Mean Excretion Research Articles

Pattern of iron chelation therapy in Egyptian beta thalassemic patients: Mansoura University Children's Hospital experience

Background: The simultaneous use of deferoxamine (DFO) and deferiprone (DFP) has an additive effect in iron excretion in transfusion-dependent thalassemic patients.Aim of the work: To evaluate the efficacy and safety of a prospective alternating therapy with DFO and DFP in patients with β-thalassemia major (TM) and increased serum ferritin with DFO monotherapy alone.Patient and methods: Sixty patients with β-TM (mean age ± SD, 13.05 ± 6.1, range 10–20 years) with iron overload (serum ferritin > 2000 ng/ml) were studied. They received DFO at a daily dose of 40 mg/kg/day for 5–7 nights/week for the past several years. These patients were randomly assigned either to continue treatment with DFO alone (DFO group, n = 30) or prospectively receive additional alternating therapy with DFP at 75 mg/kg/day for 4 days/week and DFO for the other 2 days/week (alternating therapy group, n = 30). The efficacy of both groups was assessed by measurements of serum ferritin, echocardiography, and 24 h urine iron excretion (UIE) levels throughout 1 year follow-up.Results: In the 60 evaluable patients, the mean serum ferritin (± SD) fell dramatically from 4500 (± 1250) ng/ml at the start of the study to 1250 (± 750) ng/ml (alternate therapy group; P < 0.001) at the end of the study. There was also a significant improvement in the myocardial function as assessed by the ejection fraction (P < 0.002) and fractional shortening (P < 0.01) in those patients on alternate therapy for 1 year. Their mean urinary iron excretion elevated from 0.41 ± 0.27 to 0.76 ± 0.49 mg/kg/24 h (P < 0.003). There was a significant difference between both groups as regard the studied parameters at the end of the study. Whereas, there was no statistical difference as regard the studied parameters at the start and the end of the study in the DFO group. No significant adverse effects had occurred in both groups that necessitated withdrawal from the study.Conclusions: β-Thalassemic major patients with transfusional iron overload can be safely and effectively treated with an alternate therapy of DFO/DFP with a progressive fall in the mean serum ferritin and significant improvement of myocardial performance.

Twenty-four-hour urinary thiamine as a biomarker for the assessment of thiamine intake

To investigate 24-h urinary thiamine as a potential biomarker for thiamine intake for use in validation studies to assess the validity of dietary intake data collected by self-reporting dietary methods. Seven male and six female healthy participants living for 30 days in a metabolic suite under strictly controlled conditions consuming their usual diet as assessed beforehand from four consecutive 7-day food diaries kept at home. During the 30-day study, all 24-h urine specimens were collected, validated for their completeness and analysed for thiamine. Thirty-day mean (+/-s.d.) calculated thiamine intake was 2.22+/-0.55 mg/day. Thirty-day mean (+/-s.d.) urinary excretion of thiamine was 526.5+/-193.0 microg/day (24.7+/-8.10% of intake). There was a highly significant correlation between individuals' 30-day means of thiamine intake and their mean excretion level (r=0.720; P=0.006), where 1 mg of thiamine intake predicted 268.2 microg of thiamine in urine. The correlations between intake and excretion remained significant when measurement from a single 24-h urine collection was used (r=0.56). Twenty-four-hour urinary thiamine can be used as a concentration biomarker for thiamine intake in dietary validation studies.

Lignan and isoflavone excretion in relation to uterine fibroids: a case-control study of young to middle-aged women in the United States

Uterine fibroids are hormonally responsive; estradiol and progesterone stimulate their growth, and gonadotrophin-releasing hormone agonists shrink them. Phytoestrogens, including isoflavones and lignans, can act as weak estrogens or antiestrogens. The objective of this case-control study was to evaluate the relation between uterine fibroid risk and phytoestrogen exposure. Two overnight urine collections (48 h apart) from 170 uterine fibroid cases and 173 controls were analyzed for isoflavonoids (ie, daidzein, genistein, equol, and O-desmethylangolensin) and lignans (enterodiol and enterolactone). Logistic regression was used to determine associations between the mean excretion of the 2 collections and the risk of uterine fibroids. Unadjusted isoflavone excretion did not differ significantly between cases and controls (2.33 +/- 5.82 and 2.60 +/- 5.90 nmol/mg Cr, respectively; P = 0.68), but cases excreted significantly less lignans than did controls (2.86 +/- 3.45 and 4.57 +/- 6.67 nmol/mg Cr, respectively; P < 0.01). The trend for a reduced risk of uterine fibroids with increasing quartiles of lignan excretion was significant (odds ratio for highest versus lowest quartile = 0.31; 95% CI: 0.17, 0.58; P for trend < 0.01). When adjusted for age, BMI, race, family history of uterine fibroids, and isoflavone excretion, this trend remained but was attenuated (P = 0.07). Our findings suggest a modest inverse association between lignan excretion and uterine fibroid risk. Whether this relation represents an effect of lignans per se or of other constituents of lignan-containing foods on the development of uterine fibroids remains to be determined. No association was found between isoflavone excretion and uterine fibroids; however, the intake of soy foods, the primary source of isoflavones, was low in this population.

Efficacy of various anticoccidials against experimental porcine neonatal isosporosis

The efficacies of 20 mg/kg body weight (BW) of toltrazuril (Toltra) 2 days post-infection (dpi), 2 mg/kg BW of diclazuril 2 and 3 dpi and 200 mg/kg BW of sulphadimidine 2, 3 and 4 dpi were compared in a model for piglet isosporosis. Weight gain (first 4 weeks of life) and diarrhoea and oocyst excretion from 4 to 11 dpi were evaluated (10-12 piglets/group). Additionally, animals were killed and examined for pathohistological changes of the small intestines 5, 7, 11 and 14 dpi (n = 3 per group and time point) and lengths of the intestinal villi. Diarrhoea (semi-liquid or liquid faeces) was seen from 5 dpi in all groups except Toltra, and the differences in prevalence and intensity of diarrhoea were statistically significant (p < 0.05) between Toltra and the other groups, which were similar (trial 1). Oocyst excretion was greatly reduced in the Toltra group, which was also statistically significant for the mean and median excretion rates and the percentage of excreting piglets between Toltra and the other groups (p < 0.05). Weight gain was highest in Toltra (p < 0.05). Histopathology revealed mostly villous necrosis and atrophy in the small intestines except the duodenum, which peaked at 7 dpi, in all groups except Toltra. Between 5 and 11 dpi, the Toltra group had significantly longer villi than the other groups. Reduced weight gain and diarrhoea caused by Isospora suis was controlled by a single application of Toltra in the pre-patent period, while neither diclazuril nor sulphadimidine improved the clinical picture of isosporosis.

The Effects of Oral Pancreatic Enzymes (Creon 10 Capsule) on Steatorrhea

Creon 10 Minimicrospheres is an enteric-coated, delayed-release pancrelipase preparation designed to deliver active pancreatic enzymes to the small intestine. The primary objective of this study was to compare the effect of Creon 10 with placebo in the control of steatorrhea in chronic pancreatitis patients. Secondary objectives included evaluation of stool parameters and global improvement of symptoms scales. The study was a randomized, double-blind, placebo-controlled, 2-week trial. After a placebo run-in ("washout") phase, the effect on coefficient of fat absorption (%), daily fat excretion before and after treatment, and stool frequency and consistency were assessed. In Creon 10-treated subjects, the change in mean coefficient of fat absorption (%) from run-in to double-blind phase was significantly higher compared with placebo-treated subjects (+36.7 vs. +12.1, P = 0.0185). Stool consistency improved significantly more with Creon 10 than with placebo (P = 0.0102) resulting in more subjects with formed stool; stool frequency decreased significantly more with Creon 10 than with placebo (P = 0.0015) from 10.8 during placebo run-in to 5.2 stools per day during double-blind treatment; and daily mean fat excretion in stool decreased significantly more (-56.5 vs. -11.4 g/d, P = 0.0181) in Creon 10-treated subjects compared with placebo-treated subjects. Global disease symptom scores showed greater improvement for both physicians and subjects in the Creon 10 group relative to those receiving placebo. Between treatment difference reached statistical significance for Creon 10 (P = 0.0435) for physician score and showed a trend (P = 0.0634) favoring Creon for subject score. This randomized, placebo-controlled trial found that Creon 10 treatment controlled steatorrhea, as reflected in reduced fat excretion, decreased stool frequency and improved stool consistency. Creon 10 treatment was safe and well tolerated.

An Enteric-Coated High-Buffered Pancrelipase Reduces Steatorrhea in Patients with Cystic Fibrosis: A Prospective, Randomized Study

Objective Enteric-coated (EC) high-buffered (2.5 mEq [2.5 mmol] bicarbonate per capsule) pancrelipase microsphere enzymes were compared to EC-nonbuffered pancreatic enzymes for efficacy in reducing steatorrhea in patients with cystic fibrosis. Design Prospective, randomized, controlled trial using a crossover design with each subject as his/her own control. Subjects/Setting Eighteen subjects with cystic fibrosis, who had pancreatic insufficiency and required large enzyme doses, were studied over two consecutive 7-day treatment periods. Intervention Each 7-day period consisted of 3 days at home followed by 4 days in a general clinical research center for careful control of diets, enzyme lipase doses (given at approximately 50% of the subject’s usual lipase dose), and carmine red-labeled stool collections for 72-hour fecal fat balance studies. Main Outcome Measure Fecal fat excretion. Statistical Analyses Performed Differences in fat excretion, when each subject received EC–high-buffered pancrelipase vs EC-nonbuffered enzymes, were compared using linear modeling. Results Mean fat excretion decreased significantly in each subject during periods when given EC–high-buffered pancrelipase compared with periods when given EC-nonbuffered enzymes (fat excretion 18.2% vs 24.9% or fat absorption 81.8% vs 75.1%, respectively; P=0.01). Thirteen of 18 subjects (72%) excreted less fat when receiving EC–high-buffered pancrelipase whereas 10 (56%) decreased fat excretion by more than 5%, and five subjects did not respond. Conclusions EC–high-buffered pancrelipase decreased fat excretion, symbolizing improved fat absorption, when compared with EC-nonbuffered pancreatic enzymes given at equivalent, reduced (approximately 50% of usual) lipase doses in nourished subjects with cystic fibrosis and mild pulmonary disease.

Dietary fructo-oligosaccharides in healthy adults do not negatively affect faecal cytotoxicity: a randomised, double-blind, placebo-controlled crossover trial

Fructo-oligosaccharides (FOS) are widely used in commercial food products. Most studies on FOS concern the health benefits, but some negative effects were recently reported concerning the faecal cytotoxicity and excretion of mucin-type oligosaccharides in combination with a Ca-restricted diet. The present study was performed to investigate whether these effects of FOS are observed in adults consuming a regular diet unrestricted in Ca. The study was a randomised, double-blind, placebo-controlled crossover trial, involving eleven healthy adults, who consumed 25-30 g FOS or maltodextrin (control) in a random order for 2 weeks in addition to their regular diet. Stools were collected for analysis of pH and SCFA (as markers of fermentation), for the assessment of faecal water cytotoxicity, and for the analysis of alkaline phosphatase activity (as a marker of epithelial cell turnover) and O-linked oligosaccharides (to estimate the excretion of mucin-type oligosaccharides). FOS consumption significantly altered bacterial fermentation (increased percentage of acetate, decreased percentage of butyrate) and tended to decrease stool pH. Furthermore, FOS consumption resulted in a significantly higher stool frequency and in significantly more complaints of flatulence. No significant differences between the control and FOS period were observed in the mean cytotoxicity of faecal water (37.5 (SEM 6.9)% v. 18.5 (SEM 6.9)%; P=0.084), in mean alkaline phosphatase activity (27.7 (SEM 2.9) v. 24.6 (SEM 3.2) U/g dry faeces; P=0.496) or in the mean excretion of mucin-type oligosaccharides (49.9 (sem 4.0) v. 53.5 (SEM 4.3) mg/g dry faeces; P=0.553). We conclude that dietary FOS in a dose up to 25-30 g/d altered the bacterial fermentation pattern but did not affect faecal cytotoxicity or the faecal concentration of mucin-type oligosaccharides in human adults consuming a regular diet.

An animal model of clinical kinetic analyzed to diminazene aceturate in subjects with Tripanosoma infection

Diminazene aceturate has been reported to inhibit the reverse transcriptase activity by intercalating action mechanism of a number of protozoon eucaryot parasitic like Trypanosoma species. The phamacokinetics of diminazene in the blood plasma of five infected goats treated with single intramuscular doses of 7 mg diminazen base kg-1 body weight was investigated. The concentrations of the drug were determined by reverse phase high performance liquid chromatography. Results show that the mean (± SD) Absorption, Distribution, Metabolism and Excretion (ADME) of the drug plasma followed a tri-exponential process with Ka (minutes-1) were obtained at 5.10-2 ± 26.10-3, α (minutes-1), K12 (minutes-1) and K21 (minutes-1) were obtained at 18.10-3 ± 1.10-2, 14.10-3 ± 1.10-2 and 1.10-3 ± 1.10-3. The mean values of β (minutes-1) and K13 (minutes-1) were obtained at 1.4.10-4 ± 4. 10-5 and 3.10-3 ± 2.10-3. The mean values of Tmax (minutes) and Cmax (µg.ml-1) were obtained at 53.71 ± 30.61 and 13.40 ± 8.13. The mean values of Vds (L), Cl (ml.minutes-1), T1/2β (hours-1) and AUCž (µg.L-1.minutes) were obtained at 4.91 ± 3.12, 14.29 ± 4.08, 94.91 ± 33.23 and 12.680 ± 2.722. (Med J Indones 2006; 15:69-73)

In Vitro Monitoring of Picogram Levels of Captopril in Human Urine Using Flow Injection Chemiluminescence with Immobilized Reagent Technique

A flow‐injection procedure for detection of captopril using a Co2+‐captopril complex formed on line based enhancement of luminol and dissolved oxygen chemiluminescence is described. The chemiluminescence reagents, luminol and Co2+, were both immobilized on ion exchange resin in the flow injection system. When captopril solution flowed through the immobilized Co2+ column, the Co2+‐captopril (1:2) complex formed on line could greatly enhanced the chemiluminescence intensity generated from the reaction between luminol and dissolved oxygen. The increment of chemiluminescence emission was correlated with the captopril concentration in the range from 7 to 1000 pg mL−1, and the detection limit was 2 pg mL−1 (3σ). One analysis cycle, including sampling and washing, could be accomplished in 0.5 min with relative standard deviations of less than 3.0% (n=11). The proposed method was applied directly in the assay of human urine without any pretreatment and it was found that the captopril concentration reached its maximum after being administrated orally for 1.5 hours, with the mean excretion ratio in 6.5 hours of 54.3% in the body of volunteers. The possible chemiluminescence mechanism was discussed.

Consequences of low birthweight on urinary excretion of DNA markers of oxidative stress in young men

Objective. Low birthweight (LBW) has been associated with an increased risk of development of type 2 diabetes in adult life. Both type 1 and type 2 diabetes mellitus are characterized by increased oxidative stress. The purpose of this study was to investigate whether young healthy adults born with LBW showed differences in oxidative stress under normal conditions and during the added challenge of a physiological Intralipid infusion. Material and methods. Urinary excretion of DNA markers of oxidative stress were analyzed by LC‐MS/MS in 19 men (aged 19 years) with LBW and in 19 age matched, normal birthweight (NBW) controls pre‐ and post a 3‐fold increase of plasma free fatty acids. Results. Mean excretion rates of 8‐oxo‐guanine (8oxoGua), 8‐oxo‐guanosine (8oxoGuo), 8‐oxo‐2′deoxyguanosine (8oxodG), and 1,N6‐ethenodeoxyadenosine (εdA) did not statistically differ between subjects with LBW and NBW (66.9 versus 73.9 nmol/15 h, 17.8 versus 18.5 nmol/15 h, 11.9 versus 14.4 nmol/15 h and 44.0 versus 43.2 pmol/15 h, respectively). Furthermore, Intralipid infusion did not affect excretion of DNA adducts in LBW or NBW subjects. Statistically significant correlations were found between body mass index and urinary excretion of 8oxoGua (r = 0.64, p = 0.003) and 8oxoGuo (r = 0.64, p = 0.003) in the LBW group only. Conclusions. These findings suggest that oxidative stress may be a consequence of diabetes and is not, or at least only partly, involved in the early pathogenesis of type 2 diabetes.

Oral potassium citrate treatment for idiopathic hypocitruria in children with calcium urolithiasis.

We evaluated the clinical and laboratory outcome of oral potassium citrate treatment in children with idiopathic hypocitruria and calcium stones. The charts of 64 children 1 to 15 years old with hypocitruria and calcium stones (median age 7.2) treated with oral potassium citrate were reviewed. Evaluation parameters were tolerability, adverse reactions, metabolic profile and stone recurrence. No serious adverse reaction due to potassium citrate administration was recorded. Normal citrate excretion was restored in all patients. After treatment median urinary citrate daily plus or minus SD increased from 197 +/- 72 to 632 +/- 218 mg./1.73 m.2 (p <0.001) and mean urinary pH increased from 5.3 +/- 0.3 to 6.2 +/- 0.7 (p <0.01). Mean calcium excretion decreased from 3.5 +/- 2.7 to 2.5 +/- 2.7 mg./kg. (p <0.05). At an average followup of 22 months (range 3 to 67) the recurrence rate in the group overall was 0.07 per patient-year. The previous recurrence rate of 0.32 per patient-year in the 20 children with a history of recurrent stone disease decreased to 0.17 per patient-year after treatment. None of the 44 initial stone formers had recurrent stones. Our results show the safety and efficacy of oral potassium citrate treatment for restoring normal urinary citrate and suggest a preventive effect for recurrent calcium stone disease in children with hypocitruria and calcium stones.

Pharmacokinetics and Pharmacodynamics of a Novel Extended‐Release Ciprofloxacin in Healthy Volunteers

Two open-label, randomized, 2-way crossover studies (1 single-dose and 1 steady-state) were conducted in healthy volunteers to compare the pharmacokinetics and pharmacodynamics of a novel extended-release ciprofloxacin (ciprofloxacin ER; 500 mg once daily) and immediate-release ciprofloxacin (ciprofloxacin IR; 250 mg twice daily). For both studies, mean ciprofloxacin maximum concentration (Cmax) values after once-daily ciprofloxacin ER were significantly greater than those after the first daily dose of ciprofloxacin IR (P < .0001) but were lower than those after the second daily dose of ciprofloxacin IR (P < .05). The relative bioavailability of ciprofloxacin ER compared to ciprofloxacin IR was 93.8% in the single-dose study and 97.7% in the steady-state study. Mean urinary ciprofloxacin concentrations and excretion rates after either treatment were substantially greater than the minimum inhibitory concentrations (MICs) for susceptible uropathogens in both studies. The area under the concentration-time curve (AUC)/MIC, Cmax/MIC, amount excreted (Ae)/MIC, and Ae24/MIC ratios with ciprofloxacin ER were similar to or slightly greater than with ciprofloxacin IR for all susceptible organisms.

Urinary 8-epi-PGF 2α and its endogenous β-oxidation products (2,3-dinor and 2,3-dinor-5,6-dihydro) as biomarkers of total body oxidative stress

Although measurements of plasma F 2-isoprostanes are established markers of oxidative stress, their quantification only reflects acute non-enzymatic lipid peroxidation. In this study, a new approach is described for the rapid isolation and measurement of urinary 8-epi-PGF 2α and its endogenous β-oxidation metabolites (2,3-dinor-8-epi-PGF 2α and 2,3-dinor-5,6-dihydro-PGF 2α) for use as index of total body oxidative stress. Isoprostanes were partitioned with ethyl acetate and subsequently purified by chromatography on an aminopropyl (NH 2) and silica (Si) cartridge. Final analysis of F 2-isoprostanes as trimethylsilyl-ester/pentafluorobenzyl ester derivatives was carried out by stable isotope dilution mass spectrometry. Overall recovery of F 2-isoprostanes was 80 ± 4%. Inter- and intra-assay coefficients of variation were 5% and 7%, respectively. In a group of healthy humans, the mean excretion rates expressed as nmol/mmol creatinine for 2,3-dinor-8-epi-PGF 2α, 2,3-dinor-5,6-dihydro-8-epi-PGF 2α, and 8-epi-PGF 2α were 5.43 ± 1.93, 2.16 ± 0.71, and 0.36 ± 0.16, respectively. Correlations were obtained between 8-epi-PGF 2α and 2,3-dinor-8-epi-PGF 2α or 2,3-dinor-5,6-dihydro-8-epi-PGF 2α ( r = 0.998 and r = 0.937, respectively). A strong relationship was also seen between 2,3-dinor-8-epi-PGF 2 and 2,3-dinor-5,6-dihydro-8-epi-PGF 2α ( r = 0.949). The new technique allows for high sample throughput and avoids the need for HPLC and/or other expensive equipment required for the initial sample preparation. Simultaneous analysis of urinary 8-epi-PGF 2α and its metabolites should provide unique tool in clinical trials exploring the role of oxidant injury in human disease.

Determination of urinary S‐phenylmercapturic acid, a specific metabolite of benzene, by liquid chromatography/single quadrupole mass spectrometry

A high-performance liquid chromatography/single quadrupole mass spectrometry (LC/MS) method is described for the determination of urinary S-phenylmercapturic acid (S-PMA), a specific metabolite of benzene. Urine samples were spiked with [13C6]S-PMA (used as the internal standard) and acidified; then they were purified by solid-phase extraction (SPE) on C18 cartridges. Analyses were conducted on a reversed-phase column by gradient runs with 1% aqueous acetic acid/methanol mixtures at different proportions as the mobile phase. The detector was used in electrospray negative ion mode (ESI-), the ions m/z 238 for S-PMA and 244 for [13C6]S-PMA being recorded simultaneously. The detection limit (for a signal-to-noise ratio = 3) was 0.2 microg/L, thus allowing for the measurement of background excretion of S-PMA in the general population. The use of the internal standard allowed us to obtain good precision (CV% values < 3%) and a linear calibration curve within the range of interest for monitoring occupational exposure to benzene (up to 500 microg/L). The method was applied to assay the metabolite concentration in a group of 299 workers (68 smokers and 231 non-smokers) occupationally exposed to relatively low levels of benzene (environmental concentration = 0.4-220 microg/m3, mean 11.4 microg/m3 and 236 non-exposed subjects (134 smokers and 102 non-smokers). The results clearly showed that smoking must be taken into account for the correct interpretation of the results of S-PMA measurements for the assessment of work-related benzene exposure. When only non-smokers were selected, the mean excretion of S-PMA was significantly higher in workers exposed to benzene (1.2 +/- 0.9 microg/g creatinine) than in the control group (0.7 +/- 0.6 microg/g creatinine) (p < 0.001), thus confirming the role of S-PMA as a biomarker of benzene on a group basis, even for relatively low exposure degrees.

Protection against bovine respiratory syncytial virus challenge following a single dose of vaccine in young calves with maternal antibody

Twenty-one young calves with maternally derived antibody to bovine respiratory syncytial virus (BRSV) were divided into three groups of seven, each group balanced for BRSV antibody titre. The calves had...

Renal Function and Plasma Volume Following Ultramarathon Cycling

In recreational cyclists marathon cycling influences renal function only on a minimal scale. Respective information on extreme ultramarathon cycling in better trained athletes is not available. The objective was to evaluate the renal and haematological effects of ultraendurance cycling in the world's best ultramarathon cyclists. Creatinine (CR), urea, haemoglobin (Hb), haematocrit (Hct) and plasma volume (PV) were investigated in 16 male ultramarathon cyclists during the 1st Race Across the Alps in 2001 (distance: 525 km; cumulative altitude difference: 12,600 m). All renal functional parameters were normal pre-exercise. During the race serum CR, urea and uric acid rose significantly by 33, 97 % and 18 % (p <0.001 respectively) and nearly normalised again on the following day. The decline in calculated CR clearance was 25 %. There was a negative correlation (r=- 0.575, p=0.02) between the rise in serum CR and the athlete's training kilometers. The serum urea/CR ratio rose above 40 in 12 athletes (75 %). Mean fractional sodium excretion and fractional uric acid excretion fell below 0.5 % (p <0.001) and 7 %, indicating reduced renal perfusion. The deflection of the renal functional parameters was temporary and nearly gone after 24 hours of recovery. Hct declined during the race from 0.44 to 0.42, and continued falling on the next day (0.42 --> 0.40; p <0.001). The corresponding rises in calculated PV were + 8 % and + 22 %. The study affirms that in world class cyclists the enormous strains of ultramarathon cycling influence renal function only on a minimal scale. The impact on the PV, however, is pronounced leading to marked haemodilution post-exercise. This very temporary "impairment of renal function" seems to be the physiological response to ultramarathon cycling and may be attenuated to some extent by preceding high-volume training.

Diet and blood pressure in South Africa: Intake of foods containing sodium, potassium, calcium, and magnesium in three ethnic groups

Objectives We investigated whether habitual intakes of sodium (Na), potassium, magnesium, and calcium differ across South African ethnic groups, assessed the proportion of Na intake, which is discretionary, and identified which food sources were the major contributors to Na intake. Methods This was a cross-sectional study of 325 black, white, and mixed ancestry hypertensive and normotensive subjects. Three repeated 24-h urine samples were collected for assessment of urinary Na, and three corresponding 24-h dietary recalls were administered by trained fieldworkers. Blood pressure and weight were measured at each visit. Secondary analyses were performed on existing dietary databases obtained from four regional surveys undertaken in South African adults. Results Mean urinary Na excretion values equated to daily salt (NaCl) intakes of 7.8, 8.5, and 9.5 g in black, mixed ancestry, and white subjects, respectively ( P < 0.05). Between 33% and 46% of total Na intake was discretionary, and, of the non-discretionary sources, bread was the single greatest contributor to Na intake in all groups. Ethnic differences in calcium intake were evident, with black subjects having particularly low intakes. Urban versus rural differences existed with respect to sources of dietary Na, with greater than 70% of total non-discretionary Na being provided by bread and cereals in rural black South Africans compared with 49% to 54% in urban dwellers. Conclusion White South Africans havehigher habitual intakes of Na, but also higher calcium intakes, than their black and mixed ancestry counterparts. All ethnic groups had Na intakes in excess of 6 g/d of salt, whereas potassium intakes in all groups were below the recommended level of 90 mM/d.Dietary differences may contribute to ethnically related differences in bloodpressure.

Consumption of both black tea and green tea results in an increase in the excretion of hippuric acid into urine

A major portion of the catechins in green tea is not absorbed in the small intestine. Bacteria in the colon convert nonabsorbed catechins into simpler phenolic compounds, which may also be absorbed. During the production of black tea, most catechins are polymerized to complex molecules called thearubigins. Little is known about the microbial degradation of these complex polyphenols, but hippuric acid has been identified as a major excretion product associated with black tea consumption. To investigate whether green tea and black tea have the same metabolic fate in humans. Seventeen healthy male volunteers were studied with a randomized, full-crossover design. Each intervention period lasted 4 d, ie, a 2-d run-in period with a low-polyphenol diet followed by a 2-d treatment period. Volunteers consumed a daily dose of 6 g green tea solids, 6 g black tea solids, or 360 mg caffeine. Intervention periods were separated by a 10-d washout period. Twenty-four-hour urine samples were collected during the second day of each treatment period. Hippuric acid was analyzed with HPLC-tandem mass spectrometry. The mean excretion of urinary hippuric acid during black tea and green tea consumption was 3.75 +/- 0.28 mmol/24 h and 4.22 +/- 0.28 mmol/24 h, respectively (95% CI for the difference: -0.37 to +1.30 mmol/24 h). The hippuric acid excretion during the control treatment was much lower (1.89 +/- 0.28 mmol/24 h; P < 0.0001, compared with both black tea and green tea). The ingestion of either green tea or black tea results in a major increase in the excretion of hippuric acid into urine.

RISK ASSESSMENT FOR NURSES OCCUPATIONALLY EXPOSED TO ANTINEOPLASTIC DRUGS

ISEE-404 Introductions: Cytostatic antineoplastic drugs are known as carcinogenic, mutagenic and teratogenic risk factors for health care workers who are occupationally exposed during the preparation and administration of such drugs. The purpose of the present study was to evaluate the occupational exposure and biological monitoring of the personnel handling antineoplastic agents. Material and Methods: Forty-two subjects, all women, nonsmokers, with the mean age 33 years and the duration of the exposure to the cyclophosfamide (CP), ranged from 1 to 27 years were investigated. Twenty two subjects, all women, nonsmokers, with the age ranging from 21 to 57 years, without exposure to antineoplastic drugs were included in control group. The level of contamination by antineoplastic agents in drug preparation and administration areas in a cancer treatment hospital in Romania was determined by the analysis of the air samples, wipe samples and gloves. High volume samples were used to detect cyclophosphamide (CP) in the environment of the nurses who were involved in preparing antineoplastic agents. CP was detected with gas cromatography in tandem with mass spectrometry. Results and Discussions: Release of the CP was discovered in 3 drug-preparation sites. Five from 25 air samples were positive for CP, CP concentration ranging from 7 to 73.2 ng/mc. Two out of 15 pair of gloves, used during preparation of the drugs were contaminated with CP, CP concentration being 21 and respectively 130 ?g/pair of gloves). The floors in the administration rooms were contaminated with CP. Three from 15 samples were positive (medium: 5.5 ?g/cmp). In personal air samples, the CP concentration ranged up to 10.4 ?g/mc. Excretion of the CP in urine in nurses exposed to CP, who were involved in the preparation of CP during 10 week period was detected. The mean excretion of CP was 0.47 ?g/day (range: 0.38–25.5 ?g/l urine. Urinary thioethers excretion in nurses handling cytotoxic drugs was increased in comparison with the control group (16.7 mmol/mol creatinine versus to 6.3 mmol/mol creatinine. Conclusions: Environmental monitoring and biological monitoring have to used to measure environmental exposure and uptake, respectively. To further eliminate occupational exposure to cytostatic drugs is needed introduction of the special protective measures and safety guidelines.

Does Human Ochratoxin A Aggravate Proteinuria in Patients with Chronic Renal Disease?

Background. Ochratoxin A (OTA) is a nephrotoxic metabolite occurring in foodstuffs. In the last decade, OTA‐induced nephropathy in man and animals have been confirmed by previous literature. The correlation between OTA and the severity of CRI and nephrotic syndrome was also researched. Therefore, this study was designed to determine whether OTA also played an important role in renal insufficiency of patients with chronic renal diseases in Taiwan. Methods. The patients in this study were divided into nonnephrotic syndrome and nephrotic syndrome groups, first, to look for the relation between urine protein and OTA. And then these patients were also divided into six groups: (I) patients with chronic glomerulonephritis; (II) patients with chronic interstitial nephritis; (III) patients with diabetes mellitus; (IV) patients with hypertension; (V) patients with other diseases; (VI) patients with unknown reasons. For all groups, laboratory evaluation of kidney such as serum creatinine, urinary creatinine, creatinine clear rate, urinary protein, and urinary analysis were carried out coupled with determination of ochratoxin A level in urine. Results. Higher levels of OTA were found in patients with nephrotic syndrome. There was a significantly positive correlation (P < 0.001) between 24‐hr OTA and 24‐hr urine protein. On the other hand, the mean excretion of OTA in DM group (group III) was found significantly higher compared to the other groups (P < 0.05). Distinct differences (P < 0.01) were found especially when DM group was compared with patients with chronic glomerulonephritis (group I; P = 0.0019), patients with chronic interstitial nephritis (group II; P = 0.0032) and patients with hypertension (group IV; P = 0.0062). Conclusion. The results could lead to the conclusion that OTA could play an important role in proteinuria of patients with chronic renal diseases in Taiwan. And OTA may play a role in diabetes patients with nephropathy. Further longitudinal study is needed to clarify the role of OTA in diabetic nephropathy.