scholarly journals Impact of Two Forms of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Hair Cortisol Concentrations Among Rural Laotian Children: A Randomized Controlled Trial

Nutrients ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 47 ◽  
Author(s):  
Guy-Marino Hinnouho ◽  
Robin Bernstein ◽  
Maxwell Barffour ◽  
Charles Arnold ◽  
K. Wessells ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Stress ◽  
Zinc Supplementation ◽  
Controlled Trial ◽  
Hair Cortisol ◽  
Linear Regression Models ◽  
Double Blind ◽  
Morbidity Burden ◽  
Factors Associated ◽  
The Impact

Zinc supplementation has been shown to reduce the morbidity burden among young children, and may reduce chronic stress. Hair cortisol has been promoted as an indicator of chronic stress. We assessed the impact of different strategies for delivering supplementary zinc on hair cortisol concentrations (HCC) in young Laotian children and examined risk factors associated with HCC. In a randomized double-blind controlled trial (NCT02428647), children aged 6–23 mo were randomized to one of four intervention groups and followed for ~36 weeks: daily preventive zinc (PZ) tablets (7 mg/day), daily multiple micronutrient powder (MNP) sachets (containing 10 mg zinc and 14 other micronutrients), therapeutic zinc (TZ) supplements for diarrhea treatment (20 mg/day for 10 days) or daily placebo powder. HCC of 512 children was assessed at baseline and endline. ANCOVA and linear regression models were used to assess group differences in HCC and to examine the risk factors associated with HCC, respectively. At enrollment, mean HCC was 28.8 ± 43.9 pg/mg. In models adjusted for age at enrollment, health district, and baseline HCC there was no overall effect of the interventions on endline HCC and change in HCC. When controlling for additional predetermined covariates, there was a marginally significant effect on change in HCC (p = 0.075) with a slightly lower reduction of HCC in TZ compared to PZ (mean change (95% CI): −4.6 (−7.0; −2.3) vs. −9.4 (−11.7; −7.0) pg/mg; p = 0.053). At baseline, consumption of iron rich foods was negatively associated with HCC, whereas AGP (α1-acid glycoprotein) levels, elevated AGP and C-reactive protein and high soluble transferrin receptor were positively associated with HCC. In young Laotian children, MNP, PZ and TZ had no impact on HCC. The marginal difference in change in HCC between the PZ and TZ groups was too small to be considered of health significance.

scholarly journals Study protocol for a double-blind randomised controlled trial investigating the impact of 12 weeks supplementation with aFucus vesiculosusextract on cholesterol levels in adults with elevated fasting LDL cholesterol who are overweight or have obesity

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022195 ◽  
Author(s):  
Margaret Murray ◽  
Aimee L Dordevic ◽  
Katherine H M Cox ◽  
Andrew Scholey ◽  
Lisa Ryan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Prevention ◽  
Controlled Trial ◽  
Venous Blood ◽  
Brown Seaweed ◽  
Density Lipoprotein ◽  
Seaweed Extract ◽  
Double Blind ◽  
Markers Of Inflammation ◽  
The Impact

IntroductionHyperlipidaemia, hyperglycaemia and chronic inflammation are risk factors for chronic diseases cardiovascular disease and type 2 diabetes. Polyphenols are bioactive compounds found in marine algae with potential antihyperlipidaemic, antihyperglycaemic and anti-inflammatory effects. The modulation of these risk factors using bioactive polyphenols may represent a useful strategy for disease prevention and management; research in humans, however, remains limited. This trial aims to determine the impact of a polyphenol-rich brown seaweed extract on fasting hyperlipidaemia, hyperglycaemia and inflammation. Effects on mood and cognition will also be evaluated.Methods and analysisFifty-eight hypercholesterolaemic participants who are overweight or have obesity will be randomised to receive either a polyphenol-rich brown seaweed extract (2000 mg dose containing 600 mg polyphenols) or placebo (2000 mg rice flour) daily for 12 weeks. Fasting venous blood samples will be taken at baseline, week 6 and week 12 of the intervention to assess serum cholesterol (total, low-density lipoprotein and high-density lipoprotein) and triglyceride concentrations, plasma glucose and insulin concentrations and markers of inflammation. Mood and cognitive function will be evaluated as exploratory outcomes. Independent t-tests or equivalent will be used to determine differences between the two groups in changes from baseline to week 12. Analysis of variance will be used to assess differences between the groups across the three time points (baseline, week 6 and week 12).Ethics and disseminationEthics approval has been granted by the Monash University Human Research Ethics Committee (2017-8689-10379). Results from this trial will be disseminated through publication in peer-reviewed journals, national and international presentations, and a PhD thesis. These results are essential to inform the use of polyphenol-rich brown seaweeds as a functional food or nutritional supplement ingredients for health promotion and disease prevention and management in humans.Trial registration numberACTRN12617001039370; Pre-results.

scholarly journals A randomised controlled trial investigating the effects of administering a non-steroidal anti-inflammatory drug to beef calves assisted at birth and risk factors associated with passive immunity, health, and growth

2019 ◽  
Vol 6 (1) ◽  
pp. e000364 ◽  
Author(s):  
Jennifer M Pearson ◽  
Edward Pajor ◽  
John Campbell ◽  
Michel Levy ◽  
Nigel Caulkett ◽  
...  
Keyword(s):  
Risk Factors ◽  
Controlled Trial ◽  
Average Daily Gain ◽  
Tube Feeding ◽  
Passive Immunity ◽  
Beef Calves ◽  
Factors Associated ◽  
Serum Igg ◽  
Increased Risk ◽  
The Impact

BackgroundThe objectives of this study were to investigate the impact of pain mitigation at birth to assisted beef calves and determine the risk factors associated with transfer of passive immunity (TPI), health, and growth.MethodsTwo hundred and thirty cow–calf pairs requiring calving assistance were enrolled. Calves were randomised to receive meloxicam (0.5 mg/kg) or an equivalent volume of placebo subcutaneously at birth. Calf blood samples were collected between one and seven days of age to determine serum immunoglobulin (IgG) concentration. Colostrum intake, treatment for disease, mortality, and weaning weights were recorded. Multilevel linear or logistic regression models were used to determine the effects of meloxicam and to identify risk factors.ResultsThere was no effect of meloxicam on serum IgG concentrations, average daily gain (ADG), or risk of inadequate TPI (serum IgG concentration <24 g/l), treatment for disease, or mortality (P>0.05). Bottle or tube feeding calves were associated with decreased serum IgG concentrations (P=0.01) compared with nursing. Calves with an incomplete tongue withdrawal reflex had higher odds of being treated for disease compared with those with complete withdrawal (P=0.009). Being born meconium-stained and having decreased serum IgG concentrations were associated with an increased risk of mortality (P=0.03). Being born of a mature cow, having a higher birth weight, and increased serum IgG concentrations were associated with greater ADG to weaning (P<0.05).ConclusionVigour assessment at birth along with good colostrum management may be important to improve TPI and health in high-risk calves such as those assisted at birth.

scholarly journals Impact of Preventive and Therapeutic Zinc Supplements on Citrulline Concentration and the kynurenine: tryptophan Ratio Among Lao Children: A Randomized Controlled Trial (OR07-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
K Ryan Wessells ◽  
Guy-Marino Hinnouho ◽  
Maxwell Barffour ◽  
Somphou Sayasone ◽  
Charles Arnold ◽  
...  
Keyword(s):  
Linear Growth ◽  
Controlled Trial ◽  
Plasma Concentrations ◽  
Intestinal Function ◽  
Linear Regression Models ◽  
Double Blind ◽  
Randomized Controlled ◽  
Zinc Supplements ◽  
The Impact ◽  
Parent Trial

Abstract Objectives To investigate the impact of different forms of zinc supplementation on plasma citrulline (CIT), kynurenine (KYN) and tryptophan (TRP) concentrations and the kynurenine: tryptophan ratio (KTR), considered as markers of intestinal function and systemic inflammatory response, among young Lao children. Methods In a randomized controlled double-blind trial, 3407 children aged 6–23 mo were randomized into one of four groups and followed for ∼36 weeks: daily preventive zinc dispersible tablet (7 mg zinc; PZ), daily multiple micronutrient powder (10 mg zinc, 6 mg iron and 13 other micronutrients; MNP), therapeutic zinc supplements for the treatment of diarrhea (20 mg/d for 10 days with each diarrhea episode; TZ), or daily placebo powder (Control). Plasma samples at baseline and endline for 359 children participating in the parent trial were analyzed at the NIH West Coast Metabolomics Center (UC Davis); plasma CIT, KYN and TRP concentrations were determined by hydrophilic interaction chromatography (HILIC) quadrupole time of flight mass spectrometer (QTOF) tandem mass spectrometry (MS/MS). Linear regression models were used to assess the treatment effect, controlling for baseline value, child age and district. Results The parent trial found no overall group-wise effects on linear growth or diarrhea outcomes. In the subgroup included in the present analyses, mean age at enrollment was 16.0 ± 4.9 mo, 37% were stunted and 83% were zinc deficient. At baseline, mean plasma CIT, KYN and TRP concentrations were 24.6 ± 5.4 µM, 3.27 ± 0.83 µM and 72.3 ± 12.9 µM, respectively; the mean KT ratio was 0.046 ± 0.013. 5% of children had low CIT (< 17 µM) and no children had low TRP (< 35 µM). At endline, there were no differences among intervention groups in mean plasma CIT (25.0–26.6 µM, P = 0.287), KYN (2.96–3.11 µM, P = 0.115), TRP (66.1–70.0 µM, P = 0.151) or the KTR (0.046–0.047, P = 0.981). Conclusions In this population, PZ, MNP and TZ had no overall effect on plasma concentrations of CIT, KYN, TRP and the KTR. We plan to further explore if these markers of intestinal function were predictive of subsequent linear growth, or modified the growth response to supplementation. Funding Sources The Bill & Melinda Gates Foundation, Nutrition International and the Mathile Institute for the Advancement of Human Nutrition.

scholarly journals Effects of Different Strategies for Delivering Supplemental Zinc on Selected Fecal Markers of Environmental Enteric Dysfunction Among Young Laotian Children (P04-012-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Guy-Marino Hinnouho ◽  
K Ryan Wessells ◽  
Maxwell Barffour ◽  
Somphou Sayasone ◽  
Charles Arnold ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Geometric Mean ◽  
Physical Growth ◽  
Linear Regression Models ◽  
Double Blind ◽  
Funding Sources ◽  
Supplemental Zinc ◽  
Zinc Supplements ◽  
Gates Foundation ◽  
The Impact

Abstract Objectives To assess the impact of different strategies for delivering supplemental zinc on fecal myeloperoxidase (MPO), neopterin (NEO) and calprotectin (CAL) among young Laotian children and explore modifying effects of MPO, CAL and NEO on growth Methods In a double-blind controlled trial, children 6–23 mo of age were randomized to receive either daily preventive zinc tablets (PZ; 7 mg/d), daily micronutrient powder sachets (MNP; containing 10 mg zinc and 14 other micronutrients), therapeutic zinc supplements for diarrhea treatment (TZ; 20 mg/d for 10 days) or daily placebo powder and followed for ∼36 weeks. Stool samples were collected at baseline and endline. Fecal MPO, NEO and CAL were determined in a randomly selected sub-sample of 720 children using commercially available ELISA kits. Linear regression models were used to assess main and modifying effects while controlling for baseline value, age and district Results The baseline prevalence of stunting was 39.3%, and there was no overall treatment effect on physical growth in the parent trial. At endline, geometric mean fecal MPO, NEO and CAL concentrations did not differ among the 4 groups (all P > 0.23). There was an effect modification by baseline concentrations of NEO and CAL on endline stunting (p for interaction = 0.01 and 0.02, respectively). Among children in the lowest quintile of NEO concentrations, there was a trend towards a higher stunting prevalence at endline in the TZ [47.1% (35.6, 58.7)] and the MNP [45.3% (32.7, 57.9)] groups compared to the PZ [33.6% (21.0, 46.3)] and the control [33.9% (22.8, 44.9)] groups. Similar results were found among children in the lowest quintile of CAL concentrations. Moreover, baseline concentration of CAL, modified the impact of the interventions on weight-for-height z-scores (WHZ) (p for interaction = 0.074). Among children in the lowest quintile of CAL concentrations, there was a trend towards a higher WHZ at endline in the MNP [−0.57 (−0.73, −0.42)] and TZ [−0.68 (−0.86, −0.51)] groups compared to the control [−0.79 (−0.97, −0.61)] and the PZ [−0.88 (−1.05, −0.72)] groups. Conclusions In this population of young Laotian children PZ, MNP and TZ had no overall impact on EED or growth, but intestinal function modified the growth response to supplementation suggesting its potential role in the pathways of growth impairment. Funding Sources Funded by the Bill & Melinda Gates Foundation, Nutrition International and the Mathile Institute for the Advancement of Human Nutrition.

scholarly journals Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Enterococcus faecium Infections

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 105
Author(s):  
Jatapat Hemapanpairoa ◽  
Dhitiwat Changpradub ◽  
Sudaluck Thunyaharn ◽  
Wichai Santimaleeworagun
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Proportional Hazards Model ◽  
Significant Risk ◽  
Vancomycin Resistance ◽  
Cox Proportional Hazards Model ◽  
Factors Associated ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
The Impact

The prevalence of enterococcal infection, especially E. faecium, is increasing, and the issue of the impact of vancomycin resistance on clinical outcomes is controversial. This study aimed to investigate the clinical outcomes of infection caused by E. faecium and determine the risk factors associated with mortality. This retrospective study was performed at the Phramongkutklao Hospital during the period from 2014 to 2018. One hundred and forty-five patients with E. faecium infections were enrolled. The 30-day and 90-day mortality rates of patients infected with vancomycin resistant (VR)-E. faecium vs. vancomycin susceptible (VS)-E. faecium were 57.7% vs. 38.7% and 69.2% vs. 47.1%, respectively. The median length of hospitalization was significantly longer in patients with VR-E. faecium infection. In logistic regression analysis, VR-E. faecium, Sequential Organ Failure Assessment (SOFA) scores, and bone and joint infections were significant risk factors associated with both 30-day and 90-day mortality. Moreover, Cox proportional hazards model showed that VR-E. faecium infection (HR 1.91; 95%CI 1.09–3.37), SOFA scores of 6–9 points (HR 2.69; 95%CI 1.15–6.29), SOFA scores ≥ 10 points (HR 3.71; 95%CI 1.70–8.13), and bone and joint infections (HR 0.08; 95%CI 0.01–0.62) were significant risk factors for mortality. In conclusion, the present study confirmed the impact of VR-E. faecium infection on mortality and hospitalization duration. Thus, the appropriate antibiotic regimen for VR-E. faecium infection, especially for severely ill patients, is an effective strategy for improving treatment outcomes.

Sign in / Sign up

Export Citation Format

Share Document