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[Relation between salt intake and systolic pressure in children and adolescents].

This study was undertaken to demonstrate a possible intra-population salt intake/blood pressure relationship, using dietary assessment in 312 children (man age: 11 years). Salt intake was assessed through questionnaires and interviews by a dietician and was categorized into five salt scores. A salt intake index was established by a correspondence analysis. A low but significant correlation was found between systolic blood pressure (SBP) and salt score (0,187 in boys and 0,240 in girls) even after controlling for weight. Twice as many children with a high salt intake has raised SBP then had children with a normal or low salt intake. Though it is weak the relationship between SBP and salt intake is corroborated. However, there is a great interindividual variation and it seems premature to advocate such massive public health recommendations as as reducing the sodium content of food.

Adolescent

Hydrophobic adhesin of E coli in ulcerative colitis.

Pathogenic E coli have adhesive properties which are mirrored by an increase in their surface hydrophobicity. E coli isolated from patients with ulcerative colitis possess a mannose resistant adhesin similar to that found in pathogenic E coli. In this study 42 E coli isolates from patients with colitis have been compared with 15 from controls to assess hydrophobicity and cellular adherence. The salting out method and the buccal epithelial cell technique were used respectively. E coli isolated from colitics are significantly more hydrophobic than control E coli (p less than 0.001). The salting out score correlates negatively with the buccal epithelial cell adhesion index. When E coli are grown at 18 degrees C both properties are temporarily reduced suggesting that they are related to each other. The salting out method clearly differentiates between E coli isolated from colitics and controls, and offers a simple method of detecting adhesive E coli in inflammatory bowel disease.

Adhesins, Escherichia coli

Comparative Efficacy of Janus Kinase Inhibitors Indicated for Severe Alopecia Areata: A Bayesian Network Meta-Analysis and Matching-Adjusted Indirect Comparison.

Systemic Janus kinase inhibitors (JAKIs) have markedly advanced the therapeutic landscape for alopecia areata (AA). Although baricitinib and ritlecitinib are approved in the United States (US) and Europe, and deuruxolitinib in the US for severe AA, the lack of head-to-head randomized controlled trials (RCTs) limits evidence-based prescribing decisions. Moreover, prior meta-analyses excluded data on certain oral JAKIs or incorporated findings from agents and dosing regimens that were abandoned, investigational, clinically ineffective, or associated with unacceptable safety profiles. To compare the efficacy of oral JAKIs, limited to FDA, EMA, or MHRA approved drugs and doses-baricitinib (2 and 4 mg QD), ritlecitinib (50 mg QD), and deuruxolitinib (8 mg BID)-for severe AA, using advanced indirect comparison methodologies. A systematic review was performed following PRISMA 2020 guidelines (CRD420251116775). Bayesian network meta-analysis (NMA) synthesized data from RCTs reporting Week 24 outcomes on Severity of Alopecia Tool (SALT) ≤ 10 and SALT ≤ 20 thresholds. Multilevel network meta-regression (ML-NMR) evaluated heterogeneity and adjusted for baseline imbalances. Additionally, unanchored matching-adjusted indirect comparisons (MAIC) were conducted using individual patient-level data from THRIVE trials. Surface under the cumulative ranking (SUCRA) values were calculated to rank treatments. Seven RCTs (n = 4560 participants) were included. Deuruxolitinib 8 mg significantly outperformed baricitinib 2 and 4 mg on both SALT endpoints. Differences with ritlecitinib 50 mg were directionally favorable for deuruxolitinib but not statistically significant in NMA and ML-NMR models. MAICs confirmed superior odds for deuruxolitinib versus baricitinib 2 mg (OR = 71.55) and ritlecitinib (OR = 18.27) for SALT ≤ 20. SUCRA rankings also consistently favored deuruxolitinib. Among approved oral JAKIs, deuruxolitinib 8 mg shows the highest short-term efficacy for severe AA. These findings provide preliminary evidence to guide treatment decisions but should be interpreted as exploratory pending confirmation.

Humans

Reduction of calculus accumulation in domestic ferrets with two dentifrices containing pyrophosphate.

Work performed by King et al. in the 1940's and 1950's, as well as recent studies by our group, have shown that the domestic ferret is a suitable model for the study of calculus formation, offering several advantages over the rodent and dog models in current use. We have demonstrated that mineral supplementation of a moist diet accelerates calculus accumulation, and that twice-daily application of a regular dentifrice slows the initial rate of calculus formation, but permits significant accumulation by the eighth week. The present study compared calculus accumulation in female ferrets receiving mineral-supplemented cat food and a twice-daily application of either Regular Crest toothpaste (Crest), Anti-tartar Crest (Crest-AT), or Anti-tartar Colgate Gold toothpaste (Colg-AT). Animals received an ultrasonic prophylaxis, then were fed once daily for eight weeks with moist canned cat food supplemented with sucrose and mineral salts, and were scored for area and extent of calculus accumulation at four and eight weeks after prophylaxis. The data show that the groups treated with the anti-calculus dentifrices produced significantly less calculus than the group treated with regular dentifrice; the Colg-AT group also exhibited lower scores than did the Crest-AT group, especially at four weeks. These results, similar to those seen in human studies, demonstrate that the ferret is a suitable model for the study of anti-calculus dentifrices.

Analysis of Variance

Effect of low salt, sodium, and chloride levels in poult rations on growth, bone development, and related factors.

Two 4-week trials were conducted to determine the role of sodium chloride (salt) on field rickets in poults. A comparison of added dietary salt at 0, .075, .10, .25, and .45% to a corn-soy basal with .103% salt showed significant differences (P less than .05) in body weight gains, blood calcium, magnesium and sodium, feed conversion, and adrenal gland weights among the treatments. Mortality and abnormal bone scores decreased with increasing salt. When sodium was added to the basal diet as a single element for the poults at either 0, .09, .10, .11, and .12%, or chloride at 0, .009, .01, .02, and .03% in comparison to a control group with .20% sodium and .30% chloride, significant differences were found in weekly gain, bone ash, bone breaking strength, tibia weight/body weight, and serum alkaline phosphatase levels between the sodium, chloride, and the combined element groups. Bone abnormality scores decreased with increasing levels of both sodium and chloride in diets.

Animals

Peroxidised linoleic acid and experimental pancreatitis.

High concentrations of lipid peroxidation (free-radical oxidation) products have been found in bile from patients with recurrent pancreatitis, and the principal component, after hydrolysis, has been identified as an isomerised form of linoleic acid -- typical concentration 25 mmol/l, compared with 4 mmol/l in controls. Chromatographically identical products can be generated by peroxidising linoleic acid using an ultraviolet (UV) source in the presence of albumin, whereas peroxidation by lipoxidase without albumin results in a constellation of products that bear no resemblance to those in biological fluids. These facts, and the suspicion that reflux of abnormal bile may be an initiating mechanism in acute pancreatitis, led us to investigate the effects of linoleic acid peroxidation products in the rat pancreas. Two concentrations of ultraviolet-peroxidised linoleic acid were used (3.6 mmol/l or 25 mmol/l, in a 2.09% solution of bile salts containing albumin 10 g/l) to simulate the human findings and, for comparison, the effects of lipoxidase-peroxidised linoleic acid, 25 mmol/l (in the 2.09% bile salt solution but without albumin), were also studied. 100 microliter of test solution was infused retrogradely into the pancreatic duct using a syringe pump. The results were assessed microscopically at 3-h intervals, and histologically at 12 h: if the animal died before the end of the experiment, the time of death was recorded. Both forms of peroxidised linoleic acid, 25 mmol/l, caused a greater degree of pancreatic injury than that produced by bile salts alone (e.g., macroscopic score at 3 h: ultraviolet, P less than 0.001; lipoxidase, P less than 0.05). Non-peroxidised linoleic acid 25 mmol/l caused less damage than ultraviolet-peroxidised linoleic acid 25 mmol/l, both macroscopically (3 h: P less than 0.01; 12 h: P less than 0.05) and on histology (P less than 0.01). Pancreatic haemorrhage was not a feature.

Acute Disease

Relationship of the aminopyrine breath test and the Child-Pugh score to urinary sodium retention in patients with liver cirrhosis.

This study investigated the relationship between urinary sodium excretion and liver function, as assessed by the aminopyrine breath test (ABT) and conventional parameters, in 62 patients with cirrhosis kept on a constant salt diet. Urinary sodium excretion was related non-linearly to the ABT (r = 0.76). Less significant correlations were observed to the Child-Pugh score (r = -0.65), cholinesterase (r = 0.58), bilirubin (r = -0.56), albumin (r = 0.51) and prothrombin time (r = 0.49). When patients were arbitrarily divided into 6 groups according to the ABT, sodium excretion balanced the sodium intake up to a 50% reduction in ABT. In groups with more than a 50% reduction sodium retention occurred. When patients were grouped according to the Child-Pugh score, urinary salt output was balanced in patients with scores of 5 and 6 and decreased in patients with scores greater six. However, the change in sodium output from normal salt excretion to sodium retention was less pronounced in patients grouped according to the Child-Pugh score than in patients grouped according to the ABT. The results suggest a non-linear relationship between the impairment in hepatic and renal function in cirrhosis. They are compatible with the concept of a threshold of hepatic function necessary to maintain normal renal function.

Adult

A case-control study of diet and gastric cancer in northern Italy.

Dietary factors in the aetiology of stomach cancer were investigated using data from a case-control study conducted in Northern Italy on 206 histologically confirmed carcinomas and 474 control subjects in hospital for acute, non-digestive conditions, unrelated to any of the potential risk factors for gastric cancer. Dietary histories concerned the frequency of consumption per week of 29 selected food items (including the major sources of starches, proteins, fats, fibres, vitamins A and C, nitrates and nitrites in the Italian diet) and subjective scores for condiments and salt intake. Pasta and rice (the major sources of starch), polenta (a porridge made of maize) and ham were positively related with gastric cancer risk, whereas green vegetables and fresh fruit as a whole (and specifically citrus fruit) and selected fibre-rich aliments (such as whole-grain bread or pasta) showed protective effects on gastric cancer risk. Allowance for major identified potential distorting factors (chiefly indicators of socio-economic status) reduced the positive association with pasta or rice consumption, but did not appreciably modify any of the other risk estimates. When a single logistic model was fitted including all food items significant in univariate analysis, the 3 items remaining statistically significant were green vegetables (relative risk, RR = 0.27 for upper vs. lower tertile), polenta (RR = 2.32) and ham (RR = 1.60). Indices of beta-carotene and ascorbate intake were negatively and strongly related with gastric cancer risk, but the association with these micronutrients was no longer evident after simultaneous allowance for various food items. An approximately 7-fold difference in risk was found between extreme quintiles of a scale measuring major positive and negative associations.

Adult

Clustering patterns of behavioral and metabolic risk factors for noncommunicable diseases in Iran: findings from a national STEPS survey.

BACKGROUND: Noncommunicable diseases (NCDs) are the leading cause of mortality in Iran, driven by behavioral and metabolic risk factors that frequently co-occur. OBJECTIVE: To identify patterns of co-occurring behavioral and metabolic NCD risk factors among Iranian adults and characterize their demographic and socioeconomic correlates. METHODS: This cross-sectional study analyzed data from 16,618 adults aged ≥25 years who participated in Iran's 2021 nationally representative STEPS survey. Thirteen behavioral and metabolic variables, including physical activity, nutrition score, smoking frequency, alcohol intake, salt intake, body mass index, blood pressure, fasting plasma glucose, and lipid markers, were entered into a K-means clustering analysis. Clusters were characterized by their risk profiles and demographic/socioeconomic attributes. Multinomial logistic regression examined associations between cluster membership and sociodemographic factors. RESULTS: Five distinct behavioral-metabolic clusters emerged. The smokers-drinkers (SD) cluster (3.1%) comprised mostly older, less-educated men with high smoking and alcohol use. The healthy-low-risk (HLR) cluster (40.3%) showed favorable profiles and included younger, more educated individuals. The physically active (PA) cluster (6.6%) was characterized mainly by younger men with markedly high physical activity levels. The dyslipidemic (DLP) cluster (26.0%) exhibited high dyslipidemia and overweight prevalence, while the hypertensive-diabetic (HTD) cluster (24.0%) had the highest obesity, hypertension, and diabetes rates, common among older urban adults. CONCLUSION: Behavioral and metabolic NCD risk factors in Iran formed five distinct co-occurrence patterns. Nearly half of adults belonged to metabolically high-risk clusters, highlighting the need for targeted prevention strategies that combine lifestyle interventions with screening and management of obesity, hypertension, diabetes, and dyslipidemia.

Humans

Borderline sweat test: criteria for cystic fibrosis diagnosis.

The CF diagnosis can be difficult in subjects with disease consistent symptoms and borderline values of the sweat test. This study aimed to evaluate possibly resolutory criteria. Seventy-one ill subjects with borderline sweat test values (40-70 mEq/l Cl-) aged 0.1-37.7 years (mean, 8.7; SD, 7.3) were studied and compared with 33 age-matched CF patients (Cl- over 75 mEq/l) and 25 healthy subjects. A complex CF score based on 25 variables was set: CF-specific clinical conditions, detailed analysis of sweat test (salt-free diet test included), pancreatic function, Pseudomonas infection, and others. The score ranged from 0 to a maximum of 65 and clearly distinguished the CF patients from the healthy subjects. Therefore the CF score was assumed as the best reference criterion to define the diagnosis in the borderline group: 27 of them (38%) were assigned to the CF condition and 44 (62%) to the healthy one, with a quite clear separation between the 2 subgroups. With respect to these assignments, the most discriminant variable turned out to be the sweat Cl- persisting above 40 mEq/l after 5 days of salt-free diet (mean error, 18.4%). Neither sweat Cl-/Na+ ratio nor bicarbonate duodenal output showed better discriminant power (mean error, 29% and 25%, respectively). It is concluded that in borderline situations of sweat test results a definite CF diagnosis can be achieved only by compounding many clinical and laboratory data with a preference for the sweat test after a salt-free diet period. The CF score proposal can be an effective help.

Adult

Preferences, attitudes and personality as determinants of salt intake.

Thirty-six female subjects took part in a study involving using pre-weighed table and cooking salt pots, along with complete urine collections for 7 days. Urinary sodium excretion was determined, and was used as an estimate of sodium (salt) intake. Other measures taken were, most preferred concentration of salt in soup, blood pressure, body weight and height, along with questionnaires on general food preferences, attitudes to adding table salt to foods, and the Eysenck Personality Inventory (EPI). Table salt (7 per cent) and cooking salt (8 per cent) were found to account for only a small proportion of total sodium intake, the major part (89 per cent) being from non-discretionary salt present in foods. Subjects, divided on the basis of table salt use and total intake, were found to differ in the most preferred concentration of salt in soup, but not in their sensitivity to variations from their ideal. Table salt use was predicted very well by the individual's attitude, and to a lesser extent by perceived social pressure. The only other variable related to higher table salt use was a lower preference for fruit on the general food preferences questionnaire. The lower preference for fruit was also related to higher total salt intake, which was also predicted by a lower neuroticism score on the EPI. While extraversion was positively related to non-discretionary salt intake, this relationship was not significant for total salt intake.

Adult

Propensity for spontaneous nucleation of calcium oxalate. Quantitative assessment by urinary FPR-APR discriminant score.

The stone-forming urinary environment may be conducive to spontaneous nucleation of calcium salts, since it is generally characterized by a reduced limit of metastability (FPR or minimum supersaturation required for initiation of spontaneous nucleation) and an increased saturation (APR) of calcium oxalate and brushite (CaHPO4.2H2O). A discriminant analysis of the relationship between FPR and APR yielded a FPR-APR discriminant score, which gave a quantitative measure of the propensity for spontaneous nucleation. Positive scores, indicative of the "likelihood" of spontaneous nucleation, were found in the majority of patients with hypercalciuria in whom stones formed. Negative scores, representative of the "unlikelihood" of nucleation, were found in the majority of control subjects. Treatment with thiazide or sodium cellulose phosphate significantly reduced the discriminant score for both calcium oxalate and brushite, a finding which suggested that the propensity for spontaneous nucleation of calcium salts was retarded. Allopurinol lowered the score for calcium oxalate but not for brushite. Moreover, the FPR-APR discriminant score for calcium oxalate was positively correlated with the stone formation rate. It is concluded that FPR-APR discriminant scores are useful in the identification of stone-forming potential in urine, and in the assessment of response to therapy.

Adolescent

Evidence of preservation injury to bile ducts by bile salts in the pig and its prevention by infusions of hydrophilic bile salts.

Preservation injury to bile ducts is a serious problem in liver transplantation, especially when preservation exceeds 12 hours. The authors hypothesized that the injury was caused by contact of bile ducts with bile salts during cold preservation and might be preventable by infusion of more hydrophilic bile salts. Swine livers were harvested after intraportal infusions of saline (control), of the hydrophobic bile salt taurodeoxycholate, or of the hydrophilic bile salts tauroursodeoxycholate or dehydrocholate. The effect of infusing a combination of hydrophilic and hydrophobic bile acids was also studied. Bile samples were taken before and during the infusions. Then livers were perfused with UW solution, ducts were flushed retrograde with UW, and livers were stored at 0 to 1 degree C for 20 hours. Bile ducts were harvested after preservation, and coded microscopic slides of the specimens were examined by light microscopy. There was large variability in baseline bile salt concentration. Injury after preservation consisted of sloughing and pyknosis of surface and glandular epithelium. The histologic injury score determined after preservation was directly related to bile salt concentration in bile ducts at the time of flushing. During bile salt infusions, the infused bile salt replaced most or all of the other bile salts present in bile. Severe postpreservation injury of intrahepatic ducts occurred after taurodeoxycholate infusions, but injury was minimal when either of the two hydrophilic bile salts was infused. The mixture of bile acids produced intermediate results. Retrograde flushing with UW does not prevent injury to intrahepatic ducts. The authors conclude that the injury is caused by contact with bile salts, is dependent on bile salt concentration and composition, and is preventable.

Adenosine

Neutrophil alkaline phosphatase score in chronic granulocytic leukaemia: effects of splenectomy and antileukaemic drugs.

Staining with naphthol AS phosphate and Fast Blue BB salt has been used for the estimation of neutrophil alkaline phosphatase (NAP) scores in patients with chronic granulocytic leukaemia (CGL). The very low scores found at diagnosis rise when the disease is treated, and there is some inverse correlation between the NAP score and the absolute neutrophil count. Patients treated intensively developed high NAP scores. Elective splenectomy performed during the chronic phase of CGL is followed by a pronounced but transient neutrophilia and a concurrent striking rise in the NAP score. Similar changes were observed in patients without CGL who underwent splenectomy. These observations can be explained by assuming that newly formed neutrophils in CGL have a normal content of NAP but are rapidly sequestered in non-circulating extramedullary pools, whereas the circulating neutrophil with a typically low NAP content is a relatively aged cell which has lost enzyme activity. In subjects with or without CGL, removal of the spleen, a major site of such pooling, temporarily permits the circulation of newly formed neutrophils but eventually other organs assume the sequestering functions of the spleen. Thus the aberrations of NAP score seen in CGL might be attributable not to an intrinsic cellular defect but to an exaggeration of the granulocyte storage phenomena which also occur in subjects without CGL.

Alkaline Phosphatase

IgE antibody responses to platinum group metals: a large scale refinery survey.

All 306 South African platinum refinery workers (116 white, 190 coloured) accepted for employment on grounds of absence of evidence of atopy were investigated using the skin prick test and RAST to detect sensitivity to platinum, palladium, and rhodium salts. RAST studies were made for these, together with HSA and DNP-HSA RAST. Of the 306 workers, 38 had a positive skin prick test to the platinum halide salts; of these, one gave a positive reaction to the palladium salt and six to the rhodium salt. There were no isolated positives to the rhodium and palladium halide salts. Total IgE levels were raised in 24 of the 38 (63%) platinum salt prick test positive workers compared with only 43 of the 268 (16%) prick test negative group (p less than 0.001). Positive RASTs were obtained in 62% of those with positive skin tests to the platinum salts. Four of the six giving positive rhodium salt skin tests gave a positive RAST to rhodium salt. Of these, two gave positive RASTS to HSA and all four to DNP-HSA. The palladium salt RAST was negative in the single skin test reactor. In the platinum salt skin test positive group a raised HSA RAST was obtained in 10.5% compared with only 2.5% in the skin negative group. Twenty one per cent of the platinum salt skin positive group had a raised RAST score to DNP-HSA with only 3.5% (4/116) in the skin test negative group, of whom three also had a raised HSA RAST. The latter findings are suggestive of IgE antibody production to new antigenic determinants in HSA produced by conjugation with the platinum salts.

Dermatitis, Occupational

Effect of glucarolactam on low-dose nephrotoxicities of dibekacin and gentamicin in Fischer rats.

Intramuscular administration of dibekacin or gentamicin to Fischer rats at doses of 10, 20 and 40 mg/kg for 11 days gave polyuria, enzymuria and cytauria. These changes were suppressed completely or partially by the simultaneous administration of glucarolactam sodium or potassium salt. The ameliorating results were supported by serum and histopathological analyses on day 12. A rise in BUN and serum creatinine levels was partially or completely suppressed and histopathological scores were improved by co-administration of glucarolactam salts.

Animals

Vanadium salts induce cytogenetic effects in in vivo treated mice.

Three vanadium salts, vanadyl sulfate (SVO5), sodium orthovanadate (Na3VO4) and ammonium metavanadate (NH4VO3), were tested for induction of genotoxic effects in bone marrow of mice following intragastric treatment. Micronucleus (MN) induction in polychromatic erythrocytes (PCEs), structural (sCA) and numerical (nCA) chromosome aberrations in bone marrow cells were evaluated. The micronucleus test, performed at different harvesting times (0-72 h), was found to be positive for all compounds tested. In contrast, except for vanadyl sulfate, no difference was found between controls and treated animals in the sCA test performed 24 and 36 h after treatment. At the same sampling intervals, second metaphases (M II) were positively scored for nCA induction for all three vanadium salts. In addition, the frequency of hypoploid and hyperploid cells was shown to be statistically different from the control value. Polyploid cells were also induced by all compounds, but their frequency was not statistically significant. The positive results obtained by nCA analysis support the finding of a significant presence of types of micronuclei that are probably aneuploidy-related. This finding was further supported by the successful classification of such micronuclei on the basis of shape and size according to Tinwell and Ashby (1991) during microscope analysis.

Animals

Renin and aldosterone are higher and the hyperinsulinemic effect of salt restriction greater in subjects with risk factors clustering.

Separate lines of evidence suggest that abdominal obesity, insulin, and renin are independent risk factors for coronary heart disease. Since insulin levels are higher in abdominally obese subjects and may enhance renin and aldosterone production, these risk factors may not be entirely independent. Moreover, the renin-angiotensin system may contribute to insulin resistance. These observations suggest that some inconsistencies in the literature regarding the effects of salt restriction on insulin may be explained by baseline anthropometric and metabolic differences in the subjects studied. To examine these issues, 29 volunteers with a range of risk factors were studied after 1 week each on isocaloric 20 and 200 mmol/day NaCl diets. Measurements included ambulatory blood pressures, plasma renin and aldosterone, and responses to oral glucose and intravenous insulin. Subjects were divided into three groups based on a composite score reflecting the risk factor cluster associated with abdominal obesity and hyperinsulinemia. The nine subjects with the highest scores had significantly greater values for renin and aldosterone on both the high and low salt diets than the nine subjects with the lowest scores. Fasting insulin and triglycerides, the insulin response to oral glucose, and plasma aldosterone all rose significantly more with salt restriction in the high than in the low risk subjects. Plasma renin activity also tended to increase more on the low salt diet in the high risk group. Ambulatory blood pressures were greater on the low than the high salt diet only in the high risk group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult