Early individualised parenteral nutrition for preterm infants

Considerable effort should be made to optimise parenteral nutrition of preterm infants in order to limit the development of postnatal growth restriction. A monocentric before-and-after study design was used to determine the effects of computerising parenteral nutrition ordering on the composition of parenteral nutrition (PN) solutions and early clinical outcomes of preterm infants born < or =28 weeks of gestation. Parenteral protein intake during the first week of life and parenteral lipid, glucose and energy intakes during the first and second week of life were significantly higher in infants assessed after the introduction of computerised parenteral nutrition ordering. This led to a significant reduction in the cumulative energy deficit over the first 28 days of life and to an improvement in both early growth and pulmonary outcome. Computerising the PN ordering process improves the nutrient content of the PN solutions and early postnatal outcome.     

Modulation of CYP1A1 activity by a Ginkgo biloba extract in the human intestinal Caco-2 cells

Ginkgo biloba is a widely consumed dietary supplement. Some dietary active compounds modulate the activity of biotransformation enzymes inside the enterocytes and more interestingly of cytochrome P-450 1A1 (CYP1A1). This enzyme is of a particular interest because of its implication in the metabolism of some exogenous pro-carcinogens or endogenous molecules. In the present work, we have used Caco-2 cells to study the effect of a standard reference material of a Ginkgo biloba extract (GBE) (10-400 μg/ml), as well as of its major individual active compounds (kaempferol, quercetin, isorhamnetin, ginkgolides and bilobalide), alone or in mixtures, at realistic intestinal concentrations, on the induction of CYP1A1 activity, in the presence or absence of benzo[a]pyrene (B[a]P) (0.1 μg/ml), a well-known CYP1A1 inducer. 3-O-rutinosides of kaempferol, quercetin and isorhamnetin were also tested. We have demonstrated a strong induction (p < 0.005) of CYP1A1 activity and a slight, but significant (p < 0.005), decrease of this activity in the presence of B[a]P by the GBE at the realistic exposure level of 100 μg/ml. The inductive effect was explained, in part, by quercetin and kaempferol after 24 h exposure while unknown compounds seem to be responsible for the strong CYP1A1 induction observed after 6 h exposure. The inhibitory potency of flavonols on CYP1A1 activity in presence of B[a]P was much stronger for the aglycones than for the 3-O-rutinosides, explaining the slight effect observed with the GBE, mainly composed of glycosylated flavonoids. These results indicate that GBEs may disturb intestinal CYP1A1 activity and, in turn, affect the metabolism of other compounds. The present paper thus highlights the necessity to take these side effects into account when administrating Ginkgo biloba herbal supplements.     

Can subthalamic nucleus stimulation reveal parkinsonian rest tremor?

INTRODUCTION: Rest tremor, one of the main symptoms in Parkinson's disease (PD), is dramatically improved following subthalamic nucleus stimulation (STN). Results are often better than after l-dopa treatment. The occurrence of rest tremor after neurosurgery in patients without preoperative tremor is uncommon. AIM: The aim of this work was to investigate the role of subthalamic nucleus stimulation in the appearance of parkinsonian rest tremor. PATIENTS-RESULTS: Thirty PD patients (14%) out of 215 undergoing STN deep brain stimulation had an akinetorigid form of the disease, without preoperative tremor 11 years after onset of the disease. Six of them experienced the appearance of tremor six months after bilateral STN stimulation when the stimulator was switched off in the Off medication state. This de novo parkinsonian tremor was improved by l-dopa treatment and disappeared when the stimulator was turned on. CONCLUSION: This finding suggests that infraclinical parkinsonian tremor is probably present in all PD patients.     

High intake of alcohol is associated with newly diagnosed diabetes in 60 years old men and women

Background and aimsLow or moderate alcohol intake has been found to be protective against the incidence of diabetes, while conflicting results have been found regarding high alcohol intake. This study aimed at evaluating the effect of alcohol intake on newly diagnosed diabetes among subjects aged 60 years in relation to anthropometric measurements, life-style and socio-economic factors.Methods and resultsA population-based cross-sectional study of 4106 individuals, 1973 men and 2133 women, aged 60 years, in Stockholm County, Sweden. Medical history, socio-economic factors and life-style data were collected by a questionnaire and a medical examination including laboratory tests. High total intake of alcohol, i.e. >30 g/day vs. 0–30 g/day, was significantly noted more often in newly diagnosed diabetes in men (OR 2.72, 95% CI 1.70–4.34), even when adjusting for other factors, i.e. anthropometric measurements, life-style, socio-economic and dietary factors (adjusted OR 1.94, 95% CI 1.17–3.23); a high intake of spirits, i.e. >15 g/day vs. 0–15 g/day, was significantly more often observed among women (OR 3.97, 95% CI 1.50–10.50), however, it was not significant after adjustment (OR 2.23, 95% CI 0.67–7.42).ConclusionHigh intake of alcohol among men was associated with increased risk of diabetes even when adjusting for other factors.     

Increased serum interferon alpha in HIV-1 associated lipodystrophy syndrome

BACKGROUND: A syndrome of lipodystrophy (LD) associated with peripheral lipoatrophy and central/visceral adiposity has been reported in HIV-1-infected patients treated by combined antiretroviral therapy (ART). Lipid metabolism is partly regulated by both steroid hormones and cytokines and we have previously reported that dyslipidaemia in LD-positive men is correlated to an increase in cortisol : DHEA ratio (Christeff et al., AIDS 1999;13:2251). In this study we questioned whether it is also related to cytokine perturbations. MATERIALS AND METHODS: A cross-sectional study was performed on 42 HIV-1-positive men on ART, 27 of whom had symptoms of LD, defined by computed tomography scan. Serum cytokines (IFN-alpha, TNF-alpha, sTNF-RI, sTNF-RII, IL-6, IL-1beta and IL-2) and lipids [cholesterol, triglycerides (TG) and their subclasses], and apolipoproteins (Apo), were determined. RESULTS: Serum IFN-alpha was markedly increased in LD-positive compared with LD-negative men and controls. IL-6 and TNF-alpha concentrations were also significantly elevated in HIV-positive men compared to controls but the levels of these cytokines did not differ between the two groups of patients. A significant positive correlation was found between accumulation of IFN-alpha and increased levels of cholesterol, TG, VLDL cholesterol, VLDL TG, ApoB and ApoB-ApoA1 ratio. A multivariate forward-performed analysis revealed that IFN-alpha is the best marker for lipid perturbations associated to LD, followed by insulin and cortisol : DHEA ratio. CONCLUSIONS: This study demonstrates an association between serum IFN-alpha and lipid alterations in LD-positive men. The concomittant action of IFN-alpha and cortisol : DHEA ratio is probably one of the mechanisms responsible for hyperlipidaemia in LD syndrome.