No description available.

Hexavalent chromium, Cr(VI), is an established human carcinogen that is a worldwide environmental health concern. It is well understood that reactive oxygen species, genomic instability, and DNA damage repair deficiency are important contributors to Cr(VI)-induced carcinogenesis. After decades of research some cancer hallmarks remain understudied for the mechanism of Cr(VI) carcinogenesis. Dysregulated cellular energetics have been established as a hallmark of cancer. Energy pathways that become dysregulated in cancer include mitochondrial respiration, lipogenesis, pentose phosphate pathway, one carbon metabolism, and increased anaerobic glycolysis in the presence of oxygen or ‘Warburg effect’. To investigate metabolism changes in Cr(VI) carcinogenesis, we exposed human lung epithelial cells (BEAS-2B cells) to Cr(VI) for six months and isolated a colony from soft agar. To confirm the results in the BEAS-2B cells, we used two other sets of Cr(VI)-transformed cells, human lung epithelial cells (BEP2D cells) and human lung fibroblasts (WTHBF-6 cells). We found increased lipogenesis related protein expressions including: ATP citrate lyase (ACLY), acetyl-CoA carboxylase 1 (ACC1), and fatty acid synthase (FASN) in Cr(VI)-transformed cells as compared to passage-matched control cells. We also observed increased palmitic acid levels, confirming that Cr(VI)-transformed cells were making more lipids. Cr(VI)-transformed BEAS-2B cells had decreased colony formation in soft agar and decreased cell growth when treated with a FASN inhibitor (C75). ACLY, ACC1, and FASN protein expressions were also increased in chromate-induced lung tumors in human tissue samples. We also observed that Cr(VI)-transformed human lung cells (BEAS-2B, BEP2D, and WTHBF-6 cells) had no major changes in their mitochondrial respiration as measured by the Seahorse Analyzer when compared to their passage-matched control cells. Conversely, xenograft tumor-derived cells had mitochondrial respiratory dysfunction. Interestingly, we also found that Cr(VI)-transformed human lung cells (BEAS-2B, BEP2D, and WTHBF-6 cells) had no major changes in their glycolytic function as measured by the Seahorse Analyzer when compared to their passage-matched control cells. Similarly, these cells did not have changes in glycolytic enzymes or extracellular L-lactate levels. Moreover, xenograft tumor-derived cells showed no changes in glycolytic endpoints or L-lactate levels. This indicates these cells did not undergo the ‘Warburg effect’. These data demonstrate that increased lipogenesis is important to Cr(VI)-induced lung carcinogenesis and are consistent with the cancer literature which reports that increased lipogenesis proteins occur during carcinogenesis. Additionally, our results indicate mitochondrial respiratory dysfunction is likely a result of the tumor microenvironment and a later step during Cr(VI) carcinogenesis. Lastly, we observed the ‘Warburg effect’ is not required for Cr(VI)-induced carcinogenesis in vitro. However, it remains to be shown if the ‘Warburg effect’ is still a consequence or contributing factor for tumorigenesis. Future studies are needed to investigate other metabolic pathways in Cr(VI)-induced carcinogenesis. In conclusion, some metabolism pathways are important to Cr(VI)-induced carcinogenesis, while others appear not to be.

隨著台灣人口逐漸老化、國民所得增加以及健康意識抬頭，醫療營養品市場近十年來明顯成長。由於醫療營養品是介於藥品和一般消費品之間的產業，其行銷方法比較特殊且複雜，再加上產業中的廠商不多，所以較少產業相關行銷的研究探討文獻。 在台灣醫療營養品市場中，亞培是領導品牌，本研究藉由策略行銷4C架構來比較亞培糖尿病醫療營養品-葡勝納與另一個市佔率排名第二的品牌。探討內容包含兩個面項：一般消費者的行銷分析與通路商的行銷分析，其目的是企圖找到葡勝納在一般消費者與通路商行銷方面的機會點，讓葡勝納可以嘉惠台灣更多的糖尿病病患。 以4C架構探討二個品牌後可以發現，在針對一般消費者的行銷方面，亞培葡勝納除了在總成本因為由國外原裝進口，成本較高之外，其他如總效益、降低資訊搜尋成本、降低道德危機成本以及專屬陷入成本上，其表現都優於另一產品，此可以部分說明亞培葡勝納成為市場領導品牌的原因。在通路商的行銷部分，可以發現在總成本上，亞培葡勝納仍舊處於劣勢、總效益上因為產品的優異而佔有優勢。在資訊搜尋成本以及專屬陷入成本上，亞培葡勝納的表現也都略優一些。 值得一提的是，在台灣經營醫療營養品產業，降低買者道德危機成本非常重要。醫療營養品介於相信品與經驗品之間，比起搜尋品，買者道德危機成本相對偏高。再加上使用醫療營養品的主要對象是病人，關心度自然比一般日用品高。過去幾年來，不斷有危機事件發生。一旦買者道德危機成本增加，對廠商的殺傷力相當大，在業界屢見不鮮。經營醫療營養品的公司務必要愛惜羽毛，企業經營是百年大計，不得不小心。

No description available.

<p><em>Objective: </em>We evaluated the potential effect of oral glucose supplementation on: (1) exercise performance and tolerance, (2) the concentrations of plasma uric acid and ammonia (NH₃) and (3) blood plasma markers of oxidative stress in patients with McArdle’s disease (MCD) after non-ischemic forearm exercise testing (non-ischemic forearm exercise test). <em>Methods:</em> Blood samples and exercise performance measures were performed on from 16 patients with MCD and 17 control subjects (CON) matched for age, sex and physical activity status. Subjects performed 2 exercise bouts 30 minutes apart and received oral glucose or placebo supplementation between tests. Blood samples were analyzed for concentrations of 8-isoprostanes (8-ISO), malondialdehyde (MDA) and total anti-oxidant capacity (TEAC). Exercise performance was assessed using a handgrip dynamometer to measure force of contraction over time. Exercise tolerance was assessed based on subject’s self-reported perception of pain and perception of exertion during exercise. <em>Results:</em> MCD was associated with greater fatigue, perceived pain, perceived exertion, and higher uric acid during non-ischemic forearm exercise test (P < 0.05), and higher concentrations of plasma NH₃post exercise (P < 0.05). Glucose did not influence plasma uric acid or NH₃and had no effect on exercise measures in MCD patients. Baseline plasma markers of oxidative stress were not different between MCD patients and CON; however, MCD patients who ingested glucose between non-ischemic forearm exercise tests had lower plasma 8-ISO concentrations (P < 0.05). CON who ingested glucose between non-ischemic forearm exercise tests had lower plasma 8-ISO concentrations (P < 0.05) at +1 min post exercise compared to initial non-ischemic forearm exercise test. The TEAC of control subjects was lower following non-ischemic forearm exercise test (P < 0.05), with no change in MCD patients. <em>Conclusion: </em>Glucose may have a protective effect on oxidative stress following exercise that may be due to attenuated flux through xanthine oxidase.</p> / Master of Science (MSc)

As morbid obesity increasingly affects Hispanic-Americans, the incidence of Roux-en-Y gastric bypass procedures (RYGB) among this population rises. Prospective research on the impact of postoperative educational interventions focused on Hispanic-Americans is needed to prevent premature weight loss plateau, weight regain, nutritional deficiencies, and relapse of obesity-related comorbidities. This randomized-controlled study evaluated the impact of a comprehensive nutrition and lifestyle education intervention (6 biweekly postoperative sessions that incorporated motivational strategies for behavioral change) as compared to a non-comprehensive approach (printed guidelines for healthy lifestyle). The variables to consider are body weight, obesity-related comorbidities (depression, diabetes, dyslipidemia, and others), nutrient status, physical activity, and eating habits in 144 morbidly-obese adult Hispanic-Americans 6 to 12 months following RYGB. Patients were randomly assigned to either the comprehensive intervention (n=72) or the comparison group (n=72). Participants (mean age 44.5 ± 13.5 years) were mainly Cuban-born females (83.3%). Intervention sessions attendance was 64%. At 12 months, both groups lost weight significantly, but those in the comprehensive intervention experienced greater excess weight loss than those in the comparison group (80% vs. 64% from preoperative excess weight, P<.001). Intervention participants were significantly more involved in physical activity (+ 14 min/week vs. – 4 min/week), had decreased depression, joint illness, and required less medication for comorbidities than comparison participants. Additionally, those in the comprehensive intervention had sustained supplement intake experiencing less folate deficiency (P=.014). The non-comprehensive intervention group significantly decreased their protein and supplement intake compared to the intervention group. Patients in the comprehensive intervention had significantly better eating habits reflected by fewer episodes of dumping syndrome, constipation, and night eating, than those in the comparison group who reported greater eating in response to negative emotions (P=.003). These findings support the importance of a comprehensive educational approach to achieve more effective weight reduction and health-related outcomes to prevent relapse of obesity-related comorbidities and nutritional deficiencies in Hispanic-Americans 6 to 12 months following RYGB.

Obesity has reached an epidemic level in the United States. A number of epidemiological studies have established obesity as a critical risk factor for postmenopausal breast cancer (post-BC), whereas a reverse association holds prior to menopause. A significant scientific gap exists in understanding the mechanism(s) underpinning this epidemiological phenomenon, particularly the reverse association between obesity and premenopausal breast cancer (pre-BC). This study aimed to understand how folate metabolism and DNA methylation informs the association between obesity and pre-BC. Fifty normal breast tissue samples were collected from premenopausal women who underwent reduction mammoplasty. We developed and measured the breast tissue folate by a Lactobacillus Casei microbiological assay, and the DNA methylation of LINE-1, a biomarker of genome-wide methylation, and the promoter methylation and gene expression of SFRP1, a tumor suppressor, were measured by pyrosequencing and real-time PCR. We found a high BMI is associated with increased folate level in the mammary tissue, with an increase of 2.65 ng/g of folate per every 5-unit increase of BMI (p < 0.05). The LINE-1 DNA methylation was significantly associated with BMI (p < 0.05), and marginally associated with folate concentration (p = 0.087). For the 8 CpG sites analyzed in the promoter region of the SFRP1 gene, no associations were observed for either BMI or tissue folate (p > 0.05), although a high expression of SFRP1 was observed in subjects with high BMI or high folate (p < 0.05). This study demonstrated that, in premenopausal women, obesity is associated with an increased mammary folate status, genome-wide DNA methylation and SFRP1 gene expression, indicating that the improved folate and epigenetic status is potentially responsible for the reverse association between obesity and pre-BC. More studies are warranted to further understand how obesity mediates pre-BC via altering folate metabolism and DNA methylation.

Bakgrund. I omvårdnaden ska distriktssköterskan se till människans hela situation och omvårdnaden ska utföras på ett personcentrerat och säkert sätt. I hemsjukvården utförs vården i patientens hem, antingen i ordinärt eller särskilt boende. Trycksår är en vanlig vårdskada och nutritionen är viktig för att förebygga och behandla trycksår. Syftet var att beskriva i vilken utsträckning som distriktssköterskor i hemsjukvården använder nutritionsåtgärder som trycksårsbehandling. Metod. För att besvara syftet användes en kvantitativ design där redan insamlad data från en trycksårsmätning togs del av. Resultatet visade att nutritionsåtgärder användes som trycksårsbehandling till 65% av patienterna. Bland varannan distriktssköterska som inte använde nutritionsåtgärder framkom olika orsaker. Det var vanligare att nutritionsåtgärder användes vid risk enligt riskbedömningarna MNS och SF-MNA. De vanligast använda nutritionsåtgärderna var näringsdryck och extra mellanmål. Resultatet visade att det fanns skillnader i trycksårens svårighetsgrad i förhållande till boendeform. Slutsats. Det fanns utrymme för förbättringar i att använda nutritionsåtgärder vid trycksår. Nutritionen spelar en betydelsefull roll i behandlingen av trycksår och det är viktigt att riskbedömningar utförs. Genom att tidigt använda nutritionsåtgärder som trycksårsbehandling kan distriktssköterskan främja hälsa, förebygga sjukdom och skada samt minska patientens lidande. / Background. In Nursing Care, it's important to see to the whole perspective of the patient, and the care should be performed in a person-centred and safe way. The purpose was to describe district nurses [DN] using of nutrition therapy as treatment for patients with pressure ulcers in home healthcare. Method. A quantitative design, where material from an already collected pressure ulcer study, was used. The result showed that nutritional therapy was used as pressure ulcer treatment in 65% of the patients. Among every other DN who did not use nutritional therapy as treatment of pressure ulcer, various causes were identified. It was more common to use nutritional therapy when risks according to MNS and SF-MNA assessments were found. The most common nutrition therapies were nutritional drinks and extra snacks. The result showed that there were differences in the severity of pressure ulcers in relation to patients' housing type. Conclusion. There was room for improvements in using nutrition therapy as pressure ulcer treatment. Nutrition plays an important role in the prevention and treatment of pressure ulcer, and it's important that risk assessments are performed. By initiating nutritional treatment early, the DN can promote health, prevent disease and injury, and reduce the patient's suffering.

Background: Diabetes self-management education, including nutrition education (NE) is an essential component of diabetes management. Effective NE can assist individuals with type 2 diabetes mellitus (DM) in resource limited settings to improve their dietary self-care; an area cited among the most difficult with consequent improvement in health outcomes. Aim: To develop a NE programme that is tailored to the needs of adults with type 2 DM in a resource limited setting and to evaluate the programme's effectiveness on health outcomes. Setting: Makapanstad and Mathibestad community health centres in the Moretele sub-district, North West Province (South Africa). Methods: The study was done in three phases employing mixed methods research. Qualitative methods, using focus group discussions with 31 diabetic patients (a convenience purposive sample), and an open ended self-administered questionnaire with ten health professionals serving them, assessed the NE needs and preferences (phase 1). The data were analysed according to the framework approach. The results from the needs assessment were used to plan a tailored NE programme (phase 2). A randomised controlled trial (quantitative) with a sample of 82 patients (with HbA1c ≥ 8), allocated to either intervention or control groups, evaluated the effect of the NE programme (phase 3). Outcomes [HbA1c, dietary behaviours, blood lipids, blood pressure, body mass index (BMI), diabetes knowledge and attitudes towards diabetes and its treatment] were assessed at baseline, six months and 12 months respectively. An analysis of covariance (ANCOVA) compared the groups on measured outcomes using baseline values, age, gender, and clinic as covariates. Rank ANCOVA was used for dietary intake. The level of significance for all tests was set at α < 0.05 for a two-tailed test. Results: Needs assessment Diabetes related knowledge deficits and inappropriate dietary practices, including food portion control problems, inadequate intake of vegetables and fruits and unbalanced diets, were observed. Eight barriers and two facilitators to dietary adherence were identified. Financial constraint was the major barrier while social support was the major facilitator. NE recommendations included content related to the disease and diet, group education at the clinic, a competent educator, provision of education materials and inclusion of family members. The planned NE programme consisted of eight weekly training sessions and six follow-up sessions (monthly and bi-monthly), vegetable gardening demonstrations and education materials. Nutrition education programme effects: Seventy six participants (38 per group) completed the study. The differences in HbA1c (primary outcome) between the intervention and control groups were -0.62% (p=0.15) at six months and -0.67% (p=0.16) at 12 months. Few participants, four from the intervention group and one from the control group, achieved HbA1c target (<7%) at both six and 12 months, [(p=0.20), (p=0.36)] respectively. There were no significant between group differences in BMI, lipid profile and blood pressure at six months and 12 months. Starchy foods intake (median servings) were significantly lower in the intervention group compared to the control group, 9.3 vs. 10.8 (p=0.005) at six months and 9.9 vs. 11.9 (p=0.017) at 12 months. The proportion of participants growing own vegetables significantly increased in the intervention group compared to the control group 17/41 vs. 5/40 (p=0.003) at six months and 16/38 vs. 5/38 at 12 months. No significant group differences in the intake of energy, macronutrients, vegetable and fruits, sodium, cholesterol and fibre were observed at six and 12 months. Diabetes knowledge improved in the intervention group +0.95 (p=0.033) and +2.2 (p=0.000) when compared with the control group at six and 12 months respectively. There were no significant group differences in the attitudes towards diabetes and its treatment. Conclusions: The qualitative needs assessment provided insight for planning a tailored NE programme. The NE improved some dietary behaviours (starchy foods portion control and growing own vegetables) and diabetes knowledge. A non-significant lowering of HbA1c was observed. / Thesis (Phd)--University of Pretoria, 2013. / Human Nutrition / unrestricted

Sarcopenia is a disease of muscle wasting primarily seen in older adults. Although this term was first coined over three decades ago, there is a lack of consensus on a definition, screening criteria, and treatment protocol for sarcopenia. The primary purpose of this study is to determine whether registered dietitian nutritionists (RDNs) in the United States (U.S.) screen for sarcopenia. Study participants were recruited through a randomized email list and included RDNs throughout the U.S. Respondents completed a survey questioning knowledge of sarcopenia, screening tools and company protocols in place, and the need and desire for sarcopenia education. Data revealed a lack of pre-existing protocols in place, a dissonance of validated and unvalidated screening tools used in practice, and substantial need for sarcopenia education.