Vitamin D deficiency in pregnancy and its impact on the fetus, the newborn and in childhood

AbstractObjectiveVitamin D deficiency (VDD) in pregnant women and their children is an important health problem with severe consequences for the health of both. Thus, the objectives of this review were to reassess the magnitude and consequences of VDD during pregnancy, lactation and infancy, associated risk factors, prevention methods, and to explore epigenetic mechanisms in early fetal life capable of explaining many of the non-skeletal benefits of vitamin D (ViD).Data sourceOriginal and review articles, and consensus documents with elevated level of evidence for VDD-related clinical decisions on the health of pregnant women and their children, as well as articles on the influence of ViD on epigenetic mechanisms of fetal programming of chronic diseases in adulthood were selected among articles published on PubMed over the last 20 years, using the search term VitD status, in combination with Pregnancy, Offspring health, Child outcomes, and Programming.Data synthesisThe following items were analyzed: ViD physiology and metabolism, risk factors for VDD and implications in pregnancy, lactation and infancy, concentration cutoff to define VDD, the variability of methods for VDD detection, recommendations on ViD replacement in pregnant women, the newborn and the child, and the epigenetic influence of ViD.ConclusionsVDD is a common condition among high-risk pregnant women and their children. The routine monitoring of serum 25(OH)D3 levels in antenatal period is mandatory. Early preventive measures should be taken at the slightest suspicion of VDD in pregnant women, to reduce morbidity during pregnancy and lactation, as well as its subsequent impact on the fetus, the newborn and the child

Comparative study of the degree of patient satisfaction in intermittent catheterization with Lofric and polyvinyl chloride catheters

Actas Urol Esp. 2001 Nov-Dec;25(10):725-30. [Comparative study of the degree of patient satisfaction in intermittent catheterization with Lofric and polyvinyl chloride catheters]. [Article in Spanish] López Pereira P, Martínez Urrutia MJ, Lobato L, Rivas S, Jaureguizar Monereo E. SourceUnidad de Urología Infantil, Hospital Universitario La Paz, Madrid. Abstract PURPOSE: To assess the grade of satisfaction in children on intermittent catheterization with the use of LoFric and PVC conventional catheters. MATERIAL AND METHODS: A total of 40 p with experience in CIC were included in this study. An anonymous questionnaire was sent to all patients after 2-months using the LoFric catheter. Patients were divided in 3 groups (bladder augmentation, artificial sphincter, Mitrofanoff) because of major differences in CIC discomfort between these groups. RESULTS: The questionnaire was completed by 87.5% of the patients (35 p). In 86% (30 p) LoFric catheter training was easy or very easy but in 14% (5 p) it was difficult. Four patients had some difficulty during conventional catheter insertion, in 3 (75%) the difficulty disappeared with the use of LoFric catheter. Of the 51% (18 p) who reported some discomfort during the insertion of conventional catheter, 72% said it was eliminated when the LoFric catheter was used. Of 6 p with some discomfort when removing the conventional catheter, 5 (83%) said it disappeared with the new catheter. Th LoFric catheter was favored by 70% of patients because it reduced the discomfort caused by conventional catheters, bladder insertion was easier and smoother, and gel lubrication was not needed. The 17% of patients reported some difficulty dealing with this slippery catheter. CONCLUSIONS: The use of the LoFric catheter could be justified in patients who report with conventional catheters have some discomfort. It can also be recommended in patients with artificial sphincter, bladder augmentation and Mitrofanoff procedure, in whom any complication related to CIC would have serious consequences

Alergia alimentaria y contaminación ambiental

La interacción entre el potencial genético y el medio ambiente, especialmente el aumento de la urbanización y la gestión inadecuada de residuos contribuye con la manifestación de enfermedades alérgicas. Los pacientes pediátricos son los más vulnerables, debido a la inmadurez de los sistemas respiratorio e inmunológico. La exposición prenatal y posnatal a contaminantes del aire, tanto en exteriores como interiores, acelera o agrava la morbilidad y mortalidad por enfermedades alérgicas. El "exposoma", que abarca todas las exposiciones ambientales a lo largo de la vida, influye en la salud. Las agresiones biológicas y químicas alteran la barrera epitelial, desencadenando respuestas inflamatorias y favoreciendo enfermedades alérgicas, como alergias alimentarias. El uso descontrolado de combustibles tóxicos, material particulado, detergentes y otros factores contribuyen con el deterioro continuo de la barrera epitelial intestinal, aumentando el riesgo de enfermedades alérgicas. Es importante tomar medidas urgentes para abordar estos problemas y proteger la salud del planeta

Radon exposure: a major cause of lung cancer in nonsmokers

ABSTRACT Exposure to radon can impact human health. This is a nonsystematic review of articles written in English, Spanish, French, or Portuguese published in the last decade (2013-2023), using databases such as PubMed, Google Scholar, EMBASE, and SciELO. Search terms selected were radon, human health, respiratory diseases, children, and adults. After analyzing the titles and abstracts, the researchers initially identified 47 studies, which were subsequently reduced to 40 after excluding reviews, dissertations, theses, and case-control studies. The studies have shown that enclosed environments such as residences and workplaces have higher levels of radon than those outdoors. Moreover, radon is one of the leading causes of lung cancer, especially in nonsmokers. An association between exposure to radon and development of other lung diseases, such as asthma and COPD, was also observed. It is crucial to increase public awareness and implement governmental control measures to reduce radon exposure. It is essential to quantify radon levels in all types of buildings and train professionals to conduct such measurements according to proven efficacy standards. Health care professionals should also be informed about this threat and receive adequate training to deal with the effects of radon on human health

The Effect of Transposable Element Insertions on Gene Expression Evolution in Rodents

Background:Many genomes contain a substantial number of transposable elements (TEs), a few of which are known to be involved in regulating gene expression. However, recent observations suggest that TEs may have played a very important role in the evolution of gene expression because many conserved non-genic sequences, some of which are know to be involved in gene regulation, resemble TEs. Results:Here we investigate whether new TE insertions affect gene expression profiles by testing whether gene expression divergence between mouse and rat is correlated to the numbers of new transposable elements inserted near genes. We show that expression divergence is significantly correlated to the number of new LTR and SINE elements, but not to the numbers of LINEs. We also show that expression divergence is not significantly correlated to the numbers of ancestral TEs in most cases, which suggests that the correlations between expression divergence and the numbers of new TEs are causal in nature. We quantify the effect and estimate that TE insertion has accounted for ~20% (95% confidence interval: 12% to 26%) of all expression profile divergence in rodents. Conclusions:We conclude that TE insertions may have had a major impact on the evolution of gene expression levels in rodents

Creation of Tissue-Engineered Urethras for Large Urethral Defect Repair in a Rabbit Experimental Model

Introduction: Tissue engineering is a potential source of urethral substitutes to treat severe urethral defects. Our aim was to create tissue-engineered urethras by harvesting autologous cells obtained by bladder washes and then using these cells to create a neourethra in a chronic large urethral defect in a rabbit model.Methods: A large urethral defect was first created in male New Zealand rabbits by resecting an elliptic defect (70 mm2) in the ventral penile urethra and then letting it settle down as a chronic defect for 5–6 weeks. Urothelial cells were harvested noninvasively by washing the bladder with saline and isolating urothelial cells. Neourethras were created by seeding urothelial cells on a commercially available decellularized intestinal submucosa matrix (Biodesign® Cook-Biotech®). Twenty-two rabbits were divided into three groups. Group-A (n = 2) is a control group (urethral defect unrepaired). Group-B (n = 10) and group-C (n = 10) underwent on-lay urethroplasty, with unseeded matrix (group-B) and urothelial cell-seeded matrix (group-C). Macroscopic appearance, radiology, and histology were assessed.Results: The chronic large urethral defect model was successfully created. Stratified urothelial cultures attached to the matrix were obtained. All group-A rabbits kept the urethral defect size unchanged (70 ± 2.5 mm2). All group-B rabbits presented urethroplasty dehiscence, with a median defect of 61 mm2 (range 34–70). In group-C, five presented complete correction and five almost total correction with fistula, with a median defect of 0.3 mm2 (range 0–12.5), demonstrating a significant better result (p = 7.85 × 10−5). Urethrography showed more fistulas in group-B (10/10, versus 5/10 in group-C) (p = 0.04). No strictures were found in any of the groups. Group-B histology identified the absence of ventral urethra in unrepaired areas, with squamous cell metaplasia in the edges toward the defect. In group-C repaired areas, ventral multilayer urothelium was identified with cells staining for urothelial cell marker cytokeratin-7.Conclusions: The importance of this study is that we used a chronic large urethral defect animal model and clearly found that cell-seeded transplants were superior to nonseeded. In addition, bladder washing was a feasible method for harvesting viable autologous cells in a noninvasive way. There is a place for considering tissue-engineered transplants in the surgical armamentarium for treating complex urethral defects and hypospadias cases

Comparación de tres métodos cortos contra un método estándar para analizar la composición nutricional de reportes de consumo de alimentos de adultos costarricenses

Objective: comparison of three short methods for analysis of food consumption data from a group of Costa Rican adults. Methodology: 100 questionnaires from 24-hour recalls were obtained from the Latin American Study of Nutrition and Health. Three short methods for dietary analysis based on two different exchange lists and a new food group system proposed by the researchers) were compared to a standard method based on food composition tables. The values ​​obtained were compared using the Wilcoxon signed-rank test, Spearman´s rank correlation coefficient and the Bland-Altman plot. Results: the food group system is the short method of diet whose results are more similar to the standard method in terms of energy, macro and micronutrients. In the ADA exchange lists, carbohydrates are underestimated (-19.2%) and fats are overestimated (53.8%). The Colombian exchange lists resulted in significant differences and lower correlation coefficients for sodium (0.692) and fatty acids (0.758). Conclusion: the food group system is the method that presents results which are more similar to the standard method for dietary analysis and is considered easier to use in clinical practice.Objetivo: comparar tres métodos cortos de análisis de datos de consumo de alimentos contra un método estándar en un grupo de adultos costarricenses. Metodología: se realizó un análisis de la composición nutricional de los alimentos incluidos en 100 recordatorios de 24 horas del Estudio Latinoamericano de Nutrición y Salud. Se utilizaron tres métodos cortos de análisis de dieta (listas de intercambio de la Asociación Dietética Norteamericana, listas colombianas y un nuevo sistema de grupos de alimentos propuesto por las investigadoras), así como un método estándar basado en tablas de composición de alimentos. Los valores obtenidos se compararon mediante la Prueba de Rangos de Wilcoxon, correlaciones de Spearman y gráficos de Bland-Altman. Resultados: se comprueba que el sistema de grupos de alimentos es el método corto de análisis de dieta cuyos resultados son más similares a los obtenidos por el método estándar en cuanto a energía, macro y micronutrientes. En el caso de las listas de intercambio de la ADA los carbohidratos se subestiman (-19.2 %) y las grasas se sobreestiman (53.8 %). En cuanto a las listas colombianas se observan diferencias significativas y menores coeficientes de correlación para el sodio (0.692) y los ácidos grasos (0.758). Conclusión: se encontró que el sistema de grupos de alimentos es el método que presenta los resultados más semejantes al método estándar para el análisis de dieta y se considera más fácil de utilizar en la práctica clínica.UCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de NutriciónUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicin

El Acuerdo Bruselas 2017 para Latinoamérica: una iniciativa de la GARD y SLaai

Abstract The Global Alliance against Chronic Respiratory Diseases (GARD) is a network of organizations coordinated by the World Health Organization. It is a voluntary alliance of national and international organizations, institutions and agencies with global scope that are committed with actions to improve access to prevention, care and essential medications. On its last annual meeting, celebrated in Brussels (Belgium) in September 2017, the need for actions and representation to be grouped by geographic regions was discussed. There are several successful programs regarding morbidity and mortality control of these diseases, and others that improve cost-benefi t and quality of life. Thus, SLaai proposes to contribute to the diff usion and knowledge of chronic respiratory diseases magnitude and risk factors, to identify successful programs in Latin America in order for them to be replicated in the region and to generate strategic alliances for the strengthening of joint actions. Keywords: Alliance; Respiratory diseases; Programs; Action