Nutritional status and nutrient adequacy against serum prolactin levels in lactating mothers during the COVID-19 pandemic

The COVID-19 pandemic is creating global disruption, every area of life is touched. One area that has an impact, is breastfeeding, which is caused by nutritional status and nutrient adequacy during the pandemic, this condition affects prolactin release. Prolactin hormone stimulates and initiatiates of milk secretion. Midwives employed in maternal-child settings play a pivotal role in facilitating and supporting lactating mothers. This study aimed to identify and analyze the nutritional status and nutrient adequacy against serum prolactin levels in lactating mothers during the COVID-19 pandemic. Sixty lactating mothers from Sleman Regency and Yogyakarta city participated in this cross-sectional study. All were between 0-3 postpartum months. A single blood sample was collected from women at 7-9 am. Serum samples were stored at 2-8⁰C before the prolactin assay by using VIDAS®. Data analysis using Kruskal Wallis followed by Post-Hoc Mann Whitney. Results found a statistically significant difference in serum prolactin levels between underweight vs normoweight and normoweight vs overweight (p0.05), but there was no significant difference in serum prolactin levels between underweight vs overweight (p0.05). Significant differences in serum prolactin levels also found in the nutrient adequacy (energy, carbohydrate, protein, and fat) (p 0.05). Thus, normoweight and adequate macronutrient during breastfeeding in the COVID-19 pandemic situation had better serum prolavtin levels than underweight, overweight and inadequate macronutrient.

RF9 Rescues Cortisol-Induced Repression of Testosterone Levels in Adult Male Macaques

Cortisol inhibits hypothalamic-pituitary-gonadal (HPG) axis whereas RF9, a potent agonist of kisspeptin receptor (GPR54) activates HPG-axis during fasting-induced stress and under normal physiological conditions. However, the effect of RF9 on the cortisol-induced repressed HPG-axis is not studied yet. This study investigated whether exogenous cortisol-induced repression of the HPG-axis can be rescued by RF9. Six intact adult male rhesus monkeys (Macaca mulatta) habituated to chair-restraint were administered hydrocortisone sodium succinate at a rate of 20 mg/kg of body weight (BW) per day for 12 days. Single blood sample was taken by venipuncture from each animal on alternate days for hormones analyses. On experimental day 12, hydrocortisone treated monkeys received a single intravenous bolus of RF9 (n = 3) and vehicle (n = 3). The animals were bled for a period of 4 h at 60 min intervals from an indwelling cannula in the saphenous vein. RF9 was administered intravenously at the dose of 0.1 mg/kg BW immediately after taking 0 min sample. Plasma cortisol and testosterone concentrations were measured by using specific enzyme immunoassays. Hydrocortisone treatment increased plasma cortisol levels (P ≤ 0.0001) and decreased plasma testosterone (P ≤ 0.0127) levels. Interestingly, compared to vehicle, RF9 treatment significantly increased plasma testosterone levels at 120 min (P ≤ 0.0037), 180 min (P ≤ 0.0016), and 240 min (P ≤ 0.0001) intervals in the hydrocortisone treated monkeys. From these results, we concluded that RF9 administration relieves the suppressed HPG-axis in term of plasma testosterone levels in the cortisol treated monkeys.

Blood Parasites in Endangered Wildlife-Trypanosomes Discovered during a Survey of Haemoprotozoa from the Tasmanian Devil

The impact of emerging infectious diseases is increasingly recognised as a major threat to wildlife. Wild populations of the endangered Tasmanian devil, Sarcophilus harrisii, are experiencing devastating losses from a novel transmissible cancer, devil facial tumour disease (DFTD); however, despite the rapid decline of this species, there is currently no information on the presence of haemoprotozoan parasites. In the present study, 95 Tasmanian devil blood samples were collected from four populations in Tasmania, Australia, which underwent molecular screening to detect four major groups of haemoprotozoa: (i) trypanosomes, (ii) piroplasms, (iii) Hepatozoon, and (iv) haemosporidia. Sequence results revealed Trypanosoma infections in 32/95 individuals. Trypanosoma copemani was identified in 10 Tasmanian devils from three sites and a second Trypanosoma sp. was identified in 22 individuals that were grouped within the poorly described T. cyclops clade. A single blood sample was positive for Babesia sp., which most closely matched Babesia lohae. No other blood protozoan parasite DNA was detected. This study provides the first insight into haemoprotozoa from the Tasmanian devil and the first identification of Trypanosoma and Babesia in this carnivorous marsupial.

A New Oral Testosterone Undecanoate Formulation Restores Testosterone to Normal Concentrations in Hypogonadal Men

Context A novel formulation of oral testosterone (T) undecanoate (TU) was evaluated in a phase 3 clinical trial. Objective Determine efficacy, short-term safety, and alignment of new oral TU formulation with current US approval standards for T replacement therapy. Design Randomized, active-controlled, open-label study. Setting and Patients Academic and private clinical practice sites; enrolled patients were clinically hypogonadal men 18 to 65 years old. Methods Patients were randomized 3:1 to oral TU, as prescribed (JATENZO®; n = 166) or a topical T product once daily (Axiron®; n = 56) for 3 to 4 months. Dose titration was based on average T levels (Cavg) calculated from serial pharmacokinetic (PK) samples. T was assayed by liquid chromatography–mass spectrometry/mass spectrometry. Patients had 2 dose adjustment opportunities prior to final PK visit. Safety was assessed by standard clinical measures, including ambulatory blood pressure (BP). Results 87% of patients in both groups achieved mean T Cavg in the eugonadal range. Sodium fluoride-ethylenediamine tetra-acetate plasma T Cavg (mean ± standard deviation) for the oral TU group was 403 ± 128 ng/dL (~14 ± 4 nmol/L); serum T equivalent, ~489 ± 155 ng/dL (17 ± 5 nmol/L); and topical T, 391 ± 140 ng/dL (~14 ± 5 nmol/L). Modeling/simulation of T PK data demonstrated that dose titration based on a single blood sample 4 to 6 h after oral TU dose yielded efficacy (93%) equivalent to Cavg-based titration (87%). Safety profiles were similar in both groups, but oral TU was associated with a mean increase in systolic BP of 3 to 5 mm Hg. Conclusion A new oral TU formulation effectively restored T to mid-eugonadal levels in hypogonadal patients.

Correlation between Cyclosporine Blood Levels and Area under Blood Concentration Time Curve in Iraqi Bone Marrow Transplant Patients Treated with Neoral® Oral Solution

Cyclosporine is a potent immunosuppressive drug. It has a narrow therapeutic index, and therefore the measurement of cyclosporine’s blood concentration is essential to obtain optimal therapy. Measurement of the area under the blood concentration-time curve (AUC) is reflective of total drug exposure. However, for organ transplant patients, the measurement of AUC involves many problems and difficulties. Thus, it is more clinically acceptable to use a single blood sample as a surrogate index of total drug exposure. Fifty-four adults bone marrow transplant Iraqi patients were given cyclosporine every 12 h as prophylaxis using Neoral® oral solution. Steady-state blood concentrations were monitored for each patient at zero time and then at 1, 2, 3, 4, 6, 8, 10, and at 12 h post-dosing. Cyclosporine blood levels were determined by using AXSYM automated immuno-analyzer which is a fluorescence polarization immunoassay (FPIA). The present investigation demonstrated the best correlation between C2 and the corresponding AUC0–4h and AUC0–12h compared to other concentrations. After two months of cyclosporine therapy, no unexpected biochemical changes and adverse effects were registered. It is concluded from this study that a single blood sample obtained at 2 h post-dosing (C2) and possibly at 3 h post dosing (C3) are ideal surrogate indexes for reflecting total drug exposure, and therefore may be used in clinical practice for predicting therapeutic and toxic effects of cyclosporine.

Effect of Vitamin D level on growth velocity of RHGH treated children

Objective Recent studies have shown a relationship between vitamin D status, growth hormone and insulin-like growth factor 1 axis. Aims of the study are: 1- To evaluate the vitamin-D blood level in children on substitution treatment with rhGH. 2. To find out correlation between the vitamin D level and growth velocity with rhGH therapy, height, height SDS, height/height SDS after 1 year of treatment Methods The study included 173 prepubertal children, with short stature on treatment with rhGH (90 girls and 81 boys), aged between 2 and 10.3 years. To determine vitamin D status we measured serum 1,25-OH vitamin D by taking a single blood sample in the morning, in a fasting stage. Growth velocity over the year of observation, starting height, height SDS, height at the end of the year and its SDS all were calculated and correlated to vitamin D level. Results In the present study: 56 patients had vitamin D deficiency (<10 ng/ml); 54 had vitamin D insufficiency (10–20 ng/ml) and 63 had vitamin D sufficiency (>20 ng/ml). No statistical significance correlation was found between vitamin D level and height, height SDS, follow up height, and follow up height SDS (P.09, .066, .455, .927 respectively) Significant positive correlation was found between vitamin D and growth velocity (r .445 and P.0001). Conclusions Optimizing vitamin D level in patients with short stature under growth hormone therapy may improve growth velocity and response to growth hormone.