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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
101

Influência de diferentes ambientes intrauterinos sobre a composição hormonal do colostro e leite maduro e o peso de lactentes : coorte ivapsa

Nunes, Marina January 2015 (has links)
Objetivo: Avaliar a influência de diferentes ambientes intrauterinos na concentração de hormônios no leite materno e sua relação com o peso da criança nos primeiros seis meses de vida. Materiais e Métodos: Trata-se de um de estudo de coorte prospectivo de uma amostra de recém-nascidos a termo da cidade de Porto Alegre. O recrutamento dos pares mãe-bebê ocorria 24 a 48 horas após o parto e os sujeitos incluídos em um dos cinco grupos: Diabetes, Hipertensão, Tabagistas, Pequenos para Idade Gestacional (PIG) e Controle. O colostro foi coletado no pós-parto e o leite maduro no 1º mês. Foram quantificadas as concentrações de Leptina, Adiponectina e Insulina pelo método ELISA. O peso e a estatura das mães e das crianças foram obtidos em todas as entrevistas Resultados: A concentração dos hormônios diminuiu com a maturação do leite materno com diferença estatística do colostro para o leite maduro para leptina no PIG (p=0,05) e Insulina nos grupos PIG (p=0,012) e Controle (p=0,041). O grupo PIG diferiu estatisticamente do Controle na concentração de leptina no 1M (p=0,045). O peso dos recém-nascidos PIG foi inferior aos outros grupos no nascimento e na alta hospitalar, mantendo-se diferente aos 15 dias do diabetes e controle, e, apenas do controle, no 1º mês. A partir dessa entrevista, a média de peso do PIG foi semelhante aos outros grupos indicando um catch up precoce avaliado pela diferença de escore-Z de peso para idade (>0,67). Tanto a leptina (r=-0,295; p=0,03) quanto a insulina (r=0,262; p=0,047) do leite maduro se correlacionaram com o ganho de peso da criança no 1º mês. Conclusões: A concentração dos hormônios no leite materno dos cinco grupos é semelhante ao nascimento, mas diminui do colostro para o leite maduro. A leptina e a insulina tem redução estatisticamente significativa no grupo PIG. O estudo demonstra uma antecipação metabólica do leite materno sobre a condição de PIG, relacionando-se com a possibilidade de um catch up precoce no primeiro mês de vida desses lactentes. / Objective: To evaluate the influence of different intrauterine environments on breast milk hormones concentration and its relationship with infant weight up to 6 months. Material and Methods: This is a thematic, prospective and longitudinal term born cohort from Porto Alegre, Brazil. Mother-infant pairs were recruited 24 to 48 hours after birth and then included in one of five groups: diabetes, hypertension, smoking, mothers of Small for Gestational Age (SGA) and controls. Colostrum was collected at 24h postpartum and mature milk 1 month later. Breast milk leptin, adiponectin and insulin were determined by ELISA. In all interviews mother and infant weight and height were obtained. Results: Adipokines levels decreased according to milk maturation with statistical difference in leptin from colostrum to mature milk in SGA group (p=0.05) and insulin in SGA (p=0.012) and control (p=0.041) groups. SGA differed statistically from control at colostrum in leptin concentration (p=0,045). SGA had low maternal BMI means values in all measurements reflecting in lower leptin and insulin concentration. SGA infant weight was statistically different from all groups at born and at discharge keeping different from diabetes and control at 15 days postpartum and only from control at 1 month. After, the weight mean of SGA was similar from others groups indicating an early catch up. Both, leptin (r=-0.295; p=0.03) and insulin (r=0.262; p=0.047) at 1 month were correlated with infant weight gain at 1 month. Conclusion: Breast milk hormones are similar at birth in all groups but the concentration decreases from colostrum to mature milk. SGA had a significant reduction in leptin and insulin concentration. This study demonstrates breast milk metabolic anticipation on SGA, probably is related to early catch up at 1 month of life.
102

Determinação de poluentes orgânicos persistentes (pops) em leite materno: desenvolvimento e aplicação de método analítico empregando GC-NCI-MS / Determination of persistent organic pollutants (POPs) in breast milk: development and application of an analytical method using GC-NCI-MS

Ferronato, Giovana 12 March 2014 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Persistent Organic Pollutants (POPs) receive this designation because of the time that remain unchanged in the environment. From the 1960s there was already evidence of the presence of these compounds in sediment, breast milk, fish and eggs. The food chain can be considered a source of contamination of humans by these compounds due to bioaccumulation. The fat contained in milk can accumulate POPs, so this matrix has been used as environmental bioindicator. The currently available methods for the determination of these compounds in breast milk involve, in general, multi-step sample preparation and quantification techniques with low selectivity, have high cost and are time consuming. Thus, this study aimed to develop a fast and efficient method based on sample preparation using the QuEChERS method combined Gas Chromatography coupled to Mass Spectrometry with negative chemical ionization (GC-NCI-MS). In this work we optimized the sample preparation step for the determination of 15 POPs in breast milk (Alpha HCH, beta HCH, gamma HCH, hexachlorobenzene, heptachlor, andrin, dieldrin, endrin, 2,4 DDE, DDT, endosulfan alpha, beta endosulfan, endosulfan sulfate and mirex) using 6 mL of sample extracted with 6 mL of acetonitrile. In the partition step was used 2.6 g MgSO4 and 0.6 g of NaCl. The extract clean-up was performed by dispersive solid-phase extraction of 4 mL of extract and 600 mg of MgSO4 and 200 mg of C18. The extract was evaporated in a Turbovap system and redissolved in 200 μL acetonitrile for the determination by GC-NCI-MS. The method was validated showing linearity for the 15 evaluated compounds. Recoveries of the analytes ranged between 62 and 120% with precision within the acceptable range (RSD <19%). The limits of detection for breast milk, in terms of fat percentage, ranged from 0.75 to 7.5 ng g-1 and the method limits of quantification ranged from 2.5 to 25 ng g-1. The method was applied to 20 samples of breast milk from different regions of the Rio Grande do Sul state, of which only 25% were not contaminated by the studied POPs and the others showed values below the LQ. It is important to emphasize that this is an unpublished work in the area of POPs determination in breast milk by GC-NCI-MS, and could be a basis for future works in this area. / Os Poluentes Orgânicos Persistentes (POPs) recebem essa denominação devido ao tempo que permanecem inalterados no meio ambiente. A partir dos anos 1960 já havia indícios da presença desses compostos em sedimentos, leite materno, peixe e ovos. A cadeia alimentar pode ser considerada uma fonte de contaminação do ser humano por esses compostos devido à bioacumulação. A gordura contida no leite materno pode acumular os POPs, por isso esta matriz vem sendo utilizada como bioindicador ambiental. Os métodos disponíveis atualmente para a determinação desses compostos em leite materno envolvem, em geral, várias etapas de preparo de amostra e quantificação por técnicas pouco seletivas, apresentam alto custo e demanda de tempo. Assim, esse trabalho visou o desenvolvimento de um método rápido e eficiente baseado no preparo de amostra empregando o método QuEChERS combinado a Cromatografia à Gás, acoplada à Espectrometria de Massas com ionização química negativa (GC-NCI-MS). Neste trabalho otimizou-se a etapa de preparo de amostra para a determinação de 15 POPs em leite materno (HCH alfa, HCH beta, HCH gama, hexaclorobenzeno, heptacloro, andrin, dieldrin, endrin, 2,4 DDE, DDT, endosulfan alfa, endosulfan beta, endosulfan sulfato e mirex) utilizando 6 mL de amostra e extração com 6 mL de acetonitrila. Na etapa de partição utilizou-se 2,6 g de MgSO4 e 0,6 g de NaCl. A limpeza do extrato foi realizada por extração em fase sólida dispersiva de 4 mL de extrato e 600 mg de MgSO4 e 200 mg de C18. O extrato foi evaporado em sistema Turbovap e redissolvido em 200 μL de acetonitrila para determinação por GC-(NCI)-MS. O método foi validado apresentando linearidade para os 15 compostos em estudo. As recuperações dos analitos variaram entre 62 e 120%, com valores de precisão dentro da faixa aceitável (RSD < 19%). Os limites de detecção do método para leite materno em termos de percentual de gordura variaram de 0,75 a 7,5 ng g-1e os limites de quantificação do método variaram de 2,5 a 25 ng g-1. O método foi aplicado para 20 amostras de leite materno de diferentes regiões do estado do Rio Grande do Sul, das quais, apenas 25% não apresentaram contaminação pelos POPs estudados e as demais apresentaram valores menores que o LQ. É importante destacar que trata-se de um trabalho inédito na área de determinação de POPs em leite materno empregando GC-NCI-MS, podendo servir de base para trabalhos futuros nessa área.
103

Influência de diferentes ambientes intrauterinos sobre a composição hormonal do colostro e leite maduro e o peso de lactentes : coorte ivapsa

Nunes, Marina January 2015 (has links)
Objetivo: Avaliar a influência de diferentes ambientes intrauterinos na concentração de hormônios no leite materno e sua relação com o peso da criança nos primeiros seis meses de vida. Materiais e Métodos: Trata-se de um de estudo de coorte prospectivo de uma amostra de recém-nascidos a termo da cidade de Porto Alegre. O recrutamento dos pares mãe-bebê ocorria 24 a 48 horas após o parto e os sujeitos incluídos em um dos cinco grupos: Diabetes, Hipertensão, Tabagistas, Pequenos para Idade Gestacional (PIG) e Controle. O colostro foi coletado no pós-parto e o leite maduro no 1º mês. Foram quantificadas as concentrações de Leptina, Adiponectina e Insulina pelo método ELISA. O peso e a estatura das mães e das crianças foram obtidos em todas as entrevistas Resultados: A concentração dos hormônios diminuiu com a maturação do leite materno com diferença estatística do colostro para o leite maduro para leptina no PIG (p=0,05) e Insulina nos grupos PIG (p=0,012) e Controle (p=0,041). O grupo PIG diferiu estatisticamente do Controle na concentração de leptina no 1M (p=0,045). O peso dos recém-nascidos PIG foi inferior aos outros grupos no nascimento e na alta hospitalar, mantendo-se diferente aos 15 dias do diabetes e controle, e, apenas do controle, no 1º mês. A partir dessa entrevista, a média de peso do PIG foi semelhante aos outros grupos indicando um catch up precoce avaliado pela diferença de escore-Z de peso para idade (>0,67). Tanto a leptina (r=-0,295; p=0,03) quanto a insulina (r=0,262; p=0,047) do leite maduro se correlacionaram com o ganho de peso da criança no 1º mês. Conclusões: A concentração dos hormônios no leite materno dos cinco grupos é semelhante ao nascimento, mas diminui do colostro para o leite maduro. A leptina e a insulina tem redução estatisticamente significativa no grupo PIG. O estudo demonstra uma antecipação metabólica do leite materno sobre a condição de PIG, relacionando-se com a possibilidade de um catch up precoce no primeiro mês de vida desses lactentes. / Objective: To evaluate the influence of different intrauterine environments on breast milk hormones concentration and its relationship with infant weight up to 6 months. Material and Methods: This is a thematic, prospective and longitudinal term born cohort from Porto Alegre, Brazil. Mother-infant pairs were recruited 24 to 48 hours after birth and then included in one of five groups: diabetes, hypertension, smoking, mothers of Small for Gestational Age (SGA) and controls. Colostrum was collected at 24h postpartum and mature milk 1 month later. Breast milk leptin, adiponectin and insulin were determined by ELISA. In all interviews mother and infant weight and height were obtained. Results: Adipokines levels decreased according to milk maturation with statistical difference in leptin from colostrum to mature milk in SGA group (p=0.05) and insulin in SGA (p=0.012) and control (p=0.041) groups. SGA differed statistically from control at colostrum in leptin concentration (p=0,045). SGA had low maternal BMI means values in all measurements reflecting in lower leptin and insulin concentration. SGA infant weight was statistically different from all groups at born and at discharge keeping different from diabetes and control at 15 days postpartum and only from control at 1 month. After, the weight mean of SGA was similar from others groups indicating an early catch up. Both, leptin (r=-0.295; p=0.03) and insulin (r=0.262; p=0.047) at 1 month were correlated with infant weight gain at 1 month. Conclusion: Breast milk hormones are similar at birth in all groups but the concentration decreases from colostrum to mature milk. SGA had a significant reduction in leptin and insulin concentration. This study demonstrates breast milk metabolic anticipation on SGA, probably is related to early catch up at 1 month of life.
104

Influência de diferentes ambientes intrauterinos sobre a composição hormonal do colostro e leite maduro e o peso de lactentes : coorte ivapsa

Nunes, Marina January 2015 (has links)
Objetivo: Avaliar a influência de diferentes ambientes intrauterinos na concentração de hormônios no leite materno e sua relação com o peso da criança nos primeiros seis meses de vida. Materiais e Métodos: Trata-se de um de estudo de coorte prospectivo de uma amostra de recém-nascidos a termo da cidade de Porto Alegre. O recrutamento dos pares mãe-bebê ocorria 24 a 48 horas após o parto e os sujeitos incluídos em um dos cinco grupos: Diabetes, Hipertensão, Tabagistas, Pequenos para Idade Gestacional (PIG) e Controle. O colostro foi coletado no pós-parto e o leite maduro no 1º mês. Foram quantificadas as concentrações de Leptina, Adiponectina e Insulina pelo método ELISA. O peso e a estatura das mães e das crianças foram obtidos em todas as entrevistas Resultados: A concentração dos hormônios diminuiu com a maturação do leite materno com diferença estatística do colostro para o leite maduro para leptina no PIG (p=0,05) e Insulina nos grupos PIG (p=0,012) e Controle (p=0,041). O grupo PIG diferiu estatisticamente do Controle na concentração de leptina no 1M (p=0,045). O peso dos recém-nascidos PIG foi inferior aos outros grupos no nascimento e na alta hospitalar, mantendo-se diferente aos 15 dias do diabetes e controle, e, apenas do controle, no 1º mês. A partir dessa entrevista, a média de peso do PIG foi semelhante aos outros grupos indicando um catch up precoce avaliado pela diferença de escore-Z de peso para idade (>0,67). Tanto a leptina (r=-0,295; p=0,03) quanto a insulina (r=0,262; p=0,047) do leite maduro se correlacionaram com o ganho de peso da criança no 1º mês. Conclusões: A concentração dos hormônios no leite materno dos cinco grupos é semelhante ao nascimento, mas diminui do colostro para o leite maduro. A leptina e a insulina tem redução estatisticamente significativa no grupo PIG. O estudo demonstra uma antecipação metabólica do leite materno sobre a condição de PIG, relacionando-se com a possibilidade de um catch up precoce no primeiro mês de vida desses lactentes. / Objective: To evaluate the influence of different intrauterine environments on breast milk hormones concentration and its relationship with infant weight up to 6 months. Material and Methods: This is a thematic, prospective and longitudinal term born cohort from Porto Alegre, Brazil. Mother-infant pairs were recruited 24 to 48 hours after birth and then included in one of five groups: diabetes, hypertension, smoking, mothers of Small for Gestational Age (SGA) and controls. Colostrum was collected at 24h postpartum and mature milk 1 month later. Breast milk leptin, adiponectin and insulin were determined by ELISA. In all interviews mother and infant weight and height were obtained. Results: Adipokines levels decreased according to milk maturation with statistical difference in leptin from colostrum to mature milk in SGA group (p=0.05) and insulin in SGA (p=0.012) and control (p=0.041) groups. SGA differed statistically from control at colostrum in leptin concentration (p=0,045). SGA had low maternal BMI means values in all measurements reflecting in lower leptin and insulin concentration. SGA infant weight was statistically different from all groups at born and at discharge keeping different from diabetes and control at 15 days postpartum and only from control at 1 month. After, the weight mean of SGA was similar from others groups indicating an early catch up. Both, leptin (r=-0.295; p=0.03) and insulin (r=0.262; p=0.047) at 1 month were correlated with infant weight gain at 1 month. Conclusion: Breast milk hormones are similar at birth in all groups but the concentration decreases from colostrum to mature milk. SGA had a significant reduction in leptin and insulin concentration. This study demonstrates breast milk metabolic anticipation on SGA, probably is related to early catch up at 1 month of life.
105

Mensuração de biomarcador de exposição às aflatoxinas em fluidos biológicos / measure Biomarker

Alessandra de Cássia Romero 17 October 2007 (has links)
As aflatoxinas são substâncias naturais que apresentam efeitos tóxicos aos humanos e são reconhecidamente carcinogênicas. Estas substâncias podem estar presentes na dieta humana ou, em casos específicos, no ar respirado. Desta maneira, a exposição humana às aflatoxinas é objeto de muita preocupação. Uma das maneiras mais eficazes de avaliar a exposição humana as aflatoxinas é através da mensuração da presença de biomarcadores da exposição a estas substâncias em fluidos biológicos. Dentre as possibilidades de biomarcadores de exposição às aflatoxinas tem-se que aflatoxina M1 (AFM1), presente na urina e leite humano, é considerada um biomarcador válido. Assim sendo, o objetivo deste trabalho de pesquisa foi avaliar a presença de AFM1 em amostras de urina provenientes de indivíduos residentes na região urbana e rural da cidade de Piracicaba-SP, assim como, de leite de gestantes de Piracicaba e cidades da região. Nos indivíduos doadores de amostras de urina foi levantado também o padrão de ingestão de alimentos com alto risco de conter aflatoxinas, através da aplicação de inquéritos de freqüência alimentar e recordatórios 24 horas. A análise de AFM1 em urina e leite foi realizada por cromatografia liquida de alta eficiência (CLAE) com detecção por fluorescência. A extração e purificação do extrato foram realizadas com auxílio de colunas de imunoafinidade. No total 69 amostras de urina e 18 de leite foram analisadas. Entre as amostras de urina detectou-se a presença de AFM1 em 54 (78%) das amostras, com concentrações variando de 1,8 até 39,9 pg/mL. Não foi observada diferença estatística entre as concentrações médias detectadas entre urinas de indivíduos da zona urbana e rural, bem como no nível de consumo de produtos de risco. Apesar das concentrações de AFM1 detectadas serem inferiores as concentrações médias reportadas em outros países a freqüência de amostras positivas foi bastante elevada mostrando que as populações estudadas estão sendo expostas às aflatoxinas. Assim, melhores avaliações dos níveis de exposição necessitam ser realizados considerando que a amostragem utilizada foi pontual, pode existir variação de contaminação sazonal com aflatoxinas na dieta e a contaminação é heterogênea dentro no alimento. Não foi observada uma correlação entre o nível do consumo de produtos de risco e as concentrações detectadas em amostras de urina. Apenas uma amostra de leite apresentou contaminação detectada; entretanto, o nível de contaminação estava entre o limite de detecção (LD) e o limite de quantificação (LQ). / Aflatoxins are natural substances that present toxic and carcinogenic effects to humans. These substances may be present in human diet or, in specific cases, in the breathing air. Thus, the human exposition to aflatoxins is object of concern. One of the most effective ways to evaluate human exposition to aflatoxins is to measure the presence of biomarkers in biological fluids. Among the possibilities of aflatoxin presence biomarkers, the aflatoxin M1 (AFM1), present in human urine and milk, is considered a valid biomarker. The objective of this work was to evaluate the presence of AFM1 in urine samples from individuals who live in urban and rural areas in the county of Piracicaba, state of São Paulo, Brazil, and in milk of pregnant women from Piracicaba and neighbor cities. Urine-donor individuals were researched in relation to the ingestion of food with high risk of containing aflatoxins through the application of a food frequency questionnaire and 24-hour recall. The analysis of AFM1 in urine and milk was performed through high-performance liquid chromatography (HPLC) with fluorescence detection. The extract purification and extraction were performed with the aid of immunoaffinity columns. Overall, 69 urine and 18 human breast milk samples were analyzed. Among urine samples, the presence of AFM1 was detected in 54 (78%), with concentrations ranging from 1.8 to 39.9 pg/mL. No statistical difference was observed between average concentrations detected in the urine of individuals from urban and rural areas, as well as the consumption of aflatoxin risky food. Although the AFM1 concentrations detected are lower than those reported for other countries, the frequency of positive samples was quite high, showing that the populations studied are exposed to aflatoxins. Thus, further evaluations on the exposition levels should be performed, and considering that the sampling used in this work was punctual, there may be seasonal contamination variations in diet and the contamination level is heterogeneous within a food. No correlation between the consumption of risky food and concentrations detected in urine samples was observed. Only one milk sample presented detected contamination; however, the contamination level was between the limit of detection (LOD) and the limit of quantification (LOQ).
106

Predictors of NICU Admitted Newborns Receiving Mother's Own Milk as the First Feeding, during the NICU Stay, and at Discharge

Corley, Megan E. January 2019 (has links)
No description available.
107

Mothers’ Reasons for Early Breastfeeding Cessation

Morrison, April H., Gentry, Retha, Anderson, Joanna 01 December 2019 (has links)
Purpose: The purpose of this review is to assess maternal explanations for early breastfeeding cessation in economically developed countries. Study Design and Methods: The electromic databases EBSCO, CINAHL, Child Development & Adolescent Studies, PsycInfo, Health Source: Nursing/Academic Edition, Nursing and Allied Health; ProQuest databases: Family Health Database, Health and Medical Collection, Nursing and Allied Health, Psychology Database, and Public Health Databases were searched using the terms breastfeeding, cessation, stop, discontinuation, early weaning, quit∗, early termination, and six months. Inclusion criteria included infants born at least 37 weeks gestation, single birth, and infant birthweight > 2,500 g. Results: Initial literature search yielded 117 studies; 10 studies met inclusion criteria. The two most common reasons for early breastfeeding cessation were perceived inadequate milk supply and maternal breast or nipple pain. Conclusion: Research on maternal reasons for early breastfeeding cessation is limited. Reasons for early breastfeeding cessation are varied; however, the most common themes were perceived inadequate supply and breast or nipple pain. Nurses should tailor assessment of each breastfeeding mother-baby couplet and associated interventions based on these findings.
108

The Role of Prolactin in CCL28 Regulation

Hyde, Jennie 06 March 2007 (has links) (PDF)
Infants are born with naive immune systems, making them susceptible to a variety of infections. In order to protect the newborn infant it is important that mothers be able to pass protective IgA antibodies to their infants through breast milk. B cells that produce IgA enter the mammary tissue during lactation and secrete IgA into the milk. During pregnancy, the mammary tissue expresses high levels of chemokines, molecules that allow lymphocytes to selectively home to specific tissues. The chemokine CCL28 has been shown to be upregulated during both pregnancy and lactation, and is vital for the ability of IgA-producing B cells to home to the mammary tissue during lactation. The aim of this study was to determine whether CCL28 expression is regulated by prolactin signaling.
109

The possible association between stage of HIV disease and the nutrient composition of breast milk

De Wet, G. January 2013 (has links)
Thesis (M. Tech. (Biomedical technology)) - Central University of technology, Free State, 2013 / Breastfeeding is a major source of childhood nutrition and protection, but with South Africa having one of the highest HIV prevalence in the world the risk of HIV transmission from mother to infant through breastfeeding becomes a major issue. Infant mortality due to malnutrition and infections is also of great concern. Exclusive breastfeeding and giving antiretroviral drugs to the HIV-infected mother and the HIV-exposed infant is one of the most significant ways to improve infant survival rates and reduce transmission of HIV through breastfeeding. Whether HIV disease progression and its metabolic impact on the mother will affect the nutrient composition of breast milk is a question that arises. The aim of this study was to determine the possible association between the stage of HIV disease, as measured by the immunological markers, and the nutrient composition of breast milk. The study population consisted of 60 HIV infected female volunteers who were divided into two groups. Milk and blood samples were obtained from 30 HIV-positive women that was not on any ARV treatment and from 30 HIV-positive women that was on ARV treatment. Their HIV status and treatment regime were obtained from their files. Participants were also asked to complete a questionnaire. Macro-nutrients that were measured included lactose, proteins, fat, total solids and the energy content of the breast milk. This was done on the MIRIS Human milk analyser. The micro-nutrients that were measured were calcium and phosphate on the DXC 800 chemistry analyser. Blood analysis was included to determine the stage of HIV disease progression in the HIV-positive mothers and comprised of a CD4/CD8+ T cell count, viral load and a full blood count. CD4/CD8+ T cells were determined using flowcytometry on the BD FACScalibur. The COBAS AmpliPrep/COBAS TaqMan HIV-1 Test was used for the determination of the viral load and the full blood count was done using a Sysmex XT2000i haematology analyser. When comparing the analysed haematological variables, the white blood cells and red blood cells indicated a significant difference between the two groups. Both of the groups were anaemic. The CD3+ T cell count was higher and the CD4+ T cell count was lower than the reference range in both groups. The median CD4+ T cells and HIV-1 viral load for the HIV with treatment group was higher than the HIV-infected without treatment group. The analyzed milk data yielded no p-value of great significance, suggesting that there was no statistically significant difference recorded of the measured nutrients between mothers receiving treatment and those who did not receive any treatment for HIV. The Spearman Correlation Coefficient was used to determine if HIV disease progression would have an influence on the nutrients that were measured. For the HIV-infected without treatment group, a significant correlation was found between the HIV-1 viral load and percentage total solids in breast milk. For the HIV-infected with treatment group the only positive correlation was between the CD4+ T cell count and the percentage total solids and energy content of the breast milk. No strong positive correlation could be established between the immunological markers of HIV disease progression and the analysed nutrients in the breast milk. Taking this into consideration, HIV-positive mothers can breastfeed their babies even if their HIV status is at a more advance phase, but the emphasis should be placed on exclusive breastfeeding and getting the needed support to breastfeed.
110

The effect of HIV on the nutrient composition of breast milk

Hattingh, M. January 2013 (has links)
Thesis (M. Tech. (Biomedical technology)) - Central University of technology, Free State, 2013 / Thirty-one years after the discovery and isolation of the human immunodeficiency virus (HIV) by French and American scientists, much progress has been made in basic research, clinical treatment, and public heath prevention. Although, much evidence of mother-to-child-transmission (MTCT) of HIV has been amassed since then, not much of it describes the effects of HIV on the nutrient composition of breast milk. The aim of this study was to determine the effects of HIV on the nutrient composition of breast milk, by studying two groups of adult lactating respondents from the same socio-economic background, who were chosen randomly and participated voluntarily. The study population consisted of 60 breastfeeding mothers, divided into two groups of 30 mothers each. Group one represented the control group of HIV non-infected mothers whereas group two consisted of HIV-infected mothers who did not receive any treatment. After a registered medical nurse took blood and breast milk samples, analysis was done on ethylenediamine tetra-acetic acid (EDTA) whole blood to determine the haematological and immunological parameters and breast milk was analyzed for nutrient composition. Standard laboratory operating procedures (SOP) were followed, throughout, to determine the parameters of the blood and breast milk samples. Results showed that associations between the socio-economic statuses (SES) of the two respondent groups could be established. Albeit differences were not significant, some were, however, detected in the number of people contributing to the household income of the respondents (p = 0.0051), their employment status (p < 0.0001) and the availability of water sources (p = 0.1124). It is believed that factors, such as the prevalence of HIV, if related to the different levels of SES may play an important role in the outcome of the health statuses of individuals at different levels of society. By implication, it is not the different levels of SES, but rather factors related to the different levels of SES that have an impact. Significant differences could be seen in the haematological variables between the two respondent groups: Red blood cell count (RBC) (p < 0.0001), hemoglobin (Hb) levels (p = 0.0119), hematocrit (Hct) (p = 0.0031), mean corpuscular volume (MCV) (p = 0.0005), mean corpuscular hemoglobin (MCH) (p = 0.0043) and monocyte count (p = 0.0275). These differences, however, were not significant to this study. Other differences that were significant were immunological parameters between the two respondent groups: CD4 cell count (p < 0.0001) and viral load, done only on the blood of the HIV-infected respondent group. The CD4 cell count is used as a guideline for the initiation of treatment for HIV-infected persons and is required to accurately assess the immune status of any patient at any given time. The viral load has long been established as a strong predictor of the rate of disease progression. The only significant difference in the breast milk composition was reflected in the following variables between the two groups: percentage (%) proteins (p < 0.0001) and calcium levels (p = 0.0081). The median and mean values of the percentage proteins were elevated in the subject group of mothers living with HIV, while calcium levels in the same group showed a decrease in both median and mean values. The lack of significant differences between the groups might be due to the small study population. If nothing else, this study highlights the need for further trials to evaluate the true effects of HIV on the nutrient composition of breast milk.

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