高温作业钢铁工人水溶性维生素摄入和消耗及体内水平调查

目的了解钢铁工人在目前高温作业环境下通过汗、尿消耗的水溶性维生素B_1、B_2、C及其膳食摄入和体内水平,为制定营养干预方案提供依据。方法于2014年6—7月选取高温作业钢铁工人226人及同一车间非高温作业工人39人,进行膳食调查和汗、尿收集及维生素测定,用体重差法估计出汗量,同时测定工作场所湿球黑球温度指数(wet bulb globe temperature index,WBGT指数)。结果高温作业钢铁工人维生素B_1、B_2、C平均摄入量分别为(2.2±0.5)、(1.2±0.3)、(102.0±23.3)mg/d;不同作业温度的工人每日摄入量均无明显差异(P0.05)。工人在WBGT为30~43℃高温环境作业时的汗中维生素B_1、B_2、C排出量分别为(0.24±0.08)、(0.20±0.08)、(16.30±7.78)mg/d,分别占汗、尿中排出总量的73.8%,67.9%和68.3%。同等中体力劳动高温工人的汗中维生素B_1、B_2、C排出量均高于非高温工人,差异有统计学意义(P0.01)。重体力劳动强度下不同作业温度的高温工人汗中维生素B_1、B_2、C排出量均随温度升高而增加(P0.05);尿中3种维生素排出量均随温度升高而降低。高温作业工人维生素B_1、B_2、C与尿肌酐的平均比值分别为121.8±39.7、99.4±43.8、6.1±2.3。维生素B_1、B_2、C体内缺乏人数分别占总人数的10.6%,31.9%,95.1%。中体力劳动强度的高温作业工人维生素C体内缺乏率高于非高温作业工人,差异有统计学意义(P0.05)。结论钢铁工人在高温作业环境中的维生素B_1、B_2、C消耗量较多,维生素摄入量均低于高温作业建议量。建议按摄入量与高温作业人员建议量的差值并考虑体内缺乏程度来制定工间液体补充方案。     

维生素A棕榈酸酯原料细菌内毒素检查方法研究

目的：建立检查维生素A棕榈酸酯进行细菌内毒素检查法。方法：维生素A棕榈酸酯以无水乙醇为溶剂溶解,再用细菌内毒素检查用水稀释制成乳浊液,依照《中国药典》2020年版(四部)1143细菌内毒素检查法,对维生素A棕榈酸酯细菌内毒素检查法进行干扰试验预试验和干扰试验,同时增加细菌内毒素回收干扰试验预试验和干扰试验。结果：维生素A棕榈酸酯在实验过程中出现的复析、乳浊现象对细菌内毒素检查无影响,维生素A棕榈酸酯在0.015625mg.ml-1^浓度下对细菌内毒素检查无干扰作用。结论：本法可用于维生素A棕榈酸酯细菌内毒素的质量控制。     

Survey of Vitamin and Mineral Supplementation after Gastric Bypass and Biliopancreatic Diversion for Morbid Obesity

Background: The authors investigated whether practice patterns of bariatric surgeons correlate with published data regarding metabolic deficiencies after Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). Methods: 109 surgeons completed a questionnaire to determine use of supplements and frequency of lab tests. Results: Regarding supplements routinely prescribed after RYGB, 96% of surgeons gave multivitamins, 63% gave iron, and 49% gave vitamin B₁₂. After BPD, 96% of surgeons gave multivitamins, 67% gave iron, 42% gave vitamin B₁₂, 97% gave calcium, 63% gave fat-soluble vitamins, and 21% gave protein supplements. Regarding laboratory tests obtained routinely after RYGB, 95% of surgeons do complete blood counts, 56% do iron determinations, 66% do vitamin B₁₂ determinations, 58% do folate determinations, 76% do electrolyte determinations, and 8% test for proteins. After BPD, 96% of surgeons do complete blood counts, 80% do iron determinations, 67% do vitamin B₁₂ determinations, 71% do folate determinations, 88% do electrolyte determinations, 84% do protein determinations, and 46% test for fat-soluble vitamins. Regarding frequency of blood tests, after RYGB, 22% of surgeons obtain them after 3 months, 33% after 6 months, and 41% after 12 months; 4% do not routinely obtain postoperative laboratory tests. After BPD, 46% of surgeons obtain them after 3 months, 33% after 6 months, and 16% after 12 months; one does not obtain laboratory tests. Surgeons estimated these deficiencies after RYGB: 16% iron, 12% vitamin B₁₂, 14% anemia, 5% protein, and 3% calcium. They estimated these deficiencies after BPD: 26% iron, 11% vitamin B₁₂, 21% anemia, 18% protein, 16% calcium, and 6% fat-soluble vitamins. The estimated incidence of deficiencies after RYGB was considerably lower than the published incidence. Unnecessary tests were commonly performed (electrolytes after RYGB). Conclusion: Despite wide variations in the performance of laboratory tests and the use of supplements, the practice patterns of most surgeons protect patients from developing severe metabolic deficiencies after RYGB and BPD.     

Effects of Periodic Religious Fasting for Decades on Nutrient Intakes and the Blood Biochemical Profile

The aim of the present study was to examine differences and correlations in nutrient intakes and serum parameters related to nutrient intake (lipid profile, vitamins, and trace elements) in 200 lifelong Christian Orthodox Church (COC) fasters with periodic abstinence from certain foods (predominantly of animal origin) for approximately half of the year and 200 non-fasting controls, all of whom did not take dietary supplements. Nutrient intakes were assessed through three-day dietary recalls. Blood samples were drawn for the analysis of potential biomarkers of nutrient intake. Fasters had lower energy intake, due to lower fat and protein intake, compared to non-fasters (p < 0.05). Fasters also had lower intakes of vitamins A, B₁, B₂, B₆, B₁₂, D, folate, pantothenate, sodium, calcium, zinc, and phosphorus. Most participants (in both groups) did not meet the recommended dietary allowances of most vitamins and elements. Most serum biochemical parameters did not reflect the differences in nutrient intakes between groups, and none exhibited a correlation coefficient above 0.5 with nutrient intakes. Our findings suggest that COC fasting is associated with reduced intake of many nutrients, although this does not seem to have an impact on the blood biochemical profile.     

Multivitamin supplementation and multiple births

It is well established that maternal multivitamin supplementation reduces the risk of neural tube defects and evidence suggests that it may be associated with other reproductive outcomes. The present study was prompted by a report from a randomized trial in Hungary which showed a 40% increase in multiple births among periconceptional vitamin users. Retrospectively collected data on multivitamin supplementation were obtained on multiple and singleton births from three separate studies: Atlanta Birth Defects Case-Control Study (ABDCCS) malformed and nonmalformed infants born 1968-1980, California Birth Defects Monitoring Program (CBDMP) malformed and nonmalformed infants born 1987-1989, and Boston University Slone Epidemiology Unit Birth Defects Study (SEU-BDS) malformed infants born 1987-1994. Supplementation was divided into three mutually exclusive categories based on timing: “periconceptional” use—before through at least the third month after conception; “early” use—beginning in the first month and continuing through at least the third month after conception; and “later” use—beginning in the second or third month after conception. For periconceptional use, four of five datasets showed a 30 to 60% greater prevalence of supplementation among mothers of multiple births. In contrast, this pattern was not evident for “early” and “later” use. Overall, the study findings are tentative, due to a lack of consistency across all five datasets and they should not alter recent recommendations related to folate supplementation for the prevention of neural tube defects. Am. J. Med. Genet. 71:93–96, 1997. © 1997 Wiley-Liss, Inc.     

A mechanism based approach to management of children with end-stage liver disease

Introduction: Due to parallel advances in surgical and acute care disciplines, liver transplantation (LT) has revolutionized the outlook for children with end-stage liver disease (ESLD). Contrary to advances in technical aspects of LT and the peri-operative care, pre-transplant management of ESLD remains quite a formidable challenge.

Areas covered: This review provides mechanisms based management strategies to address common complications of ESLD including malnutrition, amended metabolic pathways, gastrointestinal dysfunction, and development of ascites. Clinically relevant discussion of each paradigm is followed by an account of high impact therapeutic interventions which can be used as guides for formulating management plans. A tabulated summary of the suggested interventions is also provided. Indeed, execution of a dynamic plan tailored to the evolution of pathophysiologic derangements can further enhance outcomes of pediatric LT.

Expert commentary: LT has evolved as a dependable therapeutic option for a variety of fatal pediatric liver diseases. However, relative organ shortage remains a formidable challenge. Similarly, consumer expectations continue to grow for sustained improvement of graft and patient survival after LT. In this environment, the level of sophistication applied to the management ESLD before LT stands out as a major opportunity with lasting impact on the future of pediatric LT.     

Update on cosmeceuticals

As youth and perception of beauty are considered to be of great importance, an increasing number of new cosmeceuticals have been developed in recent years. This article will briefly present the problems of distinguishing cosmetics, cosmeceuticals or drugs and describe important new developments in raw materials, carrier systems and ingredients from the dermatological point of view. Especially active ingredients against skin‐aging, here in particular antioxidants and cell regulators, are reviewed. Important parameters for the quality of cosmetics and cosmeceuticals are evidence‐based in‐vivo and in‐vitro efficacy as well as scientifically proven wanted and unwanted effects.     

Protective effects of B vitamins and antioxidants on the risk of arsenic-related skin lesions in Bangladesh

BACKGROUND: An estimated 25-40 million of the 127 million people of Bangladesh have been exposed to high levels of naturally occurring arsenic from drinking groundwater. The mitigating effects of diet on arsenic-related premalignant skin lesions are largely unknown. OBJECTIVES: The purpose of this study was to clarify the effects of the vitamin B group (thiamin, riboflavin, niacin, pyridoxine, and cobalamin) and antioxidants (vitamins A, C, and E) on arsenic-related skin lesions. METHODS: We performed a cross-sectional study using baseline data from the Health Effects of Arsenic Longitudinal Study (HEALS), 2000-2002, with individual-level, time-weighted measures of arsenic exposure from drinking water. A total of 14,828 individuals meeting a set of eligibility criteria were identified among 65,876 users of all 5,996 tube wells in the 25-km(2) area of Araihazar, Bangladesh; 11,746 were recruited into the study. This analysis is based on 10,628 subjects (90.5%) with nonmissing dietary data. Skin lesions were identified according to a structured clinical protocol during screening and confirmed with further clinical review. RESULTS: Riboflavin, pyridoxine, folic acid, and vitamins A, C, and E significantly modified risk of arsenic-related skin lesions. The deleterious effect of ingested arsenic, at a given exposure level, was significantly reduced (ranging from 46% reduction for pyridoxine to 68% for vitamin C) for persons in the highest quintiles of vitamin intake. CONCLUSIONS: Intakes of B-vitamins and antioxidants, at doses greater than the current recommended daily amounts for the country, may reduce the risk of arsenic-related skin lesions in Bangladesh.     

Hyperhomocysteinemia and the role of B vitamins in cancer

BACKGROUND: Patients suffering from malignancies have increased complications due to corresponding cardiovascular diseases and risk factor for the development of venous thromboembolism. Epidemiological studies have shown that increased homocysteine plasma concentration (hyperhomocysteinemia) is related to a higher risk of coronary heart disease, stroke, peripheral vascular disease and malignancies. Homocysteine (tHcy) is an intermediate sulfur-containing amino acid produced from methionine during processing of dietary proteins. The plasma homocysteine levels are strongly influenced by diet, as well as by genetic factors. Folic acid, vitamins B6 and B12 are dietary components which influence the plasma homocysteine levels the most. Several studies have found that high blood levels of B vitamins are related to the integrity and function of DNA, and, are at least related to lower concentration of homocysteine. Folate depletion has been found to change DNA methylation and DNA synthesis in both animal and human studies. Because of this critical role of folate, most studies including homocysteine have focused on these two actions. CONCLUSIONS: Hyperhomocysteinemia proves to be the most common condition highly associated with both venous and arterial thrombosis in many cancer patients, while the associated pathophysiology has not been precisely established yet. Therefore, of current interest is the possible role of folate metabolism developing into a cancer initiating hyperhomocysteinemia. This review will discuss this possibility.