Pre-term delivery and periodontal disease: a case-control study from Croatia

Aim: The aim of this report was to assess the strength and influence of periodontitis as a possible risk factor for pre-term birth (PTB) in a cohort of 81 primiparous Croatian mothers aged 18-39 years. Methods: PTB cases (n=17; mean age 25 +/- 2.9 years; age range 20-33 years) were defined as spontaneous delivery after less than 37 completed weeks of gestation that were followed by spontaneous labour or spontaneous rupture of membranes. Controls (full-time births) were normal births at or after 37 weeks of gestation (n=64; mean age 25 +/- 2.9 years; age range 19-39 years). Information on known risk factors and obstetric factors included the current pregnancy history, maternal age at delivery, pre-natal care, nutritional status, tobacco use, alcohol use, genitourinary infections, vaginosis, gestational age, and birth weight. Full-mouth periodontal examination was performed on all mothers within 2 days of delivery. Results: PTB cases had significantly worse periodontal status than controls (p=0.008). Multivariate logistic regression model, after controlling for other risk factors, demonstrated that periodontal disease is a significant independent risk factor for PTB, with an adjusted odds ratio of 8.13 for the PTB group (95% confidence interval 2.73-45.9). Conclusion: Periodontal disease represents a strong, independent, and clinically significant risk factor for PTB in the studied cohort. There are strong indicators that periodontal therapy should form a part of preventive prenatal care in Croatia.

Energy and calcium stores are preserved in girls and young women with CF, independent of disease severity: An explanation for the 'gender gap'?

Bioenergetics differ between males and females of many species. Human females apportion a substantial proportion of energy resources towards gynoid fat storage, to support the energetic burden of reproduction. Similarly, axial calcium accrual is favoured in females compared with males. Nutritional status is a prognostic indicator in cystic fibrosis (CF), but girls and young women are at greater risk of death despite equivalent nutritional status to males. The aim of this study was to compare fat (energy) and calcium stores (bone density) in males and females with CF over a spectrum of disease severity. Methods: Fat as % body weight (fat%) and lumbar spine (LS) and total body (TB) bone mineral density (BMD) were measured using dual absorption X-ray photometry in 127(59M) control and 101(54M) CF subjects, aged 9–25 years. An equation for predicted age at death had been determined using survival data and history of pulmonary function for the whole clinic, based on a trivariate normal model using maximum likelihood methods (1). For the CF group, a disease severity index (predicted age at death) was calculated from the derived equations according to each subjects history of pulmonary function, current age, and gender. Disease severity was classified according to percentile of predicted age at death (‘mild’ ≥75th, ‘moderate’ 25th–75th, ‘severe’ ≤25th percentile). Wt for age z-score was calculated. Serum testosterone and oestrogen were measured in males and females respectively. Fat% and LSBMD were compared between the groups using ANOVA. Results: There was an interaction between disease severity and gender: increasing disease severity was associated with greater deficits in TB (p=0.01), LSBMD (p

Expression of the proteolysis-inducing factor core peptide mRNA is upregulated in both tumour and adjacent normal tissue in gastro-oesophageal malignancy

Gastro-oesophageal cancer is associated with a high incidence of cachexia. Proteolysis-inducing factor (PIF) has been identified as a possible cachectic factor and studies suggest that PIF is produced exclusively by tumour cells. We investigated PIF core peptide (PIF-CP) mRNA expression in tumour and benign tissue from patients with gastro-oesophageal cancer and in gastro-oesophageal biopsies for healthy volunteers. Tumour tissue and adjacent benign tissue were collected from patients with gastric and oesophageal cancer (n = 46) and from benign tissue only in healthy controls (n = 11). Expression of PIF-CP mRNA was quantified by real-time PCR. Clinical and pathological information along with nutritional status was collected prospectively. In the cancer patients, PIF-CP mRNA was detected in 27 (59%) tumour samples and 31 (67%) adjacent benign tissue samples. Four (36%) gastro-oesophageal biopsies from healthy controls also expressed PIF-CP mRNA. Expression was higher in tumour tissue (P = 0.031) and benign tissue (P = 0.022) from cancer patients compared with healthy controls. In the cancer patients, tumour and adjacent benign tissue PIF-CP mRNA concentrations were correlated with each other (P<0.0001, r = 0.73) but did not correlate with weight loss or prognosis. Although PIF-CP mRNA expression is upregulated in both tumour and adjacent normal tissue in gastro-oesophageal malignancy, expression does not relate to prognosis or cachexia. Post-translational modification of PIF may be a key step in determining the biological role of PIF in the patient with advanced cancer and cachexia. © 2006 Cancer Research.

Pre-conception care : current practice and methods of provision

This thesis examines the present provisions for pre-conception care and the views of the providers of services. Pre-conception care is seen by some clinicians and health educators as a means of making any necessary changes in life style, corrections to imbalances in the nutritional status of the prospective mother (and father) and the assessment of any medical problems, thus maximizing the likelihood of the normal development of the baby. Pre-conception care may be described as a service to bridge the gap between the family planning clinic and the first ante-natal booking appointment. There were three separate foci for the empirical research - the Foresight organisation (a charity which has pioneered pre-conception care in Britain); the pre-conception care clinic at the West London Hospital, Hammersmith; and the West Midlands Regional Health Authority. The six main sources of data were: twenty five clinicians operating Foresight pre-conception clinics, couples attending pre-conception clinics, committee members of the Foresight organisation, staff of the West London Hospital pre-conception clinic, Hammersmith, District Health Education Officers working in the West Midlands Regional Health Authority and the members of the Ante-Natal Care Action Group, a sub-group of the Regional Health Advisory Group on Health Promotion and Preventive Medicine. A range of research methods were adopted. These were as follows: questionnaires and report forms used in co-operation with the Foresight clinicians, interviews, participant observation discussions and informal meetings and, finally, literature and official documentation. The research findings illustrated that pre-conception care services provided at the predominantly private Foresight clinics were of a rather `ad hoc' nature. The type of provision varied considerably and clearly reflected the views held by its providers. The protocol which had been developed to assist in the standardization of results was not followed by the clinicians. The pre-conception service provided at the West London Hospital shared some similarities in its approach with the Foresight provision; a major difference was that it did not advocate the use of routine hair trace metal analysis. Interviews with District Health Education Officers and with members of the Ante Natal Care Action Group revealed a tentative and cautious approach to pre-conception care generally and to the Foresight approach in particular. The thesis concludes with a consideration of the future of pre-conception care and the prospects for the establishment of a comprehensive pre-conception care service.

Aedes aegypti pharate first instar aseasonal quiescence cues anticipatory plasticity with implications for urban vector ecology and control

The eggs of the dengue fever vector Aedes aegypti possess the ability to undergo an extended quiescence period hosting a fully developed first instar larvae within its chorion. As a result of this life history stage, pharate larvae can withstand months of dormancy inside the egg where they depend on stored reserves of maternal origin. This adaptation known as pharate first instar quiescence, allows A. aegypti to cope with fluctuations in water availability. An examination of this fundamental adaptation has shown that there are trade-offs associated with it. ^ Aedes aegypti mosquitoes are frequently associated with urban habitats that may contain metal pollution. My research has demonstrated that the duration of this quiescence and the extent of nutritional depletion associated with it affects the physiology and survival of larvae that hatch in a suboptimal habitat; nutrient reserves decrease during pharate first instar quiescence and alter subsequent larval and adult fitness. The duration of quiescence compromises metal tolerance physiology and is coupled to a decrease in metallothionein mRNA levels. My findings also indicate that even low levels of environmentally relevant larval metal stress alter the parameters that determine vector capacity. ^ My research has also demonstrated that extended pharate first instar quiescence can elicit a plastic response resulting in an adult phenotype distinct from adults reared from short quiescence eggs. Extended pharate first instar quiescence affects the performance and reproductive fitness of the adult female mosquito as well as the nutritional status of its progeny via maternal effects in an adaptive manner, i.e., anticipatory phenotypic plasticity results as a consequence of the duration of pharate first instar quiescence and alternative phenotypes may exist for this mosquito with quiescence serving as a cue possibly signaling the environmental conditions that follow a dry period. M findings may explain, in part, A. aegypti's success as a vector and its geographic distribution and have implications for its vector capacity and control.^

Prevalência da síndrome metabólica e seus componentes nos estágios pubertários de escolares do sexo feminino norte-rio-grandenses

The diagnosis of nutritional status is extremely re levant in clinical practice and population assessment, due to the association betwe en body fat and metabolic alterations. The aim of this study is to analyze th e prevalence of metabolic syndrome (MS) and its components in the pubertal stages of f emale students in Rio Grande do Norte state, Brazil, in accordance with Internation al Diabetes Federation criteria. This is a cross-sectional study with 449 students aged betw een 8 and 19 years, stratified into pubertal stages systematized by Marshal and Tanner (1969), as follows: 27.6% prepubertal, 44.3% pubertal and 28.1% postpubertal, with mean ages of 9.4±1.27, 12.4±2.23 and 15.1±1.88 years, respectively. Preval ences were analyzed using distribution of frequencies and their respective 95 % confidence intervals, while the chi- square test and odds ratio were applied to analyze the associations between variables. The general prevalence of MS was 3.3% (CI: 2% - 5%) , without occurrences in the prepubertal stage, observing that it emerges from t he pubertal stage onwards with a prevalence of 2.5% (CI 95% 0.1% - 5%), 1% (CI 95% 0.4% - 2.3%) of cases with overweight and 1.5% (CI 95% -0.1% - 3.2%) with obes e individuals, while in the postpubertal stage the prevalence is 7.9% (CI 95% 3 .2% - 12.6%), 0.8% (CI 95% -0.8% - 2.3%) normal weight cases, 4% (CI 95% 0.6% - 7.4% ) overweight and 3.1% (CI 0.1% - 6.2%) obese individuals. There was an association (p<0.02) between pubertal stages and MS ( x 2 =5.2), with an OR of 3.3 (CI: 1.2 - 5), showing tha t postpubertal adolescents are more prone to SM than pubertals, while the OR i n obese individuals was 2.1 (CI: 2– 2.2) compared to the overweight. Body mass index (B MI) ( x 2 = 29.4; p<0.001) and age range ( x 2 = 13.1; p<0.001) showed a significant linear assoc iation with MS. Of the adolescents with MS, those aged ten years or younge r exhibited higher %G. The most prevalent components in all the stages were altered waist circumference (27.2% [CI 23% - 31%]) and low HDL cholesterol (39.6% [CI 35% – 44%]), which, coupled with hypertension, displayed significant differences in the postpubertal stage in relation to the other stages. The results show that MS emerges from the pubertal stage onwards in proportion to excess childhood body fat, a fact tha t calls for prevention strategies using an educational approach, reducing the large demand on the National Health System. Keywords: Metabolic syndrome, pubertal stages, risk factors.

Avaliação das condicionalidades em saúde do Programa Bolsa Família

The programs of conditional cash transfer are widespread in developing countries in Latin America with emphasis on Brazil as a new paradigm in social p olicies for poverty eradication . Consist of transferring monetary funds from the government directly to poor families by fulfilling the condition alities on education and health . In health, even wi th variations between countries , conditionality targeting public pregnant women and children with a view to improving health indic ators maternoinfantil as growth , infant mortality and prenatal care. The objectives of this study are to compare the transfer progr am conditional Brazilian income , the Family and similar programs in Latin A merica in relation to it s effects on growth in children , and to evaluate the effect of Bolsa Família in the prevalence of use of services ( conditionalities ) of prenatal care in Brazilian health services whose teams joined the Programa de Acesso e Melhoria da Qualidade da Atenção Básica (PMAQ - AB) . For the first objective a systematic review , we selec ted ten articles between 1007 ( one thousand and seven ) found in the databases Embase , PubMed, Scopus , Scielo and Lilacs databases was performed . Articles are ob servational epidemiological studies of transverse descriptive and analytical types of cohort and case - co ntrol. For the second objective, for it is a prevalence study , a statistical analysis using Poisson regression with robust variance was performed to i nvestigate how the prevalence of compliance with conditionalities on health was influenced b y various explanatory variables . Ratios , crude and adjusted prevalence , with their respective confidence i ntervals of 95 % were estimated . The family joined the sch olarship program was considered as the main expo sure variable . Confounding variables were: maternal age , race / color, paid employment , marital status and region of residence . In d ata analysis software R 3.0.1 (RDevelopment Core Team 2013 ) was used . Rega rding the comparison of the Bolsa Família with other programs in Latin America , the review found similar results regarding the positive effect of income transfer in the nutritional status o f beneficiary children programs , and these effects are more evident in children under two years old and belonging to familie s of lower socioeconomic status . For the prevalence of conditionalities entres different groups of users of the Bolsa Família and nonusers results showed no statistically significant difference betwe en respondents (with children under two years ) registered and not registered in PBF on issues relating to: me et at least six prenatal visits , meet and participate in health education activities . It follows from side to increase minimum income for families in extreme poverty showed positive impact on children's health in Brazil and Latin America. The o ther is not confirmed in Brazil , an increase in conditionality expressed in use of primary care by the user s of the Bolsa Família services.

Avaliação da suplementação de vitamina E sobre a concentração de alfa-tocoferol no leite materno em mulheres com partos prematuros

The term vitamin E refers to a group of eight molecular compounds which differ in structure and bioavailability, and the RRR-alpha-tocopherol more biologically active form. The composition of vitamin E in breast milk undergoes variations during lactation, colostrum and milk richer in this micronutrient compared to transitional and mature milk. Newborns, especially premature infants are more susceptible to vitamin E deficiency and to prevent the damage caused by this deficiency has been proposed supplementation of neonates with this micronutrient, however, there is no consensus to carry out this intervention. Thus, maternal supplementation with RRRalpha-tocopherol in the postpartum period can be a good alternative to try to raise the alpha-tocopherol levels in breast milk and therefore provide the premature newborn adequate amounts of vitamin E. This study to evaluate the effect of supplementation with 400 UI acetate RRR-alpha-tocopherol in women with premature births, on the concentration of alpha-tocopherol in breast milk colostrum, transitional and mature. The study included 89 healthy adult women were enrolled in the control group (n = 51) and supplemented group (n = 38). Blood samples were collected and milk colostrum soon after birth (0h milk) twenty-four hours, new rate of colostrum milk was collected (24h milk). The transitional and mature milk were collected in seven days (7d milk) and thirty days (30d milk) after delivery, respectively. Supplementation in the supplemented group was held after the collection of blood and 0h milk. The alpha-tocopherol analyzes were performed by high-performance liquid chromatography. Serum levels of alpha-tocopherol less than 516 μg/dL were considered indicative of nutritional deficiency. The average concentration of alphatocopherol in the serum of the control group mothers was 1159.8 ± 292.4 μg/dL and the supplemented group was 1128.3 ± 407.2 μg/dL (p = 0.281). All women had nutritional status in vitamin E suitable. In both groups, it was observed that the concentration of vitamin E in colostrum milk was higher compared to transitional and mature milk. In the supplemented group, the concentration of alpha-tocopherol in the milk increased 60 % after supplementation, from 1339.3 ± 414.2 μg/dL (0h milk) to 2234.7 ± 997.3 μg/dL (24h milk). While the control group values in colostrum 0h and colostrum 24h were similar (p = 0.681). In the control group the follow-on milk alphatocopherol value was 875.3 ± 292.4 μg/dL and in the group supplemented 1352.8 ± 542.3 μg/dL, an increase of 35% in the supplemented group compared to control (p <0.001). In mature milk alpha-tocopherol concentrations between the control group (426.6 ± 187.5 μg/dL) and supplemented (416.4 ± 214.2 μg/dL) were similar (p = 0.853). Only 24h milk supplemented group answered the nutritional requirement of alpha-tocopherol (4 mg/day) of the newborn. These results show that the transport of this micronutrient for milk occurs in a controlled and limited way. Thus, the native vitamin E supplementation increases the concentration of alpha-tocopherol in colostrum and milk and transition does not influence the concentration in mature milk. Only the increase in colostrum milk was sufficient to meet the nutritional requirement of premature newborns.

Métodos de avaliação nutricional para a suplementação oral com zinco em crianças pré-púberes não deficientes em zinco

Background: Zinc is an essential nutrient that is required for numerous metabolic functions, and zinc deficiency results in growth retardation, cellmediated immune dysfunction, and cognitive impairment. Objective: This study evaluated nutritional assessment methods for zinc supplementation in prepubertal nonzinc- deficient children. Design: We performed a randomised, controlled, triple-blind study. The children were divided into a control group (10% sorbitol, n = 31) and an experimental group (10 mg Zn/day, n = 31) for 3 months. Anthropometric and dietary assessments as well as bioelectrical measurements were performed in all children. Results: Our study showed (1) an increased body mass index for age and an increased phase angle in the experimental group; (2) a positive correlation between nutritional assessment parameters in both groups; (3) increased soft tissue, and mainly fat-free mass, in the body composition of the experimental group, as determined using bioelectrical impedance vector analysis; (4) increased consumption of all nutrients, including zinc, in the experimental group; and (5) an increased serum zinc concentration in both groups (p < 0.0001). Conclusions: Given that a reference for body composition analysis does not exist for intervention studies, longitudinal studies are needed to investigate vector migration during zinc supplementation. These results reinforce the importance of employing multiple techniques to assess the nutritional status of populations.

Métodos de avaliação nutricional para a suplementação oral com zinco em crianças pré-púberes não deficientes em zinco

Background: Zinc is an essential nutrient that is required for numerous metabolic functions, and zinc deficiency results in growth retardation, cellmediated immune dysfunction, and cognitive impairment. Objective: This study evaluated nutritional assessment methods for zinc supplementation in prepubertal nonzinc- deficient children. Design: We performed a randomised, controlled, triple-blind study. The children were divided into a control group (10% sorbitol, n = 31) and an experimental group (10 mg Zn/day, n = 31) for 3 months. Anthropometric and dietary assessments as well as bioelectrical measurements were performed in all children. Results: Our study showed (1) an increased body mass index for age and an increased phase angle in the experimental group; (2) a positive correlation between nutritional assessment parameters in both groups; (3) increased soft tissue, and mainly fat-free mass, in the body composition of the experimental group, as determined using bioelectrical impedance vector analysis; (4) increased consumption of all nutrients, including zinc, in the experimental group; and (5) an increased serum zinc concentration in both groups (p < 0.0001). Conclusions: Given that a reference for body composition analysis does not exist for intervention studies, longitudinal studies are needed to investigate vector migration during zinc supplementation. These results reinforce the importance of employing multiple techniques to assess the nutritional status of populations.

Gut content, fatty acid composition and metabolic rates of the amphipod Anonyx sarsi during POLARSTERN cruise ARK-XIX/1, ice station PS64/070-6

During a winter expedition to the western Barents Sea in March 2003, benthic amphipods of the species Anonyx sarsi were observed directly below pack ice. Only males and juveniles [16.0-37.0 mm long, 16.2-120.8 mg dry mass (DM)] were collected. Guts contained macroalgal fibres, fish eggs and flesh from large carrion. Amphipods had very low levels of total lipids (2.7-17.2% DM). Analysis of lipid biomarkers showed that some of the specimens had preyed on pelagic copepods. Individual respiration rates ranged over 0.4-1.7 ml O2/day (mean: 1.2 ml, SD: 0.5 ml). Individual ammonia excretion rates varied between 7.8 µg and 49.3 µg N/day (mean: 30.7 µg, SD: 15.2 µg). The atomic O:N ratio ranged over 35 to 71 (mean: 55, SD: 14), indicating lipid-dominated metabolism. Mass-specific respiration ranged over 9.8-16.6 ml O2/day/g DM (mean: 13.1 ml, SD: 2.2 ml). The metabolic rates of A. sarsi were twice as high as those of the truly sympagic amphipod Gammarus wilkitzkii, which is better adapted to the under-ice habitat by its energy-saving attached lifestyle. It is concluded that males and juveniles of A. sarsi were actively searching for food in the water column and at the ice underside, but that the nutritional status of the amphipods in late Arctic winter was generally very poor.

Challenges in the Management of Geriatric Obesity in High Risk Populations.

The global prevalence of obesity in the older adult population is growing, an increasing concern in both the developed and developing countries of the world. The study of geriatric obesity and its management is a relatively new area of research, especially pertaining to those with elevated health risks. This review characterizes the state of science for this "fat and frail" population and identifies the many gaps in knowledge where future study is urgently needed. In community dwelling older adults, opportunities to improve both body weight and nutritional status are hampered by inadequate programs to identify and treat obesity, but where support programs exist, there are proven benefits. Nutritional status of the hospitalized older adult should be optimized to overcome the stressors of chronic disease, acute illness, and/or surgery. The least restrictive diets tailored to individual preferences while meeting each patient's nutritional needs will facilitate the energy required for mobility, respiratory sufficiency, immunocompentence, and wound healing. Complications of care due to obesity in the nursing home setting, especially in those with advanced physical and mental disabilities, are becoming more ubiquitous; in almost all of these situations, weight stability is advocated, as some evidence links weight loss with increased mortality. High quality interdisciplinary studies in a variety of settings are needed to identify standards of care and effective treatments for the most vulnerable obese older adults.

A comparative study: long and short term effect of a nutrition sensitive approach to delay the progression of HIV to AIDS among people living with HIV (PLWH) in Nigeria

Background: Malnutrition has a negative impact on optimal immune function, thus increasing susceptibility to morbidity and mortality among HIV positive patients. Evidence indicates that the prevalence of macro and micronutrient deficiencies (particularly magnesium, selenium, zinc, and vitamin C) has a negative impact on optimal immune function, through the progressive depletion of CD4 T-lymphocyte cells, which thereby increases susceptibility to morbidity and mortality among PLWH. Objective: To assess the short and long term effects of a nutrition sensitive intervention to delay the progression of human immune-deficiency virus (HIV) to AIDS among people living with HIV in Abuja, Nigeria. Methods: A randomized control trial was carried out on 400 PLWH (adult, male and female of different religious background) in Nigeria between January and December 2012. Out of these 400 participants, 100 were randomly selected for the pilot study, which took place over six months (January to June, 2012). The participants in the pilot study overlapped to form part of the scale-up participants (n 400) monitored from June to December 2012. The comparative effect of daily 354.92 kcal/d optimized meals consumed for six and twelve months was ascertained through the nutritional status and biochemical indices of the study participants (n=100 pilot interventions), who were and were not taking the intervention meal. The meal consisted of: Glycine max 50g (Soya bean); Pennisetum americanum 20g (Millet); Moringa oleifera 15g (Moringa); Daucus carota spp. sativa 15g (Carrot). Results: At the end of sixth month intervention, mean CD4 cell count (cell/mm3) for Pre-ART and ART Test groups increased by 6.31% and 12.12% respectively. Mean mid upper arm circumference (MUAC) for Pre-ART and ART Test groups increased by 2.72% and 2.52% within the same period (n 400). Comparatively, participants who overlapped from pilot to scale-up intervention (long term use, n 100) were assessed for 12 months. Mean CD4 cell count (cell/mm3) for Pre-ART and ART test groups increased by 2.21% and 12.14%. Mean MUAC for Pre-ART and ART test groups increased by 2.08% and 3.95% respectively. Moreover, student’s t-test analysis suggests a strong association between the intervention meal, MUAC, and CD4 count on long term use of optimized meal in the group of participants being treated with antiretroviral therapy (ART) (P<0.05). Conclusion: Although the achieved results take the form of specific technology, it suggests that a prolong consumption of the intervention meal will be suitable to sustain the gained improvements in the anthropometric and biochemical indices of PLWHIV in Nigeria.

Estado nutricional de escolares do semi-árido do nordeste brasileiro

SILVA, João B. da et al. Estado Nutricional de Escolares do Semi-Árido do Nordeste Brasileiro. Revista de Salud Pública, v. 11, n. 1, p. 62-71, 2009.