RESUMO
Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor alterations, which is preceded by a prodromal stage where non-motor symptoms are observed. Over recent years, it has become evident that this disorder involves other organs that communicate with the brain like the gut. Importantly, the microbial community that lives in the gut plays a key role in this communication, the so-called microbiota-gut-brain axis. Alterations in this axis have been associated to several disorders including PD. Here we proposed that the gut microbiota is different in the presymptomatic stage of a Drosophila model for PD, the Pink1B9 mutant fly, as compared to that observed in control animals. Our results show this is the case: there is basal dysbiosis in mutant animals evidenced by substantial difference in the composition of midgut microbiota in 8-9 days old Pink1B9 mutant flies as compared with control animals. Further, we fed young adult control and mutant flies kanamycin and analyzed motor and non-motor behavioral parameters in these animals. Data show that kanamycin treatment induces the recovery of some of the non-motor parameters altered in the pre-motor stage of the PD fly model, while there is no substantial change in locomotor parameters recorded at this stage. On the other hand, our results show that feeding young animals the antibiotic, results in a long-lasting improvement of locomotion in control flies. Our data support that manipulations of gut microbiota in young animals could have beneficial effects on PD progression and age-dependent motor impairments. This article is part of the Special Issue on "Microbiome & the Brain: Mechanisms & Maladies".
Assuntos
Doença de Parkinson , Animais , Drosophila , Canamicina , Antibacterianos , Proteínas QuinasesRESUMO
INTRODUCTION: Gastric lavage is still used in Mexico and other countries without evidence to support this practice. We performed a randomized controlled trial to test the hypothesis that elimination of amniotic fluid from the stomach of the newborn reduces nausea and vomiting and improves tolerance on the first feedings of breast or formula milk. PATIENTS AND METHODS: A randomized, single-blind, controlled trial was conducted in a rural general hospital in the north of Mexico. Eligible healthy term newborns were randomly allocated to receive gastric lavage (n = 63) or observation (n = 61). The primary outcome measures were the presence of nausea and/or emesis in the first 24 hours of life and the breastfeeding failure rate, evaluated by a nurse blinded to the group assignment. RESULTS: Of the 63 patients in the gastric lavage group, 13 had at least one episode of nausea or vomiting compared with 15 out of 61 patients in the control group (relative risk: 0.84; 95 % CI: 0.43 to 1.61). Breastfeeding failure occurred in seven mother-child pairs in the gastric lavage group compared with five in the control group (P = 0.8; relative risk: 0.96; 95 % CI: 0.86 to 1.08). Other variables such as sex or cesarian section rate were unrelated to outcome. There were no complications that could be attributed to the procedure. All the newborn infants were discharged without problems. CONCLUSIONS: Gastric aspiration or lavage in the healthy full-term newborn is a common procedure that should be abandoned as it confers no advantages.
Assuntos
Lavagem Gástrica , Aleitamento Materno , Feminino , Humanos , Recém-Nascido , Masculino , Náusea/prevenção & controle , Método Simples-Cego , Vômito/prevenção & controleRESUMO
OBJECTIVE: To estimate the prevalence of the metabolic syndrome (MS) in a population of patients with overweight and obesity of the A Coruña and Granada health areas, using the definitions of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III) and of the International Diabetes Federation (IDF). PATIENTS AND METHODS: During a period extending from 1996 to 2003, only those patients attending endocrinology outpatient clinics for whom all the anthropometric and biochemical parameters used to define the MS, both according to the ATP IIII and the IDF, were available were selected. The final study sample consisted of 285 patients, 198 females (69.5%) and 87 males (30.5%). RESULTS: The prevalence of the MS was 29.8% when the ATP III definition was applied, and 41.1% according to the IDF criteria. Prevalence by sex was 32.2% in men and 28.8% in women according to the ATP III, and 42.5% and 40.4%, respectively, according to the IDF. CONCLUSIONS: In a patient population with overweight or obesity, the prevalence of the MS is higher when the IDF criteria, instead of the ATP III criteria, are used. These findings may have significant implications when it comes to addressing early diagnosis of cardiovascular disease and diabetes mellitus in these patients, in order to perform therapeutic measures at the initial stages and thereby reduce metabolic and cardiovascular complications.
Assuntos
Inquéritos Epidemiológicos , Síndrome Metabólica/classificação , Síndrome Metabólica/epidemiologia , Terminologia como Assunto , Adulto , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/prevenção & controle , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/epidemiologia , Obesidade/prevenção & controle , Prevalência , Fatores de Risco , Fatores Sexuais , Espanha/epidemiologia , Organização Mundial da SaúdeRESUMO
Proporcionar unas recomendaciones prácticas para la evaluación y el manejo de la hipoglucemia en pacientes con diabetes mellitus. Miembros del Grupo de Trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición (SEEN). Las recomendaciones se formularon según el sistema Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) para establecer tanto la fuerza de las recomendaciones como el grado de evidencia. Se realizó una búsqueda sistemática en MEDLINE (PubMed) de la evidencia disponible para cada tema, y se revisaron artículos escritos en inglés y castellano con fecha de inclusión hasta el 28 de febrero de 2020. En este resumen ejecutivo incluimos la evidencia reciente incorporada desde 2013. El documento establece unas recomendaciones prácticas basadas en la evidencia acerca de la evaluación y manejo de la hipoglucemia en pacientes con diabetes mellitus.
To provide practical recommendations for the evaluation and management of hypoglycemia in patients with diabetes mellitus. Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN). The recommendations were made based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system to establish both the strength of the recommendations and the level of evidence. A systematic search was made in MEDLINE (PubMed) for the available evidence on each subject, and articles written in English and Spanish with an inclusion date up to 28 February 2020 were reviewed. This executive summary takes account of the evidence incorporated since 2013. The document establishes practical evidence-based recommendations regarding the evaluation and management of hypoglycemia in patients with diabetes mellitus.
Assuntos
Humanos , Diabetes Mellitus/prevenção & controle , Hipoglicemia/prevenção & controleRESUMO
Introducción: El lavado gástrico es un método que aún se utiliza en México y otras regiones del mundo sin una evidencia que lo sustente. Se planeó un ensayo aleatorio controlado para probar la hipótesis de que la aspiración del líquido amniótico del estómago del neonato reduce la náusea y el vómito y que produce un incremento en la tolerancia a la primera toma de leche materna o fórmula. Pacientes y métodos: Ensayo aleatorio simple ciego realizado en un hospital general rural en el norte de México. Los recién nacidos sanos elegibles fueron distribuidos de manera aleatoria para realizarles un lavado gástrico (n = 63) o simple observación (n = 61). Los resultados que había que evaluar fueron el porcentaje de neonatos con vómito/náusea en las primeras 24 h de vida y la tasa de fracaso de amamantamiento. Esto fue evaluado por una enfermera de manera ciega en el grupo al que fue asignado el recién nacido. Resultados: De los 63 pacientes en el grupo de lavado gástrico, 13 presentaron al menos un episodio de náusea o vómito, comparado con 15 de los 61 del grupo control (riesgo relativo [RR]: 0,84; intervalo de confianza [IC] del 95 %: 0,43-1,61). Siete parejas madre-recién nacido en el grupo de lavado gástrico no completaron una alimentación exitosa al seno materno, comparado con cinco en el grupo control (p = 0,8; RR: 0,96; IC 95 %: 0,86-1,08). Otras variables como el sexo del neonato o la tasa de obtención por cesárea no tuvieron efecto sobre el resultado principal. No se comunicaron complicaciones atribuidas al procedimiento. Todos los neonatos fueron dados de alta sin complicaciones. Conclusiones: El lavado o aspirado gástrico en el recién nacido de término y sano es un procedimiento común que debe anularse como práctica diaria en el cunero, ya que no representa ventaja alguna
Introduction: Gastric lavage is still used in Mexico and other countries without evidence to support this practice. We performed a randomized controlled trial to test the hypothesis that elimination of amniotic fluid from the stomach of the newborn reduces nausea and vomiting and improves tolerance on the first feedings of breast or formula milk. Patients and methods: A randomized, single-blind, controlled trial was conducted in a rural general hospital in the north of Mexico. Eligible healthy term newborns were randomly allocated to receive gastric lavage (n = 63) or observation (n = 61). The primary outcome measures were the presence of nausea and/or emesis in the first 24 hours of life and the breastfeeding failure rate, evaluated by a nurse blinded to the group assignment. Results: Of the 63 patients in the gastric lavage group, 13 had at least one episode of nausea or vomiting compared with 15 out of 61 patients in the control group (relative risk: 0.84; 95 % CI: 0.43 to 1.61). Breastfeeding failure occurred in seven mother-child pairs in the gastric lavage group compared with five in the control group (P = 0.8; relative risk: 0.96; 95 % CI: 0.86 to 1.08). Other variables such as sex or cesarian section rate were unrelated to outcome. There were no complications that could be attributed to the procedure. All the newborn infants were discharged without problems. Conclusions: Gastric aspiration or lavage in the healthy full-term newborn is a common procedure that should be abandoned as it confers no advantages
Assuntos
Recém-Nascido , Lactente , Humanos , Lavagem Gástrica , Aleitamento Materno , Náusea/prevenção & controle , Vômito/prevenção & controleRESUMO
Se analiza la evidencia científica disponible sobre las recomendaciones nutricionales en las distintas etapas de la vida a través de 10 preguntas clave que se cuestionan alguno de los hechos más relevantes en cuanto a las modificaciones dietéticas a lo largo del ciclo vital: ¿cuál debe ser la duración de la lactancia materna?, ¿cuáles son los mejores métodos para promocionar la lactancia materna?, ¿deben utilizarse fórmulas con proteínas de soja para prevenir enfermedades alérgicas en lactantes de alto riesgo?, ¿está indicada la suplementación con micronutrientes en el lactante?, ¿cómo prevenir la obesidad infantil?, ¿existen estrategias válidas de prevención de los trastornos alimentarios en adolescentes?, ¿qué alimentación debemos recomendar para la embarazada y la mujer lactante?, ¿deben utilizarse suplementos nutricionales en los ancianos con riesgo de desnutrición?, ¿deben utilizarse suplementos de micronutrientes en los ancianos para prevenir o tratar las enfermedades degenerativas? (AU)
We review the scientific evidence available on nutritional recommendations in the distinct stages of life through 10 key questions relating to dietary modifications throughout the life cycle, namely: how long should breast-feeding last? What are the best methods for promoting breast-feeding? Should soya infant formulas be used to prevent allergic diseases in infants at high risk? Is micronutrient supplementation indicated in infants? How should childhood obesity be prevented? Are there any valid strategies for preventing eating disorders in adolescents? Which type of diet should be recommended in pregnant and breast-feeding women? Should nutritional supplements be used in elderly individuals at risk of malnutrition? Should micronutrient supplements be used in the elderly to prevent or treat degenerative diseases? (AU)