist Hospital and a member of the hospital's Nephrology Training Program. He obtained his medical degree from the University of San Carlos School of Medicine in Guatemala, Central America, and completed his residency and nephrology fellowship at Baylor College of Medicine in Houston, Texas.


Assuntos
Lesão Renal Aguda/induzido quimicamente , Ácidos Aristolóquicos/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Medicamentos de Ervas Chinesas/efeitos adversos , Falência Renal Crônica/induzido quimicamente , Rim/efeitos dos fármacos , Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/fisiopatologia , Lesão Renal Aguda/terapia , Progressão da Doença , Interações Ervas-Drogas , Humanos , Rim/fisiopatologia , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/terapia , Prognóstico , Medição de Risco , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Fatores de Tempo
15.
Environ Mol Mutagen ; 60(9): 845-856, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31569270

RESUMO

Black cohosh extract (BCE) is a popular botanical dietary supplement marketed to relieve symptoms of various gynecological ailments. Studies conducted by the National Toxicology Program (NTP) showed that BCE induces micronucleated erythrocytes in female rats and mice. Subsequently, the NTP showed that a variety of BCEs, including the sample that induced micronuclei (MN) in vivo ("NTP BCE") had a similar effect in human TK6 cells. Further testing with the MultiFlow® DNA Damage Assay revealed that TK6 cells exposed to NTP BCE, as well as a BCE reference material (BC XRM), exhibited a signature consistent with aneugenic activity in TK6 cells. Results from experiments reported herein confirmed these in vitro observations with NTP BCE and BC XRM. We extended these studies to include a novel test system, the MultiFlow Aneugen Molecular Mechanism Assay. For these experiments, TK6 cells were exposed to NTP BCE and BC XRM over a range of concentrations in the presence of fluorescent Taxol (488 Taxol). After 4 h, nuclei from lysed cells were stained with a nucleic acid dye and labeled with fluorescent antibodies against phospho-histone H3 (p-H3) and Ki-67. Whereas BCEs did not affect p-H3:Ki-67 ratios (a signature of aneugenic mitotic kinase inhibitors), 488 Taxol-associated fluorescence (a tubulin binder-sensitive endpoint) was affected. More specifically, 488 Taxol-associated fluorescence was reduced over the same concentration range that was previously observed to induce MN. These results provide direct evidence that BCEs destabilize microtubules in vitro, and this is the molecular mechanism responsible for the aneugenicity findings. Environ. Mol. Mutagen. 2019. © 2019 The Authors. Environmental and Molecular Mutagenesis published by Wiley Periodicals, Inc. on behalf of Environmental Mutagen Society.


Assuntos
Aneugênicos/efeitos adversos , Núcleo Celular/efeitos dos fármacos , Cimicifuga/efeitos adversos , Mutagênicos/efeitos adversos , Extratos Vegetais/efeitos adversos , Linhagem Celular , Dano ao DNA/efeitos dos fármacos , Suplementos Nutricionais/efeitos adversos , Eritrócitos/efeitos dos fármacos , Eritrócitos/metabolismo , Histonas/metabolismo , Humanos , Testes para Micronúcleos/métodos , Mutagênese/efeitos dos fármacos , Testes de Mutagenicidade/métodos
16.
Anticancer Res ; 39(9): 4627-4635, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519560

RESUMO

In the clinical setting, administration of high daily or bolus doses of vitamin D is often solely based on 25-hydroxyvitamin D [25(OH)D] testing. This review summarizes the evidence of the effect of vitamin D on cardiovascular disease (CVD). Meta-analyses of randomized controlled trials (RCTs) have demonstrated that CVD risk markers, such as lipid parameters, inflammation markers, blood pressure, and arterial stiffness, are largely unaffected by vitamin D supplementation. Similar results have been obtained regarding CVD events and mortality from (meta)-analyses of RCTs, even in subgroups with 25(OH)D concentrations <50 nmol/l. Likewise, Mendelian randomization studies have indicated that the genetic reduction of the 25(OH)D concentration does not increase CVD risk. Some studies do not exclude the possibility of adverse vitamin D effects, such as elevated plasma calcium concentration and an increased CVD risk at a 25(OH)D concentration >125 nmol/l. Based on a conservative benefit-risk management approach, vitamin D doses beyond the nutritionally recommended amounts of 600 to 800 IE daily currently cannot be advised for the prevention of CVD events.


Assuntos
Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/metabolismo , Vitamina D/metabolismo , Animais , Biomarcadores , Doenças Cardiovasculares/epidemiologia , Suplementos Nutricionais/efeitos adversos , Overdose de Drogas/complicações , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Fatores de Risco , Vitamina D/administração & dosagem , Vitamina D/efeitos adversos , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/diagnóstico
17.
Nutrients ; 11(8)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31375014

RESUMO

Previous literature has shown that complementary and alternative medicine (CAM) is steadily increasing in autism spectrum disorder (ASD). However, little data is currently available regarding its use, safety, and efficacy in children with ASD. Thus, the purpose of this study is to describe the use of supplement-based CAM therapies in children between the ages of 4 to 17 years with ASD. This population-based, cross-sectional study evaluated children with ASD regarding supplement use. A total of 210 participants were recruited from a variety of sources including educational and physical activity programs, and social media to complete a questionnaire. Primary caregivers provided information on current supplement based CAM use. Data evaluated the proportion of children that used supplement therapies, the types of supplements used, reasons for use, perceived safety, and demographic factors associated with use (e.g. income, parental education, severity of disorder). Seventy-five percent of children with ASD consumed supplements with multivitamins (77.8%), vitamin D (44.9%), omega 3 (42.5%), probiotics (36.5%), and magnesium (28.1%) as the most prevalent. Several supplements, such as adrenal cortex extract, where product safety has not yet been demonstrated, were also reported. A gluten free diet was the most common specialty diet followed amongst those with restrictions (14.8%). Health care professionals were the most frequent information source regarding supplements; however, 33% of parents reported not disclosing all their child's supplements to their physician. In conclusion, the use of supplement therapies in children with ASD is endemic and highlights the need for further research concerning public health education surrounding safety and efficacy.


Assuntos
Comportamento do Adolescente , Desenvolvimento do Adolescente , Transtorno do Espectro Autista/dietoterapia , Comportamento Infantil , Desenvolvimento Infantil , Terapias Complementares/métodos , Dieta , Suplementos Nutricionais , Adolescente , Fatores Etários , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/fisiopatologia , Transtorno do Espectro Autista/psicologia , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Terapias Complementares/efeitos adversos , Estudos Transversais , Dieta/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Feminino , Humanos , Masculino , Estado Nutricional , Valor Nutritivo , Medição de Risco , Inquéritos e Questionários , Resultado do Tratamento
18.
BMC Med ; 17(1): 153, 2019 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-31378201

RESUMO

Pregnant women are highly susceptible to anaemia and iron deficiency due to the increased demands of pregnancy as well as other factors. Iron supplementation is recommended in pregnancy, yet the benefits on newborn outcomes are variable between populations, most likely due to the heterogeneity in the prevalence of iron deficiency, detrimental birth outcomes and infectious diseases. Furthermore, there are concerns regarding iron supplementation in malaria-endemic areas due to reports of increased risk of malaria in those receiving iron. This is compounded by limited knowledge of how iron deficiency, anaemia, malaria, and other infections may interact to influence birth outcomes. In a recent cohort study in Papua New Guinea, where there is a high burden of infections and iron deficiency, we found that iron deficiency in pregnancy was associated with a reduced risk of adverse birth outcomes. However, this effect could not be wholly explained by interactions between iron deficiency and malaria. We proposed that iron deficiency may confer a degree of protection against other infectious pathogens, which in turn caused improvements in birthweight. We argue that further studies in multiple populations are crucial to elucidate interactions between iron status, iron supplementation and birthweight as well as to understand the context-specific benefits of iron supplementation in pregnancy and inform public policy. Focus should be given to haematological studies on anaemia, haemodilution and iron absorption, as well as investigating infectious diseases and other nutritional deficiencies. This is a particular priority in resource-constrained settings where the prevalence of iron deficiency, poor nutrition, infections and poor birth outcomes are high. While current recommendations of iron supplementation and malaria prophylaxis to reduce the burden of poor pregnancy outcomes should be supported, the strength of evidence underpinning these must be improved and new insights should be garnered in order to maximise improvements in maternal and child health.Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1146-z .Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1375-9 .


Assuntos
Anemia Ferropriva , Suplementos Nutricionais , Ferro/efeitos adversos , Malária , Complicações na Gravidez , Anemia Ferropriva/prevenção & controle , Peso ao Nascer , Estudos de Coortes , Doenças Transmissíveis/epidemiologia , Suplementos Nutricionais/efeitos adversos , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Malária/epidemiologia , Papua Nova Guiné , Gravidez , Complicações na Gravidez/prevenção & controle , Resultado da Gravidez , Saúde Pública
19.
Nutrients ; 11(8)2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31387247

RESUMO

Plant-based diets rich in bioactive compounds such as polyphenols have been shown to positively modulate the risk of cardiometabolic (CM) diseases. The inter-individual variability in the response to these bioactives may affect the findings. This systematic review aimed to summarize findings from existing randomized clinical trials (RCTs) evaluating the effect of hydroxycinnamic acids (HCAs) on markers of CM health in humans. Literature searches were performed in PubMed and the Web of Science. RCTs on acute and chronic supplementation of HCA-rich foods/extracts on CM biomarkers were included. Forty-four RCTs (21 acute and 23 chronic) met inclusion criteria. Comparisons were made between RCTs, including assessments based on population health status. Of the 44 RCTs, only seven performed analyses on a factor exploring inter-individual response to HCA consumption. Results demonstrated that health status is a potentially important effect modifier as RCTs with higher baseline cholesterol, blood pressure and glycaemia demonstrated greater overall effectiveness, which was also found in studies where specific subgroup analyses were performed. Thus, the effect of HCAs on CM risk factors may be greater in individuals at higher CM risk, although future studies in these populations are needed, including those on other potential determinants of inter-individual variability. PROSPERO, registration number CRD42016050790.


Assuntos
Variação Biológica Individual , Doenças Cardiovasculares/prevenção & controle , Ácidos Cumáricos/administração & dosagem , Dieta , Suplementos Nutricionais , Doenças Metabólicas/prevenção & controle , Adulto , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Ácidos Cumáricos/efeitos adversos , Dieta/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Feminino , Humanos , Masculino , Doenças Metabólicas/sangue , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/fisiopatologia , Pessoa de Meia-Idade , Estado Nutricional , Valor Nutritivo , Fatores de Proteção , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Comportamento de Redução do Risco , Adulto Jovem
20.
Nutrients ; 11(8)2019 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-31382666

RESUMO

The active form of vitamin D (calcitriol) exerts its biological effects by binding to nuclear vitamin D receptors (VDRs), which are found in most human extraskeletal cells, including skeletal muscles. Vitamin D deficiency may cause deficits in strength, and lead to fatty degeneration of type II muscle fibers, which has been found to negatively correlate with physical performance. Vitamin D supplementation has been shown to improve vitamin D status and can positively affect skeletal muscles. The purpose of this study is to summarize the current evidence of the relationship between vitamin D, skeletal muscle function and physical performance in athletes. Additionally, we will discuss the effect of vitamin D supplementation on athletic performance in players. Further studies are necessary to fully characterize the underlying mechanisms of calcitriol action in the human skeletal muscle tissue, and to understand how these actions impact the athletic performance in athletes.


Assuntos
Atletas , Desempenho Atlético , Calcitriol/administração & dosagem , Suplementos Nutricionais , Contração Muscular/efeitos dos fármacos , Força Muscular/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Estado Nutricional , Deficiência de Vitamina D/tratamento farmacológico , Animais , Calcitriol/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Humanos , Músculo Esquelético/metabolismo , Músculo Esquelético/fisiopatologia , Receptores de Calcitriol/agonistas , Receptores de Calcitriol/metabolismo , Transdução de Sinais , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/fisiopatologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA