Malnutrition and nutritional deficiencies in children with cerebral palsy: a systematic review and meta-analysis.

OBJECTIVES: This systematic review study and meta-analysis sought to estimate the prevalence of malnutrition and nutritional deficiencies in children with cerebral palsy (CP). STUDY DESIGN: This is a systematic review and meta-analysis. METHODS: The systematic review was conducted according to the PRISMA guidelines. The articles were chosen using the PubMed, Embase, Scopus, Web of Science, Cochrane Library, SciELO, and Lilacs databases and the bibliographical reference lists of the articles. No limitations were placed on the time of publication, but the articles had to include children from 0 to 18 years old with CP who presented the prevalence of malnutrition and nutritional deficiencies. The methodological quality of the articles was assessed using the verification list for analytical cross-sectional studies, the Newcastle-Ottawa scale, and the Cochrane Collaboration tool for randomized studies. The meta-analysis of proportions was conducted based on the prevalence data for malnutrition or nutritional deficiencies. The study is registered in PROSPERO under CRD number 42020175068. RESULTS: Sixty-seven articles (N = 453,804) published between 1986 and 2019 were included. Most of the articles presented a low risk of bias and no publication was excluded for quality reasons. The most widely used anthropometric index for diagnosing nutritional status was weight-to-age and the estimated prevalence of malnutrition was 40% (95% CI = 28.0-53.0). Nutrient deficiency was investigated by nine publications, with hypocalcemia and reduced serum concentrations of zinc, copper, and vitamin D being reported the most. CONCLUSIONS: We found a high rate of malnutrition in the population in this review, moreover, we suggest that some nutritional deficiencies are associated with food deficit and that the socio-economic and age factors of these children may relate with the poor nutritional outcome. This makes monitoring and personalized nutritional management necessary, in accordance with the characteristics and particularities of children with CP.

Physical properties of films based on pectin and babassu coconut mesocarp.

The objective of this research was to study the physical properties, water sorption, thermal and structure of films made from citrus pectin (CP), babassu coconut mesocarp (BCM) and glycerol (G). Seventeen formulations were prepared according to a central compound rotational design combining different proportions of the materials and evaluating the films produced according to their moisture contents, solubility, thicknesses and water vapor permeability. The results showed a direct relationship between the composition of the film and each physical property, providing films with unique mechanical characteristics and barrier properties. In the second phase, the films were reformulated, maintaining the proportions of CP and BCM constant and altering the G content. The results showed films with permeable structures, thus favoring the use of high drying temperatures (up to 70 °C) for the confection of films, without altering their physical and structural properties.

Using the method of triads in the validation of a food frequency questionnaire to assess the consumption of fatty acids in adults.

BACKGROUND: It is of great value to develop valid instruments to estimate food consumption; for this purpose, the triads method has been applied in validation studies of dietary intake to evaluate the correlation between three measurements [food frequency questionnaire (FFQ), reference method and biomarker]. The main aim of the present study was to validate a FFQ for Brazilian adults by means of the method of triads by estimating the ingestion of total fatty acids based on the level of saturation. METHODS: The present study enrolled 152 Brazilian adults of both sexes, who were residents in the city of Viçosa, Brazil. The ingestion of total saturated, monounsaturated, polyunsaturated, trans, linoleic and linolenic fatty acids was assessed by means of a FFQ, two food records, and biomarkers, which were detected by gas chromatography. The validation coefficients were calculated using the method of triads and concordance was determined by Kappa statistics. RESULTS: The FFQ was considered an adequate dietary method, because, based on the validation coefficients, it estimates the intake of total fat (0.84), as well as linolenic (0.90) and linoleic acids (0.31). A high concordance rate was confirmed for all nutrients assessed by the FFQ and food records. Regarding the biomarkers, linolenic acid and linoleic acid presented greater concordance. CONCLUSIONS: According to the validation coefficients, the FFQ precisely estimated total fat, linolenic acid and linoleic acid contents.

Classification of different degrees of adiposity in sedentary rats.

In experimental studies, several parameters, such as body weight, body mass index, adiposity index, and dual-energy X-ray absorptiometry, have commonly been used to demonstrate increased adiposity and investigate the mechanisms underlying obesity and sedentary lifestyles. However, these investigations have not classified the degree of adiposity nor defined adiposity categories for rats, such as normal, overweight, and obese. The aim of the study was to characterize the degree of adiposity in rats fed a high-fat diet using cluster analysis and to create adiposity intervals in an experimental model of obesity. Thirty-day-old male Wistar rats were fed a normal (n=41) or a high-fat (n=43) diet for 15 weeks. Obesity was defined based on the adiposity index; and the degree of adiposity was evaluated using cluster analysis. Cluster analysis allowed the rats to be classified into two groups (overweight and obese). The obese group displayed significantly higher total body fat and a higher adiposity index compared with those of the overweight group. No differences in systolic blood pressure or nonesterified fatty acid, glucose, total cholesterol, or triglyceride levels were observed between the obese and overweight groups. The adiposity index of the obese group was positively correlated with final body weight, total body fat, and leptin levels. Despite the classification of sedentary rats into overweight and obese groups, it was not possible to identify differences in the comorbidities between the two groups.

Classification of different degrees of adiposity in sedentary rats

In experimental studies, several parameters, such as body weight, body mass index, adiposity index, and dual-energy X-ray absorptiometry, have commonly been used to demonstrate increased adiposity and investigate the mechanisms underlying obesity and sedentary lifestyles. However, these investigations have not classified the degree of adiposity nor defined adiposity categories for rats, such as normal, overweight, and obese. The aim of the study was to characterize the degree of adiposity in rats fed a high-fat diet using cluster analysis and to create adiposity intervals in an experimental model of obesity. Thirty-day-old male Wistar rats were fed a normal (n=41) or a high-fat (n=43) diet for 15 weeks. Obesity was defined based on the adiposity index; and the degree of adiposity was evaluated using cluster analysis. Cluster analysis allowed the rats to be classified into two groups (overweight and obese). The obese group displayed significantly higher total body fat and a higher adiposity index compared with those of the overweight group. No differences in systolic blood pressure or nonesterified fatty acid, glucose, total cholesterol, or triglyceride levels were observed between the obese and overweight groups. The adiposity index of the obese group was positively correlated with final body weight, total body fat, and leptin levels. Despite the classification of sedentary rats into overweight and obese groups, it was not possible to identify differences in the comorbidities between the two groups.

Production performance and milk composition of dairy cows fed whole or ground flaxseed with or without monensin.

Eight multiparous Holstein cows averaging 570 +/- 43 kg of body weight and 60 +/- 20 d in milk were used in a double Latin square design with four 21-d experimental periods to determine the effects of feeding ground or whole flaxseed with or without monensin supplementation (0.02% on a dry matter basis) on milk production and composition, feed intake, digestion, blood composition, and fatty acid profile of milk. Intake of dry matter was similar among treatments. Cows fed whole flaxseed had higher digestibility of acid detergent fiber but lower digestibilities of crude protein and ether extract than those fed ground flaxseed; monensin had no effect on digestibility. Milk production tended to be greater for cows fed ground flaxseed (22.8 kg/d) compared with those fed whole flaxseed (21.4 kg/d). Processing of flax-seed had no effect on 4% fat-corrected milk yield and milk protein and lactose concentrations. Monensin supplementation had no effect on milk production but decreased 4% fat-corrected milk yield as a result of a decrease in milk fat concentration. Feeding ground compared with whole flaxseed decreased concentrations of 16:0, 17:0, and cis6-20:4 and increased those of cis6-18:2, cis9, trans11-18:2, and cis3-18:3 in milk fat. As a result, there was a decrease in concentrations of medium-chain and saturated fatty acids and a trend for higher concentrations of long-chain fatty acids in milk fat when feeding ground compared with whole flaxseed. Monensin supplementation increased concentrations of cis9 and trans11-18:2 and decreased concentrations of saturated fatty acids in milk fat. There was an interaction between flaxseed processing and monensin supplementation, with higher milk fat concentration of trans11-18:1 for cows fed ground flaxseed with monensin than for those fed the other diets. Flaxseed processing and monensin supplementation successfully modified the fatty acid composition of milk fat that might favor nutritional value for consumers.

Central moxonidine on water and NaCl intake.

In this study we investigated: (a) the effects of intracerebroventricular (i.c.v.) injections of moxonidine (an alpha2-adrenergic and imidazoline receptor agonist) on the ingestion of water and NaCl induced by 24 h of water deprivation; (b) the effects of i.c.v. injection of moxonidine on central angiotensin II (ANG II)- and carbachol-induced water intake; (c) the effects of the pre-treatment with i.c.v. idazoxan (an alpha2-adrenergic and imidazoline receptor antagonist) and RX 821002 (a selective alpha2-adrenergic antagonist) on the antidipsogenic action of central moxonidine. Male Holtzman rats had stainless steel cannulas implanted in the lateral cerebral ventricle. Intracerebroventricular injection of moxonidine (5 and 20 nmol/1 microl) reduced the ingestion of 1.5% NaCl solution (4.1 +/- 1.1 and 2.9 +/- 2.5 ml/2 h, respectively vs. control = 7.4 +/- 2.1 ml/2 h) and water intake (2.0 +/- 0.6 and 0.3 +/- 0.2 ml/h, respectively vs. control = 13.0 +/- 1.4 ml/h) induced by water deprivation. Intracerebroventricular moxonidine (5 nmol/1 microl) also reduced i.c.v. ANG II-induced water intake (2.8 +/- 0.9 vs. control = 7.9 +/- 1.7 ml/1 h) and i.c.v. moxonidine (10 and 20 nmol/1 microl) reduced i.c.v. carbachol-induced water intake (4.3 +/- 1.7 and 2.1 +/- 0.9, respectively vs. control = 9.2 +/- 1.0 ml/1 h). The pre-treatment with i.c.v. idazoxan (40 to 320 nmol/1 microl) abolished the inhibitory effect of i.c.v. moxonidine on carbachol-induced water intake. Intracerebroventricular idazoxan (320 nmol/1 microl) partially reduced the inhibitory effect of moxonidine on water deprivation-induced water intake and produced only a tendency to reduce the antidipsogenic effect of moxonidine on ANG II-induced water intake. RX 821002 (80 and 160 nmol/1 microl) completely abolished the antidipsogenic action of moxonidine on ANG II-induced water intake. The results show that central injections of moxonidine strongly inhibit water and NaCl ingestion. They also suggest the involvement of central alpha2-adrenergic receptors in the antidipsogenic action of moxonidine.

[Neuropathies caused by thalidomide]. / Neuropathies à la thalidomide.

Symptoms and signs in four patients with thalidomide-induced neuropathy developing during treatment of discoid lupus were limited for long period to distal paresthesiae with altered sensory conduction velocities. Semi-thin biopsy specimens of the distal sural nerve showed depopulation of myelinized fibers, mainly affecting those of large caliber, and signs of axonal degeneration. Study of dissociated fibers showed a high proportion of E fibers. Morphometry confirmed the axonal lesion. Ultrastructural examination demonstrated anomalies of axons of amyelinic fibers (vacuoles, lamellar figures) and of Schwann cells (stacked cytoplasmic prolongations), together with numerous collagen pockets, all non-specific lesions. The disease course was slow, with disappearance of sensory symptoms in a few weeks in 3 of the 4 cases and normal clinical findings in one of the four patients one year after cessation of treatment. Definite correlations between the dose administered and the severity of the neuropathy could not be established. The still poorly understood mechanism of action is discussed.

[Granular cell tumor of a cerebral hemisphere: value of gliofibrillary protein acid assay]. / Tumeur à cellules granuleuses d'un hémisphère cérébral: intérêt de la recherche de la protéine acide gliofibrillaire.

A patient with a left parieto-occipital tumor presented generalized convulsions, and aphasia with alexia and agraphia. Diagnosis was confirmed by CT scan. Partial excision only was possible and was followed by radiotherapy. Histology showed the tumor to be composed of moderate and large sized cells with a granular PAS+ cytoplasm. Protoplasmic astrocytes were numerous at the periphery. Electron microscopy demonstrated typical features of Abrikossof's granular cell tumor: heterogeneous granulations constituted mainly of secondary lysosomes, autophagic vacuoles, multivesicular bodies, and rare angular bodies. The granular cells were interspersed with astrocytes, the feet of which were implanted on the capillary basal membrane. Immunoperoxidases assay of gliofibrillary protein acid demonstrated high levels in the intercellular prolongations, considered here to be astrocytic, but weak concentrations in the granular cells. This suggests uptake by the latter cells of adjacent astrocytic gliofibrillary protein acid, especially as the action of an anti-albumin serum on the tumor demonstrated that the granular cells can take up extracellular proteins by a passive mechanism. These findings stand against an astrocytic origin of the tumor. Comparison with other granular cell tumors, particularly pituicytomas, provides evidence of morphological unity, but cerebral granular cell tumors are rich in astrocytes, whereas these are absent in pituicytomas. The oncogenic unity of these tumors has not been established.

Pilot trials on the treatment of Dermatobia hominis infections in cattle with closantel.

The therapeutic and prophylactic activities of closantel given to calves inoculated with larvae of Dermatobia hominis were studied. Calves (n = 9 principals, plus 3 nontreated controls) were given closantel at different dosages (8 to 12.5 mg/kg) and schedules of treatment. The largest dosage of closantel (12.5 mg/kg) had the most efficacious therapeutic activity (97.3%). Prophylactic activity was also seen in calves given the drug before they were experimentally inoculated.