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1.
Medicina (Kaunas) ; 55(9)2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31540438

RESUMO

Background and objectives: The incidence of cutaneous melanoma has been increasing. Melanoma is an aggressive form of skin cancer irresponsive to radiation and chemotherapy, rendering this cancer a disease with poor prognosis: In order to surpass some of the limitations addressed to melanoma treatment, alternatives like vitamins have been investigated. In the present study, we address this relationship and investigate the possible role of vitamin A. Materials and Methods: We perform a co-culture assay using a macrophage cell model and RAW 264.7 from mouse, and also a murine melanoma cell line B16-F10. Macrophages were stimulated with both Escherichia coli lipopolysaccharides (LPS) as control, and also with LPS plus vitamin A. Results: Using B16-F10 and RAW 264.7 cell lines, we were able to demonstrate that low concentrations of vitamin A increase cytotoxic activity of macrophages, whereas higher concentrations have the opposite effect. Conclusion: These findings can constitute a new point of view related to immunostimulation by nutrients, which may be considered one major preventive strategy by enhancing the natural defense system of the body.


Assuntos
Macrófagos/efeitos dos fármacos , Melanoma/prevenção & controle , Neoplasias Cutâneas/prevenção & controle , Vitamina A/farmacologia , Animais , Linhagem Celular Tumoral/efeitos dos fármacos , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Macrófagos/imunologia , Camundongos , Células RAW 264.7/efeitos dos fármacos , Vitamina A/uso terapêutico
2.
Plast Surg Nurs ; 39(3): 87-94, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31441788

RESUMO

Pressure injuries are a common kind of skin lesion that may be difficult to treat. The objective of this study was to analyze the effect of hydrogel enriched with alginate, fatty acids, and vitamins A and E in the treatment of pressure injuries. This case series with 12-week follow-up included applying daily dressings with hydrogel, maintaining a photographic record, using planimetry to calculate the lesion area, and classifying the healing process using the Pressure Ulcer Scale for Healing (PUSH). In addition, exudate collection from the ulcers was performed in the beginning and after 12 weeks of treatment to determine the dosage of metalloproteinase 9 (MMP9) and tissue inhibitor of metalloproteinase 1 (TIMP1). Of the 13 patients included in the study, 2 died and 11 were monitored for 12 weeks. Only 1 patient showed full wound healing, but all patients showed a significant 12.19% (p = .023) reduction in the lesion area. The PUSH score was also significantly reduced from 15.9 to 10.54 (p = .0052). Relative to the dosage of metalloproteinase and its inhibitor, there was a reduction in the level of MMP9 and there was no change in the level of TIMP1. This study showed that hydrogel enriched with alginate, fatty acids, and vitamins A and E provided promising results for the treatment of pressure injuries by reducing the lesion area, the general PUSH score, and the amount of MMP9 in the wounds' microenvironment.


Assuntos
Alginatos/farmacologia , Ácidos Graxos/farmacologia , Lesão por Pressão/tratamento farmacológico , Vitamina A/farmacologia , Vitamina E/farmacologia , Idoso , Alginatos/uso terapêutico , Exsudatos e Transudatos/microbiologia , Ácidos Graxos/uso terapêutico , Feminino , Seguimentos , Humanos , Hidrogéis/farmacologia , Hidrogéis/uso terapêutico , Masculino , Metaloproteinase 9 da Matriz/análise , Pessoa de Meia-Idade , Lesão por Pressão/fisiopatologia , Inibidor Tecidual de Metaloproteinase-1/análise , Vitamina A/uso terapêutico , Vitamina E/uso terapêutico , Cicatrização/efeitos dos fármacos
3.
Neonatal Netw ; 38(4): 242-249, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31470395

RESUMO

Bronchopulmonary dysplasia (BPD) is a morbidity of prematurity with implications for respiratory and neurologic health into adulthood. Multiple risk factors contribute to the development of BPD leading to examination of various prevention strategies. The roles of systemic corticosteroids and caffeine have been addressed by the American Academy of Pediatrics. The place in therapy of other agents commonly utilized in clinical practice remains unclear. Inhaled nitric oxide has been the subject of numerous large, randomized controlled trials in preterm infants. Despite sound rationale, these trials have largely failed to document benefit, suggesting a limited role for inhaled nitric oxide therapy in the preterm population. In contrast, intramuscular vitamin A has been documented to reduce the incidence of BPD in randomized trials. However, the invasiveness and the sporadic availability of this therapy have led to decreased utilization. All macrolide antibiotics do not appear to have a similar impact on the incidence of BPD; however, azithromycin administered to infants colonized with Ureaplasma may have impact. Questions remain about the optimal dosing approach and long-term safety of this intervention. Finally, diuretic therapy is widely used in clinical practice despite significant toxicities and limited data supporting a role in BPD prevention. Taken together, available data suggest that caffeine and selective use of corticosteroids remain the mainstays of pharmacologic BPD prevention.


Assuntos
Corticosteroides/uso terapêutico , Displasia Broncopulmonar/tratamento farmacológico , Displasia Broncopulmonar/prevenção & controle , Cafeína/uso terapêutico , Recém-Nascido Prematuro , Enfermagem Neonatal/normas , Guias de Prática Clínica como Assunto , Antibacterianos/uso terapêutico , Diuréticos/uso terapêutico , Feminino , Humanos , Macrolídeos/uso terapêutico , Masculino , Óxido Nítrico/uso terapêutico , Vitamina A/uso terapêutico
4.
Pol Merkur Lekarski ; 47(277): 35-39, 2019 Jul 29.
Artigo em Polonês | MEDLINE | ID: mdl-31385946

RESUMO

Age-related macular degeneration (AMD) is a progressively degenerative disease at the central area of the retina, which results in severe visual impairment. It is the leading cause of irreversible blindness among people aged over 65 in developed countries. Therapies that focus on prevention through optimization of modifiable risk factors such as diet and nutritional status are key approaches to reducing the burden of disease. An adequate diet, especially rich in antioxidant compounds, seems to play an important role in this case. Available scientific data suggest that vitamins A, E, C and carotenoids, in particular lutein and zeaxantine and some minerals, may play an important role in the prevention and / or delay of AMD. There are also new data on the importance of other ingredients such as flavonoids in the AMD development. In this work, based on the available data, the study reviews the relationship between the intake of selected antioxidant nutrients and age-related macular degeneration.


Assuntos
Antioxidantes , Degeneração Macular , Vitamina A , Vitaminas , Antioxidantes/uso terapêutico , Suplementos Nutricionais , Humanos , Degeneração Macular/terapia , Vitamina A/uso terapêutico , Vitaminas/uso terapêutico
5.
Asian Pac J Cancer Prev ; 20(7): 2213-2218, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31350987

RESUMO

Background: The latest World Health Organization (WHO) inquiry on the epidemiology of cervical cancers indicate there are approximately 528,000 new cases per year, ranking fourth after breast, colorectal and lung cancer. The validity of neoadjuvant chemotherapy (NAC) alone in advanced cervical cancer is still being debated. NAC induces tumor shrinkage prior to pursuing surgery. NAC also has the benefit of sterilizing the lymph nodes and parametria, thereby lowering the need for adjuvant therapy after surgery. This research aims to determine the impact on the treatment of advanced cervical carcinoma with NAC, with the additional provision of Vitamin A during treatment to assess the factors that could affect the outcome of clinical treatment. Methodology: The research methodology and design of this study is a randomized double-blind clinical trial to compare the effects of treatment with NAC and treatment with NAC + Vitamin A, in advanced cervical carcinoma. Both study groups received treatments consisting of a regime of cisplatin and paclitaxel. The study was conducted at the General Hospital of Dr. Mohammad Hoesin. The total number of patients recruited for the trial was 30 with 15 patients per treatment arm. One group received NAC consisting of cisplatin and paclitaxel and the remaining 15 patients received NAC + Vitamin A. Results: The addition of Vitamin A was found to be much better in influencing the clinical response in the treatment of advanced cervical carcinoma, although this was not statistically significant. However, a larger sample size with the reported proportion of higher positive outcome for NAC + Vitamin A may be statistically significant. Conclusion: Based on the results, Vitamin A supplementation in the treatment of advanced cervical carcinoma with neoadjuvant chemotherapy may play a crucial role in the treatment of cervical carcinoma.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Neoadjuvante , Neoplasias do Colo do Útero/patologia , Vitamina A/uso terapêutico , Vitaminas/uso terapêutico , Quimioterapia Adjuvante , Cisplatino/administração & dosagem , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Paclitaxel/administração & dosagem , Prognóstico , Neoplasias do Colo do Útero/tratamento farmacológico
6.
Medicine (Baltimore) ; 98(25): e16043, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232938

RESUMO

BACKGROUND: Multiple sclerosis (MS) is a chronic immune mediated disease which affects the central nervous system (CNS), having a substantial financial, functional, and quality of life (QOL) impact on these people. The vitamin A supplementation has been studied as a therapeutic possibility for in MS. Therefore, the objective of this protocol is to build an outline for a future systematic review, which will provide up-to-date available evidence about the clinical impact of nutritional supplementation of vitamin A in the outcomes related to the symptoms in patients with this pathology. METHODS: The search will be performed in the following databases: PubMed, Embase, Scopus, cinahl, Scielo, Web of Science, the Cochrane Library and Science Direct, randomized clinical trials published until May 2019 that evaluate the relationship of the supplementation of vitamin A and health-related outcomes in patients with MS will be included. Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) will be used to outline the protocol, and PRISMA to the systematic review. Undergraduate handbook of quality of evidence and strength of recommendations for decision making in health (GRADE) will be used to assess the quality of evidence and the strength of the recommendation, and the JADAD scale to assess the internal validity of selected studies. For the extraction of all the data found a database in Microsoft Excel will be created. For the summary of the findings the Cochrane Collaboration Handbook recommendations will be used, and for the meta-analysis standard statistical techniques the RevMan software will be used. RESULTS: In this study, we hope to find a considerable number of articles presenting evidence about the effectiveness of vitamin A supplementation in patients with MS. CONCLUSION: Currently, many lines of evidence have been produced when it comes to the use of food supplements. This systematic review proposal might provide recent, important, and trusted information for better treatment of patients. RECORD OF SYSTEMATIC REVIEW: This review was recorded in the International Register of Prospective Systematic Reviews (PROSPERO) on the January 30, 2019 (registration: CRD42019121757). Available at: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019121757.


Assuntos
Suplementos Nutricionais/normas , Metanálise como Assunto , Esclerose Múltipla/dietoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Literatura de Revisão como Assunto , Humanos , Terapia Nutricional/métodos , /normas , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Vitamina A/uso terapêutico , Vitaminas/uso terapêutico
7.
Eur J Pediatr ; 178(8): 1255-1265, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31209560

RESUMO

This randomized double-blind placebo-controlled trial evaluated the effects of early postnatal oral vitamin A supplementation (VAS) in 196 inborn very-low birth weight (VLBW) infants requiring respiratory support at 24 h of age. Eligible infants were randomized to receive aqueous syrup of vitamin A (10,000 IU of retinol/dose; n = 98) or placebo (n = 98) on alternate days for 28 days. Primary outcome variable was composite incidence of all-cause mortality and/or oxygen requirement for 28 days. Secondary outcome variables were safety/tolerability of VAS, serum retinol concentration at recruitment and day 28, duration of oxygen requirement and respiratory support and incidences of complications. On intention-to-treat analysis, composite incidence of all-cause mortality and oxygen requirement for 28 days was significantly lower in vitamin A group (relative risk (95% confidence interval), 0.440 (0.229-0.844); p < 0.05, number needed to benefit, 7). Requirement and duration of oxygen supplementation and non-invasive respiratory support, incidences of late-onset sepsis, patent ductus arteriosus, and duration of hospital stay were also significantly lower in vitamin A group. Serum retinol concentration improved significantly after VAS. No major adverse effect was observed.Conclusions: Early postnatal oral VAS was associated with better composite outcome of all-cause mortality and oxygen requirement without any major adverse effects.Clinical Trial Registration: Clinical Trials Registry of India (CTRI/2017/03/008131). What is Known: • Postnatal intramuscular vitamin A supplementation improves the survival, respiratory outcome and other morbidities in very low birth weight neonates without major adverse effects. • Limited studies on oral vitamin A supplementation did not document substantial benefits. What is New: • Early postnatal alternate-day oral vitamin A supplementation at the dose of 10,000 IU/dose for 28 days improves the composite outcome of death and oxygen requirement in very low birth weight neonates with respiratory distress • No major adverse effects were documented.


Assuntos
Recém-Nascido de muito Baixo Peso , Síndrome do Desconforto Respiratório do Recém-Nascido/tratamento farmacológico , Vitamina A/uso terapêutico , Vitaminas/uso terapêutico , Administração Oral , Terapia Combinada , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Análise de Intenção de Tratamento , Masculino , Oxigenoterapia/estatística & dados numéricos , Síndrome do Desconforto Respiratório do Recém-Nascido/mortalidade , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Análise de Sobrevida , Resultado do Tratamento
8.
Medicina (Kaunas) ; 55(6)2019 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-31216637

RESUMO

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


Assuntos
Micronutrientes/uso terapêutico , Neoplasias/dietoterapia , Neoplasias/prevenção & controle , Nutrigenômica/métodos , Ácido Ascórbico/farmacologia , Ácido Ascórbico/uso terapêutico , Ácidos Graxos Insaturados/farmacologia , Ácidos Graxos Insaturados/uso terapêutico , Ácido Fólico/farmacologia , Ácido Fólico/uso terapêutico , Humanos , Micronutrientes/farmacologia , Nutrigenômica/instrumentação , Prebióticos , Probióticos/farmacologia , Probióticos/uso terapêutico , Medição de Risco/métodos , Selênio/farmacologia , Selênio/uso terapêutico , Vitamina A/farmacologia , Vitamina A/uso terapêutico , Vitamina D/farmacologia , Vitamina D/uso terapêutico
10.
Nutrients ; 11(4)2019 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-31010085

RESUMO

Because age-related hearing loss (ARHL) is irreversible, prevention is very important. Thus, investigating modifying factors that help prevent ARHL is critical for the elderly. Nutritional status or nutritional factors for the elderly are known to be associated with many problems related to aging. Emerging studies suggest that there was the interaction between nutrition and ARHL. We aimed to investigate the possible impact of dietary nutrients on ARHL using data from the fifth Korean National Health and Nutrition Examination Survey (KNHANES) which included 4742 subjects aged ≥ 65 years from 2010 to 2012. All participants underwent an otologic examination, audiologic evaluation, and nutritional survey. The associations between ARHL and nutrient intake were analyzed using simple and multiple regression models with complex sampling adjusted for confounding factors, such as BMI, smoking status, alcohol consumption, and history of hypertension and diabetes. Higher intake groups of riboflavin, niacin and retinol was inversely associated with ARHL prevalence (riboflavin aOR, 0.71; 95% CI, 0.54-0.94; p = 0.016, niacin aOR, 0.72; 95% CI, 0.54-0.96; p = 0.025, retinol aOR 0.66; 95% CI, 0.51-0.86; p = 0.002, respectively). Our findings suggest the recommended intake levels of riboflavin, niacin, and retinol may help reduce ARHL in the elderly.


Assuntos
Envelhecimento , Dieta , Perda Auditiva/prevenção & controle , Niacina/uso terapêutico , Estado Nutricional , Riboflavina/uso terapêutico , Vitamina A/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Ingestão de Energia , Feminino , Perda Auditiva/etiologia , Humanos , Masculino , Niacina/administração & dosagem , Niacina/farmacologia , Inquéritos Nutricionais , Razão de Chances , Análise de Regressão , República da Coreia , Riboflavina/administração & dosagem , Riboflavina/farmacologia , Vitamina A/administração & dosagem , Vitamina A/farmacologia , Vitaminas/administração & dosagem , Vitaminas/farmacologia , Vitaminas/uso terapêutico
11.
Clin Perinatol ; 46(2): 291-310, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31010561

RESUMO

Rates of bronchopulmonary dysplasia (BPD) are increasing. After preterm birth, there are important developmental periods in which neonates are more vulnerable to stressful events. These periods are opportunities for pharmacologic interventions. Many drugs remain inadequately tested and no new drugs have been approved in more than 25 years for BPD prevention or therapy. More progress is needed in defining appropriate end points based on the pathophysiology of BPD and postdischarge chronic pulmonary insufficiency of prematurity and to develop effective new drugs. In addition, much work is needed to better define perinatal factors, early postnatal findings, and physiologic phenotypes or endotypes.


Assuntos
Displasia Broncopulmonar/tratamento farmacológico , Displasia Broncopulmonar/prevenção & controle , Administração por Inalação , Corticosteroides/uso terapêutico , Broncodilatadores/uso terapêutico , Cafeína/uso terapêutico , Diuréticos/uso terapêutico , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Fator de Crescimento Insulin-Like I/uso terapêutico , Transplante de Células-Tronco Mesenquimais , Óxido Nítrico/uso terapêutico , Oxigenoterapia , Inibidores da Fosfodiesterase 5/uso terapêutico , Inibidores de Fosfodiesterase/uso terapêutico , Gravidez , Cuidado Pré-Natal , Progesterona/uso terapêutico , Progestinas/uso terapêutico , Surfactantes Pulmonares/uso terapêutico , Citrato de Sildenafila/uso terapêutico , Vitamina A/uso terapêutico , Vitaminas/uso terapêutico
12.
Expert Rev Gastroenterol Hepatol ; 13(1): 25-35, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30791845

RESUMO

INTRODUCTION: Vitamin A (VA) and metabolites such as Retinoic Acid (RA) and all-trans-RA (at-RA) are crucial in the modulation of the immune system and may be determinative in the balance of the immune responses. Inflammatory bowel diseases (IBD) consist of chronic relapsing and heterogeneous disorders with not well-known etiology. Due to its role in inflammatory processes, VA may be helpful in the treatment of IBD. Area covered: As VA plays a significant role in the inflammatory processes, this review aims to show the potential role of this vitamin in IBD, searching for cellular studies, animal models, and studies with humans. Expert commentary: Many studies have described the importance of alternative therapeutic approaches for IBD. Due to its role in the immune system, VA may also exert an indispensable role in the IBD. Nevertheless, some authors have shown that these compounds could stimulate the release of pro-inflammatory cytokines. For these reasons, more studies should be performed to establish the precise mechanisms of VA and its metabolites in systemic and intestinal inflammation.


Assuntos
Anti-Inflamatórios/uso terapêutico , Fármacos Gastrointestinais/uso terapêutico , Doenças Inflamatórias Intestinais/tratamento farmacológico , Vitamina A/uso terapêutico , Animais , Anti-Inflamatórios/efeitos adversos , Anti-Inflamatórios/metabolismo , Fármacos Gastrointestinais/efeitos adversos , Fármacos Gastrointestinais/metabolismo , Humanos , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/imunologia , Doenças Inflamatórias Intestinais/metabolismo , Fatores de Risco , Resultado do Tratamento , Vitamina A/efeitos adversos , Vitamina A/metabolismo
13.
BMC Infect Dis ; 19(1): 188, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30808282

RESUMO

BACKGROUND: Delayed vaccination increases the time infants are at risk for acquiring vaccine-preventable diseases. Factors associated with incomplete vaccination are relatively well characterized in resource-limited settings; however, few studies have assessed immunization timeliness. METHODS: We conducted a prospective cohort study examining Diphtheria-Tetanus-Pertussis (DTP) vaccination timing among newborns enrolled in a Neonatal Vitamin A supplementation trial (NEOVITA) conducted in urban Dar es Salaam (n = 11,189) and rural Morogoro Region (n = 19,767), Tanzania. We used log-binomial models to assess the relationship of demographic, socioeconomic, healthcare access, and birth characteristics with late or incomplete DTP1 and DTP3 immunization. RESULTS: The proportion of infants with either delayed or incomplete vaccination was similar in Dar es Salaam (DTP1 11.5% and DTP3 16.0%) and Morogoro (DTP1 9.2% and DTP3 17.3%); however, the determinants of delayed or incomplete vaccination as well as their magnitude of association differed by setting. Both maternal and paternal education were more strongly associated with vaccination status in rural Morogoro region as compared to Dar es Salaam (p-values for heterogeneity < 0.05). Infants in Morogoro who had fathers and mothers with no education had 36% (95% CI: 22-52%) and 22% (95% CI: 10-34%) increased risk of delayed or incomplete DTP3 vaccination as compared to those with primary school education, respectively. In Dar es Salaam, mothers who attended their first antenatal care (ANC) visit in the 3rd trimester had 1.55 (95% CI: 1.36-1.78) times the risk of delayed or not received vaccination as compared to those with a 2nd trimester booking, while there was no relationship in Morogoro. In rural Morogoro, infants born at home had 17% (95% CI: 8-27%) increased risk for delayed or no receipt of DTP3 vaccination. In both settings, younger maternal age and poorer households were at increased risk for delayed or incomplete vaccination. CONCLUSION: We found some risk factors for delayed and incomplete vaccination were shared between urban and rural Tanzania; however, we found several context-specific risk factors as well as determinants that differed in their magnitude of risk between contexts. Immunization programs should be tailored to address context-specific barriers and enablers to improve timely and complete vaccination.


Assuntos
Vacina contra Difteria, Tétano e Coqueluche/uso terapêutico , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Estudos de Coortes , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Acesso aos Serviços de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Mães , Gravidez , Estudos Prospectivos , Fatores de Risco , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Tanzânia , População Urbana/estatística & dados numéricos , Vacinação/métodos , Vitamina A/uso terapêutico
14.
Nutrients ; 11(2)2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30795563

RESUMO

A total of 12 trials have tested the effect of neonatal vitamin A supplementation (NVAS) on mortality. Overall, NVAS had no effect on mortality, but results were heterogeneous. Two competing hypotheses have been put forward to explain the divergent effects: A) NVAS works by preventing vitamin A deficiency (VAD) and not all countries have VAD; B) NVAS interacts negatively with subsequent diphtheria-tetanus-pertussis (DTP) vaccine, increasing mortality in females; in countries with low DTP coverage NVAS may have a beneficial effect. Only hypothesis A was tested in a recent meta-analysis; there is no strong empirical support for hypothesis A and it would not explain observed negative effects in some settings. Hypothesis B accounts for most observations. However, so far it has only been tested properly in a few trials. If hypothesis B is correct, it has major consequences for the understanding of the effects of vitamin A, and for the VAS policy in older children. As a WHO priority, the DTP coverage is bound to increase, and therefore hypothesis B urgently needs to be tested.


Assuntos
Suplementos Nutricionais , Vacina contra Difteria, Tétano e Coqueluche , Interações de Medicamentos , Cuidado Pós-Natal , Deficiência de Vitamina A/tratamento farmacológico , Vitamina A/efeitos adversos , Vitaminas/efeitos adversos , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Masculino , Cobertura Vacinal , Vitamina A/uso terapêutico , Vitaminas/uso terapêutico
15.
Indian J Pediatr ; 86(6): 538-541, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30644040

RESUMO

High dose vitamin A (HDVA) concentrate began to be distributed in India in 1970 as a short-term, stop-gap approach to reduce clinical signs of vitamin A deficiency. As this problem declined globally, the purpose of distributing them changed to the reduction of young child mortality. However, their impact on this has also declined, if not disappeared, as suggested in India by the enormous DEVTA study. This may be because of improved protection against and treatment of the main morbidity involved, measles and diarrhea. At the same time, semi-annual provision of mega-doses of vitamin A is not without risks, in particular linked to children's vaccination status. While a single dose is inexpensive, large-scale implementation of HDVA programs is expensive, particularly the opportunity cost involved in reducing the time health workers involved have to deal with their other commitments. Balancing potential benefits, risks and costs leads us to recommend an immediate cessation of the distribution of HDVA in India.


Assuntos
Suplementos Nutricionais , Deficiência de Vitamina A/prevenção & controle , Vitamina A/uso terapêutico , Política de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Índia/epidemiologia , Vitamina A/administração & dosagem , Deficiência de Vitamina A/tratamento farmacológico , Deficiência de Vitamina A/epidemiologia
16.
Complement Ther Med ; 42: 429-437, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30670279

RESUMO

INTRODUCTION: It is believed that tubulointerstitial inflammation plays a role in the formation of renal scarring secondary to acute pyelonephritis (APN). Vitamin A is an anti-inflammatory agent that is involved in the re-epithelialization of damaged mucosal surfaces. OBJECTIVE: The aim of this study was to evaluate the efficacy of vitamin A supplementation in combination with antibiotics for improving urinary tract infections (UTIs) symptoms and preventing renal scarring in girls with APN. STUDY DESIGN: This randomized, double-blind, placebo-controlled clinical trial was conducted on 90 girls aged 2 to 12 years old between 2015 and 2017. Patients with UTIs and first episode of APN diagnosed based on 99 mTc-DMSA scintigraphy (uptake defect) were assessed for eligibility. Patients were randomly divided into two groups that either received 10 days of oral vitamin A (intervention group) or 10 days of placebo (control group) in addition to antibiotics during the acute phase of infection. The clinical response was considered as the primary outcome [duration (positive days) of UTI symptoms during trial treatment period] and secondary outcomes (no change, improving and or worsening of 99 mTc-DMSA scan results 6 months after treatment from baseline). P < 0.05 was considered to be statistically significant. RESULTS: Seventy-four patients (vitamin A group: 36 patients, placebo: 38 patients) were included in the analysis. The mean age was 5.25 ± 1 year old. Three patients (7.89%) in the placebo group and 2 patients (5.55%) in the vitamin A group had vesicoureteral reflux (VUR) (p = 0.114). Duration of fever (vitamin A group: 1.8 days, placebo: 3.1 days, p = 0.0026), urinary frequency (1.3 days vs. 2.8 days, p = 0.003) and poor feeding (2.3 days vs. 4.2 days, p = 0.005) were significantly lower in the vitamin A group. Following the second 99 mTc-DMSA scan, worsening of lesions was observed among 8 (22.2%) and 17 (44.7%) patients in the vitamin A and placebo groups, respectively (p = 0.003). 63.8% (23 patients) of the vitamin A group and 21% (8 patients) of placebo group showed lesion improving in the photopenic region. (P < 0.0001) There was no evidence of vitamin A intolerance. DISCUSSION: Our results show the efficacy of vitamin A supplementation on reducing renal scarring secondary to APN and on fever, urinary frequency and poor feeding duration in girls with APN. CONCLUSION: Vitamin A supplementation is effective for improving the clinical symptoms of UTI and reducing renal injury and scarring following APN in girls with first APN. However, larger randomized clinical trials (RCTs) with longer follow up are needed to confirm these effects.


Assuntos
Cicatriz/prevenção & controle , Suplementos Nutricionais , Rim/efeitos dos fármacos , Pielonefrite/tratamento farmacológico , Infecções Urinárias/tratamento farmacológico , Vitamina A/uso terapêutico , Vitaminas/uso terapêutico , Doença Aguda , Criança , Pré-Escolar , Cicatriz/etiologia , Método Duplo-Cego , Comportamento Alimentar/efeitos dos fármacos , Feminino , Febre/prevenção & controle , Humanos , Lactente , Rim/patologia , Pielonefrite/complicações , Resultado do Tratamento , Infecções Urinárias/complicações , Micção/efeitos dos fármacos , Vitamina A/farmacologia , Vitaminas/farmacologia
17.
J Matern Fetal Neonatal Med ; 32(15): 2608-2615, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29447482

RESUMO

BACKGROUND: Bronchopulmonary dysplasia (BPD) is one of the most common consequence of extreme prematurity (<28 weeks of gestation). BPD affects approximately 55% of extremely low birth weight (ELBW) neonates. AIMS: The aim of this systematic review is to evaluate the role of vitamin A supplementation in prevention of BPD in ELBW neonates. METHOD: The literature search was done for various randomized control trial (RCT) by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, and ongoing clinical trials. RESULTS: This review included two RCTs that fulfilled inclusion criteria. There were statistically significant reduction in the incidence of BPD (oxygen requirement at 36 weeks of postmenstrual age (PMA)) (relative risk (RR) 0.88; 95%CI 0.77-0.99; p = .04; NNTB 14) and borderline significant reduction in combined outcomes of mortality/BPD (oxygen requirement at 36 weeks of PMA) (RR 0.90; 95%CI 0.82-1.00; p = .05). However, oxygen requirement at 28 days of life and combined outcome of mortality/BPD (oxygen requirement at 28 days of life) were not statistically significant. CONCLUSIONS: The role of vitamin A supplementation in the prevention of BPD is supported by the current evidences. However, due to limited number of studies, current evidences are not sufficient which can translate into routine clinical practice. We need large high-quality trials, with sufficient power to reliably assess clinically relevant differences in outcomes.


Assuntos
Displasia Broncopulmonar/prevenção & controle , Vitamina A/uso terapêutico , Vitaminas/uso terapêutico , Suplementos Nutricionais , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Recém-Nascido , Ensaios Clínicos Controlados Aleatórios como Assunto
19.
Biomed Pharmacother ; 109: 1394-1405, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30551390

RESUMO

Cancer development has been directly related to oxidative stress. During chemotherapy, some cancer patients use dietary antioxidants to avoid nutritional deficiencies due to cancer treatment. Among the antioxidants consumed, there are vitamins, including retinyl palmitate (PR) and ascorbic acid (AA), which have the capacity to reduce free radicals formation, protect cellular structures and maintain the cellular homeostasis. This systematic review evaluated the antioxidant and antitumor mechanisms of retinol palmitate (a derivative of vitamin A) and/or ascorbic acid (vitamin C) in cancer-related studies. Ninety-seven (97) indexed articles in the databases PubMed and Science Direct, published between 2013 and 2017, including 23 clinical studies (5 for every single compound while 13 in interaction) and 74 non-clinical studies (37 for retinol palmitate, 36 for ascorbic acid and 1 in interaction) were considered. Antioxidant and antitumor effects, with controversies over dosage and route of administration, were observed for the test compounds in their isolated form or associated in clinical studies. Prevention of cancer risks against oxidative damage was seen in lower doses of retinol palmitate and/or vitamin C. However, at high doses, they can generate reactive oxygen species, cytotoxicity and apoptosis in test systems. Non-clinical studies using cell lines have allowed understanding the mechanisms related to antioxidants and antitumor effects of the isolated compounds, however, studies on vitamin interactions, acting as antioxidants and/or antitumor are still rare and controversial. More studies, mainly related to modulation of antineoplastic drugs are needed for understanding the risks and benefits of their use during treatment in order to achieve effectiveness in cancer therapy and patient's quality of life.


Assuntos
Ácido Ascórbico/farmacologia , Ácido Ascórbico/uso terapêutico , Vitamina A/análogos & derivados , Animais , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Apoptose/efeitos dos fármacos , Diterpenos , Humanos , Espécies Reativas de Oxigênio/metabolismo , Vitamina A/farmacologia , Vitamina A/uso terapêutico
20.
Crit Rev Food Sci Nutr ; 59(11): 1767-1781, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29336593

RESUMO

Anemia is a worldwide public health problem that can be related to many causes, including vitamin A deficiency. The aim of this study was to assess and estimate the effect of vitamin A supplementation (VAS) on iron status biomarkers and anemia in humans. Six databases, including Cochrane, EMBASE, LILACS, Pubmed, Scopus and Web of Science, were searched for clinical trials and cohort studies that investigated the effect of vitamin A supplementation alone on iron status and anemia, without time-restriction. The search yielded 23 eligible studies, 21 clinical trials and 2 cohort studies, with children, teenagers, pregnant or lactating women. The meta-analysis of the clinical trials showed that VAS reduces the risk of anemia by 26% and raises hemoglobin levels, compared to non-treated group, independent of the life stage. VAS did not alter the prevalence of iron deficiency among the clinical trials conducted with children and teenagers (RR 0.82, 95% CI 0.60 to 1.12, p = 0.204), whereas a significant increase in serum ferritin levels was observed in trials conducted with pregnant and lactating women (WMD 6.61 µg/L; 95% CI 6.00 to 7.21 µg/L; p < 0.001). Therefore, vitamin A supplementation alone may reduce the risk of anemia, by improving hemoglobin and ferritin levels in individuals with low serum retinol levels.


Assuntos
Anemia Ferropriva/tratamento farmacológico , Suplementos Nutricionais , Ferro/deficiência , Deficiência de Vitamina A/tratamento farmacológico , Vitamina A/uso terapêutico , Adolescente , Adulto , Anemia Ferropriva/sangue , Biomarcadores/sangue , Criança , Ensaios Clínicos como Assunto , Bases de Dados Factuais , Feminino , Hemoglobinas , Humanos , Ferro/sangue , Lactação , Gravidez , Vitamina A/sangue
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