Maternal and umbilical cord serum vitamin A, E levels and mother-to-child transmission in the non-supplemented vitamin A, E HIV-1 infected parturients with short-course zidovudine therapy.

This study was undertaken to assess the maternal and umbilical cord serum vitamin A, E levels at delivery and mother-to-child transmission in nonsupplemented vitamin A, E HIV-1 infected parturients who received short-course zidovudine therapy. Maternal and umbilical cord serum vitamin A, E levels were quantitated by high-performance liquid chromatography in 67 HIV-1 infected parturients who received short-course zidovudine therapy. Mother-to-child transmission occurred in 13.4 per cent of HIV-1 infected parturients. There were no significant differences in the mean concentrations of vitamin A, E and vitamin E/cholesterol ratio between parturients with HIV-1 infected and non-infected infants. While maternal serum vitamin E level was adequate, nearly one-third of the parturients in the study had vitamin A deficiency. In conclusion our study has shown that there was no correlation between maternal serum vitamin A, E levels and mother-to-child HIV transmission in HIV-1 infected parturients who received short-course zidovudine therapy. However, the presence of underlying vitamin A deficiency in these parturients was common, adequate and intensive maternal-infant nutritional support should be emphasized especially in developing countries as an adjunctive measure in the reduction of mother-to-child transmission of HIV as well as the reduction in maternal and perinatal morbidity.

Serum copper and zinc levels in Thai patients with various diseases.

This study was conducted to evaluate the possible alteration of serum Cu and Zn levels in 118 medical inpatients (53 women and 65 men) in Ramathibodi Hospital. Patients were classified according to their main clinical diseases: pulmonary (n = 12), renal (14), infectious (30), malignant (9), cardiovascular (22), GI & hepatic (13) and hematological (18) diseases. Significantly increased serum Cu concentrations were found in patients with pulmonary, malignant, cardiovascular and infectious diseases; moreover, 75, 75, 50 and 37 per cent of these diseases, respectively, had serum levels greater than the normal mean + 2SD (23.6 mumol/L). Besides, 5 per cent of patients (3 in renal, 1 in infectious and 2 in GI & hepatic diseases) had low serum Cu levels suggestive of Cu depletion. By contrast, significantly decreased serum Zn concentrations were found in patients with GI & hepatic, infectious, renal, cardiovascular and malignant diseases. Serum Zn levels below the normal mean - 2SD (8.1 mumol/L) were presented in 46, 37, 29, 23 and 22 per cent of cases, respectively. It was found that serum Cu/Zn ratio in our patients not only with cancer but also with other diseases were statistically significant from the normal group. Hence, the use of serum Cu/Zn ratios as markers for the diagnosis of cancer or for staging tumors must be interpreted cautiously.

Thiamin and riboflavin status of medical inpatients.

Thiamin status was assessed by erythrocyte transketolase activity (ETKA) and thiamin pyrophosphate effect (TPPE) and riboflavin status by erythrocyte glutathione reductase activity (EGRA) and activity coefficient (AC) in 165 medical inpatients in Ramathibodi Hospital. Based on TPPE > 15 per cent, 9 per cent of the medical inpatients had thiamin depletion. Most of them were patients with renal, cardiovascular, hematological and infectious diseases. Based on AC > or = 1.2, 17 per cent of these inpatients had riboflavin depletion. Most of them were patients with pulmonary, cardiovascular and hematological diseases. Only one patient with pulmonary disease had both thiamin and riboflavin depletion. The proportion of thiamin depletion (2/37) in subjects with thiamin supplementation (mean 32.4, median 6, mode 2 md/d) tended to be less than those without (9/98). But, subjects with riboflavin supplementation (mean 3.3, median 4, mode 1 md/d) had the proportion of riboflavin depletion (0/31) significantly (Z-test, p < 0.005) lower than without supplementation (23/104). The data suggested that although the usual dose of vitamin supplementation in medical inpatients is beneficial thiamin depletion can still be present in catabolic patients.

Effects of dietary counseling on vitamin A, B-1, B-2 and zinc status of chronic hemodialysis patients.

Twenty-one chronic hemodialysis patients underwent nutritional evaluation and regular dietary counseling to improve the protein and energy intake for 8 weeks. As a result, the mean serum potassium and phosphorus concentrations were increased but were still within the normal ranges. After counseling, the frequency of abnormal TPPE and EGRAC were decreased (9.5 to 4.8 per cent and 19 to 14.3 per cent, respectively) while the frequency of hypervitaminosis A was increased from 67 to 81 per cent. Though the evidence of zinc deficiency was decreased from 81 to 62 per cent after counseling, mean serum zinc levels were low in both periods and inadequate vitamin B status cannot be totally eradicated due to the limitation of food selection. Therefore, regular supplementation of vitamin B complex is required, whereas, vitamin A supplementation must be prohibited in chronic HD patients. Small daily doses of potassium chelator and phosphate binder are mandatory if improvement of nutritional status is aimed to be one of the therapeutic goals.