scholarly journals Pre-Treatment of Dairy and Breast Milk with Sevelamer Hydrochloride and Sevelamer Carbonate to Reduce Phosphate

2013 ◽  
Vol 33 (5) ◽  
pp. 565-572 ◽  
Author(s):  
Renske Raaijmakers ◽  
Lambertus M.W. Houkes ◽  
Cornelis H. Schröder ◽  
Johannes L. Willems ◽  
Leo A.H. Monnens
Keyword(s):  
Breast Milk ◽  
Dairy Products ◽  
Tube Feeding ◽  
Calcium Content ◽  
Chloride Content ◽  
Phosphate Content ◽  
Sevelamer Hydrochloride ◽  
Increased Risk ◽  
Sevelamer Carbonate ◽  
Pre Treatment

Introduction Young children and infants with chronic kidney disease are at increased risk of hyperphosphatemia because of high intake of dairy products. Hyperphosphatemia leads to metastatic calcifications and an increased risk of cardiovascular complications. Sevelamer is an effective phosphate binder, but for children it has important practical disadvantages: it clogs enteral feeding tubes and can cause gastrointestinal complaints. Pre-treatment of dairy products to reduce their phosphate content might solve those problems. Methods Sevelamer hydrochloride and sevelamer carbonate were suspended in various dairy products (cow's milk, breast milk, baby formula, and tube-feeding formula). Each product was tested with varying concentrations of sevelamer. After suspension, each sample was stored for 10 minutes, allowing the sevelamer to precipitate. The supernatant was decanted and analyzed for pH and for phosphate, calcium, magnesium, potassium, sodium, and chloride content. Results We observed a significant decrease in the phosphate content of all tested products. With sevelamer hydrochloride, the phosphate reduction was 48% – 91% in the various products, and with sevelamer carbonate, it was 22% – 87%. The highest effectiveness was found in breast milk. A pH increase was found in all products. With sevelamer hydrochloride, a significant increase in chloride occurred. Notably, a significant decrease in calcium content (–75%) was observed in treated breast milk. Conclusions Pretreatment of a variety of dairy products with either sevelamer hydrochloride or sevelamer carbonate effectively reduced their phosphate content and might avoid troublesome ingestion of sevelamer in children. The change in pH with sevelamer hydrochloride was remarkable, reflecting buffering mechanisms. The reduction in the calcium content of breast milk is a potential concern and should be carefully considered and monitored during clinical use of sevelamer.

scholarly journals Tube Feeding Practices and Transition to Breastfeeding Experiences of Mothers of Preterm Infants at a Kangaroo Mother Care Unit of a Tertiary Hospital in South Africa

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110370
Author(s):  
Sphiwe Madiba ◽  
Malmsey Sengane
Keyword(s):  
South Africa ◽  
Breast Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Tube Feeding ◽  
Feeding Practices ◽  
Tertiary Hospital ◽  
Very Preterm Infants ◽  
Mothers Of Preterm Infants ◽  
Group Interviews

To receive human milk, most preterm infants initially receive the mothers’ expressed milk through a nasogastric tube. However, breast milk feeding the preterm infant and making the transition to direct breast-feeding come with significant challenges. The study explored and described the experiences of mothers of preterm infants regarding initiation and expressing breast milk, tube feeding practices, and transition to breastfeeding during the infants’ stay in a kangaroo care unit (KMC) of an academic hospital in South Africa. Using a qualitative design, focus group interviews were conducted with 38 mothers of preterm infants after discharge from the neonatal intensive care unit (NICU). We analyzed transcripts following the 5 steps for qualitative thematic data analysis. Tube feeding and breastfeeding preterm infants was challenging and exhausting for the mothers. Many described their experiences of initiating expression and sustaining milk supply as negative. They had constant concerns about their ability to produce adequate milk volumes to feed their infants. They had immense dislike of expressing, which they described as physically exhausting, stressful, and painful. Those who had initiated breastfeeding were highly motivated to breastfeed their preterm infants. They described breastfeeding as a positive bonding experience that they derived pleasure from. The mothers’ dislike of expressing was overshadowed by their emotional obligation toward their preterm infants. Although the KMC unit promotes breastfeeding, mothers encountered problems and struggled to initiate expression and sustain milk production. Mothers of extreme and very preterm infants need support to continue with milk expression during the long NICU and KMC stay.

scholarly journals Consumption of dairy products and the 15-year incidence of age-related macular degeneration

2014 ◽  
Vol 111 (9) ◽  
pp. 1673-1679 ◽  
Author(s):  
Bamini Gopinath ◽  
Victoria M. Flood ◽  
Jimmy C. Y. Louie ◽  
Jie Jin Wang ◽  
George Burlutsky ◽  
...  
Keyword(s):  
Dairy Products ◽  
Dairy Product ◽  
Age Related Macular Degeneration ◽  
Dairy Foods ◽  
Product Consumption ◽  
Reduced Fat ◽  
Age Related ◽  
Increased Risk ◽  
Dairy Product Consumption

Habitual consumption of dairy products has been shown to play an important role in the prevention of several chronic diseases. We aimed to prospectively assess the relationship between the change in dairy product consumption (both regular fat and low/reduced fat) and the 15-year incidence of age-related macular degeneration (AMD). In the Blue Mountains Eye Study, 2037 participants aged 49 years or above at baseline were re-examined at follow-up in 1997–9, 2002–4 and/or 2007–9. AMD was assessed from retinal photographs. Dietary data were collected using a semi-quantitative FFQ, and servings of dairy product consumption calculated. Over the 15-year follow-up, there were 352, 268 and eighty-four incident cases of any, early and late AMD, respectively. After adjusting for age, sex, current smoking, white cell count and fish consumption, a significant linear trend (Pfor trend = 0·003) was observed with decreasing consumption of total dairy foods and the 15-year incidence of late AMD, comparing the lowestv.highest quintile of intake (OR 2·80, 95 % CI 1·21, 3·04). Over the 15 years, decreased consumption of reduced-fat dairy foods was associated with an increased risk of incident late AMD, comparing the lowest to highest quintile of intake (OR 3·10, 95 % CI 1·18, 8·14,Pfor trend = 0·04). Decreasing total dietary Ca intake over the 15 years was also associated with an increased risk of developing incident late AMD (multivariable-adjustedPfor trend = 0·03). A lower consumption of dairy products (regular and low fat) and Ca was independently associated with a higher risk of developing incident late AMD in the long term. Additional cohort studies are needed to confirm these findings.

Studies with pre-treatment of milk with calcium acetata to reduce the phosphate content

1995 ◽  
Vol 154 (8) ◽  
pp. 689-689 ◽  
Author(s):  
Cornelis H. Schröder ◽  
Dorine W. Swinkels ◽  
Roland Verschuur ◽  
Hans L. Willems ◽  
Leo A. H. Monnens
Keyword(s):  
Phosphate Content ◽  
Pre Treatment

scholarly journals Can they stomach it? Parent and practitioner acceptability of a trial comparing gastric residual volume measurement versus no gastric residual volume in UK NNU and PICUs: a feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Elizabeth Deja ◽  
Louise Roper ◽  
Lyvonne N. Tume ◽  
Jon Dorling ◽  
Chris Gale ◽  
...  
Keyword(s):  
Intensive Care ◽  
Focus Groups ◽  
Feasibility Study ◽  
Research Question ◽  
Tube Feeding ◽  
Careful Consideration ◽  
Paediatric Intensive Care ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Increased Risk

Abstract Background Routine measurement of gastric residual volume (GRV) to guide feeding in neonatal and paediatric intensive care is widespread. However, this practice is not evidence based and may cause harm. As part of a feasibility study, we explored parent and practitioner views on the acceptability of a trial comparing GRV measurement or no GRV measurement. Methods A mixed-methods study involving interviews and focus groups with practitioners and interviews with parents with experience of tube feeding in neonatal and/or paediatric intensive care. A voting system recorded closed question responses during practitioner data collection, enabling the collection of quantitative and qualitative data. Data were analysed using thematic analysis and descriptive statistics. Results We interviewed 31 parents and nine practitioners and ran five practitioner focus groups (n=42). Participants described how the research question was logical, and the intervention would not be invasive and potential benefits of not withholding the child’s feeds. However, both groups held concerns about the potential risk of not measuring GRV, including delayed diagnosis of infection and gut problems, increased risk of vomiting into lungs and causing discomfort or pain. Parent’s views on GRV measurement and consent decision making were influenced by their views on the importance of feeding in the ICU, their child’s prognosis and associated comorbidities or complications. Conclusions The majority of parents and practitioners viewed the proposed trial as acceptable. Potential concerns and preferences were identified that will need careful consideration to inform the development of the proposed trial protocol and staff training.

Abstract TP25: Increased Risk for Unfavorable Outcome in Patients with Pre-existing Disability Undergoing Endovascular Therapy

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Ronen R Leker ◽  
Pavel Gavriliuc ◽  
Nour Eddine Yagmur ◽  
John M Gomori ◽  
Jose E Cohen
Keyword(s):  
Endovascular Therapy ◽  
Real Life ◽  
Unfavorable Outcome ◽  
Stroke Severity ◽  
Imaging Data ◽  
Anterior Circulation ◽  
Poor Outcome ◽  
Increased Risk ◽  
Degree Of Disability ◽  
Pre Treatment

Background and Objectives: Most studies evaluating endovascular therapy (EVT) for stroke only included patients without pre-existing disability. However, in real life many patients have pre-existing disability and whether they can benefit from EVT remains unknown. Methods: Patients with large vessel anterior circulation stroke were prospectively enrolled. Patients with no or mild disability (modified Rankin Scale [mRS] 0-2) were compared with patients presenting with pre-existing moderate disability (mRS≥3). Baseline demographics and risk factors, stroke severity (studied with the National Institutes of Health Stroke Scale [NIHSS]), imaging data including pre-treatment ASPECTS and ASPECTS collateral scores, as well as procedure related variables were accrued. Unfavorable outcome was defined as mRS≥4 at day 90. Results: Out of 100 enrolled patients, 85 had baseline mRS≤2 and 15 had pre-stroke mRS≥3. Patients with pre-existing mRS≥3 were significantly older (79.0±6 vs. 66.6±14, p=0.001) and more often had previous strokes (47% vs. 19%, p=0.04) and ASPECTS≤7 (33% vs. 12%, p=0.03). Patients with mRS≥3 at presentation were more likely to have poor outcome or death (OR 4.4 95%CI 1.3-15.0). Four of the patients with pre-existing moderate disability (27%) maintained their previous degree of disability. On multivariate analysis age (OR 1.1 95%CI 1.1-1.2), admission NIHSS (OR 1.2 95%CI 1-1.3) and complete recanalization (OR 0.2 95%CI 0.04-0.68) remained significant modifiers of poor outcome. Conclusions: Patients with pre-existing moderate disability have higher chances for sustaining unfavorable outcomes despite EVT. Nevertheless, some patients maintain the same level of moderate disability and therefore patients with pre-existing moderate disability should not be excluded from EVT.

Characterisation and protein intake analysis of no- to high meat consumption, based on the Swiss National Nutrition Survey menuCH

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Lydia Steinbach ◽  
Ivo Kaelin ◽  
Jean-Philippe Krieger ◽  
David Faeh ◽  
Isabelle Herter-Aeberli ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Health Status ◽  
Dietary Supplements ◽  
Dairy Products ◽  
Protein Intake ◽  
Multinomial Logistic Regression ◽  
Meat Consumption ◽  
Nutrition Survey ◽  
Meat Intake ◽  
Increased Risk

AbstractToday's high interest for no- or low-meat diets is driven by evidence-based associations between high meat consumption and unhealthy lifestyle factors as well as increased risk of various chronic diseases. This study aims to characterize no-, low- and high-meat consumers and describe their protein intake using data from the Swiss nutrition survey menuCH.This first national survey assessed descriptive factors by a questionnaire and dietary intake by 24-hour dietary recall (24 HDR) across all three linguistic regions, German, French and Italian of Switzerland (N = 2057). Data from the questionnaire (food avoidance) and two 24 HDRs were used to categorize total participants (N) into four subgroups: no meat (4.4%); low (15%), medium (65.6%), or high-meat eaters (15%), based on meat-energy contributions of 0; 0–2.4; 2.4–18.7; 18.7–48.4, respectively. Contributions of overall macronutrients and protein from the different food groups were described for each subgroup to identify quantitative and qualitative differences. Multinomial logistic regression analysis was applied to predict the probability of belonging to one of the four subgroups according to the following sociodemographic and behavioral variables: sex, language region, age, nationality, marital status, education, gross household income, BMI, physical activity, smoking, dietary supplements and overall health status. The subgroups differed in protein intake with 11.5%, 12.8%, 15.4% and 19.1% of total energy intake for no-, low-,medium- and high-meat diets, respectively, weighted for sampling design, non-response, weekdays and season. In general, no- and low-meat consumers included a greater variety of foods contributing to protein intake than meat consumers, including more dairy products and meat-alternatives. None of the subgroups met the Swiss Food-based Dietary Guidelines of three portions of dairy products per day. The regression analysis showed that sex, taking dietary supplements or not and BMI were important determinants of the subgroups: women had a higher predicted probability than men to be no- and low-meat eaters and for these same subgroups, individuals showed higher probabilities for taking dietary supplements. Overweight and obese participants showed higher probabilities to be high-meat eaters.These findings show considerable differences in protein intake and in variety of protein-food selections, between extremes of meat intake (no- to high meat consumption). Future surveys should include frequency methods to allow conclusions about habitual meat intake or avoidance and health status screening to analyse individuals health data.

Maternal breast milk long-chain n-3 fatty acids are associated with increased risk of atopy in breastfed infants

2004 ◽  
Vol 34 (2) ◽  
pp. 194-200 ◽  
Author(s):  
R. M. Stoney ◽  
R. K. Woods ◽  
C. S. Hosking ◽  
D. J. Hill ◽  
M. J. Abramson ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Breast Milk ◽  
Breastfed Infants ◽  
Increased Risk ◽  
Long Chain

In vitro re-mineralization of demineralized bone matrix in human serum

2006 ◽  
Vol 44 (1) ◽  
Author(s):  
Metin Manouchehr Eskandari ◽  
Hatice Gulcin Eskandari ◽  
Melih Aktas ◽  
Ugur Atik
Keyword(s):  
Human Serum ◽  
Serum Calcium ◽  
Inorganic Phosphate ◽  
Mineral Content ◽  
Demineralized Bone Matrix ◽  
Bone Matrix ◽  
Calcium Content ◽  
Study Groups ◽  
Phosphate Content

AbstractThe aim of this study was to develop an in vitro re-mineralization model in human serum. For this purpose a commercially produced demineralized human bone matrix (DBM) was incubated in samples of human serum pools obtained from two physiologically different groups. The first group consisted of young males and the second of older females. After incubation periods of 4 and 7days at 37°C, changes in the levels of calcium and inorganic phosphate content of the serum and DBM samples were measured. The results of the study showed that the change in mineral content of serum and DBM samples in both study groups was statistically significant. The decrease in serum calcium content and increase in DBM inorganic phosphate content were significant in the young group for longer incubation times. In the older group, both serum calcium and inorganic phosphate decreased and DBM mineral content increased for the same incubation time. When the two physiological groups were compared, statistically significant differences were identified for changes in mineral levels in both serum and the DBM samples. These data indicate that the mineral content of human serum decreases and that of DBM increases when these two materials are incubated together. These changes provide evidence for the re-mineralization of DBM. The model described here could also detect a difference in re-mineralization capability between two different groups of human sera.

Choline in pregnancy and breastfeeding

2015 ◽  
Author(s):  
Sir Peter Gluckman ◽  
Mark Hanson ◽  
Chong Yap Seng ◽  
Anne Bardsley
Keyword(s):  
Breast Milk ◽  
Structural Integrity ◽  
Cholesterol Transport ◽  
High Demand ◽  
Lactating Women ◽  
Methyl Group ◽  
Neonatal Life ◽  
Increased Risk ◽  
Folate And Vitamin B12 ◽  
In Pregnancy

Choline is required for the structural integrity of cell membranes and is involved in methyl-group metabolism, neurotransmission, transmembrane signalling, and lipid and cholesterol transport and metabolism. Choline is critical during fetal and neonatal life to ensure optimal brain and cognitive development. There is an intersection of the pathways of choline, folate, and vitamin B12 in the formation of methionine from homocysteine. Maternal peri-conceptional deficiency for choline, like folate, is associated with an increased risk of neural tube defects in the offspring. It is recommended that pregnant women do not restrict fat severely from their diets, as choline is derived from the lipid content of food. Strict vegetarian or vegan diets may be low in choline. The high secretion rate of choline into breast milk means that lactating women have a high demand, and multivitamins containing choline may be helpful for both pregnancy and breastfeeding.

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