[Body composition assessment in patients with chronic renal failure]

INTRODUCTION

Assessment of body composition is paramount in early assessment of nutritional status impairments due to excess or deficit. There are, however, few field reliable methods for this objective for patients with chronic renal failure (CRF.).

OBJECTIVE

To assess the reliability of the estimations of body composition by different methods as compared to dual energy X-ray absorptiometry (DEXA) as the gold standard method in patients with CRF and on regular chronic haemodialysis.

PATIENTS AND METHODS

We assessed body composition in 30 haemodialysis patients (46.9 +/- 15.1 years (18-76); BMI 25.9 +/- 5.7 kg/m(2) (18.1-41.5)), observing agreement in the percentage of fat mass (%FM) between the sum of the 4 folds (SP; calibrator Lange) and bioimpedantiometry by using different equations (BIA; Biodynamics 450) versus DEXA (Lunar DPX-L).

RESULTS

(X +/- SD) By BMI, 3 subjects had low weight (10%), 14 normal weight (46.7%), 7 overweight (23.3%), and 6 obesity (20%). The %FM with SP (30.7 +/- 7.1%) significantly differed from DEXA (27.3 +/- 10.3%; p < 0.001). With BIA there was a significant difference in %FM with the Deurenberg and Formica equations. The %FM obtained with the manufacturer's equations (Segal, Lukaski and Kyle) did not show a significant difference from DEXA. With Kyle's equation we observed a better agreement (difference with DEXA: -0.58 +/- 4.2%).

CONCLUSIONS

We found a low percentage of patients with low weight as compared to previous studies. The skin folds show low reliability to estimate the fat mass. The bioimpedantiometry, using Kile's equation may be a good filed method to assess haemodialysis patients.

GnRH antagonist ganirelix prevents premature luteinization in IUI cycles: rationale for its use

This study evaluated the efficacy of a gonadotrophin-releasing hormone antagonist (GnRHa) to prevent premature luteinization (PL) and examined its impact on intrauterine insemination (IUI) cycle outcome. A total of 662 patients who were undergoing IUI were evaluated. Ovarian stimulation was started on day 3 with recombinant (r)FSH, followed by the GnRHa and recombinant human chorionic gonadotrophin (rHCG). The overall incidence of PL was 11.5%. In patients with and without PL, the pregnancy rates (PR) were 22.4 (17/76) and 17.7% (104/586) respectively. Patients with PL were divided into two groups: (i) those with increased serum progesterone [PR was 10.7% (3/28) in this group]; and (ii) patients with elevated serum LH but normal progesterone concentrations [PR was 29.2% (14/48) in this group]. Patients in the first group who did not become pregnant (n = 22) were administered GnRHa in a second IUI cycle, and the PR was 18.1%; however, some patients (n = 6; 27.3%) in this group still had high serum progesterone concentrations. In the second group, patients (n = 26) with elevated serum LH in the previous cycle were administered GnRHa in another IUI and the PR was 23.1%. Use of a GnRHa in patients with PL who have had a previous unsuccessful IUI may be an alternative in future attempts.

Aflatoxins evaluation on in-shell and shelled dry Brazil nuts for export analysed by LC-MS/MS - 2006 and 2007 harvests

Dry in-shell and shelled Brazil nuts from two different harvests were evaluated for aflatoxins by LC-tandem mass spectrometry with atmospheric pressure chemical ionisation in the positive mode. A total of 171 samples of Brazil nuts for export, comprising 108 in-shell and 63 shelled (large, medium and small sizes) were collected in a factory located at Manaus city, State of Amazonas, in the Brazilian Amazon. They were collected from big bags (in-shell nuts) and sorting tables after size classification (shelled nuts), immediately after processing, from April to May of 2006 and 2007. Samples also had their moisture content (mc) and water activity (aw) analysed and the out- and in-door environmental conditions (relative humidity (RH) and temperature) were monitored during the sampling period. From all the samples analysed from both harvests, only 8.7% (14) of the nuts contained aflatoxin at levels >4 µg/kg (EU maximum level). This corresponded to a total number of 11 and 3 for the in-shell and shelled nuts, respectively. The 2007 harvest nuts had fewer samples with aflatoxin levels higher than 4 mg/kg, with 2 for both in-shell and shelled nuts each. The analytical method was selective, sensitive and fast (total run time of 7 min). The RH in the factory ranged from 77.1 to 95.8% (2006) and 76.9 to 91.0% (2007) being the highest RH reached in April. The data showed that the nuts' aflatoxin levels varied with the year of harvest and cleared up the speculation about which type of dried nut has aflatoxin levels safe enough for commercialisation.

Small heat-shock protein Hsp12 contributes to yeast tolerance to freezing stress

The HSP12 gene encodes one of the two major small heat-shock proteins of Saccharomyces cerevisiae and is induced under different conditions, such as low and high temperatures, osmotic or oxidative stress and high sugar or ethanol concentrations. However, few studies could demonstrate any correlation between HSP12 deletion or overexpression and a phenotype of sensitivity/resistance, making it difficult to attribute a role for Hsp12p under several of these stress conditions. We investigated the possible role of Hsp12p in yeast freezing tolerance. Contrary to what would be expected, the hsp12 null mutant when subjected to prolonged storage at −20 °C showed an increased resistance to freezing when compared with the isogenic wild-type strain. Because the mutant strain displayed a higher intracellular trehalose concentration than the wild-type, which could mask the effect of manipulating HSP12, we overexpressed the HSP12 gene in a trehalose-6-phosphate synthase (TPS1) null mutant. The tps1Δ strain overexpressing HSP12 showed an increase in resistance to freezing storage, indicating that Hsp12p plays a role in freezing tolerance in a way that seems to be interchangeable with trehalose. In addition, we show that overexpression of HSP12 in this tps1Δ strain also increased resistance to heat shock and that absence of HSP12 compromises the ability of yeast cells to accumulate high levels of trehalose in response to a mild heat stress.

Soluble vascular endothelial-cadherin levels correlate with clinical and biological aspects of severe ovarian hyperstimulation syndrome

BACKGROUND

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovarian stimulation, and the pathophysiological mechanisms that trigger the syndrome remain unknown. HCG increases serum vascular endothelial growth factor (VEGF) concentrations, and VEGF modulates transendothelial permeability via endothelial adherens junctions, a downstream target for VEGF signalling. We examined whether women with severe OHSS have altered serum levels of soluble vascular endothelial (sVE)-cadherin.

METHODS

We conducted a prospective, case-control study of 28 women with severe OHSS and 34 women undergoing controlled ovarian hyperstimulation (COH) for IVF without developing OHSS. We collected serum samples from both groups on the day of ovum retrieval (Day 0), and on Days 3, 6, 9 and 15. Samples were assayed for sVE-cadherin by enzyme-linked immunosorbent assay.

RESULTS

Women with severe OHSS had significantly higher levels of sVE-cadherin than patients without OHSS (P = 0.001). sVE-cadherin serum levels decreased with clinical improvement; however, they did not reach normal levels in the resolution phase. A positive correlation was demonstrated between sVE-cadherin and serum estradiol levels at the time of HCG administration (r = 0.621; P < 0.001). Serum sVE-cadherin levels were more closely chronologically correlated with corpus luteum function than with biological and clinical aspects of severe OHSS.

CONCLUSIONS

sVE-cadherin may be involved in the pathogenesis of severe OHSS and may possibly serve as an indicator of corpus luteum function after COH.

Depression during pregnancy and the postpartum period in adolescent and adult Portuguese mothers

OBJECTIVE

To study prevalence as well as risk factors for pregnancy and postpartum depression in a sample of adolescent and adult Portuguese mothers.

METHODS

The Edinburgh Postnatal Depression Scale (EPDS) was administered to 108 (54 adult and 54 adolescent) Portuguese women at 24-36 weeks of pregnancy and at 2-3 months postpartum.

RESULTS

Rates for EPDS > 12 are high during the 3(rd) trimester of pregnancy (18.5%) and at 2-3 months postpartum (17.6%), and not significantly different between these two periods; more than 1/4 of the sample (27.8%) had an EPDS > 12 before or after delivery. Adolescent mothers presented more depressive symptoms as well as more EPDS > 12 than adult mothers, both in pregnancy (25.9% versus 11.1%) and at 2-3 months postpartum (25.9% versus 9.3%); moreover, when considering other socio-demographics, adolescent mothers were still at risk for depressive symptoms during pregnancy as well as for postpartum depression. Women depressed in pregnancy, and ones who are under 18 years old and who live with the partner, were at risk for postpartum EPDS > 12.

CONCLUSION

Adolescent mothers seem particularly at risk for depression during pregnancy and the postpartum period, therefore, just like the women who are depressed during pregnancy, they should be better targeted in preventive and intervention measures.

Sugar utilization patterns and respiro-fermentative metabolism in the baker's yeast Torulaspora delbrueckii

The highly osmo- and cryotolerant yeast species Torulaspora delbrueckii is an important case study among the non-Saccharomyces yeast species. The strain T. delbrueckii PYCC 5321, isolated from traditional corn and rye bread dough in northern Portugal, is considered particularly interesting for the baking industry. This paper reports the sugar utilization patterns of this strain, using media with glucose, maltose and sucrose, alone or in mixtures. Kinetics of growth, biomass and ethanol yields, fermentation and respiration rates, hydrolase activities and sugar uptake rates were used to infer the potential applied relevance of this yeast in comparison to a conventional baker's strain of Saccharomyces cerevisiae. The results showed that both maltase and maltose transport in T. delbrueckii were subject to glucose repression and maltose induction, whereas invertase was subject to glucose control but not dependent on sucrose induction. A comparative analysis of specific sugar consumption rates and transport capacities suggests that the transport step limits both glucose and maltose metabolism. Specific rates of CO(2) production and O(2) consumption showed a significantly higher contribution of respiration to the overall metabolism in T. delbrueckii than in S. cerevisiae. This was reflected in the biomass yields from batch cultures and could represent an asset for the large-scale production of the former species. This work contributes to a better understanding of the physiology of a non-conventional yeast species, with a view to the full exploitation of T. delbrueckii by the baking industry.