Use of Ultrasonography for Lung Transplant Recipients on Postoperative Care

The authors report their findings regarding lung ultrasound profiles in a population of transplant recipients. Twenty‐two patients were studied once each in multiple different ultrasound windows focusing on pleural, lung, and diaphragmatic signatures. All studies were performed in presumably otherwise healthy recipients at an outpatient follow‐up visit at least 3 months after transplantation. Those with recent pulmonary infections or decline in lung function were excluded from enrollment. The majority of scans revealed otherwise normal lungs with lung sliding, but there were more abnormalities than one would expect in a healthy control group. Lung ultrasonography will likely never replace other cross‐sectional imaging given its inherent visual limitations but adds another modality to interrogate the lung/pleural interface and diaphragmatic function.     

Nutritional Interventions to Improve Asthma-Related Outcomes through Immunomodulation: A Systematic Review

Asthma is a chronic inflammatory disease of the airways, characterized by T-helper (Th) 2 inflammation. Current lifestyle recommendations for asthma patients are to consume a diet high in fruits and vegetables and to maintain a healthy weight. This raises the question of whether other nutritional interventions may also improve asthma-related outcomes and whether these changes occur via immunomodulation. Therefore, we systematically reviewed studies that reported both asthma-related outcomes as well as immunological parameters and searched for relations between these two domains. A systematic search identified 808 studies, of which 28 studies met the inclusion criteria. These studies were divided over six nutritional clusters: herbs, herbal mixtures and extracts (N = 6); supplements (N = 4); weight loss (N = 3); vitamin D3 (N = 5); omega-3 long-chain polyunsaturated fatty acids (LCPUFAs) (N = 5); and whole-food approaches (N = 5). Fifteen studies reported improvements in either asthma-related outcomes or immunological parameters, of which eight studies reported simultaneous improvements in both domains. Two studies reported worsening in either asthma-related outcomes or immunological parameters, of which one study reported a worsening in both domains. Promising interventions used herbs, herbal mixtures or extracts, and omega-3 LCPUFAs, although limited interventions resulted in clinically relevant results. Future studies should focus on further optimizing the beneficial effects of nutritional interventions in asthma patients, e.g., by considering the phenotypes and endotypes of asthma.     

The Baseline Serum Lipoprotein Profile Is Related to Plant Stanol Induced Changes in Serum Lipoprotein Cholesterol and Triacylglycerol Concentrations

Objective: Baseline characteristics of subjects might be related to the effect of plant stanols on the serum lipoprotein profile. The aim of the study was to examine effects of subjects’ baseline characteristics (baseline serum concentrations of lipids and lipoproteins at the start of the study, lathosterol, campesterol and sitosterol; gender, age, BMI, smoking, use of oral contraceptives and menopause) on the effects of plant stanol esters on the serum lipoprotein profile.

Methods: We used data of five studies performed at our Department. A random intercept model was used for statistical analysis, using serum lipid and lipoprotein concentrations after plant stanol ester consumption, as dependent variables.

Results: After plant stanol ester consumption, higher baseline serum concentrations of total and LDL cholesterol resulted in larger absolute decreases in their respective serum concentrations. For the ratio of total to HDL cholesterol and triacylglycerol, higher baseline serum levels resulted in larger absolute and relative decreases in their serum levels. HDL cholesterol concentrations increased in subjects with low baseline concentrations and decreased in those with high baseline concentrations. Effects however were small. No relationships were observed with baseline serum cholesterol-standardized lathosterol and campesterol concentrations, although LDL cholesterol concentrations tended to decrease more at higher baseline sitosterol concentrations. No effects of other baseline characteristics were found.

Conclusions: People with an unfavorable serum lipid and lipoprotein profile benefit even more of plant stanols than people with a more favorable profile.     

Long-term plant stanol and sterol ester-enriched functional food consumption, serum lutein/zeaxanthin concentration and macular pigment optical density

Observational epidemiological studies have shown that low carotenoid intake and/or low carotenoid blood levels increase the risk of degenerative diseases like age-related macular degeneration. Functional foods enriched with plant sterol or stanol esters may lower serum concentrations of fat-soluble carotenoids. Theoretically, as a result the macular pigment optical density (MPOD), a marker for eye health, may change. We carried out a double-blind placebo-controlled human intervention trial with a duration of 18 months to evaluate the possible effects of plant stanol and sterol esters on serum lutein/zeaxanthin concentration in relation to the MPOD. Forty-seven subjects were randomly assigned to one of the three treatment groups: margarine without added plant sterols or stanols, plant sterol-enriched margarine, or plant stanol-enriched margarine. Serum cholesterol and lutein/zeaxanthine concentrations and the MPOD were evaluated at baseline and at study end. Changes in lipid-adjusted serum lutein/zeaxanthine concentrations between baseline and study end differed significantly between the three groups (P = 0.001). We found no differences in the MPOD between the three treatment groups, despite the differences in both absolute and cholesterol-standardized serum lutein/zeaxanthine concentrations. This shows that the observed reduction in serum carotenoid concentrations during 18 months consumption of these functional foods does not affect MPOD.     

Antisaccade task performance in patients at ultra high risk for developing psychosis

Patients with schizophrenia consistently perform worse than healthy controls on the antisaccade task in which the subject is required to inhibit a reflexive saccade to a suddenly appearing visual target and look in the opposite direction. To our knowledge there is no research yet showing how patients at ultra high risk (UHR) for developing psychosis perform on the antisaccade task. The aim of the present study was to investigate antisaccade task performance in UHR patients. Patients were eligible for the study when they met criteria for one or more of the following groups: Attenuated symptoms or brief limited intermitted psychotic symptoms or a first-degree family member with a psychotic disorder and reduced functioning or basic symptoms. In 35 UHR patients we assessed antisaccades, neuropsychological test performance and symptomatology. Antisaccade task results were compared with those obtained in 42 age- and intelligence-matched patients with recent-onset schizophrenia and 28 matched healthy controls. Antisaccade error rate was significantly higher in the UHR patients than in the controls. Schizophrenia patients performed worse than the UHR patients and the control subjects. We found a trend towards higher antisaccade error rate at baseline in the UHR patients who later made the transition to psychosis compared to the UHR patients who did not make the transition to psychosis. Poor spatial working memory function was related to increased antisaccade errors in the UHR group. Abnormal antisaccade task performance is also present in patients at UHR for developing psychosis. Subsequent research needs to clarify if increased antisaccade error rate is predictive of a psychotic episode. In UHR patients, poor antisaccade performance may reflect working memory dysfunction.     

Level of glycogen stores and amount of ingested glucose regulate net carbohydrate storage by different mechanisms

The respective effects of the level of glycogen stores and the size of the glucose load on the pathways of carbohydrate (CHO) metabolism were compared over the 5-hour period following glucose ingestion in normal human subjects. For this purpose, labeling of the oral glucose load with [3-(3)H]- and [U(14)C] glucose was combined with indirect calorimetry. In group I, 75 g glucose was given to subjects who had either been "fed" with intravenous (IV) glucose or fasted for 13, 24, or 36 hours, or 4 days. In fed versus 4-day-fasted subjects, net CHO storage averaged approximately 15 versus 63 g/5 h (P <.001). About 83% of the increase in fasted subjects was due to suppression of glycogen breakdown, with only minimal stimulation of glycogen synthesis from oral glucose. Over the whole range of nutritional conditions tested, a strong positive correlation existed between basal CHO oxidation and glycogen breakdown occurring during the oral glucose tolerance test (OGTT), suggesting that the initial degree of repletion of hepatic glycogen stores is a major determinant of postprandial glycogen turnover. In group II, OGTTs with 33 and 100 g glucose were compared in 13-hour-fasted subjects. Net storage rose from approximately -6 to approximately 37 g/5 h (P <.001) solely because of an increase in glycogen synthesis with no inhibition of glycogen turnover. Overall, these results show that the initial dietary state and the size of the glucose load modulate postprandial net CHO accumulation by different mechanisms.     

Post-genomic opportunities for understanding nutrition: the nutritionist's perspective

Until 15-20 years ago, many nutritionists were mainly interested in the effects of diet on health-related variables such as blood pressure and serum cholesterol concentrations. Without doubt, these studies have made an important contribution to our current understanding of the relationship between diet and health. For many reasons, however, few researchers have tried to explain these effects at the molecular level. Nowadays, however, it seems that the picture has been reversed; much research is being directed towards studying the effects of dietary components at the molecular level. This type of research has been made possible by, among other factors, the implementation of techniques from the more fundamental sciences into nutrition research. Also, the availability of genome sequences has accelerated this shift of interest. The aims of these studies are to obtain detailed information on the molecular and metabolic responses of cells and tissues, or even the whole organism, to dietary components. In these studies, also, the interactions between diet and genetic background, and between diet and different physiological and pathological conditions need to be addressed. However, it is not only important to obtain information on mechanisms, but also on the functional consequences for the organism. One ultimate question, however, is whether this information can be used to develop tests that can form the basis of dietary advice for specific subpopulations. These challenging questions can only be tackled through an integrated approach that combines the expertise from various disciplines.