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Biomedical subjects

L Bernardo

Publications and source records attributed to L Bernardo.

18 recordsLinked to original sources

Philadelphia-positive T-cell acute lymphoblastic leukemia with polymyositis, migratory polyarthritis and hypercalcemia following a chronic myeloid leukemia.

Transformation of chronic myeloid leukemia (CML) often results in acute myeloblastic or, less frequently, in precursor B-cell acute lymphoblastic leukemia (ALL). T-cell blast crisis is rare. Hypercalcemia has also been described as a rare complication of CML, but this usually occurs as a terminal event. Here we report a case of a 35-year-old woman who developed a CD4(+)/CD8(+) T-cell ALL 2 years after the diagnosis of a typical Ph(+) CML. Polymyositis and polyarthritis preceded by 4 months, and symptomatic hypercalcemia occurred just before blastic transformation, probably representing paraneoplastic manifestations of the disease.

Adult↗

Growth, neurobehavioral and circadian rhythm development in newborn baboons.

We measured body temperature continuously using telemetry to determine the development of circadian rhythmicity in neonatal baboons after birth. Twelve fetal baboons (nine males and three females) of known gestational age ranging from 167 to 193 d were studied. We eliminated the influence of maternal factors by hand rearing these infants from the moment of birth until 45 d of life. All infants showed steady growth in body weight, head circumference, and crown-rump length. Neurobehavioral responses including visual and auditory orientation, motor maturity, irritability, and consolability increased as a function of age. Circadian rhythms of body temperature were present in the second week of life, and the amplitude of this rhythm increased throughout the developmental period studied. The increase in the amplitude of circadian body temperature rhythm independent of environmental time cues may indicate the maturation of the brain. These neonatal nonhuman primates offer an excellent model for studying neurobehavioral development and maturation of circadian rhythms while controlling external factors in a manner that is not possible with human neonates.

Animals↗

Adolescence: macronutrient needs.

Dietary needs during adolescence lack specific definitions, and most evidence is derived from indirect indications. The data on dietary needs for energy and proteins are mainly extrapolated from subjects in other age-classes. Lipids and carbohydrates are being progressively considered for preventive purposes since the qualitative distribution of saturated and unsaturated fats and slowly and rapidly absorbed carbohydrates, respectively, seems to be associated with metabolic index predictors of degenerative disorders in later stages of life. The recent results of multicentric autoptic studies in young people from the US indicate that the lipoprotein status of the second decade of life is associated with the first raised arterial lesions in the third decade. The evidence of these links needs further confirmation from ongoing surveys. We must recognize that adolescence is a critical period of life, and food fads may deeply change the dietary habits acquired within the familiar group. As nutritionists, we may suggest that all adolescents should be supplied with nutritional support in terms of education, maybe at school, to improve their knowledge of nutrition.

Adolescent↗

Dietary 18:3n-3 and 22:6n-3 as sources of 22:6n-3 accretion in neonatal baboon brain and associated organs.

The bioequivalence of dietary linolenic acid (LNA) and docosahexaenoic acid (DHA) for brain DHA accretion was measured in neonatal baboons at 4-6 wk of age using stable isotope tracers. Neonates consumed a conventional U.S. term-infant formula devoid of long chain polyunsaturates and with an n-6/n-3 ratio of about 10:1. At 4 wk of age, neonates were dosed with either 13C LNA or 13C DHA. At 6 wk of age, neonate brain, retina, and other organs were harvested for fatty acid and isotopic analyses. The relative accretion of labeled DHA was 7-fold greater as a percentage of dose for the DHA-dosed animals compared to the LNA-dosed animals. The baboon is an omnivore that regularly consumes meat and insects; its plasma lipid profile responds similarly to humans in response to changes in feeding and living habits. These observations suggest that the baboon is a suitable model for human unsaturated fatty acid studies.

Animals↗

The LUNAR project: A description of the population of individuals who seek health care at emergency departments.

INTRODUCTION: Although little information exists about the consumers of emergency services and their illness behaviors, such information is essential for decision making by providers, administrators, and policy makers. The purpose of the LUNAR Project was to describe the population of individuals who seek health care at emergency departments. METHODS: After they attended a training course, 90 emergency nurses served as site coordinators in 89 emergency departments in 35 states. A standardized protocol was used to collect data retrospectively from 140 randomly selected patient records at each site. The final sample included 12,422 ED patients. RESULTS: Overall, 52% of the patient visits were for nonurgent care, 40% were for urgent care, and 8% were for emergent care. Most visits occurred between 10 AM and 8 PM and peaked at 6 PM. Children and younger adults were the largest consumers of services, primarily for nonurgent care. The most frequent reasons for visits were fever, chest pain, and abdominal pain, and the most common discharge diagnoses were middle ear infection, chest pain, and acute upper respiratory infection. DISCUSSION: The profile of ED patients showed a need for new types of services to provide nonurgent care and new interventions for preventing illnesses and injuries commonly treated in the emergency department.

Adolescent↗

Carob is not allergenic in peanut-allergic subjects.

BACKGROUND: The antigenic potential of proteins from the carob bean, a member of the legume family used as a food additive, have not so far been investigated and legumes share antigenic proteins with peanut, a potent trigger of anaphylaxis. OBJECTIVE: To assess the carob protein determinants of sensitization in peanut-allergic children. METHODS: In a prospective, double-blind, placebo-controlled study 12 patients (median age 9.5 years) with a history of hyperreactivity to peanut (anaphylaxis) were assessed. Skin prick tests with a commercial peanut allergen, raw carob pulp, raw and cooked carob cotyledon formula were used to confirm the history. RAST for peanuts and cooked carob were used to evaluate sensitization to these proteins. Carob-specific IgE were identified by immunoblotting analyses. Allergic reactivity was evaluated during double-blind placebo-controlled food challenges (DBPCFC; 5.5 g carob extract and cooked carob cotyledon formula). RESULTS: Peanut allergen-induced skin prick test positivity in all children (confirmed during double-blinded challenge in 6/12 patients), carob pulp in 3/12 patients, raw carob bean in 6/12, and cooked carob cotyledon formula in none. RAST were positive for peanut in all cases but negative for carob beans in 9/12 cases. Immunoblot analyses found peanut-specific IgE in all cases and raw carob bean-specific IgE in eight cases. Carob allergens were identified in the 17.5, 48, and 66 kDa MW bands. The least allergenic density was found for cooked carob proteins. There was no clinical reactivity with either raw or cooked carob during DBPCFC. CONCLUSIONS: These data suggest that carob-specific sensitization, apparent both in vitro and in SPTs, can be concordant with peanut allergy and that cooked carob can be ingested by children who are allergic to peanuts. That heat-processing deactivates carob protein allergenicity has dietary implications for polyallergic children.

Adolescent↗

Long-chain polyunsaturated fatty acids in human milk.

Arachidonic acid and docosahexaenoic acid are the most representative long-chain polyunsaturated fatty acids (LCPUFA) since they may affect infants' growth and development. LCPUFA are present in the milk of all lactating women throughout lactation. The mothers' dietary habits may affect the levels of these fatty acids in maternal blood lipids and then in milk. LCPUFA show marked differences in levels as wt%, particularly from colostrum to mature human milk, but only mild differences in absolute content. Both the major presence of LCPUFA in human milk phospholipids and some regulatory mechanisms in the mammary gland cells could contribute to the LCPUFA levels in milk beyond those in maternal plasma.

Arachidonic Acid↗

Bioequivalence of dietary alpha-linolenic and docosahexaenoic acids as sources of docosahexaenoate accretion in brain and associated organs of neonatal baboons.

The dietary bioequivalence of alpha-linolenic (LNA) and docosahexaenoic acids (DHA) as substrates for brain and retinal n-3 fatty acid accretion during the brain growth spurt is reported for neonatal baboons who consumed a long-chain-polyunsaturate free commercial human infant formula with a n-6/n-3 ratio of 10:1. Neonates received oral doses of 13C-labeled fatty acids (LNA*) or (DHA*) at 4 wk of age, and at 6 wk brain (occipital cortex), retina, retinal pigment epithelium, liver, erythrocytes, and plasma were analyzed. In the brain, 1.71% of the preformed DHA* dose was detected, whereas 0.23% of the LNA* dose was detected as DHA*, indicating that preformed DHA is 7-fold more effective than LNA-derived DHA as a source for DHA accretion. In LNA*-dosed animals, DHA* was greater than 60% of labeled fatty acids in all tissues except erythrocytes, where docosapentaenoic acid was 55%. Estimates using dietary LNA levels as tracees indicate that brain turnover of DHA is less than 5% per week between weeks 4 and 6 of life. For retina and retinal pigment epithelium, preformed DHA was at levels 12-fold and 15-fold greater than LNA-derived DHA. Liver, plasma, and erythrocytes ratios were 27, 29, and 51, respectively, showing that these pools do not parallel tissue metabolism of a single dose of omega-3 fatty acids. The distributions of labeled fatty acids for LNA*-dosed animals were similar, in the order DHA > DPA > EPA > LNA, except for erythrocytes where docosapentaenoic acid predominated. These are the first direct measurements of the bioequivalence of DHA and LNA in neonatal primate brain and associated tissues.

Administration, Oral↗

Low levels of linoleic acid in plasma total lipids of HIV-1 seropositive children.

OBJECTIVE: To assess the plasma fatty acid status of a group of well-nourished children with the human immunodeficiency virus type-1 (HIV-1) and how this relates to the blood total CD4+ lymphocyte count. SUBJECTS: Fourteen HIV-1 seropositive children at various stages of disease and with adequate growth indices were assessed and compared to a control group of 30 healthy children. RESULTS: The concentrations (mg/dL) of plasma total fatty acids were not different between the two groups. HIV-1 seropositive children presented lower levels of 18-C essential polyunsaturated fatty acids (PUFA: linoleic acid, LA, and alpha-linolenic acid) and higher levels of their 20-C long-chain derivatives (di-homo-gamma-linolenic acid, arachidonic acid, AA, and eicosapentaenoic acid) and docosahexaenoic acid in their plasma total lipids. The lowest plasma LA levels were observed in the subgroup of patients with more advanced stages of disease. In bivariate analyses the plasma LA levels related positively (Spearman r = 0.50, p = 0.06), while the LA/AA ratio related negatively (Spearman r = -0.51, p = 0.06), to the total CD4+ count. CONCLUSIONS: Childhood HIV-1 infection is associated with changes in plasma fatty acid profile suggestive of an increased PUFA turnover. Decreased levels of LA (together with higher plasma AA levels) appear to be associated with more advanced clinical and biochemical stages of disease.

8,11,14-Eicosatrienoic Acid↗

Heat treatment modifies the allergenicity of beef and bovine serum albumin.

The effect of heat on the allergenicity of beef and bovine serum albumin was investigated among 10 toddlers skin prick test (SPT)-positive to raw and cooked beef. The meat-allergy diagnosis was confirmed during double-blind, placebo-controlled food challenge (DBPCFC) with 180 g of beef cooked for 5 min at 100 degrees C. SPT with homogenized and freeze-dried beef, and heated and unheated bovine serum albumin were performed. Both heated and unheated bovine serum albumin, homogenized beef, and freeze-dried beef were used in trial DBPCFC. All children were SPT-positive to unheated bovine serum albumin. Seven were positive to heated bovine serum albumin, one to freeze-dried beef, and none to homogenized beef. DBPCFCs were negative for homogenized beef and freeze-dried beef, positive for unheated bovine serum albumin in five patients, and positive for heated albumin in four children. We conclude that heating reduces sensitization to beef and bovine serum albumin but does not abolish reactivity to albumin under home conditions. However, industrially heat-treated and sterilized homogenized beef and freeze-dried beef may be suitable substitutes in beef-allergic children's diets.

Allergens↗

Effect of nedocromil sodium on bronchial hyperreactivity in children with nonatopic asthma.

BACKGROUND AND OBJECTIVES: Although cromones inhibit immediate bronchial responses to both allergen and nonspecific challenge, their effectiveness in treating nonatopic childhood asthma is unknown. We therefore investigated a possible effect of nedocromil sodium on bronchial hyperreactivity and asthmatic symptoms in a group of children receiving this drug for nonatopic asthma. STUDY DESIGN AND METHODS: A double-blind, placebo-controlled, randomized trial of two parallel groups was carried out in our pediatric respiratory disease clinic. Twenty children with mild, nonatopic asthma hyperreactive to fog-induced challenge were treated with inhaled nedocromil sodium 16 mg each day for 6 weeks (group N) or with a placebo (group P). Five girls and five boys (7 to 13 years of age) were randomly assigned to group N, and three girls and seven boys (aged 6 to 16 years) to group P. Symptoms and bronchodilator use were reported on diary cards. Ultrasonic nebulized distilled water PD10 was measured administering increasing doses of nebulized distilled water (2.5, 5, 10, 20, and 40 L). RESULTS: Symptom scores were significantly affected by the active treatment. Baseline lung function was normal and remained unaltered after treatment with nedocromil sodium. Nonspecific reactivity was significantly reduced over time only in the active treatment group. CONCLUSIONS: Nedocromil sodium can reduce the severity of asthmatic symptoms and nonspecific bronchial hyperreactivity at fog-induced challenge in children with stable, nonatopic asthma.

Adolescent↗

Clinical and pro-host effects of cefaclor in prophylaxis of recurrent otitis media in HIV-infected children.

The aim of this study was to evaluate the efficacy of cefaclor in the prophylaxis of recurrent acute otitis media (AOM) in human immunodeficiency virus (HIV)-infected children. The study was carried out in children born between 1 January 1986 and 31 December 1996 who had been vertically HIV infected Patients who had experienced recurrent AOM between October 1997 and March 1998 (period 1) were eligible for the trial. Recurrent AOM was defined as the occurrence in the same patient of three or more episodes of AOM within 6 months of the observation period. Patients recruited for this trial received cefaclor at a dose of 20 mg/kg once daily for 6 months between April and September 1998 (period 2). Clinical observation was carried out in periods 1 and 2 and for the first 6 months after prophylaxis, i.e. October 1998 - March 1999 (period 3). Natural killer-cell activity, phagocytosis and myeloperoxidase activity were determined before and at the end of the prophylactic period. For each period, CD4-cell count measurement and CD4-positive cell class were recorded. Seventeen children were recruited for this trial. No significant differences were observed in natural killer-cell activity between periods 1 and 2, nor were any significant differences observed in CD4-positive cell class or CD4-positive cell count between the three periods. However, cefaclor administration was associated with a reduction in the number of AOM episodes in 100% of cases and a mean increase in myeloperoxidase activity in 57% of cases. This suggests that cefaclor may be useful in the prophylaxis of recurrent AOM in HIV-infected children.

Acute Disease↗