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Τετάρτη 12 Οκτωβρίου 2022

Maternal diet during breastfeeding in correlation to calcium and phosphorus concentrations in human milk

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Abstract

Background

The impact of maternal diet on minerals concentration in human milk (HM) remains unclear. The main aim of this study was to investigate the relationship between maternal dietary intake and calcium and phosphorus concentrations in HM. Furthermore, we aimed to evaluate the intake of both minerals by exclusively breastfed infants.

Methodology

HM samples were obtained from 30 mothers at 6-8 weeks postpartum. Each mother was asked to express pre- and post-feeding milk four times during 24-h period (6.00-12.00, 12.00-18.00, 18.00-24.00, 24.00-6.00). Maternal dietary assessment was based on food frequency questionnaire and 3-day dietary records. Analyzed minerals were determined by inductively coupled plasma mass spectrometer (NexION 300D ICP Mass Spectrometer, Perkin Elmer SCIEX, USA).

Results

The mean concentrations of calcium and phosphorus in HM samples were 278.7 ± 61.0 mg/L and 137.1 ± 21.9 mg/L, respectively, maintaining 2:1 ratio b y weight. The concentration of both minerals was correlated with each other (r=0.632, p=<0.001). The infants' mean calcium intake was 149.53 ± 36.41 mg/L and for phosphorus it was 74.62 ± 19.41 mg/L. The risk of insufficient intake of calcium was reported in 60% of infants (n=18). Spearman/Pearson correlation coefficients did not reveal any correlations between HM calcium concentration and maternal diet, contrary to HM phosphorus concentration, which was positively correlated with energy (r=0.369, p=0.045), total protein (r=0.464, p=0.01), calcium (r=385, p=0.036), phosphorus (r=501, p=0.005), niacin (p<0.001) and pyridoxine (r=382, 0.037) intake. However, in multivariable analysis we observed that maternal dietary intake of both minerals had positive influence on their concentration in HM.

Conclusion

Maternal calcium and phosphorus intake influenced concentration of both minerals in HM, however the relationship was rather weak. Additionally, we observed that c alcium intake by most of the exclusively breastfed infants was insufficient to meet the recommended daily intake.

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Improved Survival after Liver Transplantation for Patients with HIV and HIV/HCV Coinfection in the INSTI and DAA eras

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Abstract
Background
Patients with human immunodeficiency virus (HIV) with and without hepatitis C virus (HCV) coinfection had poor outcomes after liver transplant (LT). Integrase strand transfer inhibitors (INSTI) and direct-acting antivirals (DAA) changed the treatment landscape for HIV and HCV, respectively; their impact on LT outcomes remains unclear.
Methods
This retrospective analysis of adults with HIV monoinfection (n = 246) and HIV/HCV coinfection (n = 286) who received LT compared mortality in patients with HIV who received LT before vs. after approval of INSTI and in patients with HIV/HCV coinfection who received LT before vs after approval of DAA. In secondary analysis, we compared the outcomes in the different eras with those of propensity score (PS) matched control cohorts of LT recipients without HIV or HCV infection.
Results
HIV monoinfected LT recipients did not experience a significant improvement in su rvival between the pre-INSTI and INSTI recipients with HIV (aHR 0.70 [0.36-1.34). However, recipients with HIV/HCV coinfection in the DAA era had a 47% reduction (aHR 0.53 [0.31-9.2] in one-year mortality than co-infected recipients in the pre-DAA era. Compared to non-HIV or HCV recipients, HIV monoinfected recipients had higher mortality during the pre-INSTI era (aHR, ), but survival was comparable between groups during the INSTI era (aHR, ). HIV/HCV coinfected recipients also experienced comparable survival during the DAA era compared to non-HIV or HCV recipients (aHR, ).
Conclusions
Post-LT survival for patients with HIV monoinfection and HIV/HCV coinfection has improved with the introduction of INSTI and DAA therapy, suggesting that LT has become safer in these populations.
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Using indocyanine green angiography to achieve complete engraftment of pectoralis major myocutaneous flaps

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This report describes the usefulness of indocyanine green angiography (ICGA) to achieve complete engraftment of the PMMC flap. Five patients with oral cancer underwent reconstruction with a PMMC flap after cancer ablation. During the skin paddle design and flap elevation, the blood supply to the flap was assessed by ICGA. (Source: International Journal of Oral and Maxillofacial Surgery)
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