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Acid Supplements (acid + supplement)
Kinds of Acid Supplements Terms modified by Acid Supplements Selected AbstractsChemopreventive effects of rofecoxib and folic acid on gastric carcinogenesis induced by N-methyl-N,-nitro-N-nitrosoguanidine in ratsJOURNAL OF DIGESTIVE DISEASES, Issue 3 2006Su Juan FEI OBJECTIVES: Epidemiological and experimental studies indicate that non-steroidal anti-inflammatory drugs (NSAIDs) are chemopreventive agents of gastrointestinal cancers, but few studies on gastric cancer have been carried out. A decrease in folic acid supplement and subsequent DNA hypomethylation are related to gastrointestinal cancers, and it has been shown that high-dose folic acid may interfere with gastric carcinogenesis in dogs. The objective of this study was to investigate the effects of rofecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, and folic acid on the chemoprevention of gastric cancer induced by N-methyl-N,-nitro-N-nitrosoguanidine (MNNG) in Wistar rats, and to evaluate the cell proliferation of gastric mucosa in different experimental groups. METHODS: Eighty male Wistar rats were randomly divided into five groups (16 rats in each group). In the control group, the rats were given pure water and basal diet. In the MNNG group, the rats received MNNG in drinking water (100 mg/L) and basal diet. In the MNNG + low-dose rofecoxib group, the rats were given MNNG and rofecoxib 5 mg/kg per day with basal diet. In the MNNG + high-dose rofecoxib group, the rats were given MNNG and rofecoxib 15 mg/kg per day with basal diet. In the MNNG + folic acid group, the rats were given MNNG and folic acid 5 mg/kg per day with basal diet. The experiment was terminated at 50 weeks, and all rats were killed. Blood samples of 3 mL were obtained for measurement of serum folic acid concentrations in the control group, the MNNG group and the MNNG + folic acid group by using chemiluminescent method. The stomach was removed from all rats for histopathological examination and immunohistochemical study. Proliferating cell nuclear antigen (PCNA) expression in gastric epithelial cells was also determined. RESULTS: In the MNNG group, five of 11 rats (45.5%) developed gastric cancer, while in all other four groups no gastric cancer was found (P < 0.05). The positivity rate of PCNA expression in the cancerous tissues was significantly higher than that in the non-cancerous tissues (80.0%vs 14.1%, P < 0.05). The positivity rate of PCNA expression in the gastric mucosal cells of the MNNG group was significantly higher than that in the other four groups. The mean serum folic acid concentration of rats was significantly higher in the MNNG + folic acid group (193.70 ± 60.73 ng/mL) than those in the control group (84.21 ± 25.26 ng/mL) and the MNNG group (72.27 ± 16.70 ng/mL, P < 0.05). It was shown that both low- and high-dose rofecoxib as well as folic acid interfered with the development of gastric cancer induced by MNNG in Wistar rats. CONCLUSIONS: The results indicate that rofecoxib as well as folic acid interferes with gastric carcinogenesis induced by MNNG in Wistar rats, and the suppression of gastric cell proliferation may play a crucial role in the chemoprevention of gastric cancer by rofecoxib and folic acid. The higher serum folic acid concentration of rats may play an important role in the prevention of gastric cancer. [source] Effect of dietary pantothenic acid supplement on growth, body composition and intestinal enzyme activities of juvenile Jian carp (Cyprinus carpio var. Jian)AQUACULTURE NUTRITION, Issue 5 2009Z.-P. WEN Abstract A 9-week feeding trial was carried out with juvenile Jian carp to study the effect of dietary pantothenic acid (PA) on growth, body composition and intestinal enzyme activities. Semi-purified diets with seven levels (4.0, 15.5, 25.6, 36.1, 45.9, 56.1 and 65.9 mg PA kg,1) of supplemental calcium d -pantothenate were fed to Jian carp (13.0 ± 0.0 g). PA improved specific growth rate (SGR), protein productive value (PPV), protein efficiency ratio (PER) and lipid production value (LPV) (P < 0.05). Fish fed the control diet had significantly lower feed efficiency (FE) than that in any other group (P < 0.05). Body protein content increased with increasing PA levels (P < 0.05), but moisture, lipid and ash of fish carcasses were negatively related to the graded PA levels (P < 0.05). Intestine protein content (IPC), hepatopancreas protein content (HPC) and activity of ,-amylase, lipase, trypsin, Na+,K+ -ATPase, alkaline phosphatase (AKP) and gamma-glutamyl transpeptidase (,-GT) were all positively affected by the dietary PA levels (P < 0.05), while intestine index (ISI) and hepatopancreas index (HSI) decreased with the increment of supplemental levels of PA (P < 0.05). These results suggested that PA could enhance fish growth and intestinal enzyme activities. The dietary PA requirement of juvenile Jian carp, Cyprinus carpio var. Jian (13.0,73.0 g), for optimal growth estimated by the broken-line analysis was 23.0 mg PA kg,1 diet. [source] Improved Fermentation Processes for NS0 Cell Lines Expressing Human Antibodies and Glutamine SynthetaseBIOTECHNOLOGY PROGRESS, Issue 1 2003Jonathan Dempsey To meet the increasing requirement for therapeutic antibodies to conduct clinical trials, an enhanced culture medium and fed-batch process was developed for GS-NS0 cell lines. This process was shown to produce high concentrations of monoclonal antibodies for several cell lines expressing different antibodies. Cells were adapted to growth in a glutamine- and serum-free medium containing bovine serum albumin (BSA), cholesterol, and transferrin. A number of amino acids were found to be depleted during cell culture. The concentrations of these amino acids were increased, and further cell culture analyses were performed. This process of cell growth and analysis was repeated over multiple cycles until no depletion was detected. This resulted in an amino acid supplement that was shown to be generic and enhanced antibody productivity up to 5-fold for the three cell lines tested. Transferrin was replaced using tropolone, a lipophilic iron chelator and ferric ammonium citrate. Cell growth was equivalent to that in transferrin-containing medium over the wide ranges tested. A concentrated feed solution, based on the amino acid supplement and the components of the serum-and protein-free supplements, was formulated. Addition of this feed in response to metabolic requirements resulted in a harvest titer a further 2-fold higher than the enhanced culture medium. Harvest antibody titers of up to 600 mg/L were achieved for three cell lines expressing different antibodies, representing an increase of 10-fold over the starting concentrations. [source] Folic acid supplementation on red kidney bean-induced diarrhoea and enteric bacterial translocation into mesenteric lymph nodes in rats: a pilot studyACTA PAEDIATRICA, Issue 1 2002R Shoda Deaths following childhood diarrhoea, a major health problem in developing countries, are often associated with malnutrition and septicaemic complications. Folic acid has been used in the treatment of acute and chronic diarrhoea in the tropics. Using a rat model, we evaluated the protective effect of large doses of folic acid on diarrhoea, small intestinal bacterial overgrowth and translocation of enteric bacteria into mesenteric lymph nodes induced by a raw red kidney bean-based diet containing lectin (phytohemagglutinin). Long-Evans rats in 2 groups of 5 each (60 g to 70 g in weight, 28 d old) were used. All 10 rats, individually kept in metabolic cages, received a raw red kidney bean-based diet for 10 d, and 5 of them also received a daily folic acid supplement (160 ,g/g feed) both during and for 10 d before the experiment. The faecal weight was measured and a quantitative aerobic bacterial culture of the small intestinal mucosal scrapings and of the mesenteric lymph nodes was made. Folic acid supplementation did not reduce faecal output nor did it prevent loss of body weight associated with lectin-induced diarrhoea. However, the mean total count of enteric bacteria translocated to the mesenteric lymph nodes was significantly reduced in the supplemented rats (1.27 ± 0.61 vs 2.66 ± 0.84, p= 0.028) and a trend towards reduced bacterial count in the small intestinal mucosal scrapings (0.40 ± 0.89 vs 1.42 ± 1.31, p= 0.16) was documented. A significant positive correlation was also seen between the bacterial count in the jejunal mucosal scrapings and in the mesenteric lymph nodes. Conclusion: Although large-dose folic acid supplementation did not prevent diarrhoea and malnutrition induced by a lectin-based diet, it substantially reduced the count of enteric bacteria translocated into the mesenteric lymph nodes and showed a trend towards a reduction in indigenous bacteria adhering to jejunal mucosa. These findings could be of relevance in the prevention of septicaemic complications following many clinical conditions, including diarrhoea with malnutrition in children known to have bacteraemic and septicaemic complications. [source] n-3 polyunsaturated fatty acid supplementation, monocyte adhesion molecule expression and pro-inflammatory mediators in Type 2 diabetes mellitusDIABETIC MEDICINE, Issue 1 2001M. J. Sampson SUMMARY Aims To examine the effect of n-3 polyunsaturated fatty acid supplements on the monocyte surface expression of adhesion molecules involved in pro-atherogenic monocyte,endothelial interactions, and on pro-inflammatory mediators in Type 2 diabetes mellitus. Methods Twenty-nine subjects with Type 2 diabetes and 21 controls without diabetes were studied. Monocyte expression of leucocyte function-associated antigens 1 and 3, intercellular adhesion molecule-1, and the major histocompatibility complex class II molecule HLA-DR were measured using a laser flow cytometric method. Supplementation with 2.08 g n-3 fatty acids for 21 days was undertaken and measurements repeated. Plasma soluble adhesion molecule concentrations, plasminogen activator inhibitor-1 activity and antigen and pro-inflammatory mediators (cysteinyl leukotriene and monocyte leukotriene B4) were also measured. Results Groups did not differ in monocyte expression of adhesion molecules or HLA-DR, or in leukotriene production although plasma soluble adhesion molecule concentrations were higher in the diabetes groups (P < 0.05). n-3 fatty acid supplementation influenced neither the expression of these molecules nor plasma soluble adhesion molecule concentrations or leukotriene production. Conclusions This study does not support increased monocyte adhesion molecule expression or abnormal monocyte production of pro-inflammatory mediators as mechanisms for increased atherogenic risk in Type 2 diabetes. Cardioprotective actions of n-3 fatty acids may not be mediated through these mechanisms. [source] Autophagy and amino acid homeostasis are required for chronological longevity in Saccharomyces cerevisiaeAGING CELL, Issue 4 2009Ashley L. Alvers Summary Following cessation of growth, yeast cells remain viable in a nondividing state for a period of time known as the chronological lifespan (CLS). Autophagy is a degradative process responsible for amino acid recycling in response to nitrogen starvation and amino acid limitation. We have investigated the role of autophagy during chronological aging of yeast grown in glucose minimal media containing different supplemental essential and nonessential amino acids. Deletion of ATG1 or ATG7, both of which are required for autophagy, reduced CLS, whereas deletion of ATG11, which is required for selective targeting of cellular components to the vacuole for degradation, did not reduce CLS. The nonessential amino acids isoleucine and valine, and the essential amino acid leucine, extended CLS in autophagy-deficient as well as autophagy-competent yeast. This extension was suppressed by constitutive expression of GCN4, which encodes a transcriptional regulator of general amino acid control (GAAC). Consistent with this, GCN4 expression was reduced by isoleucine and valine. Furthermore, elimination of the leucine requirement extended CLS and prevented the effects of constitutive expression of GCN4. Interestingly, deletion of LEU3, a GAAC target gene encoding a transcriptional regulator of branched side chain amino acid synthesis, dramatically increased CLS in the absence of amino acid supplements. In general, this indicates that activation of GAAC reduces CLS whereas suppression of GAAC extends CLS in minimal medium. These findings demonstrate important roles for autophagy and amino acid homeostasis in determining CLS in yeast. [source] Maternal use of folic acid supplements during pregnancy and four-year-old neurodevelopment in a population-based birth cohortPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2009Jordi Julvez Summary The use of folic acid supplements during very early pregnancy is recommended in order to reduce the incidence of neural tube defects. Little is known about the possible benefits of folic acid on child neurodevelopment. A total of 420 children (87% of those eligible) from a birth cohort had complete data for final analyses at age 4 years. Information about folic acid and other over-the-counter dietary supplements was obtained prospectively using interviewer-administered questionnaires at the end of the first trimester of pregnancy. Psychological outcomes were assessed by two psychologists and teachers 4 years later. Low maternal socio-economic status, smoking, high parity and short duration of breast feeding were associated with lower prevalence of folic acid supplement use. Verbal (b = 3.98, SE = 1.69), motor (b = 4.54, SE = 1.66) and verbal-executive function (b = 3.97, SE = 1.68) scores, social competence (b = 3.97, SE = 1.61) and inattention symptom [OR = 0.46; 95% CI 0.22, 0.95] scores were associated with reported folic acid use. Reported folic acid supplement use during pregnancy was associated with improved neurodevelopment in children after adjusting for a number of sociodemographic and behavioural factors. [source] Peri-conceptual folic acid supplementation in type 1 diabetesPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 4 2001C.J. Wills Specialist Registrar in Diabetes, Endocrinology Abstract Aim To document peri-conceptual folic acid supplementation in women with type 1 diabetes mellitus (DM) attending the diabetic ante-natal clinic of a university teaching hospital. Methods Women with pre-existing type 1 DM who booked at the diabetes antenatal clinic at University Hospital, Nottingham over 3 years (1996,98) took part in a telephone survey about folic acid supplements. Results Data was available on 50 women, 65 pregnancies. Folic acid supplements were used before 50.7% (33) pregnancies, all planned, and started on confirmation of pregnancy in 34% (22), at a mean gestation of 5.8 weeks. No folic acid was used before or during 10 (15.4%) pregnancies. 75.4% (49) pregnancies were planned. 24 planned pregnancies were in women who had never had pre-pregnancy counselling. 70.8%(17) of these were in multiparous women, and folic acid was taken before 41.1% (seven) of such pregnancies. Lack of awareness was the predominant reason for failure to take folic acid supplements in all groups. Conclusions Folic acid was taken before conception in only half of the pregnancies in the survey, due to lack of awareness of its importance. Three-quarters of pregnancies were planned but a disappointing number of women had pre-pregnancy counselling, probably due to poor advertising and the assumption that women who had been pregnant before did not need such a session. Women with DM should be informed about folic acid and offered pre-pregnancy counselling. It should not be assumed that women who have had a pregnancy know about folic acid. Copyright © 2001 John Wiley & Sons, Ltd. Key Points Folic acid supplementation prior to conception and in the first trimester helps to prevent neural tube defects. Almost half of the women in this survey failed to take folic acid prior to conception. Women who did not take folic acid were unaware of its importance. We need to ensure that women with diabetes understand the importance of folic acid. [source] Mutations in PEX10 are a cause of autosomal recessive ataxiaANNALS OF NEUROLOGY, Issue 2 2010Luc Régal MD Peroxisomal biogenesis disorders typically cause severe multisystem disease and early death. We describe a child and an adult of normal intelligence with progressive ataxia, axonal motor neuropathy, and decreased vibration sense. Both patients had marked cerebellar atrophy. Peroxisomal studies revealed a peroxisomal biogenesis disorder. Two mutations in PEX10 were found in the child, c.992G>A (novel) and c.764_765insA, and in the adult, c.2T>C (novel) and c.790C>T. Transfection with wild-type PEX10 corrected the fibroblast phenotype. Bile acid supplements and dietary restriction of phytanic acid were started. Peroxisomal biogenesis disorders should be considered in the differential diagnosis of autosomal recessive ataxia. ANN NEUROL 2010;68:259,263 [source] Soybean protein concentrate as a protein source for turbot Scophthalmus maximus L.AQUACULTURE NUTRITION, Issue 4 2000O.J. Day In the first of two experiments, the effect of a gradual substitution of dietary fish meal with soybean protein concentrate (SPC) on growth, feed consumption and protein digestibility was examined in 13 g turbot Scophthalmus maximus. Five isonitrogenous and isoenergetic diets (50% protein and 22 kJ g,1) containing SPC at protein replacement levels of 0, 25, 50, 75 and 100% were offered by hand twice daily. Growth rates of fish fed diets with zero and 25% replacement were not significantly different, with SGRs of 2.47 and 2.28, respectively. At higher replacement levels, growth rates decreased significantly with SGRs of 2.00, 1.33 and 0.68, respectively. Feed conversion ratios increased with soya replacement, with values of 0.68, 0.75, 0.89, 1.27 and 2.32, respectively, although there was no significant difference between the first two. Feed consumption rates remained constant up to 50% replacement, above which they decreased significantly, possibly because of reduced diet palatability. Apparent protein digestibility (APD) was not affected by the incorporation of SPC and ranged from 82.8 to 87.5%. Results suggest that protein catabolism increases in SPC-rich diets, possibly because of rapid assimilation and utilization of the methionine supplement. In the second experiment, the importance of amino acid supplements and the beneficial effects of protecting these, either by coating them in protein or incorporating them in a protein,lipid emulsion, was investigated. Growth data provided some indication that the utilization of SPC may be improved by incorporating the methionine and lysine supplement in a protein,lipid emulsion prior to diet preparation, although this finding was not found to be statistically significant (0.1 < P < 0.2). [source] Methotrexate catabolism to 7-hydroxymethotrexate in rheumatoid arthritis alters drug efficacy and retention and is reduced by folic acid supplementationARTHRITIS & RHEUMATISM, Issue 8 2009Joseph E. Baggott Objective To assess the catabolism of methotrexate (MTX) to 7-hydroxy-MTX (7-OH-MTX) in patients with rheumatoid arthritis as well as the effect of folic acid and folinic acid on this catabolism. Methods Urinary excretion of MTX and its catabolite, 7-OH-MTX, was measured in 2 24-hour urine specimens collected after MTX therapy. Urine samples were collected from patients after the sixth and seventh weekly doses of MTX. MTX and 7-OH-MTX concentrations were determined by high-performance liquid chromatography mass spectrometry. Swelling and pain/tenderness indices were used to measure symptoms before and at 6 and 7 weeks of therapy. Patients received either folic acid or folinic acid supplements (1 mg/day) from week 6 to week 7. Results Folic acid inhibited aldehyde oxidase (AO), the enzyme that produces 7-OH-MTX, but folinic acid did not. Excretion of 7-OH-MTX (determined as a percentage of the dose of MTX or as mg 7-OH-MTX/gm creatinine) was not normally distributed (n = 39). Patients with marked improvement in swelling and pain/tenderness indices had a lower mean 7-OH-MTX excretion level (P < 0.05). Patients who received folic acid supplements had decreased 7-OH-MTX excretion (P = 0.03). Relatively high 7-OH-MTX excretion was correlated with relatively high MTX excretion and with relatively low MTX retention in vivo (P < 0.05) (n = 35). Conclusion Our findings of a non-normal distribution of 7-OH-MTX excretion suggest that there are at least 2 phenotypes for this catabolism. Decreased 7-OH-MTX formation suggests folic acid inhibition of AO and a better clinical response, while increased 7-OH-MTX formation may interfere with MTX polyglutamylation and binding to enzymes and, therefore, may increase MTX excretion and decrease MTX retention and efficacy in vivo. [source] Folate intake and the primary prevention of non-neural birth defectsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2006Carol Bower Objectives: To investigate whether maternal periconceptional folate intake is associated with a reduction in selected non-neural birth defects in Western Australia (WA). Methods: Case-control study of folate intake in women whose infants had orofacial clefts (62); congenital heart defects (151); urinary tract defects (117); limb reduction defects (26); or other major birth defects (119); and 578 control women. Results: Neither folic acid supplements nor dietary folate intake in women not using supplements was significantly associated with a reduction in risk in any of the case groups. In contrast to neural tube defects, WA population data for orofacial clefts, heart defects, limb reduction defects and urinary tract defects showed no fall in prevalence since the introduction of folate promotion and voluntary food fortification. Conclusions: This study provides no evidence of folate being an important factor in the prevention of birth defects other than neural tube defects. [source] Tracking the prevention of folic acid,preventable spina bifida and anencephalyBIRTH DEFECTS RESEARCH, Issue 9 2006Karen N. Bell BACKGROUND: The fortification of wheat flour with folic acid prevents most cases of spina bifida and anencephaly by raising serum folate levels among women capable of bearing children, as does encouraging women to consume folic acid supplements prior to pregnancy. Unfortunately, surveillance is conducted in few countries where the need is greatest. METHODS: A method for assessing the prevention of these birth defects is presented that combines fortification program information with country case prevalence estimates. RESULTS: This approach suggests that about 70% of all cases could be prevented within a year of implementation of fortification programs, were it not for the inertia of regulatory agencies. CONCLUSIONS: Professional researchers and clinicians can help combat this situation by becoming advocates for child health in their respective countries. Birth Defects Research (Part A) 76:654,657, 2006. © 2006 Wiley-Liss, Inc. [source] Folate concentrations and folic acid supplementation among women in their first trimester of pregnancy in a rural area with a high prevalence of neural tube defects in Shanxi, ChinaBIRTH DEFECTS RESEARCH, Issue 6 2006Le Zhang Abstract BACKGROUND: Although an information campaign concerning periconceptional folic acid supplementation was launched in 1998 in Shanxi Province, China, the prevalence of neural tube defects in rural areas was reported as high as 140 per 10,000 births in 2002. The blood folate concentrations and the practice of folic acid supplementation among pregnant women in rural areas of the province are described. METHODS: A total of 483 pregnant women (mean gestation, 8.1 weeks) in a rural area of Shanxi were interviewed. Nonfasting blood samples and information on folic acid supplementation were collected. Folate concentrations in plasma and erythrocytes were determined by a microbiological assay. RESULTS: The mean concentrations of plasma and erythrocyte folate for pregnant women was 10.4 nmol/liter and 375.8 nmol/liter, respectively. Deficiencies of plasma and erythrocyte folate were observed in 20.9% and 47.6% of women, respectively. Seasonal variations were noted in the prevalence of folate deficiency, with significantly lower plasma folate concentrations in spring and summer and lower erythrocyte folate concentrations in seasons other than summer. Among pregnant women, <10% reported having taken or currently taking folic acid, and virtually no women (0.6%) took folic acid as recommended. CONCLUSIONS: Women in rural areas had low plasma and erythrocyte folate levels, and folate deficiency was highly prevalent in the area. Few women followed the recommendations regarding folic acid supplementation, and the information campaign in Shanxi was unsuccessful. These findings suggest the urgent need for combined strategies in rural areas to fortify grain with folic acid and promote folic acid supplements for childbearing-age women. Birth Defects Research (Part A) 76:461,466, 2006. © 2006 Wiley-Liss, Inc. [source] Extremely high prevalence of neural tube defects in a 4-county area in Shanxi Province, ChinaBIRTH DEFECTS RESEARCH, Issue 4 2006Zhiwen Li Abstract BACKGROUND In the past, northern China's Shanxi Province has reported the highest incidence of neural tube defects (NTDs) in the world. However, little is known about the epidemiology of NTDs in this area in recent years. METHODS Data were collected from a population-based birth defects surveillance system in 4 counties that captures information on all live births, stillbirths of at least 20 weeks' gestation, and pregnancy terminations at any gestational age resulting from prenatal diagnosis of a birth defect. We also surveyed mothers of NTD case patients to determine their use of folic acid before and during early pregnancy. RESULTS During 2003, 160 NTD cases were identified among 11,534 births (NTD birth prevalence = 138.7/10,000 births). The rates of anencephaly, spina bifida and encephalocele were 65.9, 58.1, and 14.7 per 10,000, respectively, and a female predominance was observed among anencephaly cases (male-to-female relative risk [RR], 0.49; 95% confidence interval [CI], 0.30,0.79), but not among spina bifida (RR, 0.90; 95% CI, 0.55,1.45) and encephalocele (RR, 1.03; 95% CI, 0.40,2.69) cases. The percentages of pregnancy termination following prenatal diagnosis of anencephaly, spina bifida, and encephalocele were 50%, 41.8%, and 35.3%, respectively. NTD birth prevalence tended to be higher among mothers aged <20 or ,30 years (P = .06) and was markedly associated with lower levels of maternal education (P < .001). Among 143 NTD mothers, only 6 (4.2%) used folic acid supplements during the periconceptional period. CONCLUSIONS The NTD birth prevalence rate in the study area is among the highest worldwide. Folic acid deficiency may be one important risk factor. Birth Defects Research (Part A), 2006. © 2006 Wiley-Liss, Inc. [source] Case for mandatory fortification of food with folate in Australia, for the prevention of neural tube defectsBIRTH DEFECTS RESEARCH, Issue 11 2004Carol Bower BACKGROUND Since the publication of randomized controlled trials demonstrating the prevention of neural tube defects (NTDs) with periconceptional folate, several Australian states have promoted an increase in periconceptional use of folic acid supplements. Since 1996, voluntary fortification of food with folate has been allowed in Australia and New Zealand for the purpose of preventing NTDs. METHODS For this report, we synthesized published and unpublished data on folic acid supplement use, voluntary fortification, and trends in NTDs. RESULTS There has been an increase in the proportion of women (up to 30,40%) taking periconceptional folic acid supplements in Australia, and many foods (mainly breakfast cereals) are fortified. Supplement use is strongly correlated with educational and socioeconomic status; consumption of voluntarily fortified foods is not. There has been a fall in NTDs of about 30% in the non-Aboriginal population, but no change has been seen in the Aboriginal population. CONCLUSIONS These data support mandatory fortification of food as a more equitable approach to achieving sufficient folate intake in the periconceptional period for all women in Australia and New Zealand to prevent the majority of NTDs in their offspring. In May 2004, based on these and other considerations, the Australia and New Zealand Food Regulation Ministerial Council agreed that mandatory fortification of food with folate should be considered as a priority. Birth Defects Research (Part A), 2004. © 2004 Wiley-Liss, Inc. [source] The effect of fever, febrile illnesses, and heat exposures on the risk of neural tube defects in a Texas-Mexico border populationBIRTH DEFECTS RESEARCH, Issue 10 2004Lucina Suarez Abstract BACKGROUND Hyperthermia produces neural tube defects (NTDs) in a variety of animal species. Elevated maternal body temperatures may also place the developing human embryo at risk. We examined the relation between maternal hyperthermia and the development of NTDs in a high-risk Mexican-American population. METHODS Case-women were Mexican-American women with NTD-affected pregnancies who resided and delivered in any of the 14 Texas counties bordering Mexico, during 1995,2000. Control-women were randomly selected from study area residents delivering normal live births, frequency-matched to cases by hospital and year. Information on maternal fevers, febrile illnesses, exposures to heat generated from external sources, and hyperthermia-inducing activities was gathered through in-person interviews, conducted about six weeks postpartum. RESULTS The risk effect (OR) associated with maternal fever in the first trimester, compared to no fever, was 2.9 (95% CI, 1.5,5.7). Women taking fever-reducing medications showed a lower risk effect (OR, 2.4; 95% CI, 1.0,5.6) than those who did not (OR, 3.8; 95% CI, 1.4,10.9). First-trimester maternal exposures to heat devices such as hot tubs, saunas, or electric blankets were associated with an OR of 3.6 (95% CI, 1.1,15.9). Small insignificant effects were observed for activities such as cooking in a hot kitchen (OR, 1.6; 95% CI, 1.0,2.6) and working or exercising in the sun (OR, 1.4; 95% CI, 0.9,2.2). CONCLUSIONS Maternal hyperthermia increases the risk for NTD-affected offspring. Women intending to become pregnant should avoid intense heat exposures, carefully monitor and manage their febrile illnesses, and routinely consume folic acid supplements. Birth Defects Research (Part A), 2004. © 2004 Wiley-Liss, Inc. [source] Method of weighted proportion of reproductive-aged women taking folic acid supplements to predict a neural tube defect rate decline,BIRTH DEFECTS RESEARCH, Issue 12 2003Quanhe Yang Abstract BACKGROUND Neural tube defect (NTD) rates can be lowered by increased consumption of folic acid (FA) by women before and during early pregnancy. The crude proportion of reproductive-aged women taking FA supplements has been used to predict a decline of the NTD rate in the general population. In this study we examine the potential error in using the crude proportion to predict NTD risk reduction, and offer an alternative method. METHODS The crude proportion measures the number of women taking FA. It ignores the substantial variability by maternal age in the probability of giving birth. Age-specific fertility rates (ASFRs) reflect the probability that a woman in a specific age group will give birth in a given year. In this study, we show how to calculate a proportion weighted by ASFRs to predict a decline in the NTD rate, and to assess the effectiveness of FA consumption in preventing NTDs. RESULTS Our results show that a crude proportion of 50% of women (15,49 years old) taking FA is associated with a range of 24,77% in weighted proportions. Assuming a 40% risk reduction from taking 400 ,g of FA daily, the expected NTD rate decline could vary from 9.6% to 30.6%, depending on the age distribution of women taking FA. CONCLUSIONS The ASFR-weighted proportion estimates the proportion of babies born to women taking FA, as opposed to the crude proportion of women taking FA. We recommend using the ASFR-weighted proportion to predict an NTD rate decline and measure the success of FA education campaigns. We found that when women in high-fertility age groups increased their FA consumption, the decline in the NTD rate was greater than when women in low-fertility age groups did so. Our findings suggest that the more efficient approach to NTD prevention is to focus on women with a higher probability of giving birth. For example, by focusing on <50% of women of childbearing age (20,34 years), as much as 76% of the maximum NTD rate reduction can be achieved. Birth Defects Research (Part A), 2003. Published 2003 Wiley-Liss, Inc. [source] Lipids, lipid modifying agents and cardiovascular risk: a review of the evidenceCLINICAL ENDOCRINOLOGY, Issue 6 2009David Preiss Summary It is well-established that serum total-cholesterol, LDL-cholesterol, low HDL-cholesterol and calculated indices such as total cholesterol : HDL-cholesterol ratio or less commonly used indices such as non-HDL cholesterol are strongly predictive of cardiovascular events. Serum triglycerides, by contrast, are only modestly associated with coronary heart disease (CHD) in multivariate analysis and incorporation of triglycerides into prediction algorithms is therefore unlikely to improve their prediction capability. Meta-analysis of studies including > 90 000 subjects has provided robust evidence that statins reduce important clinical end-points. These included a 12% fall in all-cause mortality, 19% fall in CHD mortality and 23% fall in CHD mortality or myocardial infarction. Furthermore there are high quality data showing additional benefit of intensive statin therapy over standard statin therapy for secondary prevention of cardiovascular disease. However, meta-analysis of 10 fibrate trials has shown inconsistent evidence of vascular benefit and non-cardiovascular mortality has been slightly but consistently elevated in most fibrate trials and in meta-analysis. The general use of fibrates for cardiovascular risk reduction can therefore not be supported at present. Other second line agents such as bile acid sequestrants, nicotinic acid and omega-3 fatty acid supplements have been evaluated in a few randomized controlled studies in which cardiovascular benefit has been found but clearly further data are required to properly establish their use in clinical practice. Ongoing studies such as ACCORD, IMPROVE-IT, ASCEND, ORIGIN and HPS2-THRIVE should assist in answering outstanding questions over the next 5 years. [source] | |||||||||||||