Vitamina D y enfermedades respiratorias pediátricas / Vitamin D and pediatrics respiratory diseases

Resumen: El mejor entendimiento sobre la actividad global de la vitamina D, ha llevado a una intensa búsque da de sus implicancias en enfermedades no esqueléticas. En este artículo se presenta una revisión actualizada de la relación entre la vitamina D y la patología respiratoria pediátrica. Se realizó una búsqueda bibliográfica en PUBMED utilizando términos libres y MESH: vitamina D, enfermedades del sistema respiratorio, asma, bronquiolitis. Se seleccionó estudios en humanos menores de 18 años y animales, publicados en inglés y español hasta el 2017. Se encontraron 507 artículos, de los cuales se incluyeron 43. Evidencia indirecta apunta hacia un rol de la vitamina D y la maduración pulmonar fetal. En relación a la patología pulmonar pediátrica, los estudios son escasos y poco concluyentes. Nuevos meta - análisis, con evaluación individualizada de los participantes, muestran un importante rol protector de la suplementación en la prevención de exacerbaciones asmáticas severas e infecciones virales agudas. En bronquiolitis los resultados son contradictorios, sin relación clara entre niveles plasmáticos y severidad. No existe suficiente evidencia que evalué los beneficios en fibrosis quística y tuberculosis. Recientemente se ha propuesto una relación directa entre la severidad de los trastornos respiratorios del sueño y los niveles plasmáticos de vitamina D, aunque se desconoce los mecanismos exactos involucrados a esta asociación. La información actual permite suponer que la suplementación de vitamina D puede representar una estrategia costo - efectiva en la reducción de importantes causas de morbimortalidad infantil.

Abstract: The better understanding of the global activity of vitamin D has led to an intense search for its involvement in non-skeletal diseases. This article presents an updated review of the relationship between vitamin D and pediatric respiratory pathology. A literature search was performed in PUBMED using free terms and MESH terms: vitamin D, asthma, respiratory system diseases, and bronchiolitis. Stu dies in human patients younger than 18 years and animals, published in English and Spanish until 2017 were included. 507 articles were found, of which 43 were included. Indirect evidence suggests a role of vitamin D and fetal lung maturation. In relation to pediatric pulmonary pathology, studies are scarce and inconclusive. Recent meta-analyses performed with individualized evaluation of the participants shows an important protective role of vitamin D supplementation in the prevention of severe asthma exacerbations and acute viral infections. In bronchiolitis, the results are contradictory, with no clear relationship between plasma levels and severity. There is not enough evidence to assess the benefits of vitamin D supplementation in cystic fibrosis and tuberculosis. A direct relationship between the severity of sleep-related breathing disorders and vitamin D plasma levels has recently been proposed, although the exact mechanisms involved in this association are unknown. Current information suggests that vitamin D supplementation may represent a cost-effective strategy in redu cing important causes of infant morbidity and mortality.

Vitamina D y riesgo de preeclampsia: revisión sistemática y metaanálisis / Vitamin D and risk of preeclampsia: A systematic review and meta-analysis

Resumen Introducción. Cada vez son más los hallazgos sobre la relación entre las concentraciones de vitamina D en el ser humano y diversas condiciones clínicas. Hay una gran cantidad de estudios que informan sobre dicha asociación, especialmente con complicaciones obstétricas, incluidas la preeclampsia y la diabetes mellitus de la gestación, entre otras, pero sus resultados todavía no son definitivos, por lo que se requieren estudios de intervención de calidad que confirmen la relación de la vitamina D con dichos resultados. Objetivo. Revisar la información plasmada en estudios en torno al papel de la vitamina D materna y el desarrollo de la preeclampsia. Materiales y métodos. La metodología usada siguió las recomendaciones de la guía Cochrane para la elaboración de revisiones sistemáticas y de la guía del grupo Meta-analysis of Observational Studies in Epidemiology (MOOSE) para los metaanálisis. La búsqueda incluyó estudios observacionales y ensayos clínicos controlados. Resultados. Los niveles bajos de vitamina D, medida con el examen de 25-hidroxivitamina D, son comunes en el embarazo. Los resultados de esta revisión sistemática y del metaanálisis sugieren una asociación inversa entre los niveles de vitamina D y el desarrollo de preeclampsia. Hubo heterogeneidad en los estudios en cuanto a su diseño, población y ubicación geográfica, así como a las definiciones de exposición y resultado. Los ensayos clínicos controlados aleatorizados se excluyeron del metaanálisis. Conclusión. Se encontró una asociación inversa que sugiere que, a mayores concentraciones de vitamina D, menor es la probabilidad de desarrollar preclampsia, a pesar de la heterogeneidad de la medida global en este tipo de análisis.

Abstract Introduction: Human vitamin D levels have been increasingly related to a wide range of clinical outcomes. There is a large amount of reports on its associations, especially with obstetric complications, including preeclampsia and gestational diabetes. These results are scarcely consistent and there is still a lack of quality intervention studies to confirm the role of vitamin D in those outcomes. Objective: To review the available scientific evidence on the role of maternal vitamin D in the development of preeclampsia. Materials and methods: The methodology used followed the recommendations of the Cochrane guide for the preparation of systematic reviews, and for metaanalysis, the Guide of the Metaanalysis of Observational Studies in Epidemiology group (MOOSE). The search included both observational studies and controlled clinical trials. Results: Low vitamin D levels, measured by the 25-hydroxyvitamin D test, are common in pregnancy. The results of this systematic review and metaanalysis suggest an inverse ratio between vitamin D levels and the development of preeclampsia. There was heterogeneity among the studies with regard to the design, population, geographic location, definitions of exposure, and the outcome. We excluded randomized controlled trials from this meta-analysis. Conclusion: The inverse association we found suggests that the higher the levels of vitamin D the lesser the probability of developing preeclampsia, in spite of the heterogeneity of the global measurement in this type of analysis.

Papillary atrophy of the tongue and nutritional status of hospitalized alcoholics / Glossite atrófica e estado nutricional de alcoolistas hospitalizados

BACKGROUND: Atrophy of the papillae, mucosa, and dorsum of the tongue are considered classical signs of nutritional deficiencies. OBJECTIVE: To assess the nutritional status of hospitalized alcoholics with or without papillary atrophy of the tongue. METHODS: This study was performed with 21 hospitalized alcoholics divided into Atrophic Glossitis Group (n=13) and Normal Tongue Group (n=8). Healthy, non-alcoholic volunteers composed the Control Group (n=8). Anthropometry and bioelectric impedance were performed, and serum vitamins A, E, and B12 were determined. RESULTS: There were no statistical differences in relation to age (46.7±8.7 vs. 46.8±15.8 years) or gender (92.3% vs. 87.5% male), respectively. Control Group volunteers were also paired in relation to age (47.5±3.1 years) and male predominance (62.5%). In relation to hospitalized alcoholics without atrophic lesions of the tongue and Control Group, patients with papillary atrophy showed lower BMI (18.6 ± 2,5 vs 23.8 ± 3.5 vs 26.7 ± 3,6 kg/m² ) and body fat content 7.6 ± 3.5 vs 13.3 ± 6.5 vs 19.5 ± 4,9 kg). When compared with the Control Group, alcoholic patients with or without papillary atrophy of the tongue showed lower values of red blood cells (10.8 ± 2.2 vs 11.8 ± 2.2 vs 14.5 ± 1,6g/dL) and albumin (3.6 ± 0.9 vs 3.6 ± 0.8 vs 4.4 ± 0.2g/dL). The seric levels of vitamins A, E, and B12 were similar amongst the groups. CONCLUSION: Hospitalized alcoholics with papillary atrophy of the tongue had lower BMI and fat body stores than controls, without associated hypovitaminosis.

FUNDAMENTOS: A deficiência crônica de nutrientes pode levar à hipotrofia das papilas e da mucosa e do dorso da língua, considerada um sinal clássico de subnutrição protéico-energética. OBJETIVO: O objetivo do presente estudo é comparar o estado nutricional, incluindo as dosagens dos níveis séricos de vitaminas A, E e B12 em pacientes alcoolistas com ou sem alterações tróficas das papilas linguais. MÉTODOS: O estudo caso-controle incluiu 21 pacientes adultos alcoolistas internados em um hospital universitário. Utilizando-se de um sistema de fotografia da cavidade oral, dois clínicos independentes classificaram os indivíduos alcoolistas de acordo com a presença ou não de alterações tróficas na língua. Foram registrados os dados antropométricos, a composição corporal pela impedância bioelétrica e os exames laboratoriais para avaliação clínica e nutricional, incluindo dosagens das vitaminas A, E e B12. O estudo incluiu ainda voluntários saudáveis, não alcoolistas como Grupo Controle (n=8). A comparação entre os grupos foi feita por ANOYA-F ou pelo teste de Kruskal-Wallis, de acordo com a curva de normalidade dos resultados. Foram considerados significativos diferenças com p < 0,05. RESULTADOS: De acordo com a presença de alterações tróficas nas papilas linguais, os pacientes alcoolistas foram alocados no Grupo Língua Despapilada (n=13) e Grupo Língua Normal (n=8), sem diferença estatística quanto à idade (46,7 ± 8,7 vs 46,8 ± 15,8 anos) e gênero masculino (92,3 vs 87,5%). Os voluntários do Grupo Controle apresentaram 47,5 ±3,1 anos, sendo 62,5% do gênero masculino. Os pacientes alcoolistas com hipotrofia papilar apresentaram menor IMC (18,6 ± 2,5 vs 23,8 ± 3,5 vs 26,7 ± 3,6 kg/m2) e gordura corporal (7,6 ± 3,5 vs 13,3 ± 6,5 vs 19,5 ± 4,9 kg), quando comparados com os demais grupos. Em relação ao Grupo Controle, os alcoolistas apresentaram menores valores de hemoglobina (10,8 ± 2,2 vs 11,8 ± 2,2 vs 14,5 ± 1,6 g/dL) e albumina sérica (3,6 ± 0,9 vs 3,6 ± 0,8 vs 4,4 ± 0,2 g/dL). Os níveis plasmáticos de vitaminas A, E e B12 foram similares entres os grupos. CONCLUSÃO: Os pacientes alcoolistas com achados físicos de hipotrofia de papilas linguais apresentam menores valores em medidas antropométricas, de hemoglobina e albumina séricas que os grupos Controle ou de alcoolistas sem língua despapilada. Não houve evidências de hipovitaminoses associadas.

Nutritional profile of asymptomatic alcoholic patients / Perfil nutricional de pacientes alcoólatras assintomáticos

CONTEXT: Alcoholism may interfere with nutritional status, but reports are often troubled by uncertainties about ingested diet and organ function, as well as by ongoing abuse and associated conditions. OBJECTIVE: To identify nutritional and body compartment changes in stable alcoholics without confounding clinical and dietetic variables, a prospective observational pilot study was designed. Three well-matched populations were considered: subjects with chronic alcoholic pancreatitis, alcoholics without visceral disease, and healthy never-drinking adults (controls). METHODS: Subjects (n = 60) were asymptomatic males with adequate diet, no superimposed disease or complication, and alcohol-free for at least 6 months. After exclusions, 48 patients were compared. Variables encompassed dietary recall, bioimpedance analysis, biochemical profile and inflammatory markers. Main outcome measures were body fat, lean body mass, serum lipids, C-reactive protein, and selected minerals and vitamins. RESULTS: Both alcoholic populations suffered from reduced lean body mass (P = 0.001), with well-maintained body fat.Magnesium was depleted, and values of vitamin D and B12 correlated with alcohol abuse. LDL and total cholesterol was increased in alcoholics without pancreatitis (P = 0.04), but not in those with visceral damage. C-reactive protein and serum amyloid A correlated with duration of excessive drinking (P = 0.01). CONCLUSIONS: Undernutrition (diminished lean body mass, risk of magnesium and vitamin deficiencies) contrasted with dyslipidemia and increased cardiovascular risk. This second danger was masked during chronic pancreatitis but not in alcoholics without visceral disease. Further studies should focus special requirements of this population.

CONTEXTO: O alcoolismo pode interferir no estado nutricional, todavia, os relatos frequentemente sofrem com o viés das incertezas sobre dieta consumida, danos orgânicos subjacentes e persistência do abuso. OBJETIVO: Para identificar alterações nutricionais e de compartimentos corpóreos em alcoólatras estáveis sem variáveis de confusão clínica e dietética, foi desenhado o presente estudo piloto observacional prospectivo. Três populações bem pareadas foram consideradas: casos de pancreatite crônica alcoólica, alcoólatras sem enfermidade visceral e adultos que nunca consumiram etanol (controles). MÉTODOS: Os pacientes (n = 60) eram homens assintomáticos com dieta satisfatória, nenhuma evidência de enfermidade ou complicação exceto as do protocolo e afastados do etanol por no mínimo 6 meses. Após exclusões, 48 pacientes foram comparados. As variáveis abrangeram recordatório alimentar, análise de bioimpedância, perfil bioquímico e marcadores inflamatórios. Os principais resultados buscados foram gordura corporal, massa magra, lípides séricos, proteína C reativa e vitaminas e minerais selecionados. RESULTADOS: Os dois grupos que ingeriam álcool exibiram redução da massa magra (P = 0,001) com gordura corporal bem conservada. O magnésio estava diminuído e as taxas de vitamina D e B12 se correlacionaram com o abuso de álcool. O colesterol total e LDL estavam aumentados nos alcoólatras sem pancreatite (P = 0,04), porém, não naqueles com dano pancreático. A proteína C reativa e o seroamilóide A correlacionaram-se com a duração do excesso etílico (P = 0,01). CONCLUSÕES: A desnutrição (menor massa magra, possibilidade de carência de magnésio e vitaminas) contrastou com a dislipidemia e o risco cardiovascular elevado. Este segundo perigo permaneceu mascarado na vigência de pancreatite crônica, porém, não nos alcoólatras sem lesão visceral. Estudos adicionais deverão focalizar as necessidades nutricionais específicas desta população.

Alimentação complementar e estado nutricional de crianças menores de dois anos atendidas no Programa Saúde da Família em Acrelândia, Acre, Amazônia Ocidental Brasileira / Complementary feeding and nutritional status of 6-24-month-old children in Acrelândia, Acre State, Western Brazilian Amazon

Com objetivo de investigar o estado nutricional e alimentação complementar em crianças de 6 a 24 meses, residentes na Amazônia Ocidental Brasileira, um estudo transversal foi realizado na área urbana do Município de Acrelândia, Estado do Acre, com 164 crianças. As prevalências de déficit de estatura/idade e anemia foram de 12 por cento e 40 por cento, respectivamente, e de deficiência de ferro isolada, de 85 por cento. Os níveis séricos das vitaminas A e B12 estavam baixos em 15 por cento e 12 por cento das crianças, respectivamente. Houve baixo consumo alimentar dos seguintes nutrientes ( por cento de crianças abaixo das recomendações): ácido fólico (33 por cento), vitamina C (40 por cento), vitamina A (42 por cento), zinco (46 por cento) e ferro (71 por cento). A biodisponibilidade de ferro da dieta foi de 8 por cento. Observou-se baixo consumo de frutas, hortaliças e carnes, com consumo excessivo de leite de vaca e mingau.

Our objective was to investigate nutritional status and complementary feeding practices in children from 6 to 24 months of age living in the Western Brazilian Amazon. A cross-sectional study was conducted within an urban area of Acrelândia, Acre State. A total of 164 children were studied. Prevalence rates for stunting and anemia were 12 percent and 40 percent, respectively, and overall prevalence of iron deficiency was 85 percent. Vitamin A and B12 serum levels were below normal thresholds in 15 percent and 12 percent of children, respectively. Low intake was observed for the following nutrients ( percent of children): folic acid (33 percent), vitamin C (40 percent), vitamin A (42 percent), zinc (46 percent), and iron (71 percent). Iron bioavailability in the diet was approximately 8 percent. Very low dietary intakes of fruits, vegetables, and meats were observed, in contrast with excessive consumption of cow's milk and porridge.

Folato, vitamina B6 e B12: ingestão dietética, níveis sanguíneos e relação com a concentração sérica de homocisteína em adolescentes de Indaiatuba, São Paulo / Folate, vitamin B6 and B12: the relationship between serum homocysteine concentration and dietary intake and status of vitamins among adolescents of Indaiatuba, São Paulo

O folato e outras vitaminas do complexo B estão metabolicamente relacionadas à elevação sanguínea do aminoácido homocisteína (hcy). Este, por sua vez, se mostrou associada ao aumento de risco de eventos adversos, sobretudo as doenças cardiovasculares. Objetivo: Investigar a ingestão dietética e níveis sanguíneos das vitaminas folato, B6, e B'2, e sua relação com a concentração sérica de hcy, entre adolescentes Métodos: Estudo observacional, transversal, em adolescentes de ambos os sexos, faixa etária de 16 a 19 anos, foi conduzido na escola de ensino técnico da cidade de Indaiatuba-SP-Brasil. Coletou-se registro alimentar de três dias não consecutivos. Os valores dos nutrientes referentes aos registros foram obtidos no software NDSR. Para a estimativa da dieta habitual pela remoção da variabilidade intrapessoal e a prevalência de inadequação da ingestão pelo método da EAR como ponto de corte, utilizou-se o PC-Side, versão 1.0. As análises bioquímicas de folato, B6, BI2 e hcy foram conduzi das de acordo com os métodos preconizados pela literatura científica. Todas as análises estatísticas foram realizadas no STA TA® versão 10.0 considerando o nível de significância 5 por cento. Resultados: O estudo foi conduzido com 99 adolescentes, sendo a maioria do sexo feminino (58,6 por cento) e média de idade de 17,6 (dp 0,9) anos. As médias da concentração sérica de folato, B6 e B'2 foram de 9,2 (dp 3,4) ng-ml, 18,7 (dp 5,1) nmollL e 397,5 (dp 188,4) pg-ml, respectivamente. 15,2 por cento dos adolescentes apresentavam inadequação da ingestão de folato, 10,2 por cento, de 86 e <1 por cento, de BI2' Os alimentos que mais contribuíram para a ingestão dos nutrientes foram: pão francês (23,1 por cento), macarrão (9,7 por cento) e feijões (8,2 por cento) para folato; arroz branco (9,9 por cento), carne de frango (5,7 por cento) e carne bovina (4,2 por cento) para B6, e carne bovina magra (16,4 por cento), leite integral (15 por cento) e carne bovina...

Folate and the metabolically related B vitamins are intimately connected with metabolic pathways of homocysteine (hcy). Epidemiologic studies have shown that increased total homocysteine concentration is an independent predictor for a number of human diseases, especially, cardiovascular diseases. Objective: to investigate the dietary intake and status of folate, related B-vitamin, and the relationship to total homocysteine concentration among adolescents. Methods: A cross-sectional study was conducted among adolescents, both genders, aged 16 to 19 years, in a public school of Indaiatuba, São Paulo. Dietary intake was measured using three-day dietary record. The energy and nutrients were computed using Nutrition Data System for Research software. The usual intake and prevalence of inadequate by EAR cut-point method were estimated using PC-SIDE, version 1.0. Biochemical analyses were determined according the methods recommended by the scientific literature. All statistical analyses were performed using STATA, version 10.0. A two-tailed p value <0.05 was considered significant. Results: The study was conducted among 99 adolescents, 58 (58.6%) were girls, mean age of 17.6 (SD 0.9) years old. The means of folate, B6 and B12 vitamins status were of 9.2 (SD 3.4) ng/ml, 18.7 (SD 5.1) nmol/L and 397.5 (SD 188.4) pg/ml, respectively. The proportion of adolescents with folate, B6 and B12 intakes above the recommendation was 15.2%, 10.2%, e <1%, respectively. The foods that more contributed for folate intake were French bread (23.1%), pasta (9.7%) and beans (8.2%). For B6 intake rice (9.9%), chicken (5.7%) and meat (4.2%). For B12 intake, meat without fat (16.4%) whole milk (15%) and meat with fat (12.3%). The mean of hcy was 15.4 (SD 10.2) µmol/L in boys and 8.2 (SD 2.2) µmol/L in girls. In boys, 25% of them showed values of serum hcy concentration upper to 15 µmol/L and, means of folate and vitamin B12 decreased...

role of RCC, vimentin and cytokeratin 7 in the differential diagnosis of conventional renal cell carcinoma

The present study investigates the value of RCC, Cytokeratin 7 and vimentin immunohistochemical staining in the distinction between granular variant of renal cell carcinoma, chromophobe renal cell carcinoma and oncocytoma. Chromophobe renal cell carcinomas were characterized by positive cytoplasmic immunoreactivity to CK7 [100%] while they were negative to vimentin, and RCC. Conventional renal cell carcinoma showed positive immunoreactivity to; vimentin [100%], RCC [73%], and CK7 [14%]. On the other hand, oncocytoma showed focal weak staining to RCC while they were negative to the other markers. A panel of antibodies including RCC, Cytokeratin 7, and vimentin is useful tool in differentiating chromophobe renal cell carcinoma from granular type renal cell carcinoma and oncocytoma

Serum micronutrient and micromineral concentrations and ratios in healthy Omani subjects

This study aimed to establish reference ranges of serum concentrations of copper, zinc, retinol, alpha-tocopherol, copper: caeruloplasmin and copper: zinc ratios in a group of healthy Omani men and women. Assay techniques employed were atomic absorption spectrophotometry [copper and zinc], reverse-phase high-pressure liquid chromatography with isocratic elution [retinol and alpha-tocopherol], immunonephelometry [caeruloplasmin] and spectrophotometry [albumin and cholesterol]. The mean +/- SD [microM] obtained for copper, zinc, retinol, and alpha-tocopherol were 15.9 +/- 3.0, 14.2 +/- 2.0, 1.45 +/- 0.39 and 16.9 +/- 4.4, respectively. The mean +/- SD for copper: zinc and copper: caeruloplasmin ratios were 1.15 +/- 0.30 micromol/mmol and 6.99 +/- 0.84 micromol/g, respectively. Significantly higher [p < 0.0001] copper and caeruloplasmin concentrations, copper: zinc and copper: caeruloplasmin ratios and lower zinc, retinol, alpha-tocopherol, cholesterol concentrations and alpha-tocopherol: cholesterol ratio were present in women compared to men. Age appeared to be associated with copper and retinol concentrations, and copper: caeruloplasmin ratios in women; in men, the association was mostly moderate with caeruloplasmin, alpha-tocopherol, cholesterol concentrations and alpha-tocopherol: cholesterol ratios. Smokers had decreased albumin [p = 0.002], zinc [p = 0.023] concentrations, and copper: caeruloplasmin ratios [p = 0.002], increased alpha-tocopherol concentrations [p = 0.016] and alpha-tocopherol: cholesterol ratios [p = 0.021] compared with non-smokers. Deficiency incidence was

Hepatitis C viraemia and cortisol level in thalassaemic children along with other viraemia risk factors

Hepatitis C virus [HCV] is the major cause of post-transfusion hepatitis world-wide and as thalassaemic patients are exposed to repeated bloodú transfusions, theyú are at' high-risk to get HCV infection. This study aimed at shedding some light on any association between serum cortisol, human immunodeficiency virus [HIV] or Schistosoma mansoni [S. manson i] infections and HCV viraemia in Egyptian thalassaemic children. This study was carried out on 51 thalassaemic children [34> and 17 +], aged 1-14 y attending the Hematology unit. Thirty-eight had been found to be + ve for HCV antibody [Ab], whereas 23 of them had HCV-RNA by reverse transcriptase polymerase chain reaction [RT-PCR]. All children were investigated for complete blood picture, hemoglobin electrophoresis, some liver function tests, HIV infection and serum cortisol level. Most of them tested for infection and S. mansoni serology. HCV -Ab +ve group were associated with blood transfusion >/= 10 units [P < 0.001]. heptomegaly [P < 0.05], hepatic tenderness [P< 0.0001], splenectomy [P < 0.02], elevated ALT [P < 0.01] and decreased serum cortisol [P < 0.000 1]. HCV -viraemia was associated with tender hepatomegaly [P < 0.05] only. Serum cortisol decrease was dependent on multiple blood transfusion rather than on HCV infection, whether associated with viraemia or not, in HCV-Ab the thalassaemic children. We recommend farther study for decrease of serum cortisol in HCV infected thalassaemics and other factors, not tested in the present study, behind HCV viraemia in these patients

Risk factors for coronary artery disease and levels of lipoprotein(a) and fat-soluble antioxidant vitamins in Asian Indians of USA.

High rates of coronary artery disease have been reported in the Asian Indians who have migrated to other countries. Although many coronary artery disease risk factors (diabetes, high serum cholesterol, lipoprotein[a], and smoking) have been suggested, studies of coronary artery disease risk factors in Asian Indians living in USA are only a few. We investigated coronary artery disease risk factors in 110 Asian Indian physicians living in USA by questionnaire and measurement of their serum lipids and fat-soluble antioxidant vitamins. Differences in risk factors between genders, vegetarian diets and diabetic status were also studied. We found that lipoprotein(a) (mean=20 mg/dl), low density lipoprotein cholesterol, and diabetes (prevalence of 7.5%) are more important risk factors for coronary artery disease, but not smoking, when compared to other Americans. Higher levels of low density lipoprotein cholesterol, retinol, alpha-tocopherol, cryptoxanthin and lycopene, and lower levels of high density lipoprotein cholesterol were found in the males than in females. Comparable levels of lipoprotein(a) were found for males and females. Vegetarians, compared to non-vegetarians, had similar levels of lipids and fat-soluble antioxidants. Lower levels of retinol, lutein/zeaxanthin and lycopene were found in the diabetics compared to non-diabetics. These findings suggest that (1) the control of low density/high density lipoprotein cholesterol levels could be important in prevention of coronary artery disease in Indian males, (2) the vegetarian diets of Asian Indians do not favourably influence the serum lipid and antioxidant levels, and (3) increased serum levels of antioxidants may be beneficial for diabetics. Furthermore, for the first time, we show that serum levels of lutein/zeaxanthin and lycopene are significantly lower in the diabetics.

Current nutritional status of mothers and children in Al Ain, United Arab Emirates

Forty-six mothers and children from the United Arab Emirates participated in a pilot study to determine possible micronutrient deficiencies in the country. Thirty-five per cent [35%] of the children and 21% of the mothers had low serum ferritin levels, while 30% of the mothers had low serum 25-hydroxyvitamin D with 28% of mothers having a low serum folate status. These deficiencies are widespread in the nationals of the United Arab Emirates. In view of the increasing importance of intrauterine and early infant nutrition, further investigation and a national study seem warranted

Avaliaçäo dos níveis séricos das vitaminas A, E, C e B2, de carotenóides e zinco, em idosos hospitalizados / Assessment of vitamin A, E, C and B2, carotenoid and zinc serum levels in elderly hospital patients

Foram verificados os níveis séricos de zinco, carotenóides e vitaminas A, E, C, B2 em todos os idosos (n=202) internados nas diversas enfermarias do hospital estudado, no período de fevereiro de 1986 a outubro de 1988. Foram estudados 130 homens e 72 mulheres que apresentaram média de idade de 67,8 anos, com variaçäo entre 60 a 88. A percentagem de níveis séricos deficitários foi de 59,5 para o zinco, 56,5 por cento para a vitamina C, 34,5 por cento para a vitamina B2, 26 por cento para a vitamina E, 13,2 por cento para a vitamina A e 6,8 por cento para os carotenóides. Os idosos portadores de leucoses, magaesôfogo, doença pulmonar obstrutiva crônica e insuficiência cardíaca congestiva constituíram-se no grupo de pacientes com grande prevalência de estado deficitário de zinco e das vitaminas estudadas, resultados que mostram a importância de se investigar as deficiências desses micronutrientes e däo subsídios para a abordagem terapêutica mais racional do paciente idoso internado

Nutritional status of institutionalized elderly in south Florida

To assess the nutritional status of an elderly nursing home population of South Florida, forty-seven persons with ages ranging from 65 to 96 years were studied. Complete clinical examination and anthropometric measures were performed, along with blood cell count, biochemical blood parameters and assessment of water-soluble vitamins levels. The most common clinical finding were edentulous (67%), general pallor (44%), hyperpigmentation (33%), dry skin (26%) and arcus corneitis (26%). Thirty-five percent of the studied population had cholesterol levels greater than 220 mg/dl. Triglyceride levels were also significantly elevated in a considerable subset of our subjects, with 30% having levels above threshold value of 150 mg/dl. Small proportions of subjects showed low levels of albumin (6%), total protein (28%), ascorbic acid (2%), and thiamin (9%). Forty-five percent of males were pyridoxine deficient, while 63% of the females presented such deficiency. This study underscores the need to define, with greater precision, the nutritional status of aged populations as well as improve our inadequate standards associated with the normal aging process. Nutritional intervention--only possible when appropriate standards are defined--can potentially serve not only to prevent the occurrence of significant morbidity and mortality, but can also be employed to enhance quality of life in the elderly individuals