Glutathione S-transferases related to P. aeruginosa lung infection in cystic fibrosis children: preliminary study

ObjectivesIn cystic fibrosis (CF) children, we investigated the predictive impact of glutathione S-transferases (GST) activity and genotypes P1, M1 and T1, and antioxidant levels on stage-severity of Pseudomonas aeruginosa lung infection.MethodsGST activity was determined in whole blood by spectrophotometry, and GST genotypes by multiplex PCR RFLP for 36 CF and 9 control children. Levels of glutathione in erythrocyte and vitamins A, E and C in plasma were measured by HPLC.ResultsNo difference in GST activity and no relationship between GST activity and antioxidant levels were observed in CF children as compared to controls. However, GST activity was lower in CF children with severe clinical status and infection, and the frequency of GSTP1 wild type genotype AA, prevalent in uninfected CF children (75%), decreased in infected ones (33%).ConclusionGST activity and genotype could play an important role in modulating P. aeruginosa lung infection in CF patients.     

Transition Phase Nutrition Recommendations: A Missing Link in the Nutrition Management of Preterm Infants

Background: Despite the availability of international nutrition recommendations, preterm infants remain vulnerable to suboptimal nutrition. The standard approach of assessing nutrient intakes chronologically may make it difficult to identify the origin of nutrient deficits and/or excesses. Objective: To develop a “nutrition phase” approach to evaluating nutrition support, enabling analysis of nutrient intakes during the period of weaning from parenteral nutrition (PN) to enteral nutrition (EN), called the transition (TN) phase, and compare the data with those analyzed using the standard “chronological age” approach to assess whether the identification of nutrient deficits and/or excesses can be improved. Methods: Analysis of a comprehensive nutrition database developed using actual nutrient intake data collected on an hourly basis in 59 preterm infants (birth weight ≤1500 g, gestation <34 weeks) over the period of PN delivery (range, 2–21 days). Results: The nutrition phase analysis approach revealed substantial macronutrient and energy deficits during the TN phase. In particular, deficits were identified as maximal during the EN‐dominant TN phase (enteral feeds ≥80 mL/kg/d) of the infant’s nutrition course. In contrast, the chronological age analysis approach did not reveal a corresponding pattern of deficit occurrence but rather intakes that approximated or exceeded recommendations. Conclusion: Actual intakes of nutrients, analyzed using a nutrition phase approach to evaluating nutrition support, enabled a more infant‐driven rather than age‐driven application of nutrition recommendations. This approach unmasked nutrient deficits occurring during the transition phase. Overcoming nutrient deficits in this nutrition phase should be prioritized to improve the nutrition management of preterm infants.     

Relationships between acceptance of sour taste and fruit intakes in 18-month-old infants

The present study examined whether infants show an acceptance for extreme sour tastes and whether acceptance of sour taste is related to infants' fruit intake. Fruit intake of fifty-three infants at 6, 12 and 18 months was assessed using 3 d food records. Sour acceptance of these infants was studied at 18.1 (SD 1.5) months. Acceptance for four solutions differing in citric acid concentrations (0.00 M, 0.013 M, 0.029 M and 0.065 M) was measured by allowing infants ad libitum ingestion of each solution over brief time periods. The base solution to which citric acid was added was blackcurrant squash diluted in water. Infants' relative intake of each solution was used as a measure of sour acceptance. At 18 months, twelve infants readily accepted the two highest citric acid concentrations, whereas the remaining infants rejected these. Infants who accepted the most sour solutions had a significantly higher fruit intake (P = 0.025) and a higher fruit variety (P = 0.015) at 18 months than the infants who rejected the highly sour taste. Furthermore, infants who accepted the most sour solutions consumed fruits more frequently at 18 months (chi2 5.1; P = 0.024). Infants who accepted the sourest solutions also had a higher fruit intake at 6 months, and a significantly higher increase in their fruit intake from 12 to 18 months. This is the first scientific study that demonstrates the acceptance of sour tastes in some infants at the age of 18 months. Furthermore, the present results suggest a relationship between acceptance of sour tastes and infants' fruit intakes.     

Low dose supplementation with two different marine oils does not reduce pro-inflammatory eicosanoids and cytokines in vivo

In view of the reported potential anti-inflammatory activity of the New Zealand green lipped mussel (NZGLM), we aimed to compare the effect of low dose marine oil supplementation, from mussels and fish, in reducing blood markers of inflammation. Thirty apparently healthy males and females were recruited from the general public in Melbourne, Australia to participate in a double blind, randomised, parallel intervention study. Subjects were consuming approximately 73 mg of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) daily in their background diet prior to the commencement of the intervention. Subjects were randomly assigned to consume either 2 mL/day of the NZGLM oil preparation (mixed with olive oil and dl-alpha-tocopherol) or fish oil preparation (also mixed with olive oil and dl-alpha-tocopherol) for six weeks. Two mL of the oils contained 241 mg and 181 mg of n-3 LCPUFA, respectively. Neutrophil phospholipid fatty acids, serum thromboxane B2 (TXB2), stimulated monocyte production of prostaglandin E2 (PGE2), interleukin-1 beta (IL-1 beta) and tumor necrosis factor alpha (TNFalpha) were measured. During the intervention, the total intakes of n-3 LCPUFA from the background diet and the supplements were 199 mg/d and 173 mg/day for the NZGLM and FO groups, respectively. Following six weeks of supplementation, both groups showed a small, but significant increase in neutrophil phospholipid proportion of eicosapentaenoic acid. The NZGLM group also showed a significant increase in docosahexaenoic acid levels. There were no significant changes with time or treatment for TXB2, PGE2, IL-1 beta or TNFalpha. This study showed that low dose supplementation with n-3 LCPUFA from two different marine oil preparations showed no difference in inflammatory markers in this group of healthy individuals. Further studies are warranted including dose response trials and studies in populations with inflammatory conditions.     

Patients with advanced lung cancer: is there scope to discontinue inappropriate medication?

Background Polypharmacy—taking five or medications per day—is common in lung cancer patients. This patient group is prescribed medication to control acute symptoms associated with cancer and also to prevent or treat other long-term conditions. These medications increase the pill burden for the patient and also the probability of developing a drug-related toxicity. Objective To assess the prevalence of inappropriate medication in patients taking erlotinib for the treatment of advanced non-small cell lung cancer. Method This was a multicentre study across three sites in the North of England. Medication histories for patients receiving erlotinib were retrospectively extracted from medical notes and assessed by the clinical team (a consultant pharmacist, nurse specialist and clinical oncologist) to determine if the medication was appropriate or inappropriate. The clinical team considered the following factors when deciding if the medication was appropriate or inappropriate: remaining life expectancy of the patient, time until benefit of the treatment, goals of care and treatment targets. Results Among the 20 patients assessed, 19 (95 %) according to the clinical team were taking medications that were inappropriate. The mean number of medications the patients were taking was 8 (range 1–16) and the most common class of medication used were drugs affecting the Central Nervous System. In addition, there were 11 patients (55 %) who were taking erlotinib in combination with a proton pump inhibitor (PPI)—a clinically significant drug interaction that impairs the absorption of erlotinib. Conclusions Patients taking erlotinib for the treatment of advanced non-small cell lung cancer take many inappropriate medications for the treatment or prevention of long-term conditions. These patients should have their medications reviewed in the context of their original therapeutic goals.