Evaluation of the galactogogue effect of silymarin on mothers of preterm newborns (<32 weeks)

Hypogalactia has a relative high frequency in women having delivered preterm infants, who often have difficulties in maintaining a sufficient production of milk for their infants’ needs over prolonged periods of time. Recent studies have shown a potential galactogogue effect of silymarin on milk production in animal models (cows and rats) and in humans (mothers of term newborns); nonetheless, none of the studies conducted on humans consisted of double-blind randomized clinical trials and no data are available concerning mothers who delivered preterm infants. The aim of our study was to assess the efficacy of silymarin (BIO-C®) as galactogogue and its tolerability in mothers who delivered preterm infants. We enrolled 50 mothers at 10±1 days post-partum who had delivered infants at ® and placebo arms. No adverse events were observed in the 2 arms among mothers and infants, and silymarin and its metabolites were not detectable in the analyzed human milk samples. Further investigation on specific patient groups affected by hypogalactia, defined according to stricter criteria, should be planned to assess the efficacy of the product in increasing milk production

Analysis of Thermal Sensitivity of Human Cytomegalovirus Assayed in the Conventional Conditions of a Human Milk Bank

One of the main concerns in human milk banks (HMB) is the transmission of human cytomegalovirus (HCMV) that could be present in the milk of infected women. There are consistent data showing that this virus is destroyed by Holder pasteurization (62.5°C for 30 min), but there is a lack of information about the response of the virus to the treatment at lower temperatures in strict HMB conditions. In order to analyze the effectiveness of different temperatures of pasteurization to eliminate HCMV in human milk, a preliminary assay was performed incubating HCMV-spiked raw milk samples from donor mothers at tested temperatures in a PCR thermocycler and the viral infectivity was assayed on cell cultures. No signs of viral replication were observed after treatments at temperatures equal or >53°C for 30, 20, and 10 min, 58°C for 5 min, 59°C for 2 min, and 60°C for 1 min. These data were confirmed in a pasteurizer-like model introducing HCMV-spiked milk in disposable baby bottles. No viral infectivity was detected on cell cultures after heating treatment of milk for 30 min at temperatures from 56 to 60°C. Thus, our results show that by using conventional pasteurization conditions, temperatures in the range of 56–60°C are enough to inactivate HCMV. Consequently, we consider that, in order to provide a higher quality product, the current recommendation to pasteurize both mother's own milk and donated milk at 62.5°C must be re-evaluated

Nutritional adequacy of a novel human milk fortifier from donkey milk in feeding preterm infants: Study protocol of a randomized controlled clinical trial

Abstract Background Fortification of human milk is a standard practice for feeding very low birth weight infants. However, preterm infants often still experience suboptimal growth and feeding intolerance. New fortification strategies and different commercially available fortifiers have been developed. Commercially available fortifiers are constituted by a blend of ingredients from different sources, including plant oils and bovine milk proteins, thus presenting remarkable differences in the quality of macronutrients with respect to human milk. Based on the consideration that donkey milk has been suggested as a valid alternative for children allergic to cow’s milk proteins, due to its biochemical similarity to human milk, we hypothesized that donkey milk could be a suitable ingredient for developing an innovative human milk fortifier. The aim of the study is to evaluate feeding tolerance, growth and clinical short and long-term outcomes in a population of preterm infants fed with a novel multi-component fortifier and a protein concentrate derived from donkey milk, in comparison to an analogous population fed with traditional fortifier and protein supplement containing bovine milk proteins. Methods The study has been designed as a randomized, controlled, single-blind clinical trial. Infants born <1500 g and <32 weeks of gestational age were randomized to receive for 21 days either a combination of control bovine milk-based multicomponent fortifier and protein supplement, or a combination of a novel multicomponent fortifier and protein supplement derived from donkey milk. The fortification protocol followed is the same for the two groups, and the two diets were designed to be isoproteic and isocaloric. Weight, length and head circumference are measured; feeding tolerance is assessed by a standardized protocol. The occurrence of sepsis, necrotizing enterocolitis and adverse effects are monitored. Discussion This is the first clinical study investigating the use of a human milk fortifier derived from donkey milk for the nutrition of preterm infants. If donkey milk derived products will be shown to improve the feeding tolerance or either of the clinical, metabolic, neurological or auxological outcomes of preterm infants, it would be an absolute innovation in the field of feeding practices for preterm infants. Trial registration ISRCTN - ISRCTN70022881

CARACTERIZAÇÃO DE MINIIMPLANTES ORTODÔNTICOS ATRAVÉS DE MICROSCOPIA ELETRÔNICA DE VARREDURA

O controle da ancoragem é um dos fatores decisivos no sucesso da mecânica ortodôntica. Fraturas devido ao estresse de inserção e remoção de mini-implantes são associadas ao design das peças e à qualidade da liga de titânio. O presente estudo analisou a topografia de cinco mini-implantes(Neodent, SIN, Morelli, Conexão e ForestaDent). Análise ao Microscópio Eletrônico de Varredura da cabeça e perfil transmucoso, porção rosqueável e ponta ativa (50x,100x e 200x) foi realizada com o propósito de avaliar o design e defeitos de fabricação (n=3/grupo). Os resultados demostraram que os mini-implantes apresentam diferenças significativas no design. Irregularidades superficiais na porção rosqueável e na ponta ativa foram também observadas. Conclui-se que diferenças no design dos mini-implantes e a presença de irregularidades superficiais podem influenciar na efetividade da ancoragem durante o tratamento ortodôntico

Adherence to the Traditional Mediterranean Diet and Human Milk Composition: Rationale, Design, and Subject Characteristics of the MEDIDIET Study

Introduction: Knowledge about how a lactating woman's diet influences the composition of her breast milk is still very limited. In particular, no study has evaluated the role of adherence to the Mediterranean diet on human milk characteristics.Aim: We carried out an observational study to investigate the influence of mother adherence to a Mediterranean diet on her breast milk composition.Methods: Between 2012 and 2014, 300 healthy mothers, who exclusively breastfed their babies, were enrolled from five centers across Italy. During a visit to the hospital center 6 weeks after childbirth these women were asked to provide a sample of their freshly expressed breast milk and to answer a series of questions on personal characteristics and lifestyle factors. The application of a validated food frequency questionnaire allowed the collection of detailed dietary habits. Milk was collected and then stored until chemical analyses were performed. The study has been registered (Trial Registration: Dutch Trial register NTR3468). Descriptive analyses on baseline characteristics of mothers and babies were carried out on the participants, overall and stratified by center.Results: The participants had a mean age of 33 years (SD = 4.06), and a pre-pregnancy BMI of 22.3 Kg/m2 (SD = 3.22). Forty-seven percent gave birth to their first child, 40% to the second 13% to the third or subsequent child. Babies had a mean birth weight of 3,324 g (DS = 389), and a mean length of 51 cm (SD = 1.94). Fifty-three percent were males.Conclusion: The present work provides the general description and the characteristics of mothers and babies included in the MediDiet study

MORDIDA ABERTA ANTERIOR: ETIOLOGIA E TRATAMENTO

A mordida aberta anterior pode ser definida como uma deficiência no contato vertical normal entre as bordas incisais dos dentes anteriores superiores e inferiores, cuja etiologia é multifatorial, estando muitas vezes ligada a uma desordem miofuncional orofacial, seja por fatores genéticos ou pela ação prolongada de hábitos orais deletérios. Esse estudo teve por objetivo realizar uma revisão na literatura sobre mordida aberta anterior, selecionando artigos científicos pertinentes ao tema, esclarecendo a etiologia e as opções de tratamento e fatores associados para essa alteração oclusal. Diversos métodos têm sido relatados para a correção da mordida aberta anterior: grades palatinas, esporões linguais, aparelho extrabucal conjugado, bite block, bionator, barra transpalatina, mecânicas com extrações dentárias e uso de dispositivos temporários de ancoragem. Percebe-se a importância da associação de ortodontistas, cirurgiões, otorrinolaringologistas e fonoaudiólogos, visto que a função dos aparelhos ortodônticos é limitada