Urea production in normal breast-fed infants measured with primed/intermittent oral doses of [15N,15N]urea

Urea kinetics were measured on 11 occasions in six normal, breast-fed infants aged 29-88 days. Prime and intermittent oral doses of [¹⁵N,¹⁵N]urea with measurement of enrichment of urea in urine were used. The rate at which urea appeared in the urea pool was 265 mg N/kg per hour, 85% of which derived from endogenous production and 15% from the diet. Urinary excretion of urea was 87 mg N/kg per hour. Therefore, 60% of the urea entering the pool each day was hydrolysed by the metabolic activity of the colonic microflora and the nitrogen was made available for further metabolic interaction. The rate of urea appearance and the extent to which urea nitrogen was salvaged were greater in infants under 6 weeks than in those over 6 weeks, indicating that urea kinetics is a more active process at an early age, and slows with time. With respect to factors influencing urea kinetics, the apparently conflicting results which have appeared in the literature may be explained. The results may help explain the growth of breast-fed infants on low protein intakes.     

Effect of Traditional Food on Nutrition Improvement of Iranian Tribeswomen

In most developing countries, women receive less food than men, both in absolute terms and in relation to their nutritional needs. However, they spend more time in total productive work than men. One way to supplement women’s nutritional needs is to use locally accessible and sustainable food commonly known as “traditional food.” To examine this concept, 481 household members from 48 subtribes of Iranian tribes in Fars province were recruited. A simple and low cost package was designed and prepared with available local foods. The nutrient value of the package was described to influential members of the community including elders, schoolteachers, formally educated girls and parents. The supplementary package contained 322.6 Kcal, 14.05 g protein, 351.2 mg calcium, 487.2 μg vitamin A, and 42.7 mg vitamin C. Using the supplementary food package increased the tribeswomen’s body mass index (BMI) significantly (P < 0.01). This finding suggests that use of traditional food can positively improve mothers’ nutritional status.     

Curcuminoids Modulate Pro‐Oxidant–Antioxidant Balance but not the Immune Response to Heat Shock Protein 27 and Oxidized LDL in Obese Individuals

Curcuminoids have potentially important functional qualities including anti‐inflammatory and antioxidant properties. In this randomized double‐blind placebo‐controlled cross‐over trial, the effects of a curcuminoid supplement on serum pro‐oxidant–antioxidant balance (PAB) and antibody titres to Hsp27 (anti‐Hsp27) and oxLDL (anti‐oxLDL) were investigated. Thirty obese individuals were randomized to receive either curcuminoids (1 g/day) or placebo for a period of 30 days. After a wash‐out period of 2 weeks, subjects were crossed over to the alternate regimen for another 30 days. Serum PAB along with anti‐Hsp27 and anti‐oxLDL titres was measured at the beginning and at the end of each study period. There was no significant carry‐over effect for any of the assessed parameters. Curcuminoid supplementation was associated with a significant decrease in PAB (p = 0.044). However, no significant change was observed in serum concentrations of anti‐Hsp27 or anti‐oxLDL (p > 0.05). These findings suggest that oral curcuminoids supplementation (1g/day) is effective in reducing oxidative stress burden, though this needs to be validated in larger study populations. Copyright © 2013 John Wiley & Sons, Ltd.     

Long‐term quality of life and cost‐effectiveness of treatment of partial thickness burns: A randomized controlled trial comparing enzyme alginogel vs silver sulfadiazine (FLAM study)

The clinical effectiveness and scar quality of the randomized controlled trial comparing enzyme alginogel with silver sulfadiazine (SSD) for treatment of partial thickness burns were previously reported. Enzyme alginogel did not lead to faster wound healing (primary outcome) or less scar formation. In the current study, the health‐related quality of life (HRQoL), costs, and cost‐effectiveness of enzyme alginogel compared with SSD in the treatment of partial thickness burns were studied. HRQoL was evaluated using the Burn Specific Health Scale‐Brief (BSHS‐B) and the EQ‐5D‐5L questionnaire 1 week before discharge and at 3, 6, and 12 months postburn. Costs were studied from a societal perspective (health care and nonhealth‐care costs) for a follow‐up period of 1 year. A cost‐effectiveness analysis was performed using cost‐effectiveness acceptability curves and comparing differences in societal costs and Quality Adjusted Life Years (QALYs) at 1 year postburn. Forty‐one patients were analyzed in the enzyme alginogel group and 48 patients in the SSD group. None of the domains of BSHS‐B showed a statistically significant difference between the treatment groups. Also, no statistically significant difference in QALYs was found between enzyme alginogel and SSD (difference ?0.03; 95% confidence interval [CI], ?0.09 to 0.03; P = .30). From both the health care and the societal perspective, the difference in costs between enzyme alginogel and SSD was not statistically significant: the difference in health‐care costs was €3210 (95% CI, €‐1247 to €7667; P = .47) and in societal costs was €3377 (95% CI €‐6229 to €12 982; P = .49). The nonsignificant differences in costs and quality‐adjusted life‐years in favor of SSD resulted in a low probability (<25%) that enzyme alginogel is cost‐effective compared to SSD. In conclusion, there were no significant differences in quality of life between both treatment groups. Enzyme alginogel is unlikely to be cost‐effective compared with SSD in the treatment of partial thickness burns.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.     

Effects of metoprolol on mortality and late infarction in diabetics with suspected acute myocardial infarction. Retrospective data from two large studies

From two large scale studies in patients with suspected acutemyocardial infarction we report the outcome in diabetics aftertreatment with either metoprolol or placebo. In the GoteborgMetoprolol Trial mortality at 3 months was reduced by metoprololfrom 17.9% to 7.5% and late infarction was reduced from 16.4%to 3.8%. In the MIAMI Trial, mortality was decreased by metoprololfrom 11.3% to 5.7% and the occcurence of late infarction wasdecreased from 4.5% to 31% during 15-day follow-up. Comparedwith the overall results, the effect of metoprolol on mortalityappears particularly impressive in diabetics.