Administration Of Supplements Research Articles

Mechanism for the Increase in Human Growth Hormone with Administration of a Novel Test Supplement and Results Indicating Improved Physical Fitness and Sleep Efficiency.

An oral test supplement increases serum human growth hormone (hGH) levels after acute administration in healthy adults. We investigated the mechanism for the increase in hGH and the effect of continued daily administration of the test supplement on measures of physical fitness and sleep efficiency. In Study 1, serum triiodothyronine (T3) was measured in samples from a prior placebo-controlled, double-blind study in which 16 healthy participants received both placebo and the test supplement in a crossover design; treatment order was randomized, and treatments were separated by a 1-week washout. In Study 2, physical fitness (VO2 max) was measured at baseline and after 2 weeks of daily administration of the test supplement (N = 12 healthy participants). Study 3 assessed daily sleep onset latency and time awake during 3 weeks of daily administration of the test supplement (N = 15 healthy participants). A fall from baseline in T3 was observed with placebo (-6.1 ± 8.5 ng/dL, P = .01). Of note, the change in T3 was smaller with the test supplement (-3.3 ± 10.7 ng/dL, P = not significant) but was not statistically different from placebo. Mean VO2 max increased by 6% from baseline after 2 weeks (P = .02). Sleep-onset latency and time awake during the night were reduced from baseline to week 3 by 22% and 65%, respectively (P = .01 and P = .02). The conservation of T3 levels suggests that the mechanism for increased hGH secretion by the test supplement is through somatostatin inhibition. Furthermore, pilot studies indicated that daily administration of the supplement improved physical fitness and sleep efficiency from baseline, effects consistent with increased endogenous hGH release. Clinical Trial Registration No. NCT02987868.

Mothers' knowledge of breastfeeding and infant feeding types affect acute respiratory infections.

SummaryIntroductionWorld Health Organization (WHO) recommends exclusive breastfeeding for new-borns until 6 months of age. However, exclusive breastfeeding in Indonesia only reached 52.3% in 2014 and 65.16% in 2018. It is known that administration of infant formula and non-formula supplements to infants aged less than 6 months increases the risk of Acute Respiratory Infections (ARIs). In addition, the high prevalence of ARIs in infants in Sleman Regency, Indonesia indicates the need of optimal early prevention. Therefore, we conducted this study to confirm that mothers’ knowledge of breastfeeding and infant feeding types affect the prevalence of Acute Respiratory Infections (ARIs).MethodsData were collected through questionnaires from 50 mothers with infants aged 7-12 months who had experienced ARIs in the last 3 months (case group) and 50 mothers with healthy infants (control group). Collected data were then analysed using Chi-Square, Logistic Regression, Lambda, and Somers’ D tests.ResultsThe results showed that types of infant feeding are associated with the prevalence of ARIs. Non-breastfed infants were 14 times riskier to contract ARIs. Mothers’ knowledge of exclusive breastfeeding influenced their preferences of feeding practice. However, their attitude towards breastfeeding did not appear to significantly affect their choices of feeding practice.ConclusionsExclusive breastfeeding during the first 6 months of an infant’s life can lower the prevalence of ARIs for when they are older. Mothers’ good knowledge of breastfeeding is associated with its practice.

Progressive Hypoxia: A Pivotal Pathophysiologic Mechanism of COVID-19 Pneumonia

Progressive Hypoxia: A Pivotal Pathophysiologic Mechanism of COVID-19 Pneumonia

The Downs and Ups of the SNAP Caseload: What Matters?

AbstractBeginning in the 1990s, states have received unprecedented flexibility to determine Supplemental Nutrition Assistance Program (SNAP) eligibility and program administration. We find state SNAP policies accounted for nearly half of the 2000–2016 caseload increase. State economic conditions also play an important role in caseload changes, accounting for almost half of the 2007 through 2013 increase. Within distinct periods of our 1990–2016 data, policy and the economy make different contributions to caseload changes. Policy simulations indicate that mandating states to maintain their 2000 SNAP policies, prior to the greatest expansion in latitude, would have lowered 2000–2016 caseload growth by 38%.

B Vitamins and One-Carbon Metabolism: Implications in Human Health and Disease.

Vitamins B9 (folate) and B12 are essential water-soluble vitamins that play a crucial role in the maintenance of one-carbon metabolism: a set of interconnected biochemical pathways driven by folate and methionine to generate methyl groups for use in DNA synthesis, amino acid homeostasis, antioxidant generation, and epigenetic regulation. Dietary deficiencies in B9 and B12, or genetic polymorphisms that influence the activity of enzymes involved in the folate or methionine cycles, are known to cause developmental defects, impair cognitive function, or block normal blood production. Nutritional deficiencies have historically been treated with dietary supplementation or high-dose parenteral administration that can reverse symptoms in the majority of cases. Elevated levels of these vitamins have more recently been shown to correlate with immune dysfunction, cancer, and increased mortality. Therapies that specifically target one-carbon metabolism are therefore currently being explored for the treatment of immune disorders and cancer. In this review, we will highlight recent studies aimed at elucidating the role of folate, B12, and methionine in one-carbon metabolism during normal cellular processes and in the context of disease progression.

Perspectives for the therapy of anemia of chronic diseases

AbstractThe incidence of anemia of chronic disease (ACD) is underestimated, increases with age, and affects about 30% of the elderly. ACD treatment is currently based on the pharmacotherapy of diseases that caused anemia, erythropoiesis-stimulating agents, and parenteral administration of iron supplementation in case of iron deficiency. Increasing knowledge on the pathophysiology of ACD has resulted in the burst of research on the development of new drugs that are focused on three main areas. The first group of drugs includes substances that inhibit hepcidin transcription, namely direct and indirect bone morphogenetic protein 6 (BMP6) inhibitors and/or SMAD signaling pathway inhibitors, and drugs that regulate hepcidin transcription through STAT3 signaling pathway. The second group of drugs includes direct hepcidin inhibitors (e.g., aptamers, anticalin proteins, monoclonal antibodies) or substances that inhibit the binding of hepcidin to ferroportin. The third group of drugs improves erythropoiesis mainly by upregulation of erythropoietin and/or inhibition of proinflammatory cytokines. In the latter group, hypoxia-inducing factor stabilizers and IL-6 or TNFα antagonists are particularly important. This article discusses new drug groups and substances that are in different phases of development, including both preclinical and clinical studies, and focuses on the prospects of their use in ACD.

Oxygen targets in the intensive care unit during mechanical ventilation for acute respiratory distress syndrome: a rapid review

Supplemental oxygen is frequently administered to patients with acute respiratory distress syndrome (ARDS), including ARDS secondary to viral illness such as coronavirus disease 19 (COVID-19). An up-to-date understanding of how best to target this therapy (e.g. arterial partial pressure of oxygen (PaO2) or peripheral oxygen saturation (SpO2) aim) in these patients is urgently required. To address how oxygen therapy should be targeted in adults with ARDS (particularly ARDS secondary to COVID-19 or other respiratory viruses) and requiring mechanical ventilation in an intensive care unit, and the impact oxygen therapy hason mortality, days ventilated,days of catecholamine use, requirement for renal replacement therapy, and quality of life. We searched the Cochrane COVID-19 Study Register, CENTRAL, MEDLINE, and Embase from inception to15 May 2020 for ongoing or completed randomized controlled trials (RCTs). Two review authors independently assessed all records in accordance with standard Cochrane methodology for study selection. We included RCTs comparing supplemental oxygen administration (i.e. different target PaO2 or SpO2 ranges)in adults with ARDS and receiving mechanical ventilation in an intensive care setting. We excluded studies exploring oxygen administration in patients with different underlying diagnoses or those receiving non-invasive ventilation, high-flow nasal oxygen, or oxygen via facemask. One review author performed data extraction, which a second review author checked. We assessed risk of bias in included studies using the Cochrane 'Risk of bias' tool. We used the GRADE approach to judge the certainty of the evidence for the following outcomes;mortality at longest follow-up,days ventilated,days of catecholamine use, and requirement for renal replacement therapy. We identified one completed RCT evaluating oxygen targets in patients with ARDS receiving mechanical ventilation in an intensive care setting. The study randomized 205 mechanically ventilated patients with ARDS to either conservative (PaO2 55 to 70 mmHg, or SpO2 88% to 92%) or liberal (PaO2 90 to 105 mmHg, or SpO2 ≥ 96%) oxygen therapy for seven days. Overall risk of bias was high (due to lack of blinding, small numbers of participants, and the trial stopping prematurely), and we assessed the certainty of the evidenceas very low. The available data suggested that mortality at 90 days may be higher in those participants receiving a lower oxygen target (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.03 to 3.27). There was no evidence of a difference between the lower and higher target groups in mean number of days ventilated (14.0, 95% CI 10.0 to 18.0 versus 14.5, 95% CI 11.8 to 17.1); number of days of catecholamine use (8.0, 95% CI 5.5 to 10.5 versus 7.2, 95% CI 5.9 to 8.4); or participants receiving renal replacement therapy (13.7%, 95% CI 5.8% to 21.6% versus 12.0%, 95% CI 5.0% to 19.1%). Quality of life was not reported. We are very uncertain as to whether a higher or lower oxygen targetis more beneficial in patients with ARDS and receiving mechanical ventilation in an intensive care setting. We identified only one RCT with a total of 205 participants exploring this question, and rated the risk of bias as high and the certainty of the findings as very low. Further well-conducted studies are urgently needed to increase the certainty of the findings reported here. This review should be updated when more evidence is available.

Enteral feed based gradual improvement of body mass index and normalization of micronutrients in children with malnutrition

Aim: Malnutrition is a serious and frequently encountered condition affecting more than 900 million individuals worldwide. Its relationship with negative clinical outcome, bad prognosis and susceptibility to diseases has been demonstrated in numerous studies alongside with the importance of early nutritional intervention. The aim of this study was to define the beneficial influence of a hypercaloric enteral supplement on body mass index (BMI) z-score as well as ferritin, vitamin B12 and vitamin D micronutrients. Methods: This study is a retrospective observational study. Records of patients who were diagnosed with malnutrition via a physician by having height and weight scores below -2 standard deviation were collected from Gaziosmanpaşa Training and Resource Hospital, Istanbul, Turkey. A comparative statistical analysis was performed on 205 pediatric malnutrition patients (ages 1 to 16) by gathering their BMI, ferritin, b12 and vitamin D at baseline with their measurements at 2 follow-up visits after the administration of hypercaloric (1.5kcal/mL) enteral supplement over 6 months. Results: There was a significant inverse correlation between BMI z-scores and the duration of enteral supplement administration, reflected by a 33.2% reduction of the mean BMI z-scores from -2.11 to -0.7 over 6 months (Z=-12.4, P<0.001). Additionally, there was a reduction in the number of patients with excessive or insufficient amounts of ferritin, b12 and vitamin D concentrations with 80%, 41.7% and 39.3% respectively over six months. Conclusions: Hypercaloric enteral supplementation is a short-acting and highly beneficial nutritional intervention in pediatric patients diagnosed with malnutrition, which provides a robust improvement in the BMI z-scores as well as a 2-tailed improvement of aforementioned micronutrients after six months of supplementation.

Tocotrienol-Rich Fraction Of Palm Oil Attenuates Type II Collagen-Induced Temporomandibular Joint Rheumatoid Arthritis In Rats For Future Clinical Application

Temporomandibular joint involvement in rheumatoid arthritis (RA) is not uncommon. Nonsteroidal anti-inflammatory drugs (NSAIDs), are considered main line of RA treatment but they can cause side effects. Tocotrienol rich fraction (TRF) extracted from palm oil was reported to possess potent antioxidant and anti-inflammatory activities. This research was designed to study the therapeutic potential of TRF against TMJ arthritis. 30 Albino Wistar rats were divided into: Control (C), Arthritis (A) and Arthritis + TRF (A-TRF) groups. A-TRF group received TRF daily from day 30 up to day 45 after TMJ arthritis induction was accomplished. Serum inflammatory cytokines were assessed and TMJ histopathological examinations were done. Plasma levels of inflammatory cytokines increased in A-group and they were comparable in both C and A-TRF groups. A-TRF group showed that, the inflammatory changes were mild on examination of stained sections of TMJ. A-TRF-group bone mineral density was notably increased after TRF administration. In conclusion, the decreased plasma levels of inflammatory cytokines and the increased bone mineral density associated with tocotrienolsrich-fraction supplements administration could be provide an evidence that TRF could be used as an effective therapy of TMJ rheumatoid arthritis.

Prevention of Delirium in Older Adults With Dementia: A Systematic Literature Review.

Although dementia is the largest independent risk factor for delirium and leads to poor health outcomes, we know little about how to prevent delirium in persons with dementia (PWD). The purpose of the current systematic literature review was to identify interventions designed to prevent delirium in older PWD. Seven studies meeting inclusion criteria were extracted. Five studies were in the acute care setting and two were community settings. One study used a randomized controlled trial design. Five of the seven interventions comprised multiple components addressing delirium risk factors, including education. Two studies addressed delirium by administration of medication or vitamin supplementation. Using the GRADE framework for the evaluation of study quality, we scored three studies as moderate and four studies as low. Thus, high-quality research studies to guide how best to prevent delirium in PWD are lacking. Although more research is required, the current review suggests that multicomponent approaches addressing delirium risk factors should be considered by health care professionals when supporting older PWD. [Journal of Gerontological Nursing, 46(10), 43-54.].

Evaluation and Treatment of Disorders of Phosphate Balance

The purpose of this article is to review (1) the molecular mechanisms and hormonal factors involved in phosphate handling and regulation, (2) how to appropriately interpret serum and urine phosphate measurements in pediatric patients, (3) the pathophysiology of hypophosphatemic and hyperphosphatemic conditions, and (4) current strategies for treatment of hypophosphatemia and hyperphosphatemia in pediatric patients. For decades, treatment of some hypophosphatemic conditions like X-linked hypophosphatemic rickets (XLH), characterized by a primary increase in fibroblast growth factor 23 (FGF23) activity, consisted of non-specific therapy with phosphate supplementation and calcitriol administration. However, in the past few years, burosumab, a targeted anti-FGF23 antibody, has been developed, representing a promising new medication for the treatment of pediatric XLH patients. The treatment of hyperphosphatemic conditions like chronic kidney disease (CKD) consists of dietary phosphate restriction and enteral phosphate binders; however, the development of new binders and inhibitors of cellular phosphate transporters may offer additional treatment options in the future. The evaluation and treatment of disorders of phosphate balance in children is complex, as numerous interrelated mechanisms and hormones are involved in phosphate handling and regulation. Knowledge of the pathophysiology of hypophosphatemic and hyperphosphatemic conditions informs optimal diagnostic and treatment strategies.

Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Induced by Long-Term Use of Citalopram and Short-Term Use of Naproxen

Patient: Female, 88-year-oldFinal Diagnosis: Syndrome of inappropriate antidiuretic hormone secretionSymptoms: Decreased appetite • malaise • nauseaMedication:—Clinical Procedure: LaboratorySpecialty: Endocrinology and Metabolic • Geriatrics • NephrologyObjective:Rare co-existance of disease or pathologyBackground:Use of selective serotonin reuptake inhibitors (SSRIs) has been reported to be associated with the syndrome of inappropriate antidiuretic hormone (SIADH), although it is uncommon. Nonsteroidal anti-inflammatory drugs (NSAIDs), as a sole agent, are an even rarer cause of SIADH. Despite being documented in the literature, the understanding of the mechanism of both agents is limited. Here, we report a case of a patient taking both of these medications, a dangerous combination that led to the development of SIADH.Case Report:An 88-year-old woman with a history of asymptomatic chronic hyponatremia presented to our facility with symptomatic acute-on-chronic hyponatremia after she started using naproxen in addition to her daily citalopram. Her hyponatremia symptoms resolved after discontinuing these 2 offending agents, along with administration of fluid restriction and oral sodium supplements.Conclusions:Naproxen is commonly prescribed and is often taken by elderly patients to control long-term or short-term pain. SSRIs, on the other hand, are a first-line treatment for depression and are usually prescribe by a psychiatrist. Hyponatremia is a rare medication adverse effect that should be kept in mind when treating these patients with either of these medications, and should especially be considered when combining them. Medication reconciliation should be done carefully by the provider to avoid adverse effects and drug interactions. When hyponatremia is encountered, options for future medication prescriptions include rechallenging with the same medication, switching to a different medication with the same mechanism of action, or using a medication from another class altogether. Monitoring of serum sodium level is warranted when titrating the offending agent.

Identification of compound mutations of SLC12A3 gene in a Chinese pedigree with Gitelman syndrome exhibiting Bartter syndrome-liked phenotypes

BackgroundGitelman syndrome is a rare salt-losing renal tubular disorder associated with mutation of SLC12A3 gene, which encodes the Na-Cl co-transporter (NCCT). Gitelman syndrome is characterized by hypokalemia, metabolic alkalosis, hypomagnesemia, hypocalciuria, and renin-angiotensin-aldosterone system (RAAS) activation. Different SLC12A3 variants may lead to phenotypic variability and severity.MethodsIn this study, we reported the clinical features and genetic analysis of a Chinese pedigree diagnosed with Gitelman syndrome.ResultsThe proband exhibited hypokalaemia, hypomagnesemia, metabolic alkalosis, but hypercalciuria and kidney stone formation. The increased urinary calcium excretion made it confused to Bartter syndrome. The persistent renal potassium wasting resulted in renal tubular lesions, and might affect urinary calcium reabsorption and excretion. Genetic analysis revealed mutations of SLC12A3 gene with c.433C > T (p.Arg145Cys), c.1077C > G (p.Asn359Lys), and c.1666C > T (p.Pro556Ser). Potential alterations of structure and function of NCCT protein due to those genetic variations of SLC12A3 are predicted. Interestingly, one sibling of the proband carried the same mutant sites and exhibited similar clinical features with milder phenotypes of hypokalemia and hypomagnesemia, but hypocalciuria rather than hypercalciuria. Family members with at least one wild type copy of SLC12A3 had normal biochemistry. With administration of spironolactone, potassium chloride and magnesium supplement, the serum potassium and magnesium were maintained within normal ranges.ConclusionsIn this study, we identified compound mutations of SLC12A3 associated with varieties of clinical features. Further efforts are needed to investigate the diversity in clinical manifestations of Gitelman syndrome and its correlation with specific SLC12A3 mutations.

Evaluation of Oral Administration of Lauric Acid Supplement on Fasting Blood Glucose Level and Pancreatic Histomorphological Studies in High Fat Diet/Streptozotocin-Induced Type 2 Diabetic Male Wistar Rats

Background: Diabetes mellitus is the most common serious metabolic disease in human with a hall-mark of an elevated blood glucose concentration caused by a number of biochemical and physiological alterations Aim: The aim of the study was to evaluate the effect oral administration of lauric acid supplement on fasting blood glucose level and pancreatic histomorphological studies in high fat diet/streptozotocin (STZ)-induced type 2 diabetic male Wistar rats. Study Design: Thirty-five apparently healthy male Wistar rats of 6-8 weeks, weighing between 70 g-90 g were grouped into seven groups of five animals each (n=5) and treated for a period of twenty-one days (21) with graded doses of lauric acid supplement after validation of diabetes. Group 1 and 3 were fed with normal rat feed while group 2, 4, 5, 6, 7 were fed with high fat diet for eight weeks after which low dose STZ was given to same groups. Methodology: Group 1: (Normal control), Group 2: (Diabetic control untreated), Groups 3: (Normoglycemic) received 125 mg/kg Lauric acid, Group 4, 5 and 6 were administered 125, 250 and 500 mg/kg body weight of lauric acid, Group 7: (Standard control) received metformin 100 mg/kg. Blood glucose level was determined at weekly intervals using glucose test strips and digital glucometer (Accu-Chek Advantage, Roche Diagnostic, Germany). At the end of twenty-one (21) days, rats were anaesthetized using ketamine and xylazine at 75 and 25 (mg/kg) respectively. The Pancreatic tissues were excised and subjected to routine histological investigation for histo-pathological changes. Result: The results showed that lauric acid at all doses significantly (P<0.05) decreased the fasting blood glucose level from (32.45 ± 0.54, 28.85 ± 1.81, 28.85 ± 2.52 mmo/L) to (7.9 ± 1.07, 5.27 ± 0.39 and 4.45 ± 0.48 mmol/L) after three weeks of treatment. And also, Subsequent histomorphological evaluation also showed necrosis and vacuolization of islet β-cells to be reasonably reduced in the diabetic treated rats Conclusion: This study has been able to demonstrate the Antidiabetic potential of graded doses of lauric acid supplementations for 21 days of administration and it has found out that it possesses strong Antihyperglycemic potencies and induced β-cell regeneration in high fat diet/streptozotocin induced type 2 diabetic rat models.

Effectiveness of vitamin D3 in improving sperm count, motility and morphology in subfertile men

The effect of vitamin D3 in improving sperm count, motility and morphology of men was assessed using design. All men who attended OPD at a selected hospital were screened with Male Fertility Profile. Forty-six men among them were diagnosed as were chosen as study participants. A detailed explanation of the study was given to the selected participants, and the written consent was received from each study participant. They were given treatment under the guidance of our fertility experts, the oral administration of vitamin D3 supplements per oral twice a day for 72 days and the post-test semen analysis was done on 73rd day. The findings of the study revealed that there is an improvement in the semen quality (counts in the sperm /ml, progressive motility level, total progressive motility level P&amp;lt;0.00001 and morphology P &amp;lt;0.00007). In contrast, there were no changes revealed in the level of volume, and PH was slightly alkaline. Vitamin D enhances . Therefore, vitamin D supplements can be administered in men.

The Case of Acute Steroid-Induced Myopathy in the Patient with Autoimmune Thrombocytopenia

The article concerns one of the common adverse effects during treatment — steroid myopathy. The information about pathogenic specifics of myopathy development in administration of glucocorticoids, the most typical clinical manifestations are described, and results diagnostic methods with estimation of a role of enzyme level evaluation, electromyography, ultrasound study of the muscle tissue, computer and magnetic resonance tomography. There is description of muscle weakness development in 49-year old woman who has been receiving methylprednisolone 88 mg/day due to revealed thrombocytopenia. One week after the treatment was started the patient experienced onset and progression of muscle weakness limiting her motion and self-maintenance. After performing of investigation including electromyography steroid genesis of myopathy was suggested. The patient’s condition began to improve after disc ontinuation of glucocorticoids and administration of calcium supplements, vitamin D, and anabolics, and the patient was discharged.

Effects of Chrysin and Its Major Conjugated Metabolites Chrysin-7-Sulfate and Chrysin-7-Glucuronide on Cytochrome P450 Enzymes and on OATP, P-gp, BCRP, and MRP2 Transporters.

Chrysin is an abundant flavonoid in nature, and it is also contained by several dietary supplements. Chrysin is highly biotransformed in the body, during which conjugated metabolites chrysin-7-sulfate and chrysin-7-glucuronide are formed. These conjugates appear at considerably higher concentrations in the circulation than the parent compound. Based on previous studies, chrysin can interact with biotransformation enzymes and transporters; however, the interactions of its metabolites have been barely examined. In this in vitro study, the effects of chrysin, chrysin-7-sulfate, and chrysin-7-glucuronide on cytochrome P450 enzymes (2C9, 2C19, 3A4, and 2D6) as well as on organic anion-transporting polypeptides (OATPs; 1A2, 1B1, 1B3, and 2B1) and ATP binding cassette [P-glycoprotein, multidrug resistance-associated protein 2, and breast cancer resistance protein (BCRP)] transporters were investigated. Our observations revealed that chrysin conjugates are strong inhibitors of certain biotransformation enzymes (e.g., CYP2C9) and transporters (e.g., OATP1B1, OATP1B3, OATP2B1, and BCRP) examined. Therefore, the simultaneous administration of chrysin-containing dietary supplements with medications needs to be carefully considered due to the possible development of pharmacokinetic interactions. SIGNIFICANCE STATEMENT: Chrysin-7-sulfate and chrysin-7-glucuronide are the major metabolites of flavonoid chrysin. In this study, we examined the effects of chrysin and its conjugates on cytochrome P450 enzymes and on organic anion-transporting polypeptides and ATP binding cassette transporters (P-glycoprotein, breast cancer resistance protein, and multidrug resistance-associated protein 2). Our results demonstrate that chrysin and/or its conjugates can significantly inhibit some of these proteins. Since chrysin is also contained by dietary supplements, high intake of chrysin may interrupt the transport and/or the biotransformation of drugs.

Functional Outcomes in Patients Admitted to the Intensive Care Unit with Traumatic Brain Injury and Exposed to Hyperoxia: A Retrospective Multicentre Cohort Study.

BackgroundSupplemental oxygen administration to critically ill patients is ubiquitous in the intensive care unit (ICU). Uncertainty persists as to whether hyperoxia is benign in patients with traumatic brain injury (TBI), particularly in regard to their long-term functional neurological outcomes.MethodsWe conducted a retrospective multicenter cohort study of invasively ventilated patients with TBI admitted to the ICU. A database linkage between the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS-APD) and the Victorian State Trauma Registry (VSTR) was utilized. The primary exposure variable was minimum acute physiology and chronic health evaluation (APACHE) III PaO2 in the first 24 h of ICU. We defined hypoxia as PaO2 < 60 mmHg, normoxia as 60–299 mmHg, and hyperoxia as ≥ 300 mmHg. The primary outcome was a Glasgow Outcome Scale-Extended (GOSE) < 5 at 6 months while secondary outcomes included 12 and 24 months GOSE and mortality at each of these timepoints. Additional sensitivity analyses were undertaken in the following subgroups: isolated head injury, patients with operative intervention, head injury severity, and PaO2 either subcategorized by increments of 60 mmHg or treated as a continuous variable.ResultsA total of 3699 patients met the inclusion criteria. The mean age was 42.8 years, 77.7% were male and the mean acute physiology and chronic health evaluation (APACHE) III score was 60.1 (26.3). 2842 patients experienced normoxia, and 783 hyperoxia. The primary outcome occurred in 1470 (47.1%) of patients overall with 1123 (47.1%) from the normoxia group and 312 (45.9%) from the hyperoxia group—odds ratio 0.99 (0.78–1.25). No significant differences in outcomes between groups at 6, 12, and 24 months were observed. Sensitivity analyses did not identify subgroups that were adversely affected by exposure to hyperoxia.ConclusionsNo associations were observed between hyperoxia in ICU during the first 24 h and adverse neurological outcome at 6 months in ventilated TBI patients.Electronic supplementary materialThe online version of this article (10.1007/s12028-020-01033-y) contains supplementary material, which is available to authorized users.

Anti-Inflammatory Effects of Garlic Consumption and Regular Exercise in Sedentary Overweight Individuals

Background: A sedentary lifestyle can result in chronic inflammation, which is a risk factor for Cardiovascular Disease (CVD). Lifestyle modifications, including physical activity and herbal supplements, may have health benefits. Objectives: The present study aimed to investigate the effect of regular exercise and garlic consumption on some inflammatory biomarkers in sedentary overweight individuals. Methods: Forty-four sedentary overweight male participants (20 - 30 years) were randomized to the following groups: Exercise + garlic (ES), exercise + placebo (E), garlic (G), and placebo (P). The training protocol included 20 - 45 minutes of walking/running at 60 to 75% of the maximum heart rate, three sessions per week for eight weeks. Participants consumed two capsules containing 500 milligrams of garlic powder or placebo (starch) per day. Before and 48 h after the exercise intervention and supplement administration, blood samples were collected to assess the hs-CRP and TNF-α serum levels. One-way ANOVA and Tukey’s post hoc tests were used to analyze the data at a significance level of P &lt; 0.05. Results: A significant difference was observed between the groups regarding the hs-CRP and TNF-α levels after the experimental period (P &lt; 0.05). There was a significant difference between EG and placebo groups (P &lt; 0.05). Conclusions: Based on the findings, garlic consumption, along with exercise training could exert anti-inflammatory properties in overweight subjects.

Comparison of the effect of polyethylene glycol and simultaneous administration of polyethylene glycol with probiotics in the treatment of chronic functional constipation: a clinical trial

Background and aims: Constipation is one of the most common issues in pediatrics. The aim of this study was to compare the effect of polyethylene glycol and the simultaneous administration of polyethylene glycol along with probiotics in the treatment of chronic functional constipation. Materials and Methods: In this randomized double-blind clinical trial, 150 children with chronic functional constipation referred to Imam Ali Clinic affiliated with Shahrekord University of Medical Sciences from 2017 to 2018 were included. The first group (A) consumed 1 g/ kg of body weight per day of water-soluble polyethylene glycol powder and the second group (B) consumed a probiotic powder and 1 g/kg of body weight of the water-soluble polyethylene glycol powder daily. In weeks 0, 1, and 2, questionnaires were filled out by the parents of the children and the data were analyzed. Results: The results showed that there was no significant difference in any of the variables between groups A and B (P=0.07) including the frequency of fecal excretion in week 1 (77% and 71%) and week 2 (4% and 5.4%) and stool consistency in week 1 (4% and 6.7%) and week 2 (86.7% and 92%). Moreover, there was no significant difference between groups A and B in any of the variables frequency of painful excretion in week 1 (74% and 73%, respectively) and week 2 (5.3% and 4%, respectively), frequency of abdominal pain in week 1 (61.3% and 49.3%, respectively) and week 2 (4% and 5.3%, respectively), and the frequency of fecal incontinence in week 1 (22.77% and 18.7%, respectively) and week 2 (6.7% and 1.3%) (P&gt;0.05, respectively). Conclusion: Our results indicated that the administration of probiotic supplement (Lactobacillus Rhamnosus, Lactobacillus acidophilus, Lactobacillous Bulgaricus) has no effect on the improvement of symptoms in children with chronic constipation.