The blood acid base and gastrointestinal response to three different forms of sodium citrate encapsulation

Enterically coated (ENT) or delayed-release (DEL) capsules may lessen gastrointestinal symptoms (GIS) following acute sodium citrate (SC) ingestion, although the effects on blood acid-base balance are undetermined. Fourteen active males ingested 0.4  g.kg−1 body mass (BM) SC, within gelatine (GEL), DEL and ENT capsules or 0.07 g.kg−1 BM sodium chloride control (CON). Blood acid-base balance and GIS were measured for 4 h. Ingestion form had no significant effect on total GIS experienced (GEL: 2 ± 7; DEL: 1  ± 8; ENT: 1 ± 4 AU). Most (7/14) participants experienced zero symp-toms throughout. Peak GIS typically emerged ≤100 min post- ingestion, with a similar time to reach peak GIS between ingestion form (GEL: 36 ± 70; DEL: 13 ± 28; ENT: 15 ± 33 AU). Blood [HCO3−] was significantly higher with ENT versus GEL (ENT: 29.0 ± 0.8; GEL: 28.5 ± 1.1 mmol.L−1, P = 0.037). Acute ingestion of a reduced SC dose elicited minimal GIS, producing significant changes in blood [HCO3−] from rest, irrespective of ingestion form (GEL: 6.0 ± 0.9; DEL: 5.1 ± 1.0; ENT: 6.2 ± 0.8 mmol.L−1). The necessity of individualized ingestion strategies is also challenged, with sustained increases in blood [HCO3−] of ≥4 mmol.L−1 for up to 153 min highlighted. If commencing exercise at peak alkalosis augments subsequent per-formance above starting at a standardized time point where HCO3− is still elevated remains unclear

Associations between birthweight, gestational age at birth and subsequent type 1 diabetes in children under 12: a retrospective cohort study in England, 1998–2012

Abstract Aims/hypothesis With genetics thought to explain only 40–50% of the total risk of type 1 diabetes, environmental risk factors in early life have been proposed. Previous findings from studies of type 1 diabetes incidence by birthweight and gestational age at birth have been inconsistent. This study aimed to investigate the relationships between birthweight, gestational age at birth and subsequent type 1 diabetes in England. Methods Data were obtained from a population-based database comprising linked mother–infant pairs using English national Hospital Episode Statistics from 1998 to 2012. In total, 3,834,405 children, categorised by birthweight and gestational age at birth, were followed up through record linkage to compare their incidence of type 1 diabetes through calculation of multivariable-adjusted HRs. Results Out of 3,834,405 children, 2969 had a subsequent hospital diagnosis of type 1 diabetes in childhood. Children born preterm (<37 weeks) or early term (37–38 weeks) experienced significantly higher incidence of type 1 diabetes than full term children (39–40 weeks) (HR 1.19 [95% CI 1.03, 1.38] and 1.27 [95% CI 1.16, 1.39], respectively). Children born at higher than average birthweight (3500–3999 g or 4000–5499 g) after controlling for gestational age experienced higher incidence of type 1 diabetes than children born at medium birthweight (3000–3499 g) (HR 1.13 [95% CI 1.03, 1.23] and 1.16 [95% CI 1.02, 1.31], respectively), while children at low birthweight (<2500 g) experienced lower incidence (0.81 [95% CI 0.67, 0.98]), signifying a statistically significant trend (p trend 0.001). Conclusions/interpretation High birthweight for gestational age and low gestational age at birth are both independently associated with subsequent type 1 diabetes. These findings help contextualise the debate about the potential role of gestational and early life environmental risk factors in the pathogenesis of type 1 diabetes, including the potential roles of insulin sensitivity and gut microbiota

Tracking national neonatal transport activity and metrics using the UK Neonatal Transport Group dataset 2012-2021: A narrative review

\ua9 Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.There are no internationally agreed descriptors for categories of neonatal transports which facilitate comparisons between settings. To continually review and enhance neonatal transport care we need robust categories to develop benchmarks. This review aimed to report on the development and application of key measures across a national neonatal transport service. The UK Neonatal Transport Group (UK-NTG) developed a core dataset and benchmarks for transported infants and collected annual national data. Data were reported back to teams to allow benchmarking and improvements. From 2012 to 2021, the rate of UK neonatal transfers increased from 18 to 22/1000 live births despite a falling birth rate. Neonatal transfers on nitric oxide increased until 2016 before plateauing. The proportion of transport services able to provide high frequency oscillation and servo-controlled therapeutic hypothermia increased over the study period. High-flow nasal cannula oxygen use increased, becoming the most frequently used non-invasive respiratory support mode. For infants &lt;27 weeks of gestational age, transfers for uplift of care in the first 3 days of life have fallen from 420 (2016) to 288 (2020/2021) and for lack of neonatal capacity from 24 (2016) to 2 (2020/2021). The rate of ventilated infants completing transfer with CO2 out of the benchmark range varied from 9% to 13% with marked variation between transport services\u27 rates of hypocapnia (0-10%) and hypercapnia with acidosis (0-9%). The development of the UK-NTG dataset supports national tracking of activity and clinical trends allowing comparison of patient-focused benchmarks across teams

Telomere length analysis and preterm infant health: the importance of assay design in the search for novel biomarkers.

Preterm infants develop an ‘aged’ phenotype in comparison with term-born infants, one component of which is adverse metabolic health and, therefore, long-term health follow-up is warranted to identify morbidity. In light of this, the identification and use of biomarkers to aid with prognosis would be a welcome development. Telomeres are repeat sequences at the ends of each chromosome arm known to shorten as a consequence of cellular aging, and in relation to several disease conditions. The hypothesis that expreterm infants manifest alterations in telomere attrition rate is, therefore, one of interest. Analysis of telomere length maybe a plausible technique to predict prognosis in relation to preterm birth, and early life environmental and nutritional exposures. In this article, we review the literature on telomere length analysis in the preterm infant population and examine the tools available to measure telomere length

Food and nutrient intakes in young adults born preterm

Background Adults born preterm have higher levels of cardiometabolic risk factors than their term-born peers. Studies have suggested that at least those born smallest eat less healthily. We examined the association between early (<34 weeks) and late (34 to 36 weeks) preterm birth and diet and food preferences in adult age. Methods Participants of two cohort studies located in Finland completed a validated food frequency questionnaire(FFQ) at age 24y to assess their usual diet and the adherence to healthy eating guidelines by using a recommended diet index(RDI).182 were born early preterm, 352 late preterm and 631 were term born controls. Results Young women born early preterm scored 0.77 points (95% CI 0.03, 1.51) lower in RDI when adjusted for sex, age, parental education and early life confounders, indicating a lower quality of diet. There were no differences between young women born late preterm and controls or among men. When food groups were assessed separately, men born early preterm had lower consumption of fruits and berries than controls. Conclusions Young women born early preterm have poorer adherence to healthy eating guidelines than their peers born at term. Differences in diet may contribute to increased cardiometabolic risk among adults born early preterm