Point-of-Care Fecal Calprotectin Monitoring in Preterm Infants at Risk for Necrotizing Enterocolitis.

OBJECTIVE: To establish baseline trends in fecal calprotectin, a protein excreted into the stool when there is neutrophilic inflammation in the bowel, in infants at risk for necrotizing enterocolitis (NEC). STUDY DESIGN: We performed a prospective observational cohort study in infants with a birth weight of <1500 g without existing bowel disease at a level IV neonatal intensive care unit from October 2015 to September 2016. Stools were collected once daily for 30 days or until 32 weeks postmenstrual age and processed using the Fecal Calprotectin High Range Quantitative Quantum Blue assay. RESULTS: In 64 preterm infants, during the first week after birth, 62% of infants had an initial stool sample with high baseline calprotectin levels (≥200 µg/g). In assessment of maternal and neonatal risk factors, maternal etiology for preterm birth (ie, eclamplsia or preeclampsia) was the only significant factor associated with high baseline calprotectin level. Two patients in the cohort developed NEC. Calprotectin levels for the entire cohort fluctuated during the observed period but generally increased in the third and fourth weeks after birth. CONCLUSIONS: At-risk infants had highly variable fecal calprotectin levels, with maternal causes for preterm birth associated with higher baseline levels. More longitudinal data in infants with NEC are necessary to determine whether acute rises in fecal calprotectin levels prior to clinical diagnosis can be confirmed as a diagnostic or prognostic biomarker.

Text Message Intervention (TEACH) Improves Quality of Life and Patient Activation in Celiac Disease: A Randomized Clinical Trial.

OBJECTIVE: To determine the impact of the Text Message Educational Automated Compliance Help (TEACH) text message intervention as a pragmatic approach for patient engagement among adolescents with celiac disease (CD) as measured by gluten-free diet (GFD) adherence, patient activation, and quality of life (QOL). STUDY DESIGN: Randomized controlled trial with patient recruitment at a pediatric, university-based hospital and through social media; 61 participants ages 12-24 years with CD diagnosed at least 1 year were enrolled. The TEACH intervention cohort received 45 unique text messages over a 3-month study period while the control group received standard of care treatment. Primary outcome measures included objective markers of GFD adherence included serum tissue transglutaminase IgA and deamidated gliadin peptide IgA levels. Secondary patient-reported outcomes collected via online survey included the Celiac Dietary Adherence Test, National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Global Short Form measure of QOL, Celiac Symptom Index, and Patient Activation Measure. All measures were assessed at enrollment and after the 3-month study period. Statistical analysis performed using the 2-tailed paired Student t test. RESULTS: Among the TEACH intervention group, there was significant improvement comparing enrollment scores with 3-month follow-up scores in patient activation (Patient Activation Measure score 63.1 vs 72.5, P?=?.01) and QOL (NIH PROMIS Global Mental Health 50.8 vs 53.3, P?=?.01 and NIH PROMIS Global Physical Health 50.8 vs 57.7, P?=?.03). There was no statistically significant difference in patient-reported or objectively measured GFD adherence. CONCLUSIONS: TEACH is an effective intervention among patients with CD to improve patient activation and QOL, even among a cohort with GFD adherence at baseline. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02458898.

Genetic diversity, population structure, and association mapping of agronomic traits in waxy and normal maize inbred lines.

Understanding genetic diversity, population structure, and linkage disequilibrium is a prerequisite for the association mapping of complex traits in a target population. In this study, the genetic diversity and population structure of 40 waxy and 40 normal inbred maize lines were investigated using 10 morphological traits and 200 simple sequence repeat (SSR) markers. Based on a population structure analysis, the 80 maize inbred lines were divided into three groups: I, II, and admixed. Significant marker-trait associations were identified between the markers and the 10 morphological traits, which were studied according to the model used to confirm the association. Using a general linear model, the lowest R(2) value (9.03) was detected in umc1139, which was associated with ear number, and the highest (43.97) was in umc1858, which was associated with plant height. Using a mixed linear model, the lowest R(2) value (18.74) was in umc1279, which was associated with ear weight; the highest (27.66) was in umc1858, which was associated with 100-kernel weight. The SSR markers identified in the present study may serve as useful molecular markers for selecting important yield and agronomic traits. These results will be useful for marker-assisted selection in maize breeding programs, to help breeders choose parental lines and markers for crosses.

Rapid cessation of acute diarrhea using a novel solution of bioactive polyphenols: a randomized trial in Nicaraguan children.

Goal. We assessed the effectiveness of bioactive polyphenols contained in solution (LX) to restore normal bowel function in pediatric patients with acute diarrhea. Background. While providing oral rehydration solution (ORS) is standard treatment for diarrhea in developing countries, plant-derived products have been shown to positively affect intestinal function. If a supplement to ORS resolves diarrhea more rapidly than ORS alone, it is an improvement to current care. Study. In a randomized, double-blind, placebo-controlled cross-over study, 61 pediatric patients with uncontrolled diarrhea were randomized to receive either ORS + LX on day 1 and then ORS + water on day 2 (study arm) or ORS + water on day 1 and then ORS + LX on day 2 (control arm). Time to resolution and number of bowel movements were recorded. Results. On day 1, the mean time to diarrhea resolution was 3.1 h (study arm) versus 9.2 h (control arm) (p = 0.002). In the study arm, 60% of patients had normal stool at their first bowel movement after consumption of the phenolic redoxigen solution (LX). On day 2, patients in the study arm continued to have normal stool while patients in the control arm achieved normal stool within 24 h after consuming the test solution. Patients in the control arm experienced a reduction in the mean number of bowel movements from day 1 to day 2 after consuming the test solution (p = 0.0001). No adverse events were observed. Conclusions. Significant decreases in bowel movement frequency and rapid normalization of stool consistency were observed with consumption of this novel solution.

Associations of elevated liver enzymes among hospitalized adolescents with anorexia nervosa.

OBJECTIVES: To analyze the prevalence, predictors, and evolution of increased liver enzymes in a large sample of adolescents hospitalized with anorexia nervosa (AN). STUDY DESIGN: Electronic medical records of all subjects 10-22 years of age with AN, first admitted to a tertiary children's hospital from January 2007 to December 2012, were reviewed retrospectively. Demographic factors, anthropometric factors, initial prescribed calories, and alanine aminotransferase levels were recorded. Multivariate analysis was performed to assess the effect of sex, degree of malnutrition, and initial calories prescribed on having alanine aminotransferase ≥40 IU/L. RESULTS: A total of 356 subjects met eligibility criteria (age 16.1 ± 2.4; 89.0% female; admission body mass index [BMI] 15.9 ± 1.9; admission percentage median BMI 78.2 ± 8.5), with elevated liver enzymes present in 37.0% on admission and in 41.1% at any point during the hospitalization. Lower percentage median BMI (aOR 0.96; 95% CI 0.93-0.98) and male sex (aOR 0.45; 95% CI 0.22-0.94) were significantly associated with odds of elevated liver enzymes on admission. Higher initial prescribed calories were associated with odds of elevated liver enzymes after admission (aOR 1.81; 95% CI 1.04-3.18). CONCLUSIONS: In this study of AN and elevated liver enzymes, the degree of malnutrition and male sex predicted elevated liver enzymes on admission but initial prescribed calories also may be associated with elevated liver enzymes after admission in a small proportion of patients. Future research should better characterize the evolution of elevated liver enzymes in patients hospitalized with AN undergoing refeeding.

Genetic characterization of hatchery populations of Korean spotted sea bass (Lateolabrax maculatus) using multiplex polymerase chain reaction assays.

The spotted sea bass, Lateolabrax maculatus, is an important commercial and recreational fishery resource in Korea. Aquacultural production of this species has increased because of recent resource declines, growing consumption, and ongoing government-operated stock release programs. Therefore, the genetic characterization of hatchery populations is necessary to maintain the genetic diversity of this species and to develop more effective aquaculture practices. In this study, the genetic diversity and structure of three cultured populations in Korea were assessed using multiplex assays with 12 highly polymorphic microsatellite loci; 144 alleles were identified. The number of alleles per locus ranged from 6 to 28, with an average of 13.1. The mean observed and expected heterozygosities were 0.724 and 0.753, respectively. Low levels of inbreeding were detected according to the inbreeding coefficient (mean FIS = 0.003-0.073). All hatchery populations were significantly differentiated from each other (overall fixation index (FST) = 0.027, P < 0.01), and no population formed a separate cluster. Pairwise multilocus FST tests, estimates of genetic distance, mantel test, and principal component analyses did not show a consistent relationship between geographic and genetic distances. These results could reflect the exchange of breeds and eggs between hatcheries and/or genetic drift due to intensive breeding practices. For optimal resource management, the genetic variation of hatchery stocks should be monitored and inbreeding controlled within the spotted sea bass stocks that are being released every year. This genetic information will be useful for the management of both L. maculatus fisheries and the aquaculture industry.

Geographical rural status and health outcomes in pediatric liver transplantation: an analysis of 6 years of national United Network of Organ Sharing Data.

OBJECTIVE: To determine whether children in rural areas have worse health than children in urban areas after liver transplantation (LT). STUDY DESIGN: We used urban influence codes published by the US Department of Agriculture to categorize 3307 pediatric patients undergoing LT in the United Network of Organ Sharing database between 2004 and 2009 as urban or rural. Allograft rejection, patient death, and graft failure were used as primary outcome measures of post-LT health. Pediatric end-stage liver disease/model of end-stage liver disease scores >20 was used to measure worse pre-LT health. RESULTS: In a multivariate analysis, we found greater rates of allograft rejection within 6 months of LT (OR 1.27; 95% CI 1.05-1.53) and a lower occurrence of posttransplantation lymphoproliferative disorder (OR 0.64; 95% CI 0.41-0.99) in patients in rural areas. The difference in allograft rejection was eliminated at 1 year of LT (OR 1.18; 95% CI 0.98-1.42). Rural location did not impact other outcome measures. CONCLUSION: We conclude that rural location makes a negative impact on patient health within the first 6 months of LT by increasing the risk for allograft rejection, although patients in rural areas may have lower rates of developing posttransplantation lymphoproliferative disorder. Long-term adverse health effects were not seen.

Avaliação do teor de óleo essencial de Baccharis trimera (Less. ) DC. em diferentes embalagens durante o armazenamento / Assessment of Baccharis trimera (Less. ) DC. essential oil content in different packages during storage

O uso de plantas medicinais como fonte terapêutica é milenar e nos últimos anos o seu valor tem aumentado, tanto para a população quanto para a ciência. Várias empresas nacionais e internacionais empregam matéria-prima vegetal na elaboração de seus produtos, o que torna indispensável o cultivo comercial e o beneficiamento pós-colheita destas espécies. O objetivo deste trabalho foi avaliar o teor de óleo essencial de carqueja [Baccharis trimera (Less.) DC.], em três embalagens diferentes ao longo de um ano de armazenamento. Observou-se que ao longo do armazenamento, a embalagem de papel Kraft foi a que melhor preservou a integridade de certas características físicas e químicas do produto, assim como, manteve o teor de óleo ao longo de um ano de armazenamento.

The use of medicinal plants as therapeutic source is ancient and has increased in value in recent years for both the population and the science. Several national and international companies use raw plant material in the preparation of their products, making essential the commercial cultivation and the post-harvest processing of these species. The aim of this study was to evaluate the essential oil content of [Baccharis trimera (Less.) DC.] in three different packages over one year of storage. During storage, Kraft-paper package best preserved the integrity of some physical and chemical characteristics of the product and maintained the oil content for one year of storage.

Population genetic structure of wild and hatchery black rockfish Sebastes inermis in Korea, assessed using cross-species microsatellite markers.

The population structure of the black rockfish, Sebastes inermis (Sebastidae), was estimated using 10 microsatellite loci developed for S. schlegeli on samples of 174 individuals collected from three wild and three hatchery populations in Korea. Reduced genetic variation was detected in hatchery strains [overall number of alleles (N(A)) = 8.07; allelic richness (A(R)) = 7.37; observed heterozygosity (H(O)) = 0.641] compared with the wild samples (overall N(A) = 8.43; A(R) = 7.83; H(O) = 0.670), but the difference was not significant. Genetic differentiation among the populations was significant (overall F(ST) = 0.0237, P < 0.05). Pairwise F(ST) tests, neighbor-joining tree, and principal component analyses showed significant genetic heterogeneity among the hatchery strains and between wild and hatchery strains, but not among the wild populations, indicating high levels of gene flow along the southern coast of Korea, even though the black rockfish is a benthic, non-migratory marine species. Genetic differentiation among the hatchery strains could reflect genetic drift due to intensive breeding practices. Thus, in the interests of optimal resource management, genetic variation should be monitored and inbreeding controlled within stocks in commercial breeding programs. Information on genetic population structure based on cross-species microsatellite markers can aid in the proper management of S. inermis populations.

Agmatine inhibits hypoxia-induced TNF-alpha release from cultured retinal ganglion cells

The effect of hypoxia on the release of tumor necrosis factor-alpha (TNF-alpha) in transformed rat retinal ganglion cells (RGCs) and the effect of agmatine on the hypoxia-induced production of TNF-alpha in RGCs were evaluated. RGCs were cultured under hypoxic conditions with 5% oxygen, with or without 100 microM agmatine. The expression levels of TNF-alpha and its receptor-1 (TNF-R1) were investigated by Western blot analysis. After 6 hours of hypoxia, we noted an increase in TNF-alpha production in RGCs. Agmatine significantly reduced TNF-alpha level after 12 hours of hypoxic treatment. The expression of TNF-R1 was not affected by the hypoxia or agmatine treatment. Our results show that agmatine inhibits the TNF-alpha production of RGCs in hypoxic condition. These results demonstrate a possible neuroprotective mechanism for agmatine against hypoxic damage in RGCs.(AU)

Agmatine inhibits hypoxia-induced TNF-alpha release from cultured retinal ganglion cells

The effect of hypoxia on the release of tumor necrosis factor-alpha (TNF-alpha) in transformed rat retinal ganglion cells (RGCs) and the effect of agmatine on the hypoxia-induced production of TNF-alpha in RGCs were evaluated. RGCs were cultured under hypoxic conditions with 5% oxygen, with or without 100 microM agmatine. The expression levels of TNF-alpha and its receptor-1 (TNF-R1) were investigated by Western blot analysis. After 6 hours of hypoxia, we noted an increase in TNF-alpha production in RGCs. Agmatine significantly reduced TNF-alpha level after 12 hours of hypoxic treatment. The expression of TNF-R1 was not affected by the hypoxia or agmatine treatment. Our results show that agmatine inhibits the TNF-alpha production of RGCs in hypoxic condition. These results demonstrate a possible neuroprotective mechanism for agmatine against hypoxic damage in RGCs.

Optimization of the enzymatic hydrolysis of chicken meat using response surface methodology.

The hydrolysis of chicken breast meat by the commercial protease Alcalase 2.4L was studied to evaluate the influence of temperature (43 to 77 degrees C), enzyme:substrate ratio (0.8% to 4.2%), and pH (7.16 to 8.84) on the responses of degree of hydrolysis and protein recovery. The enzymatic hydrolysis was optimized for maximum degree of hydrolysis and protein recovery using response surface methodology. The optimum conditions determined were the following: 52.5 degrees C, 4.2% (w/w) enzyme:substrate ratio, and a pH value of 8.00. Under these conditions, a degree of hydrolysis of 31% and protein recovery of 91% were obtained. A characterization of the protein hydrolysate obtained using the optimized process conditions was carried out, evaluating the chemical composition, electrophoretic profile and amino acid composition.

Bevacizumab para la degeneración macular relacionada a edad / Bevacizumab for age-related macular degenaration

Objetivo: Evaluar la eficacia de Bevacizumab en las neovascularizaciones coroideas subfoveales y yuxtafoveales de Degeneración Macular Relacionada a Edad (DMRE). Pacientes y Métodos: Serie intervencional sin control. Criterio de re-tratamiento basado en examen clínico con o sin angiofloresceinografía y OCT. Resultados: 44 ojos de 42 pacientes de DMRE recibieron la inyección intravítrea de bevacizumab 1.25mg y tuvieron seguimiento de 4-40 semanas, promedio 21.8 semanas. AV inicial fue entre 0.02 - 1.0, promedio 0.18 (log Mar 0.75) y AV final fue entre c/d - 1.0, promedio 0.25 (log Mar 0.58); que la diferencia resultó ser estadísticamente significativa (p<0.025). 26 (59 por ciento) ojos ganaron la AV al menos 1 línea de ETDRS, y dentro de los cuales 15 (34 por ciento) ojos ganaron 3 o más líneas de ETDRS. 24 (54 por ciento) ojos recibieron 2 o más inyecciones. 19 (43 por ciento) pacientes presentaron la DMRE cicatricial en su ojo contra lateral. Hubo un caso de leve hemovítrea como complicación. Conclusiones: Bevacizumab sería la terapia electiva para la DMRE exudativa en nuestro medio por su indiscutible eficacia, seguridad y bajo costo.

Objective: To study the efficacy of Bevacizumab for subfoveal or juxtafoveal choroidal neovascularization of Age-related Macular Degeneration (AMD). Patients and Methods: Interventional case series without control group. Re-treatment criteria was based on clinical examination with or without florescein angiography or OCT. Results: 44 eyes of 42 patients received intravitreal injection of bevacizumab 1.25mg. The mean follow up was 21.8 weeks, range 4-40 weeks. The mean initial VA was 0.18 (log Mar 0.75), range 0.02 - 1.0, and the mean final VA was 0.25 (log Mar 0.58), range finger count - 1.0. The difference between both VA was statistically significant (p<0.025). 26 (59 percent) eyes gained VA 1 line of ETDRS at least, and 15 (34 percent) eyes gained 3 or more lines of ETDRS. 24 (54 percent) eyes received 2 or more injections. 19 (43 percent) patients had disciform AMD in contra lateral eye. We had only one case of slight vitreal hemorrhage as complication. Conclusion: Bevacizumab would be the first line therapy for exudative AMD owing to its indisputable efficacy, security and low cost.

Estudo da umidade de equilibrio de duas espécies de plantas do gênero Phyllanthus após secagem para o armazenamento

Quebra-Pedra é o nome popular atribuído a espécies do gênero Phyllanthus (Euphorbiaceae). P. niruri e P. amarus são estudadas no Brasil e no mundo quanto às suas atividades farmacológicas, decorrentes das indicações populares. O estudo de secagem a armazenamento visa fornecer parâmetros para se obter a matéria prima uniforme e de qualidade. Os objetivos deste trabalho foram determinar o teor de umidade final das espécies e a curva de umidade de equilíbrio (UE) entre 10 e 90 por cento de UR. As duas espécies foram cultivadas no CPQBA, colhidas a 50cm de altura e direcionadas à secagem (T = 50°C) em estufa com circulação forçada de ar. Na determinação da curva de UE utilizou-se o método estático, empregando-se soluções salinas saturadas. O peso foi controlado através de pesagens periódicas, até atingir o equilíbrio (peso constante), sendo então determinada a UF. Por meio das curvas, determinouse a umidade de equilíbrio característica de cada espécie na faixa de umidade relativa do ar estudada. Os modelos matemáticos que melhor se ajustaram a P. amarus foi o de Hasley (9,3 por cento), e P.niruri GAB (8,9 por cento).

Species of the genus Phyllanthus (Euphorbiaceae) is known popularly in Brazil as "Quebra Pedra" (Break-stone) and indicated for the treatment of renal lithiasis. P. niruri and P. amarus have been studied in Brazil and around the world regarding pharmacologycal activity, due to folk uses. Drying and storage parameters intend to provide a standard raw material with high quality. The storage condition can determine the durability of raw material and relative humidity is one of the most important factors. The aim of this study was to determine the final percentage of humidity and the desorption isotherms. The species were cultivated on experimental field at CPQBA/UNICAMP. The experimental area was harvest and the aerial part was dried in 50ºC until constant weight. After dried, the final humidity was determined. The equilibrium moisture had been determined by static gravimetric method, with a range of relative humidity from 10 to 90 percent. The most commonly used equilibrium moisture content (EMC) and equilibrium relative humidity (ERH) equations were compared with their ability of best fiting the published sorption data for selected medicinal and aromatic plants. The best-fitted equation identified for P. amarus was Hasley (9,3 percent), and for P.niruri was GAB (8,9 percent).

Brazilin protects cultured rat hepatocytes from BrCCl3-induced toxicity.

Brazilin, the main constituent of Caesalpinia sappan, is an antioxidative substance that has catechol moiety in its chemical structure. Considering the antioxidant-activity of brazilin, it was expected to have protective effects on the toxicities of radical generating chemicals. The incubation of rat hepatocytes with BrCCl3 resulted in significant increase in lipid peroxidation, leakage of cytoplasmic enzymes and cytoplasmic glutathione depletion. The BrCCl3-induced toxicities on hepatocytes were reduced by the treatment of brazilin. Brazilin has been also proved to have a protective effect on the BrCCl3-induced depression of microsomal calcium sequestration activity. These results indicate that brazilin plays a protective role in BrCCl3-induced hepatocyte injury of the rat.

Flurbiprofeno y midriasis en facoeresis / Flurbiprofen and mydriasis in phakoeresis

La buena midriasis es una de las condiciones primordiales con que se debe contar para las operaciones de la catarata. El flurbiprofeno 0,1% (Tolerane), administración tópica, es utilizado para esta finalidad, ya que es un potente inhibidor de Prostaglandina. Se realizó EEC más LIO en 45 pacientes por un cirujano y se observó que el diámetro pupilar disminuía apenas en un 6,2% desde el inicio hasta el final de las operaciones (de x 7,7 mm a 7,2 mm); se requirió de un miótico para asegurarse de ubicación retroiridiana del LIO, situación para la cual tanto neostigmina como acetilcolina resultaron ser útiles