Nutrition
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Review Meta Analysis
Micronutrient supplementation for critically ill adults: a systematic review and meta-analysis.
This systematic review assessed the effects of micronutrient supplementation on adults recovering from critical illness. Primary outcomes included clinical endpoints (mortality, infectious complications, length of intensive care unit and of hospital stay). Secondary outcomes included descriptions of practice issues, micronutrient status, morbidity, course of the acute-phase response, and oxidative stress. ⋯ This review does suggest a potential benefit of micronutrient supplementation in critically ill adults by possibly being associated with a decrease in mortality.
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Comparative Study
Increased hypoglycemia associated with renal failure during continuous intravenous insulin infusion and specialized nutritional support.
To evaluate glycemic control for critically ill, hyperglycemic trauma patients with renal failure who received concurrent intensive insulin therapy and continuous enteral nutrition (EN) or parenteral nutrition (PN). ⋯ Despite receiving a modified RHI infusion, critically ill trauma patients with renal failure are at greater risk for developing hypoglycemia and have more glycemic variability than patients without renal failure.
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Zinc-suppressed inflammatory cytokines by induction of A20-mediated inhibition of nuclear factor-κB.
Chronic generation of inflammatory cytokines and reactive oxygen species are implicated in atherosclerosis, aging, cancers, and other chronic diseases. We hypothesized that zinc induces A20 in premonocytic, endothelial, and cancer cells, and A20 binds to tumor necrosis factor (TNF)-receptor associated factor, and inhibits Iκ kinase-α (IKK-α)/nuclear factor-κB (NF-κB), resulting in downregulation of TNF-α and interleukin-1β (IL-1β). ⋯ Our studies suggest that zinc suppresses generation of NF-κB-regulated inflammatory cytokines by induction of A20.
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We recently identified an inverse relation between systolic blood pressure (SBP) and serum 16α-hydroxyestrone, a metabolite of 17β-estradiol, in postmenopausal women. Formation of 16α-hydroxyestrone is catalyzed primarily by CYP1A2, a cytochrome P450 enzyme. The objective of this study was to evaluate the relations between known modifiers of CYP1A2 activity and serum 16α-hydroxyestrone in postmenopausal women. We hypothesized that fruits, vegetables, and grains, which contain more soluble fiber (a known inducer of CYP1A2) as a proportion of total fiber, would be more positively associated with serum 16α-hydroxyestrone than legumes, which contain less soluble fiber as a proportion of total fiber. ⋯ These results are consistent with previous studies demonstrating a negative relation between SBP and dietary fruits and vegetables and a positive relation between African-American race and SBP. Further research is needed regarding dietary factors that may influence the serum concentration of 16α-hydroxyestrone.
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Previous research has focused on the beneficial effects of soy and its active ingredients, isoflavones. For instance, soy consumption has been associated with lower cardiovascular and breast cancer risks. However, the number of reports demonstrating adverse effects of isoflavones due to their estrogenlike properties has increased. ⋯ This case indicates that soy product consumption is related to hypogonadism and erectile dysfunction. To the best of our knowledge, this is the first report of a combination of decreased free testosterone and increased DHEA blood concentrations after consuming a soy-rich diet. Hence, this case emphasizes the impact of isoflavones in the regulation of sex hormones and associated physical alterations.